A Moment in Time

Source: Dawid Zawiła

Theodore Roosevelt famously said, “In any moment of decision, the best thing you can do is the right thing, the next best thing is the wrong thing, and the worst thing you can do is nothing.”

Some might suggest that, today, we stand at just such a moment of decision – at least with regard to the futures of our children.

A November 2016 cover story in TIME magazine, “Teen Depression and Anxiety: Why the Kids Are Not Alright,” states, “Adolescents today have a reputation for being more fragile, less resilient and more overwhelmed than their parents were when they were growing up. Sometimes they’re called spoiled or coddled or helicoptered. But a closer look paints a far more heartbreaking portrait of why young people are suffering. Anxiety and depression in high school kids have been on the rise since 2012 after several years of stability. It’s a phenomenon that cuts across all demographics – suburban, urban and rural; those who are college bound and those who aren’t. Family financial stress can exacerbate these issues, and studies show that girls are more at risk than boys.”

Not surprisingly, that stress manifests itself in some pretty unhealthy ways.

The TIME piece begins with the story of 20-year-old Faith-Ann Bishop, who started cutting in eighth grade. She reflected on the blood and the relief from anxiety, saying, “It makes the world very quiet for a few seconds ... For a while I didn’t want to stop, because it was my only coping mechanism. I hadn’t learned any other way.”

For his part, “Josh” – a high school sophomore who didn’t want his actual name revealed – told TIME, that his “parents began checking on him after the Sandy Hook shooting that killed 20 children and six adults. Despite their vigilance, he says, they’re largely unaware of the pain he’s been in. ‘They’re both heterosexual cis people, so they wouldn’t know that I’m bisexual. They wouldn’t know that I cut, that I use red wine, that I’ve attempted suicide,’ he says. ‘They think I’m a normal kid, but I’m not.’”

Sadly, he may be more normal than he thinks.

According to a 2016 Child Mind Institute report, “Mental health disorders are the most common health issues faced by our nation’s school-aged children. One in five children suffers from a mental health or learning disorder, and 80% of chronic mental disorders begin in childhood. There is an urgent need to identify the signs of these conditions early in life if children are to get the care and support they need to thrive.

“Children struggling with mental health and learning disorders are at risk for poor outcomes in school and in life, and outdated approaches to discipline are only making matters worse … A widely deployed, integrated system of evidence-supported, school-based mental health and preventive services is needed. If we want to help our children and our schools, we cannot wait.”

A moment in time.

What does this mental health crisis look like?

The same report reveals that 75% of ADHD “manifests” by age eight, separation anxiety by age 10, oppositional defiant disorder by age 14 and social phobia by age 15.

Mirroring those concerns is a January 2015 article in The Huffington Post by Michael Mulligan, head of The Thacher School in California. He writes, “According to the social scientists, the last of the millennials are now gracing our high school campuses. The Pew Research Center report on this cohort describes them as ‘confident, connected, and open to change.’ I agree. Technology is their métier. They embrace diversity like no generation before them. They seek to serve the dispossessed and the disadvantaged. They work to find green solutions to the environmental mess we have bequeathed them. In this regard, they are focused and unrelenting: a good thing for all of us. Beneath their energy and commitment to building a better world, though, is stretched, for too many, a fragile membrane that is easily punctured. We have raised a generation that is plagued with insecurity, anxiety and despair.”

In an article published on PsychiatryAdvisor.com, Avital E. Falk, Ph.D., and John T. Walkup, M.D., explain, “Anxiety disorders constitute the most prevalent class of mental health problems in children and adolescents, with prevalence rates estimated from 15-20%.” Additionally, a new report from the Substance Abuse and Mental Health Services Administration reveals that among American adolescents aged 12-17, “1 in 9 report having had a major depressive episode (MDE) in the past year.”

And this is all before we get to suicide and the epidemic that is opioid and heroin addiction.

On the first score, the National Center for Health Statistics, which sits within the Centers for Disease Control and Prevention (CDC), reported last April that the suicide rate in the United States “surged” to a near 30-year high. In total, more than 40,000 took their lives in 2014 as compared to about 30,000 in 1999. It also noted that suicides among girls ages 10-14 tripled during the same time period.

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A recent New York Times article amplifies that alarm, noting that, according to the CDC, “It is now just as likely for middle school students to die from suicide as from traffic accidents.”

As for addiction, last month’s Washington Post piece “The Great Opioid Epidemic” detailed record-breaking deaths in 2015 (52,404) due to drug overdoses. While the majority – about 80 percent – of the overdoses were tied to opioid use, likely both prescribed and illicit, it’s clear that increased oversight of prescriptions by medical practitioners has sent addicts scrambling to find easier-to-access and less expensive drugs, including heroin.

Indeed, in a late December 2016 article The New York Post points out, “Overwhelmingly, the ones who become addicted are those who start off using opioids for recreational purposes. The next stop is street drugs.” In part, the story attributes a recent “reformulation” of OxyContin to make it more difficult to abuse as instigating a decline in opioid use and a dangerous rise in other addictive substances. The article shares that abusers “switched in droves to heroin, which is far more dangerous, and deaths from heroin overdose soared from 3,000 in 2009 to 13,000 in 2015. Worse still, black-marketeers are now blending fentanyl — a highly potent, synthetic version of heroin — with heroin itself, or substituting it outright for the ‘natural’ drug. That’s responsible for much of the soaring ODs.”

So, where do we go from here … this moment in time?

Advice on action is not hard to find. With regard to mental health awareness, the TIME article counsels counseling, referring back to Faith-Ann who, apparently with the support of her parents, found help in psychotherapy, learning such cognitive behavioral skills as deep-breathing and positive self-talk. She also leaned on her innate creativity (filmmaking) to combat her “cycle of anxiety, depression and self-harm.”

Also pointing to parents as part of the solution is Rhett Smith, author of the book The Anxious Christian: Can God Use Your Anxiety for Good? and a practicing marriage and family therapist. In his article “Naming, Navigating, and Reframing Depression in the Lives of Teenagers” he says, “Most parents are privy to occasions when their teenagers mope around the house, spending inordinate amounts of time alone in their room playing video games or texting, seeming emotionally short-fused in verbal tone and responses, and generally refusing to engage in family activities. These are some of the behaviors mentioned by family members and other caring adults when they begin to wonder if a young person is experiencing depression.”

In the same article, which was published by the Fuller Theological Seminary, Smith suggests that parents ask three questions when they sense something may be amiss.

1. Do the behaviors I observe differ from the typical and “normal” behaviors of my teen?
2. Has a recent event occurred that might be related to this variation in behavior and mood?
3. Is it possible that something I considered a personality trait might instead be a form of long-term depression?

Further, he advises that parents of young people experiencing depression be nonjudgmental, explore multiple options for treatment and stay “present” in the life of their child.

Op-ed columnist David Brooks refers to “a ministry of presence” in recounting the struggles of a family whose tragedies he writes about in The New York Times. Significantly, he reminds us, “Neither age, experience nor personal belief correlated with sensitivity and love.”

On National Public Radio’s “All Things Considered,” psychologist Debbie Hall, like David Brooks, also speaks about presence. She says, “Presence is a noun, not a verb; it is a state of being, not doing. States of being are not highly valued in a culture which places a high priority on doing. Yet, true presence or ‘being with’ another person carries with it a silent power – to bear witness to a passage, to help carry an emotional burden or to begin a healing process. In it, there is an intimate connection with another that is perhaps too seldom felt in a society that strives for ever-faster ‘connectivity.’ … With therapy clients, I am still pulled by the need to do more than be, yet repeatedly struck by the healing power of connection created by being fully there in the quiet understanding of another. In it, none of us are truly alone. The power of presence is not a one-way street, not only something we give to others. It always changes me, and always for the better.”

Encouraging.

When it comes to addiction, Maureen Wittels, a retired elementary school teacher and founder of the Houston, Texas, chapter of GRASP (Grief Recovery After a Substance Passing), writes in her November 2016 Huffington Post piece, “The Loss of My Son Harris Wittels to Heroin,” of her beliefs that addiction must be treated as a health, rather than legal, issue; so-called “maintenance drugs” as well as ones that reverse overdoses (such as Naloxone) should be widely available; and rehab programs need to be better regulated with an eye toward “current trends for treatment.”

On that last point, technological innovations are leading the way to the future of treatment for anyone struggling with mental health issues or drug or alcohol addiction. One such approach appears to mirror telemedicine, with “online” treatment provided by licensed drug counselors on secure video. Jason Brian, CEO and Founder of OnlineTreatment.com and a member of the national advisory board at the Center for Adolescent Research and Education, says, “Virtual counseling is one possible choice to consider when investigating treatment options for addiction. Using our software platform, there is no need to travel away from home or take time off from work or school. OnlineTreatment.com lets you schedule and attend individual or group counseling sessions using your smartphone, tablet or PC. We are helping to bridge the gap for people looking for answers to get the help they need.”

Leading the way to the future … and not a moment too soon.