The effects of parental mental illness on children

There is not enough research in this field but enough clinical evidence that parents who are unwell, effect their children. Common sense would also confirm the truth of this statement.
The effect varies with the type, length and severity of the illness.The effect varies with the child's age, developmental stage, intellectual capacity, resilience and other supports available.
The effects range from psychological, physical, developmental, social and educational impacts

Anxiety disorder is common, 30% of the general population and anxious parents usually have anxious children. The children do not feed or sleep well in early infancy, suffer reflux and separation anxiety later in childhood. The children suffer nightmares, anxieties of their own or shared with their parents. these children often are anxious about their parents as much as their parents are anxious about them. Adolescence can be difficult as separation anxiety, social anxiety, performance anxiety can affect the normal separation from parents and finding a sense of identity and place in society.
Depression is very distressing for infants who can only communicate by feeling the emotions of their parents and expressing their own emotions. Without external support and opportunity to have fun and play with other people or siblings, they often become depressed too. They often worry about their parents, and feel a sense of responsibility for the state of play or guilt that they may have caused the problem.
Substance abuse disorder has major problems for children as it is usually chronic, severe and affects all levels of family function from maintaining family denial, avoiding social groups, not able to take friends home, suffering neglect, lack of money, domestic fighting and violence, secondary effects of physical, mental complications in the parent and loss of employment and housing Frequent changes in accommodation and schools are common and this affects social, emotional and educational development. 50 % of children of alcoholics will abuse alcohol as well.
Psychotic disorders have been found to have a smaller effect on children so long as they are not neglected or abused.
Clearly the effects of prolonged illness, hospital admissions, side effects to medications and effects on capacity to work and provide family time have a greater impact on children than mild or short term illness. Suicide or attempts are particularly malignant for everyone in society but more so for children show have a sense of responsibility, guilt, abandonment and are more likely to copy a parent or try to be with them. Supporting a grieving parent can be very difficult for children. Some will try to take over the parent role and others will disengage.
Work in the field is mostly looking at how to build resilience and support systems for at risk children. 

Post traumatic stress

It seems like a long time since I penned a letter on my blog.
The current storm season, hail, winds, rain, electricity outages, damage to houses and cars as well as fires are hitting our news recently. It is that time of the year in Australia, a land of droughts and flooding rains.
My thoughts turn to those 20 % of people who when traumatic events happen will develop symptoms of acute stress reactions and post traumatic stress disorder. We used to think, hope, that this could be prevented with emergency therapy, critical stress debriefing, but research evidence seemed to prove otherwise. We certainly know that family and friend support, communities pulling together and sharing their grief and sorrows as well as their triumphs and joy is the best way to cope with the issues life throws at us. It is at these times that she discover our neighbours and community supports.
Early detection of stress disorder is now thought to be the best approach. If you have nightmares, can't sleep, have recurring memories of bad events, this can be the warning signs of post traumatic stress disorder.  Erratic moods with tears, sadness, irritability and frustration are also common signs of difficulty. Anxiety, agitation, worrying, are common. Withdrawing from people and activities you normally enjoy are also warning signs.
If these things happen, see your local doctor. Ask for referral to see a psychiatrist. Your doctor may also send you to a psychologist. There are also medications that can help. Getting sleep back in order is essential as lack of sleep can make the whole problem much worse.  Look after each other too. If a friend or family member is suffering suggest that help is available.
Knowledge of the problems is like a preparation plan for disasters. Not only do we need to have a fire, flood, evacuation plan with stores of batteries, a radio, food and fresh water available but a mental health plan as well. 

Gender Identity Dysphoria

GID has made some news recently in the highly publicised account of Bradely/Chelsea Manning
http://abcnews.go.com/US/wireStory/convicted-wikileaks-soldier-prison-20109354
Such distress about identity, especially the sensitive field of sexuality and gender is acute and pervasive.
It was interesting to note that inter-sex disorder, children born with ambiguous genitals were a rare case of gender identity dysphoria. These issues are more easily dealt with with chromosomal analysis.
Many people feel they are in the wrong body  from early childhood but most delay seeking help until early adulthood. It can then be a complex issue to deal with reassignment from a psychological point of view. Depression, anxiety are often part of the process. Relationships and family ties, work place issues and friends all have to be coped with.
Help is available however by going to see your local doctor.

PMS

One of the most interesting things about pre-menstrual syndrome is that it is a depression (Mood disorder). The best results available are with antidepressant medications. I realise that it is hormonal and therefore logically should respond to hormone treatment. Unfortunately many women are sensitive to the oral contraceptive, implant or patches and their mood disorder becomes worse.
PMS can be very severe, not just for the sufferer but their family and friends as well. There is ample evidence that it affects cognitive functioning and the likelihood of breaking the law or precipitating significant social effects is high.
There is little data as to whether it increases the chances of a major depressive disorder. There is anecdotal evidence that it settles somewhat after having a child. but I do not see pregnancy as a 'cure'. It has been noted in Bipolar Disorder as well as unipolar depression. Anxiety symptoms have not been recorded as related to menstrual cycle although this seems unusual.
Antidepressants are the best treatment. Pulse therapy, an increased dose two weeks before a period and reduced dose on the first day of menses, has the best outcomes if mood still varies with the monthly cycle.
It is all related to the hypothalamic/pituitary/immune axis of brain function.
So there is help available. You don;t have to suffer in silence.

Controlled drinking

Recent reports have promoted controlled drinking as a more appealing prospect than total abstinence.
Alcoholism is a terrible disorder that not only robs the sufferer but their family as well. Families often leave as they cannot cope. Patients often lose their health and job. They get depression, anxiety and brain disease from alcohol abuse. The current government guidelines is for controlled drinking, that is one standard drink per 24 hours. Any more than that is an alcohol related problem drinking.
One of the major problems facing a person who is addicted to alcohol is total abstinence. it seems harsh and the pull of the alcohol makes it seem doomed to failure. Most people addicted to alcohol can tell you however that one drink is all it takes to fall into old habits again. One drink and the alcohol starts overtaking sensible thinking about the effects of too much alcohol. One drink, controlled drinking, rarely works for this reason and is actually harder to do than total abstinence.
Controlled drinking seems easier. You can continue to drink with your friends and go to all the same places. Total abstinence usually means  new places to go out to and new friends who don't drink.  It is however a continual pull towards drinking if you still go to the same places and drink with the same people where alcohol is freely available.
It is also easier to continue fooling yourself about how much you have been drinking if you do not change your environment. There will always be someone who will say, come on one more cant harm or you have been so good, you deserve a drink for that.
Therefore I suggest total abstinence is a safer and easier way to attempt to control alcohol abuse than controlled drinking. Ultimately you have to choose for yourself which way you want to take control Either way is better than not choosing at all.

Pharmacy costs

Firstly I would like to thank all my readers. Please take the time to comment or add to the discussion.
Australia is the only country in the world with its PBS, Pharmaceutical Benefits Scheme. The government buys bulk order medicines directly from the companies and then on sells then to the public at controlled prices. Mostly that means a reduced price by the government and reduced due to the benefits of bargaining for bulk orders. In other countries when you enter the pharmacy the pharmacist is a middle man between you and the pharmaceutical company. Most pharmaceutical companies are multinationals and drive profit margins high for their investors. They also have high research and development costs and huge insurance costs. As most of them have offices in the United states of America they have large litigation bills to cover. All these things drives up the cost of medicines. Protection from the government, especially with pensioner and health care plans  means that people can afford medicines.
Once the pharmaceutical company loses its rights over a medicine it has developed, about five years, anyone can copy the drug. hence the pharmaceutical company needs to drive up the costs in the first five years as it loses most of its market share after this. It is good for society as it forces the pharmaceutical companies to continually research and find new drugs and treatments. It is not so good that the whole research industry is driven by profit making companies. This skews research towards profitable. There is little money left for independent research.
This is different in the Translational centre in Brisbane, led by Professor Ian Frazer, where research is the key focus but to make it profitable and keep it in Australia, the research feeds directly to the manufacture part of the complex. This ethical approach is not the normal for most pharmaceuticals.
Of course the government want to pay less for the medicines and so pass the savings onto the consumers and the general public. Its approach is that cheaper manufacturers who essentially steal the research and development from the pharmaceutical companies can make the drugs at cheaper price. It would seem logical that the generic and the original are the same. They are not always in fact but very little research is available to test the hypothesis as no-one would pay for this research.
The government is now wanting to cut the rebate cost to pharmacists. Of course we all want to pay less. We all want quality. We all want quality services. The pharmacist is a professional who needs adequate compensation or income but the government is controlling it. Already pharmacists have to supplement their income and business viability by selling other items like cosmetics and perfumes, after hours service and discount competition. We need our pharmacies. Lets not squeeze them out of existence. Lets protect this industry which is the envy of the world. 

Mental Health Politics

Now is the time to ask the prospective new Prime Ministers of Australia and their parties, what do they plan for mental health services for Australians. How much funding will go to children and adolescents given the bed closures and mass sackings in the public sector. What programs are they going to support? How will they integrate public and private health care? What funds are going to be made available for research in Australia in the field of mental health?
What are the plans for State/ Federal cooperation and organisation? How has Australian registration worked given State mental health laws and State control of services? What about Medicare levies and PBS costs?
I hope that the real questions will be put to these would-be leaders and real answers will be given rather than character assassinations and point scoring. We have , as the public, a huge advantage at this point in time and it will only last a month, to promote our citizen rights, ask the difficult questions, force the public debate and then choose the right candidate. May the best person win because our mental health care needs are huge.