Young Families INSIGHTS
Spring 2006

Linda Swann, NAMI NC Young Families Program Coordinator, Editor
Linda Buzard, Layout Manager
 

Advice for Professionals:  Dealing with the Objective and Subjective Burdens of Having a Child/Family Member with a Brain Disorder:

The relationship between professionals and the families they serve is strengthened when professionals do what they can to reduce the family burden and help meet the family’s needs. There are four categories of family goals for relief: help with the subjective burden, help with the objective burden, family education, and help with the management of symptomatic behaviors. Here are some strategies offering concrete ways professionals can be most helpful to families.

Objective Burden: Advice on Dealing with Practical Issues

  • Make interventions practical and reality-oriented. Set one or two priority goals at a time as defined by the family. Use step-by-step problem solving.
  • Remain pragmatic. Ask the family often for feedback on what is helping. Find ways to widen their support network.
  • Assess family resources and plan strategies reflective of the family’s coping mechanism.
  • Explain how the service system works. Ask families how they want to be involved.
  • Offer concrete information and direct assistance in exploring entitlement programs.

Subjective Burden: Strategies to Reduce Anxiety and to Develop Realistic Expectations

  • Help families understand they are not to blame for their child’s illness. Use every strategy to reduce blame, to comfort, and to understand what the family is experiencing. Sensitize yourself to their pain.
  • Explain how the symptoms of brain disorders interfere with the child’s ability to function. Help families become more patient and hopeful in the recovery process.
  • Try to normalize the anger and frustrations that families experience. Encourage them to express their feelings.
  • Help them cope with stress, interpersonal difficulties, social isolation, depression, etc.
  • Understand the mortal fear that families feel when their child is in crisis. Call in all system and social resources to meet the emergency.
  • Persuade families to take time out, to seek respite. Encourage them to plan for self-care and to go on with their lives.
  • Connect families to groups like NAMI where they can find support and information. Encourage them to relate to other families with similar experiences.

(Source: “What Hurts/What Helps: A Guide to What Families of Individuals with Serious Brain Disorders Need from Mental Health Providers” by Joyce Burland, Ph. D.)

Managing a Manic Episode in a Child or Adolescent

 

The best way to manage a manic episode is to help your child avoid triggers that can cause mood swings and conditions that might make manic feelings more intense. Some simple lifestyle adjustments can help. Work with your child to:

  • Maintain a stable sleep pattern. Your child should go to bed around the same time each night and awaken around the same time each morning. Changing sleep patterns can cause chemical changes in the body that trigger mood episodes.
  • Maintain a regular daily routine. Your child should follow a routine of trying to do the same things every day at about the same time.
  • Set realistic goals. Setting high goals and focusing too hard on achieving them can trigger a manic episode.
  • Avoid alcohol and illegal drugs. It may be tempting for your child to use alcohol or drugs to help get through a manic episode. However, this will make the mood changes worse. Even small amounts can interfere with sleep, mood, or medications used to treat bipolar disorder. Nonprescription medications for a cold, allergies, or pain can also trigger a change in mood.
  • Get help from family and friends. Your child will sometimes need help getting through a manic episode, especially if he or she loses touch with reality. Having a plan in place before any mood changes occur will assist family members and friends in getting the needed help. However, remember that these mood changes can sometimes be upsetting to loved ones and that these people may also need to seek support.
  • Reduce stress at home and at school or work. Your child should try to keep regular hours at school and at work. Doing a good job is important, but avoiding a depressive or manic mood episode is more important. Communicate with your child's teachers and guidance counselor about your child's needs. Academic adjustments or a plan such as an individualized education program (IEP) may be helpful.
  • Learn to recognize the early warning signs of a new manic episode. This is one of the most important ways to avoid a full-blown manic episode. If you catch the episode in its early stages, your child may be able to avoid an intense manic episode by avoiding triggers that are causing the new mood change. You may want to keep a chart to record your child's mood changes and the activities that may trigger those changes.
  • Continue treatment. It may be tempting for your child to discontinue treatment because he or she feels better or enjoys the euphoric feeling of a manic episode. However, it is very important to continue treatment as prescribed to avoid the unpleasant consequences associated with mania. If you have concerns about treatment or the side effects of your child's medications, talk with your doctor; do not adjust the medication on your own.

(Source: http://health.msn.com/encyclopedia/healthtopics/articlepage.aspx?cp-documentid=100110086. The author is Stuart J Bryson. Updated May 27, 2005)

What Helps Family Members Who Have Anxiety?

The Depression and Bipolar Support Alliance or DBSA recently conducted an anxiety survey online. People who responded to the survey offered the following advice for dealing with people with anxiety.

DO

  • Recognize what I am going through.
  • Talk to me, help me calm down when I am keyed up or panicked. For example, if I lose something, help me think of where it might be.
  • Praise my accomplishments.
  • If I become very irritable, you might need to get out of my way.
  • Drive me to appointments, take me out to eat, or go shopping with me.
  • Comfort me.
  • Go to therapy with me.
  • Let me cry on your shoulder.
  • Help with expenses.
  • Tell me you care about me.

DON’T          

  • Treat me as if I am not smart or like I am imaging things.
  • Tell me I am selfish and that my illness is caused by poor life decisions.
  • Ignore the situation and hope it will go away.
  • Tell me I need to get a job.
  • Assume I could fix it if I did not dwell on it.
  • Get irritated and tell me I am getting tense.
  • Tell me I need to grow up.
  • Try to run my life.
  • Crowd me.

(Source: DBSA e-newsletter, April 15, 2005. For more information, go to http://www.dbsalliance.org)

 

 

Surgeon General Releases Web-based Family Health History Tool

 

My Family Health Portrait is a Web-based tool designed to help families gather and share their health information. The tool, released as part of the U.S. Surgeon General's Family Health Initiative, organizes information into a printout that an individual can use, in partnership with a health professional, to determine whether he or she is at increased risk for six common diseases with a known genetic contribution, and for other conditions that may run in families. Users can highlight certain diseases, such as heart disease or diabetes, and produce personalized diagrams or charts for each family member that can then be used to develop individualized diagnosis, treatment, and prevention plans. The tool is intended for use by individuals, families, and health professionals in understanding the importance of collecting a family health history and in making the process of gathering the information easier and more efficient. The tool is available in both English and Spanish at: https://familyhistory.hhs.gov.

 

2006 North Carolina Children’s Index

Action for Children North Carolina, previously known as the North Carolina Child Advocacy Institute, recently released their 2006 Children’s Index. The index features data addressing the following areas: child health and safety, economic security, early care and education, child maltreatment, juvenile justice, and demographics.

There are reasons to celebrate and there is also cause for concern. We can be glad that there is more stability for foster children. There is also a new section in the index that looks at what is right with our youth. There we see that children are involved in positive ways in their communities.

Here are a few reasons for increased concern:

Ø      One-in-nine children lacks health insurance.  North Carolina has experienced one of the largest drops in employer-based coverage in the nation. Progress with Health Choice has reached a plateau and the percentage of children lacing health insurance has risen since 2001. On the good side, most children (85%) are reportedly in good health.

Ø      Suicide is the fourth leading cause of death among youth ages 15 – 17, as reported in 2004.  One-in-four adolescents reports extended periods of feeling sad or hopeless. One-in-seven reports having seriously considered suicide.

Ø      Seventy-five percent of youth in the Juvenile Justice System have mental health needs; 40% have substance abuse problems. 8,413 youth were sentenced in 2004; 473 youth were placed in Youth Development Centers.

For more information, visit Action for Children’s website at www.ncchild.org.

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