Let's Talk Mental Health

"You, yourself, as much as anybody in the entire universe, deserve your love and affection." - Buddha

Abuse and neglect are incredibly difficult experiences to endure, and thus, it is no surprise that those who grow up in these challenging circumstances frequently suffer from mental health issues. In honour of May being Mental Health Awareness Month, we will be releasing a series of articles highlighting the ways trauma can take a toll on one's mental health. To begin, we thought we would offer some insight about different mental health conditions and their correlation with abuse and neglect.

Anxiety

Anxiety is the feeling of nervousness, unease, or worry that typically occurs in someone when there is no immediate threat. Anxiety is the body’s natural response to stress and can be helpful, but when those feelings become hard to control, are excessive, or interfere with daily life, it could be due to an anxiety disorder.

When traumatic experiences become a pattern for kids, they often try to anticipate any future trauma. They tend to be on alert to try to manage the pain they are experiencing, and this anticipation sets in as anxiety. Children who have an anxiety disorder typically act in one of two ways; they can be quiet and well behaved, or they can be disruptive and act out. Both cases often end up with the child’s anxiety going unnoticed and untreated. Anxiety can manifest in four different ways: thoughts, emotions, behaviour, and physical feelings.

Common symptoms of anxiety in kids include:

Tantrums
Excessive studying
Irritability
Fidgety, amped up, unable to sit still
Tired
Procrastinating
Reassurance seeking
School refusal

A common misconception is that children will grow out of their anxiety. When left untreated, anxieties can get worse and can lead to other illnesses like depression, which oftentimes follows them into adulthood.

Common symptoms of anxiety in adults include:

Perfectionism
Intolerance of uncertainty
Having others make decisions for you
Information seeking or list making

Depression

Depression is a complex mood disorder that often causes an overwhelming feeling of despair in those who suffer from it. Many children with depression end up going untreated because it can be hard to differentiate depression from regular moodiness. Childhood trauma has been shown to be significantly correlated with the development of depression. In general, stress is a risk-factor for depression and children that experience abuse and/or neglect, typically also experience continuous high stress.

Common symptoms of depression in kids are:

Sad, irritable, bored most of the time, or withdrawn
Loss of interest in things they used to enjoy
Weight loss or gain
Have trouble sleeping
Lose interest in friends
Complain of stomach or head aches
Be more anxious or clingy towards caretakers

Common symptoms of depression in adults are:

Feelings of helplessness and hopelessness
Loss of interest in things they used to enjoy
Weight loss or gain
Sleep changes
Anger or irritability
Loss of energy
Reckless behaviour
Difficulties concentrating
Aches and pains

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is a psychiatric disorder that is triggered by a scary event, whether that be directly experiencing it or witnessing it. People suffering with PTSD often have intense, disturbing thoughts well after the event has occurred, and they may experience flashbacks, nightmares, and severe anxiety. Although it is expected that when someone experiences a traumatic event, they will have temporary difficulty coping, if the difficulties persist for months and/or years after the event's occurrence, they may have PTSD.

Common symptoms of PTSD include:

Intrusive memories (Nightmares, flashbacks)
Avoiding things that remind them of the event
Feeling nervous or "on edge" all the time
Startling very easily
Having a hard time concentrating
Feeling irritable
Difficulty sleeping
Feeling disconnected from their body or thoughts

Common symptoms of PTSD specific to children include:

Refusing to sleep alone
Regressive behaviour (Thumb-sucking, Bed-wetting)
Recreating the traumatic event through play
Crying or tantrums
Declining grades or academic failure
Avoidance of developmental opportunities in adolescence, such as dating, driving, etc.

Children that grow up in homes with abuse and/or neglect are quite likely to have either directly experienced or witnessed a traumatic event. Frequently, abused children experience multiple traumatic events, and this can lead to the development of Complex-PTSD. C-PTSD is a condition that has become more widely recognized by doctors in recent years, and develops when a child is exposed to repeated traumatic situations. When a child faces abuse and neglect, they can feel trapped in a damaging family dynamic, and their continuous exposure to these terrifying events during their formative years can often hinder the way the brain and its communication systems develop.

Symptoms of C-PTSD generally include those of PTSD, along with some additional ones. These other symptoms include:

Lack of emotional regulation
Feelings of hostility and distrust towards the world
Constant feelings of emptiness and hopelessness
Experiences of dissociation
Negative self-perception
Difficulty with relationships
Distorted perception of abuser
Loss of faith

Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a mental health disorder that impacts the way a person thinks and feels about themselves and others. It usually begins in early adulthood and can be caused by a history of child abuse and/or neglect, genetics, or brain abnormalities.

Common symptoms of BPD include:

Intense fear of abandonment
Suicidal threats, behaviour, or self-injury
Mood swings
Impulsive behaviour
Patterns of unstable, intense relationships
Rapid changes in self-identity and self-image
Inappropriate, intense anger

In the past, it was hypothesized that personality traits of adolescents and children with BPD were less stable, however, this is not the case. In the last 13 years, there has been a strong research base comparing BPD in adults versus youth. It was found that personality traits of children and adolescents are as stable as those in adults.

Dissociative Identity Disorder

Dissociative Identity Disorder (DID) is defined as a severe form of dissociation where one sustains at least two distinct and lasting personalities. This disorder is recognized as a coping mechanism where the person dissociates themselves from a situation or experience that is too violent, traumatic, or painful to endure. This disorder can be caused by a variety of factors, the most common being trauma in early childhood (usually extreme and repetitive physical, sexual, or emotional abuse).

A person living with DID may dissociate to avoid situations, places, and sensory imagery such as smells, colours, and music that remind them of their childhood trauma. This person may also experience memory loss, sudden changes in mood and behaviour, and flashbacks of traumatic experiences, among others.

The case of Jeni Haynes is a well-known and widely reported story of an Australian woman who created over 2,500 personalities to survive childhood abuse from her father. A documentary of her story can be found here:

Bipolar Disorder

Bipolar Disorder (BD) is a mental health condition that causes extreme mood swings involving emotional highs (mania or hypomania) and lows (depression). Mania and hypomania are distinct episodes, however, they have the same symptoms (abnormally upbeat behaviour, increased energy, euphoria, racing thoughts, etc.). The primary difference is that mania is more severe than hypomania and causes more problems in work, school, and relationships. Alternatively, a major depressive episode may be characterized by feelings of sadness or emptiness, insomnia, excessive guilt, weight loss, etc.

BD is mainly caused by hormonal imbalances or environmental factors such as abuse, mental stress, “significant loss” or other traumatic events. It is most commonly diagnosed between the ages of 15 and 25 years, however, it can happen at any age and affects both males and females equally. According to the International Journal of Bipolar Disorders, there is an association between childhood trauma and BD susceptibility and severity. Across multiple BD studies, three results consistently appear:

Association between childhood trauma and an earlier age at onset
An increased risk of suicide attempt
Co-morbid substance misuse

If BD is developed as a child, the person may endure long periods of continuous rapid cycling. If developed as an adult, however, the illness appears in discrete episodes, and symptoms may go into remission for months or even years at a time.

Schizophrenia

Schizophrenia is a serious mental disorder that affects how a person perceives reality and the world around them. This, in turn, can have repercussions on the cognitive, behavioural, and emotional aspects of an individual.

The most common symptoms include:

Distortion of typical functioning
Difficulties with attention, concentration, and memory

Around 1% of Canadians are affected by schizophrenia. Onset is usually between the ages of 18-25 in men and 25-35 in women, and most cases gradually begin displaying signs and symptoms rather than suddenly. Approximately one-third of individuals with schizophrenia require institutionalization, and usually, a person with schizophrenia's social, academic, and occupational functioning is impaired. Genetics and environmental factors that occur during one's early years have been shown to be a risk factor for development, but, generally, the cause is unknown.

The correlation between abuse and schizophrenia has not been studied as in-depth as other areas of mental health. However, existing literature has shown that childhood and adulthood sexual and/or physical abuse in a patient's history increases their chance of developing schizophrenic symptoms. Additionally, reported abuse can lead to the experiencing of flashbacks, hallucinations, and paranoia, which are all schizophrenic symptoms as well. Another study has shown that experiencing severe abuse as a child increases one's chances of developing schizophrenia three-fold, in comparison to individuals who had not experienced such abuse. Dr. Richard Bentall, of the University of Liverpool, says, "People who had severe and multiple traumas in their lives, in some of their studies they'd go up to an odds ratio of 50 times greater risk of psychosis [in later life]” (2012).

Written By: Daphna, Jasper, Sydney, and Prish

References:

https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

https://www.bbrfoundation.org/content/childhood-trauma-what-role-does-it-play-depression

https://www.helpguide.org/articles/depression/depression-symptoms-and-warning-signs.htm

https://www.psychiatrictimes.com/child-adolescent-psychiatry/effects-childhood-trauma-depression-and-suicidality-adulthood/page/0/1

https://www.anxietycanada.com/disorders/generalized-anxiety-disorder/

https://www.bridgestorecovery.com/blog/can-childhood-trauma-cause-anxiety-whats-the-best-way-to-approach-treatment/

https://www.anxietycanada.com/disorders/generalized-anxiety-disorder-2/

https://www.everydayhealth.com/anxiety/guide/

https://www.healthlinkbc.ca/health-topics/ty4640

https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967