Blog #2: Why is there an increase in mental illness in kids? A review of ACEs and risk factors for mental illness

It seems every time we turn on the television or read the news headlines there is mention of another teenager who died by suicide or committed a crime while under the influence of drugs or was involved in a school shooting. Mental illness and suicide in children and teenagers are increasing rapidly, which begs the question: ‘why?’

Decades of research and studies have determined that there is no one single definitive reason for developing a mental illness, rather it is a combination of factors which influence brain growth and development: genetics, early environment (in utero) and current environment. For example, genetics play a significant role in the development of schizophrenia, alcohol intake during pregnancy increases the risk of a child having Fetal Alcohol Syndrome. However, it is the current environment that the child/teenager lives in that appears to have the most impact on a child/teenager’s mental health and brain development and increases the likelihood of mental illness.

If you recall, in Blog #1, we reviewed the different components of the brain and the role of the six domains of brain function e.g. physical, perception, emotion, plus the role of the frontal lobe in teenagers making impulsive decisions, engaging in risky behaviours, etc.

A child/teenager’s identity is shaped by environment, relationships, experiences and natural abilities. The way a child is parented and the relationship with parents, guardians, and other adults has a significant impact not only on brain development but also on how the child attains milestones, develops healthy relationships, and copes with stressful and challenging situations. Kids learn by example, and a mentally healthy child will be confident, have self esteem and positive self worth, quality of life and function well at home, in school and in the community.

Adverse Childhood Events (ACEs)

Unfortunately, many children live in, and are exposed to, unsafe, abusive, and scary environments. Back in the 1990’s, research revealed that when a child/teenager encounters stressful situations over and over again, the stress response shifts into overdrive and re-sets on high creating more inflammation in the brain which predisposes him/her to developing health problems in later life e.g. mental illness, obesity, chronic health conditions, etc.

There are three types of Adverse Childhood Experiences (ACEs)*:

  1. Abuse: physical, emotional, sexual
  2. Neglect: physical, emotional
  3. Household Dysfunction: divorce, substance abuse, mental illness, mother treated violently, incarcerated relative

In the early 2000s, the National Scientific Council on the Developing Child* coined the term “toxic stress” to describe extensive, scientific knowledge about the effects of excessive activation of stress response systems on a child’s developing brain, as well as the immune system, metabolic regulatory systems, and cardiovascular system. Experiencing ACEs triggers all these interacting stress response systems. Specifically, the chronically stressed brain releases a hormone that shrinks the size of the brain directly affecting the amygdala (fear processing) and the hippocampus (stress, memory, emotions). Also, brain cells which are part of the immune system start producing neurochemicals that lead to neuro inflammation.

In the child/teenager who has experienced mental and physical suffering, these inflammatory chemicals continually flood the body from head to toe. Consequently, when a child experiences multiple ACEs over time, especially without supportive relationships with adults to provide buffering protection these experiences trigger an excessive and long-lasting stress response, which can have a wear-and-tear effect on the body, like revving a car engine for days or weeks at a time.

My ACE score is 5/10 which indicates there is an increased risk of me developing a mental illness. I experienced my first depressive episode at age 29yrs., my second episode of depression occurred at age 41yrs., and then in 2015, at age 51 yrs., I suffered another episode of depression so severe, that I felt I would never survive and led to me writing my book, Escaping the Rabbit Hole: my journey through depression.

*If you want to take the ACEs quiz, please check out this site https://www.safelaunch.org/aces-quiz/
*For information about the NSCDC please visit https://developingchild.harvard.edu

Risk Factors for a Child/Teenager Developing a Mental Illness

1. Genetic predisposition

2. Early environment

3. Current environment:

  • loneliness, isolation, social exclusion
  • homeless, poverty
  • mental illness/suicide in the family
  • addiction in the family
  • history of trauma
  • history of aggression/crime in the family or in the community
  • involvement with drugs, alcohol, or tobacco
  • deficits in social or cognitive abilities
  • bullying, cyberbullying, social rejection by peers
  • poor academic performance, learning disorder, developmental delays
  • poor family functioning, low parental involvement, little to no attachment to parents or caregivers, little to no support from family members

Common Mental Illnesses in Children and Teenagers

Recent statistics show that 1 in 5 children/teenagers have a mental illness and 50 percent of all mental illnesses will shows signs by age 14 yrs. and 75 percent of all mental illnesses will show signs by age 24yrs. Depression in the younger generation has increased steadily for the past 50 years, approximately 20 percent of children have an anxiety disorder, and suicide in teenagers has increased 28 percent since 2000. Suicide is now the second leading cause of death in children ages 5 to 24yrs old. Children as young as six and seven years old are being diagnosed with major depressive disorder, generalized anxiety disorder and obsessive-compulsive disorder.

Every single day, approximately 3041 students in grades 9 through 12 attempts to die by suicide.

Are you horrified? Saddened? Speechless?

I am!

Common mental illnesses diagnosed in children and teenagers:

  • Anxiety disorders
  • ADHD
  • Mood disorders e.g. depression
  • Panic disorder
  • Obsessive compulsive disorder
  • Eating disorder

So, after reading all this information, let’s now look at the world today, the world our children and teenagers live in. The world is ravaged by wars, riots, poverty, natural disasters, unemployment, fake news, the threat of global warming, civil unrest, migration, anti-Semitism. Crime is escalating, homelessness and economic hardship is increasing, sex/human trafficking is widespread. Then, add in the opioid crisis, gangs, the constraints of schoolwork, the impact of bullying especially cyberbullying, and the influence of social media, and we have a world full of confusion, hatred and very little regard for the health and wellbeing of others. As adults, many of us feel frustrated, uncertain and concerned. No wonder our children and teenagers feel that they have little control over their lives and their future.

Our children and teenagers are being exposed to life situations and stressors their parents never experienced. Even bullying in school has become more widespread and more dangerous. Furthermore, bullying is no longer confined to school, because cyberbullying is an ever present, constant and predatorial threat in kids’ lives 24/7.

Research is beginning to show not only a connection between bullying and mental illness, but also that students who are bullied have smaller and less developed brains. Children and teenagers are being bullied and victimized at an alarming rate. In the USA, 160,000 students skip school daily for fear of being bullied. Every seven seconds a child or teenager is bullied. Make no mistake, bullying is a very real and harmful threat and increases a child/teenager’s risk of developing a mental illness significantly.

Many kids I have spoken to say they feel lost; they have no clear direction and purpose in life. I believe adult expectations, the competitive need to be bigger – better – the best, and the constant need to live stress free and to be happy is a major problem. We have become a world where entitlement, popularity, good looks and acquiring material goods is the norm. We expose children and teenagers to life problems, the horrors of the world and yet we rarely sit down with them and explain right from wrong, good from bad. Practically every child and teenager own a phone or tablet and social media has become the surrogate parent, the teacher, and the babysitter. We seem to think that giving our kids whatever he/she wants, treating them as if they are our best friends and confidantes, will make them happier and feel loved. Sadly, this is not true.

The only way we can truly help support our children and teenagers is by listening to them, hearing what they say, be understanding, non-judgmental, and compassionate. Help them to problem solve, to be assertive and to be kind. Be there for them, tell them how loved they are, show them. Our kids need help now. In the words of John Fitzgerald Kennedy:
“children are the world’s most valuable resource and it’s best hope for the future.”

In my next Blog #3
I will be reviewing the five most common mental illnesses children and teenagers may experience

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