Anxiety Disorders in Children: a family affair

According to the Surgeon General, anxiety disorders affect approximately 13% of children. Some diagnoses that reflect a problem with anxiety are: Generally Anxiety Disorder, Social Phobia, Avoidant Personality Disorder, and Panic Disorder. All of these show similar symptoms of anxious feelings, sweaty palms, pounding heart, increased respiratory out put, sick or sore stomach, and other symptoms. 

What is the cause of anxiety disorders? It’s not fully understood, but we do know that anxiety disorders tend to run in families—probably a mixture of environmental upbringing and heredity. 

There is also a correlation between anxiety disorders and children that have trouble sleeping. Sometimes it is hard to know what came first, the chicken or the egg. But children that have trouble sleeping tend to have higher levels of stress during the day, which increases stress hormones like Cortisol. Cortisol tends to deplete Serotonin, a feel-good neurotransmitter, which sets them up for problems like anxiety or depression. 

When I see a child for anxiety, I test the parents as well. More than not, I find at least one parent that will also be experiencing anxiety. I will also note that the parent tends to have an “anxious parent” type of parenting style. This is shown by a tendency of over-protectiveness and a tendency towards elevated expressed emotion when stressed. Unfortunately, too often a child learns from this parent how to experience and deal with the world. If the parent has a highly reactive style towards spiders, for example, the child often will also. 

I also would like to note the correlation between anxiety and frequent illness. If you see your child getting sick a lot and missing school you might want to go get your child checked for an anxiety disorder with your Psychiatric Mental Health Nurse Practitioner or Psychiatrist. They are often missed. Thousands of dollars later you may find that your child has an anxiety disorder and not an ulcer!

Secondhand Smoke and Mental Illness — Is there a link?

Very interesting study published in the Archives of General Psychiatry. It is reported that secondhand smoke exposure may have a link to schizophrenia, depression, delirium and other psychological conditions. It turns out that tobacco also brings on negative moods in animals, and other studies on humans seem to show a correlation between depression and smoking. 

I thought this was highly interesting as I recently had a patient go to Rehab who suffered from some other mental health conditions. She told me that at Rehab there was a social group on the back patio every couple of hours for the smokers. The patient ended up coming home with a new addiction to smoking. She basically replaced one addiction for another. I can’t help wondering if these facilities have the best interest of patients in mind… I also think it is interesting to observe that the very large majority of Schizophrenics (I think it’s in the 90ish percentile) are smokers. Coincidence?

An aspirin a day keeps Schizophrenia away?

According to a recent article in the Journal of Clinical Psychiatry, aspirin therapy reduces symptoms of psychosis in Schizophrenia Spectrum Disorders. It is speculated that inflammation is causing havoc in the brain as well as the body now. This reminds me of a study published I believe in the early 2000’s that suggested Ibuprofen may prevent Alzheimer’s Disease, another prevalent brain disease. 

Does that mean that we should all start taking aspirin daily? I wouldn’t do this without consulting with your psychiatric mental health nurse practitioner or psychiatrist. For some people aspirin and other anti-inflammatories can actually irritate the digestive tract and may even cause inflammation, so if you are in the category you may not be a good candidate for aspirin. Like anything, it is important to weigh the benefits with possible consequences. No two people are alike… However, it is the middle of the day and I am feeling a little cognitively fuzzy (and I have Schizophrenia and Alzheimers in the family)…not much of a caffeine drinker—just an occasional diet coke—perhaps I should try an aspirin? Hmm….

Memory Loss: Is it Alzheimers?

I get a lot of questions about concerns patients and family members have about troublesome symptoms of memory loss when I am treating them for Depression and Anxiety. They wonder whether they have Alzheimer’s Disease and not Major Depression. 

Memory loss—and that is short-term memory loss—is very common with Depression. Depression affects the brain in a way that impairs the storage of information into long-term memory. What I mean by short-term memory is the memory of what you had for dinner the night before or what you discussed with a friend earlier in the day. People with Depression often lose some short-term memory but not memory from when they were a child (or long-term memory). 

It is normal for people to have some trouble with memory when they are stressed from time to time. But if it is happening every day and creating embarrassment in your life, i.e. forgetting 3 days in a row your preschooler needing to be picked up at a certain time or repetitively forgetting appointments, then I would suggest you go get an evaluation from your Psychiatric Mental Health Nurse Practitioner. You may be depressed or anxious and could be helped with some therapy and possibly medication. 

Years ago, I suffered from a bout of Post Partum Depression after my last child. My older daughter who was about 14 at the time felt the brunt of it. One day she called me from school and asked me to bring her term paper that she forgot. She had called me in the middle of the day to bring it at the end of the day. A half hour before she needed it, she called me again to remind me because she knew I had an issue with that. I reassured her that I would be there. Then I get a third call from her after I didn’t show up 10 minutes after I should have been there. She was very upset with me and distressed. I was so embarrassed! I felt bad knowing that I had let her down and how she must have felt thinking that her own mother didn’t put her needs on a higher priority than what I was doing at the time. I’ve always wondered if I scarred her for life during that very dark time for me. Hopefully, she has forgiven me… 

Please don’t let this happen to you! Get help if you see some concerns with memory—particularly short-term memory.

Supplement may prevent psychosis!

Attention families with psychosis among relatives! Omega-3 fatty acids may prevent onset of psychotic disorders in high-risk populations. This is according to a study published by Amminger and associates in the Arch Gen Psychiatry, 2010 Feb;67(2):146-54. The study suggests that a common supplement that we use for heart disease and stroke prevention may also prevent the progression of psychotic illness in those who have what is called prodromal symptoms (or what I call “pre-psychotic symptoms”). What are pre-psychotic symptoms? Early symptoms may include hearing voices or having some unusual sensory experiences; mood disorders; disorganization in surroundings, speech or actions; and unusual motor activities or posturing. My opinion with this study is that it is certainly worth trying as we all have heard how good Omega-3s are for the body and brain. I think too often we are inclined to jump to powerful drugs earlier than is necessary. How about trying upping our fatty fish consumption or using a supplement? For many the Omega-3s may be enough!