Lost at Sea: Mental Health Crisis in the Young Adult Years

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Mental health crisis often hits just as young adults are attempting to leave their families and create lives of their own. It’s no surprise that a mental health problem can leave a young adult feeling directionless on the journey toward fully independent adulthood. Young adults are hit harder than any other stage by the effects of a new mental illness. To understand why, we need to look at development.

Human beings are remarkably adaptable to our environments. Most of us absorb language and culture with no effort at all as small children. We are designed to sponge up this hidden knowledge at different stages of our development, supported by the brain’s balance at each unique stage.

Imagine how limited language and cultural learning would become if a young child spent most of her time isolated, in silence. Environment alters the course of development at key stages. Forming language in early childhood has a lot in common with forming identity in early adulthood. First, the brain is wired to receive the fundamental lessons of the stage, and then life experiences shape the outcome.

If my late teens and early twenties are filled with academic success and solid friendships, it’s reasonable to expect that I will learn to believe I am capable and likable. By contrast, if those years are marked with failure and rejection, I’m more likely to believe myself incapable and unlovable. The late teens and twenties are a time for experimenting in the world, and learning to understand our personalities, strengths/weaknesses, and interests.

So, what then is the impact of the growing mental health crisis of our current youth? When record numbers of teens and twenty-somethings take psychiatric medications and receive diagnoses that label them with life long brain diseases, what do they believe about themselves? Perhaps that they are broken and will never live normal lives. This leaves young people lost, adrift during a developmental stage that shapes identity.

How can mental health professionals help mitigate the effects of a new illness on identity formation?

  • To start, professionals can change the way we educate young patients and their parents. Too many young adults are told after a first episode of illness to expect a life of chronic disease, despite the reality that this is simply untrue for a large percentage of them. Instead, professionals can tell patients to continue treatment, and work with their healthcare team to make decisions, but that many people with mental illness achieve a full recovery. Some patients reach a point where treatment is no longer necessary, and others live healthy lives with simple long-term treatments.
  • Also, we should maintain an awareness of development and discuss how various stages of brain and social development lead to transient symptoms, which might pass with time and improved coping skills.
  • And finally, professionals can do more to offer hope. “You’re not stuck this way,” should be our refrain for all of the people suffering and seeking our help.
Posted on January 8, 2018 by Melissa Deuter.

For a Happier 2018, Change Just One Thing: Your Expectations

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Happy New Year!

If you wonder what the photo above has to do with this post, read on.

It’s the dawn of a new year, and for many, new resolutions for change. Most people set their sights on ways to be happier and healthier. Maybe you vow to drink less, exercise more, or stay better connected with your friends and family. But will your resolutions really lead to greater happiness?

For most of us, following through on our resolutions won’t be enough to make us happier day-to-day. To understand what it takes to be happier, it helps to begin with an understanding of where our un-happiness comes from.

People are happy when reality turns out to be as good, or better than they imagined. In other words, when our expectations are met or exceeded, we are pleased. When life turns out to be less or worse than pictured, we feel disappointed, let down, and unhappy.

But then it’s important to note that we all tend to have pretty unrealistic expectations. When there is no traffic, I can drive to the office in about 30 minutes. However, it routinely takes quite a lot longer in morning rush hour. If my expectation is always 30 minutes, I’m going to suffer a lot of disappointment and only the rare sense of satisfaction. Expecting it to take 45-50 minutes for the commute means that if I get there in 35, it feels like my luck has hit an upturn.

If you’ve ever met a person who appears truly happy, he wasn’t necessarily the one with the most perfect life. In fact, if you think about the truly happy folks you know, they usually aren’t the ones who are rich and beautiful, they are the ones who find beauty in the little things. The happiest guy around is the one who is most able to accept his world just as it is right now.

Maybe you’re thinking, “Sure, that’s easy for some people, but I’ve got real problems!” In truth, moments of happiness can be part of every life, even when things aren’t easy in the slightest. I recall a lovely patient (she was treated for anxiety) who experienced happiness and beauty while she was dying of cancer. She was deeply grateful for the love and kindness that surrounded her. How did she find beauty in such terrible circumstances? She resisted the temptation to compare her cancer reality to a healthy reality, and instead she took each event as it came.

Even for people struggling with illness, moments of happiness or well-being don’t have to be elusive. Expectations can dictate greater or lesser degrees of suffering.

There are pleasant surprises all around us, if we can only accept them as they come. Take for example the picture attached to this post: I found it while searching through stock photos, and it was pleasantly entertaining. It’s a little unexpected for sure, but I hope you accepted it with a smile!

Happy 2018.

Posted on January 1, 2018 by Melissa Deuter.

After Mental Health Crisis, Well-Being Is Possible Again, But It’s Probably Not Going To Come From A Prescription Pill

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At a recent medical conference, I was surprised to hear a speaker knock the recovery movement in mental health. The presenter implied that there was something bad, and inherently “political” about the consumer movement, where people with mental illness advocate for themselves and push for full recovery. I wondered what was wrong with wanting to be fully well.

I’m sure someone on the inside of the physicians organizations could explain this to me- bring me up to speed on what I’m not seeing. Probably it’s a matter of “us” and “them.” “Us” physicians are being accused of not providing “them,” the healthcare consumers (patients) with opportunities for full recovery. And heck, that hurts our feelings because we really are doing the best we can over here.

The psychiatric profession cares about recovery, but on the whole I think we may be focusing on the wrong road to get to it: Neuroscience. Our research focuses on finding the specific brain areas involved in diseases, and the genes that encode those diseases, all to help us create better medications so we can cure mental health conditions. Neuroscientific discovery is vital to improving treatments for mental health conditions, no doubt. But mental health is bio-psycho-social and spiritual. Getting well isn’t just a function of neurotransmitters and circuits in the brain.

Psychiatric physicians need to acknowledge the importance of the recovery movement without the narrow focus on biology. After a mental health crisis or a break, well-being is possible again, and it’s probably not going to come from a prescription pill bottle. The pills will help in many cases, to turn off problem nervous system activity. And yet they won’t make people well.

Real recovery is about picking yourself back up when the time comes, and that comes from courage and hope.

Hope doesn’t come from the doctor’s symptom checklists, or from tweaking meds at every appointment because we think that’s the job description. What is the prescribing psychiatrist’s role, then, in helping patient achieve a true place of recovery? We need to have hope for our patients. We need to offer a perspective of experienced wisdom, and show them that we know it can get better.

Recovery in mental health leans largely on the psychosocial and the spiritual aspects of well-being. When symptoms are managed, recovery stems from rebuilding courage, through the hope we reflect back to our patients.

Posted on December 18, 2017 by Melissa Deuter.

When Our Kids Fail

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I spend a lot of time in sessions with parents, and in my writings as well, encouraging parents of adults to let go. We cannot rescue our kids, especially after they become adults. We have to let them find their way. But sometimes that is really hard to do, especially when they fail.

“Jake” is a kind-hearted, highly intelligent high school senior with a mix of poor organizational abilities and social anxiety. His parents came to talk to me recently, because Jake has had a lot of failures lately, and his parents hurt for him deeply. He fails classes because he misses deadlines, even when he understands the coursework. He won’t be getting credit for his math class this year. And he’ll be starting his adult life on the heels of repeated disappointment in himself. He started a job, and was fired for his awkward interactions with customers and for forgetting important steps in his workflow. His parents are facing the fact that there may be nothing they can do. They put Jake in treatment. He sees a therapist. But he still has problems and he doesn’t seem to function up to his potential. His parents are accepting that they may have to watch him struggle and fail, and they are simply going to have to accept it.

Failure is a normal part of life. Someone is going to get cut during tryouts. Someone is going to bomb the test. We can’t all win at everything all the time. And yet, the knowledge that failure is expected doesn’t prevent the parent of a kid who fails from feeling helpless and maybe responsible for the failure.

Parents raise kids and throughout development, try to teach them the skills they need. When failure happens, parents often wonder if they left out some vital lesson.

            Did I not teach her to strive harder? To give her absolute best?

            Maybe I should have hired a tutor for the SAT.

            Perhaps I let him down by leaving him to figure this out on his own.

While it’s natural for parents to care and to hurt when their children hurt, it’s also important to remember that failure isn’t something to be avoided. Not only is failure inevitable, failure is a great teacher. Failure is often necessary for children, teens, and new adults to truly learn what they need to know. Without failure, they may not grow.

So we have to let go and let them fail. Even when it’s scary or painful. Even when we are parenting a kid who seems to lose more than others.

Jake has many strengths, and his recent failures can help him find the career and the life that fit best for him. He’ll be okay, as long as his parents continue to see him as capable and lovable.

What can we do when our kids struggle and fail? We can love them unconditionally and walk through it with them. That’s all we can do, but for a kid facing failure, it’s everything.

Posted on December 11, 2017 by Melissa Deuter.