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January


How can we prevent future mental illness suffering? Tuesday January 17, 2017

It is wonderful how Moodscope enables this brave community to share support, experiences and tips for 'getting through' life. But that shows a sad fact; most people with mental illness, whether it be diagnosed as anxiety, depression, bipolar, psychosis, personality disorder, OCD, whatever – don't actually get out of it completely. A good outcome is to be able to live 'ok', perhaps supported by meds. The ongoing impacts on happiness, and on ability to work, are huge. There is no glory or pleasure in being mentally ill, and it is not part of identity.

We also know that genetic inheritance is a big causal risk factor. If we suffer from mental ill-health, there's a much higher chance that our children and nieces and nephews will do too.

Wouldn't it be great if we could prevent this suffering going on down the generations? What more loving thing can we do for future generations but to help them head this suffering off before it even starts?

When Paul Farmer surveyed the public for the NHS Mental Health Taskforce in 2015, he include the 'prevention' word, really for the first time in public discourse (globally); it went straight to the top of key issues [http://bit.ly/2itXLqH].

Now the debate is developing, led by NGO's such as Mental Health Foundation [http://bit.ly/2iDTqzZ] - full disclosure I am a trustee - and Mind [http://bit.ly/2jgLq6H], think tanks such as EPI [http://bit.ly/2iDS3Rv] and Mental Elf [http://bit.ly/2itS8sy], and Public Health England [http://bit.ly/2iyHnAl].

My view is that parenting is a key factor for many, and could easily be improved (in fact I think there should be a mandatory parenting certificate for all parents-to-be, just like a driving test, focusing on parenting well for the future mental health of the child). As well as unconditional love and attachment, and preventing abuse of all forms, wiser parenting would include keeping expectations reasonable (high achieving children often become confused as to whether they are loved for themselves or their A grades, and get trapped on a mouse wheel that is impossible to sustain), and working hard to stop drug intake before the child's brain has reached adulthood.

I also am very hopeful about pre-emptive CBT; equipping school children with the idea that some of their [or their friends] thoughts may be wonky and irrational ('Facebook says everyone else is having a non-stop party life – I must do the same'). Research shows that pre-emptive CBT reduces depression incidence in at risk people [http://bit.ly/21tlmEt].

The Moodscope community could be wonderfully helpful here;

- What do you think caused your mental illness? Could it have been prevented?
- What are you doing to prevent your illness recurring in your children or nieces and nephews?

Adrian Stott
A Moodscope supporter.
(My personal opinions: http://bit.ly/2jX9Dlr)

Thoughts on the above? Please feel free to post a comment below.


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Comments

Jane Tue, Jan 17th 2017 @ 5:19am

Thanks Adrian. For me I think it was both nature and nurture. I have tried to do things differently with my children but that has not stopped my eldest from suffering from depression for some periods. I work in Public Health and there is still a long way to go to improve MH services. I agree that there should be increased focus on prevention also. PH focus is on the lifecourse, particularly aiming to give every child the best start in life in every way. No small challenge. I do feel that there could be a lot more guidance and support for parents. I'm also aware that my children support me when I am ill which is not ideal. They are three marvellous, caring young people though.

Leah Tue, Jan 17th 2017 @ 5:38am

Thanks Adrian for an thought provoking blog.
I spent many years wondering where my bipolar came from. There was nothing in my family history, I was the first. Unlike others here on Moodscope I had no trauma, abuse, accident or tragedy in my childhood or my life. My parents were caring and loved me unconditionally.
So now I felt so guilty ,after all I had great genes and a delightful childhood and life. Why should I have a mental illness. Most of the research would make me the odd one out. So after years of worrying and wondering what caused my illness, I decided to let that go. I would focus on getting well what is past is past.
So I feel all this emphasis on what causes illness only leads to blame and guilt.
Why can't we focus on getting well.

Just my humble opinion. I am sure lots will disagree.

Tutti Frutti Tue, Jan 17th 2017 @ 8:53am

Hi Leah I kind of agree that the treatment is more important than the cause, except for us to learn the lessons for the next generation. I don't have perfect genes but I don't think they are too bad and Ihad a happy and supportive childhood. The only nurture thing I can come up with was the shock of moving from a small comprehensive school where I was the star pupil and very supportive parents to a top university where I had to really work to be average. Love TF x

Leah Tue, Jan 17th 2017 @ 10:02am

TF and everyone When I said great genes I just meant I did not I inherit any mental illness I was not boasting. For me the most traumatic thing that happened was being diagnosed with manic depression when I was 16.

Tutti Frutti Tue, Jan 17th 2017 @ 1:44pm

Hi Leah, I actually thought that you were talking about mental health genes only and so was I when I said my genes are "not perfect but not too bad". I do know of some relatives who have had mental health issues but not a majority and I am not sure there's any history of bipolar rather than depression. It's mainly quite a way back and of course social attitudes of the time mean I wouldn't necessarily know how serious it all was. It seems unlikely that I am going to find out exactly what went on with my grandfather when my father was 3, but as far as I have been told/remember he didn't have any continuing issues. Love TF x

the room above the garage Tue, Jan 17th 2017 @ 6:25am

I could get tearful here. I'd say I can trace mine back to the end of childhood, it changed my entire future, and I'd say every single part of my parenting has been about trying to prevent history repeating, shoring up the sides so that my children have a fighting chance of deflecting it if a curve ball flies their way and are equipped to deal with it should it hit them. I think some mental illness could be prevented, or at least understood before it took hold more firmly. We don't give people cars and expect them to drive safely. Great thought provoking post thank you. Love ratg x.

Pablo Tue, Jan 17th 2017 @ 7:13am

Not sure if it is genetics or not. I have had 3 major depressions in my life. I am 60 yes old now and I am struggling to get out of this 3rd episode. The first depression was in my early 30's about 4 years after my 48 year old mum committed suicide. I had a happy childhood though and Mums depression was hidden from me. The second bout of depression came in 2009 after Dad died naturally age 74 in 2004. This coupled with money worries and youngest daughter depression. She is ok now thankfully. My current depression and anxiety is money and health related. Slowly working through it. Trying spiritual healing and accupuncture as well. I will get there but it is tough going at present. Hugs to you all.

Jane Tue, Jan 17th 2017 @ 7:31am

Hugs back Pablo

Tutti Frutti Tue, Jan 17th 2017 @ 9:55am

Pablo Thinking of you and sending hugs TF xoxo

LP Tue, Jan 17th 2017 @ 8:16am

My depression and anxiety has been directly linked to how I was parented. I find it abhorrent even though I know that it was the same for my mother and her mother. There could be genetics involved but poor early childhood attactment and years of emotional terrorism just for starters have been the cause in my case. I'm still having to fend off being told what to do in my 50's and finding myself increasingly having to provide "care" as my family duty.

On the bright side, I have been a lovely mother to my children emotionally. I've taught them how to be caring considerate compassionate and above all enjoy life.
Issues now between myself and an in law have led me to withdraw from family events, but writing this has strengthened my resolve to focus on the "enjoy" life bit for my kids and us as a family.
Thanks Adrian. Hugs and moments of joy to all. LPxx

DAVE Tue, Jan 17th 2017 @ 8:56am

Hi Adrian,
I believe that my BP started (predictive text will be my downfall, one day, as on rereading this first line, before correcting it read ...I believe that my BO started......("ONLY YOUR BEST FRIEND WILL TELL YOU THAT")......at 18 years old, and I certainly believe that the onset was mixing with a very rough lot to in the merchant navy, and was abused, not sexually but, verbally.
That affected my personal confidence for 20 years. My parents, like all parents were struggling after the war, and working to obtain financial security. My mother never admitted she had BP, my Grandfather had BP and one of my uncles....One of my daughters has BP, my other daughter I believe also has it , as I've seen her depressed and high as a kite. My son is very self centered and struggles with relationships girlfriends in particular...He's looking for Mrs Right...The only one he'll find is one with a Christian name of ALWAYS ! !
If we were to take these 20 Moodscope emotions and moods and offer them to someone in the street, you'de find that the majority would struggle to achieve 50/60 %.
Based upon that brings....TO MY MIND...There is a GREAT difficulty in Separating some BP TRAITS from Our PERSONALITIES....
I am convinced, that the route to 'WELLNESS' is directly linked to individual lifestyles, in the market n KEEPING occupied...I am not going to repeat ORDER in life....But to dilute the effects of CONSTANTLY dwelling on the Whys and Wherefores of MH opens a breeding ground for negativity, a depressing, downtrodden lifestyle. WE NEED to EMBRACE HOOE....but need to seek employment which we'll enjoy and which enables us to live a 'comfortable' lifestyle...sufficient for our needs, keeping out if debt. ! !

Dave

Jul Tue, Jan 17th 2017 @ 8:59am

Good morning Adrian. I agree a lot more needs to be done in schools to help children even as young as five with troubling life issues. I don't think the issue of mental health is quite so simple where parenting is involved although personally I can see where my depression originated and that was in my family situation as I was growing up. I do not apportion blame however. My parents did their utmost best to raise their two daughters well. When I was a prison visitor,one of the things that struck me and I was told about this in training and on visits was the generational unemployment. Children were being raised in families who for two generations had not worked. So dysfunctional examples of parenting were set at birth through no fault of the parents. I think bad parents are in the minority and too much blame is put on them. Some parents do need help I agree but most do not. IMO what does need addressing is the wealth gap in this country. I read yesterday that 9, yes nine! people own the wealth of nearly half the global poor. A horrifying statistic. I found your blog very interesting with helpful insights so thank you Adrian.(I also think the issue of identity needs exploring further as OK I agree depression shouldn't become an identity for anyone but I think it shapes us and can produce positives). Jul

Tutti Frutti Tue, Jan 17th 2017 @ 9:40am

Jul I totally agree with what you are saying on inequality (although I think parenting courses can help all of us be better parents regardless of financial circumstances and I did choose to do one). The 9 people is indeed a scary statistic. It sounds too low a number to be true but I assume you found it somewhere reputable. Still an absolutely shocking state of affairs but I wonder if the 9 would include people like Bill Gates who has done an awful lot to support the poor. Also well done on doing the prison visiting. Love TF x

Jul Tue, Jan 17th 2017 @ 10:15am

Yes TF, it does include Bill Gates and I was going to mention this. He and his wife give such a lot away to charity and have done wonderful things with their wealth. I read it in The Times. I have just rechecked the article and in fact it says 8 not 9 people! It was research carried out by Oxfam. Mark Zuckerberg (Facebook) is one of the 8 and of course he too has set up a charitable foundation. It's just an overwhelming statistic for me and one I found difficult to comprehend. I think parenting classes are invaluable. You are right to say regardless of income. Thank you for this Tutti. Julxxx

Tutti Frutti Tue, Jan 17th 2017 @ 1:46pm

Thanks it's interesting to know more about the research and it is mind boggling! TF x

Sarah yellow rose Tue, Jan 17th 2017 @ 8:59am

Thank you for this post and the honest replies. I think Moodscope is a wonderful community. If I read comments after watching an on line documentary I am shocked by the criticism , impatience and anger of the comments. This just reminds me of how safe and connected I feel in the Moodscope community.

DAVE Tue, Jan 17th 2017 @ 9:02am

I'll have to try to turn off predictive text on my iPad....does anyone know how.

6th line up from the bottom....
Should read...lifestyles, MAINLY KEEPING OCCUPIED !

Third line up HOPE !

Dave

Tutti Frutti Tue, Jan 17th 2017 @ 9:27am

No technical tips I am afraid but your digression on BO gave me my chuckle for the morning and it was obvious what the other bits should have said. Perhaps we should all keep the predictative text on for humour value. I am sure someone will know how to turn it off though as I know our computer services did it at work after a few of our technical terms were rendered into amusing alternatives. TF x

Tutti Frutti Tue, Jan 17th 2017 @ 9:12am

Thanks for a very thought provoking post Adrian. As I said in my reply to Leah I think it must be a mix of nature and nurture for me but it's not clear that there's anything really big on either side! I should think through what I am doing to protect my daughter's mental health and equip her to deal with anything she might come up against in future in a more structured way. I have spoken to her about negative thinking and she picks me up on it far more often than I challenge her (hopefully because she is a reasonably confident and robust rather than because I am missing stuff). Her school also does a fair amount on resilience, failing well and growth mindset, most of which my daughter treats with a heavy dose of teenage sarcasm but which I think sounds good. I just hope some of it filters through and sticks. I also agree that parenting courses would be helpful and I have done one, although I can't see how you could do anything to enforce attendance in practice. Some TV programmes Supernanny etc also seem good to me.
Love to all TF x

Jul Tue, Jan 17th 2017 @ 9:13am

Hello again Adrian. Do you think parents who suffer mental health issues are more aware of the effect thismight have on their children and therefore take steps to avoid their offspring becoming depressed? If that's possible. I think I do worry my two children will suffer and one of them has a similar personality to me but so far they seem OK. They have had their normal problems but these are not to be exaggerated or worried about. Obviously I hope very much that they get through life without dramatic mental health problems and I do feel that a lot of my parenting has been geared towards them not falling into the same pitfalls as I did. My parents knew little about mental health. Education and awareness as you say is the key. Jul

Carol Tue, Jan 17th 2017 @ 9:29am

Thanks for this excellent post, Adrian. I would love to see awareness of mental health issues and appropriate CBT for all older primary school children, say from the age of 8.
Personally I believe I've both inherited my tendency to depression and anxiety from my mother's side of the family (whose female members actually disliked and were unable to deal with babies and small children) and had it hugely reinforced by a bad boarding school experience from the age of 12 to 18 from 1965-70. This has undoubtedly affected me profoundly. Although our mother was able to love my brother unconditionally, there were issues with my father (a wartime POW) and my brother was similarly affected. He died of a brain tumour in his 40s.
Of course we were children of our time but now 50 years later with all that we know and can do, so much suffering might be prevented.

Wyvern Tue, Jan 17th 2017 @ 9:30am

For me, perhaps a combination of my own personality, childhood (especially school) experiences, triggered by events in my adult life bringing on periods of super-anxiety, panic attacks, depression. I don't wish to dwell on it too much.
My priority now is doing things in a way that helps me to stay as well as I can be. Moodscope is a great monitor of that. When my score dips over a week I know I need to take some action. Odd days I ignore, they don't count.
My children are adults. I did my best at the time they were growing up and continue to do my best. One has problems, the other doesn't. Very different personalities, different challenges, different responses.
Could things have been different? What if, what if, what if??? No point for me in speculating. What is, is, and I go forwards from here. Just doing my best each day. :-)

Michael Tue, Jan 17th 2017 @ 1:40pm

Apparently a recent study on the effectiveness of psychoanalysis revealed that it was still effective two years after the last session. But and this is a big BUT, the clients were still classified as mild to moderately depressed. What psychoanalysis did was to prevent a relapse to severe. So I had mixed feelings, that is good I never want to go back to severe, but am I destined to stay in the mild to mod category.

There is a two year wait for psychoanalysis, on the NHS so I decided to go private as that was way too long to wait.

Then there is cost and benefit. The NHS managers and accounts would not like th look of a therapy such as psychoanalysis as it could carry on indefinitely and how does one define it as curative or a success? NHS like you have 6 to 12 sessions, probably CBT and then you are sorted.
Whereas relatively indefinite psychoanalysis may be keeping people out of the "danger" zone and cutting down on hospitalisation.

Another big problem in NHS psychiatry is the lack of continuity of care. Your initial psychiatric assessment gives your consultant a whole hour to get to know you. Thereafter it is 15 minute appointments, so when, inevitably, your psychiatrist moves on, and their post is filled with locums. Suddenly a psychiatrist has to be up and running with your case in a mere 15 mins.
As we know aetiology on psychiatric disorders is probably THE most complicated field of medicine to work out what are causative factors, contributing factors etc etc. So one feels a little lost in the revolving door, here is another locum scenario

Tutti Frutti Tue, Jan 17th 2017 @ 1:49pm

Michael Interesting thanks for sharing. TF x

Anne Tue, Jan 17th 2017 @ 3:43pm

Wow! Thought provoking blog Adrian - thank you.
Personally see how nurturing (or lack of) from family/significant others had a place - and can also see how there is something in my nature too - that feels different to my brother, yet we had similar experiences.... For me the fact we use different strategies and see our depression in different ways tells me that parenting isn't the whole story.
How do I stop repeating this - I chose not to have children. Too scared and didn't want anyone to feel like I have (at my lowest)... which raises a whole set of other questions about choice, power and control...
Thanks for all Moodscopers honesty, it's really helped me think through my own experience and triggered a desire for further discussion with others.
Cheers

g Tue, Jan 17th 2017 @ 4:10pm

Hi Adrian , Thank you for your blog .I do not know if you will respond to comments here but it would be nice if you did . I have no time at the moment to read all the information that you supply links to but I will try to do it soon . Prevention is the word for living. For all . For the whole of medicine and not just mental health and I do hope that the mentally ill are not being singled out . As to a licence to become a parent I sense immediately another controlling unhealthy movement restricting freedoms.
Of course education should include lots more than it does as long as it is for all.
Money management is as important as arts , sport , relaxation , thinking , learning how to learn etc. which our feudal education system neglects or limits .
There is a movement for meditation being taught in schools even primary once and it works with little ones beautifully , however I am doubtful how mindfulness is helpful .
We do not know yet but if genes were the only culprit would you forbid these individuals from procreating ? You have bundled together so many subjects and suggested that by waiving a magic wand of one word all the problems in all these areas may be prevented - oh , if life was that simple !

Rose Tue, Jan 17th 2017 @ 6:53pm

Thank you for including both those with and without children.

The Gardener Tue, Jan 17th 2017 @ 7:34pm

Oops, what a lot of thought-provoking stuff. I can pin-point the start of my bi-polar - real struggle to get third son (found out later only one 'going' kidney and childbirth dangerous). I should have been over the moon, and remember with absolute clarity feeling desperately miserable when he was 7 days old. PND of course, not recognised. Obvious now my Dad was bi-polar, third son first depression at 13 - then throughout his life in episodes of lesser or greater severity, I don't think he ever hit a serious manic state. Adrian, you talk of family strength, so important. I was seriously manic when this son was 3 - the treatment was I was sent to bed, thrown Mogadon as soon as I woke up, and no worries. This little boy was literally dumped on any neighbour who was free. I've always believed he felt he had been naughty to be packed away from Mummy. His elder brothers were at school, of course. I think that in our over-crowded world - and now, in UK, the near impossibility of youngsters getting on the 'housing' ladder non-achieving and not 'mattering' can trigger depression even it not already in the genes. Social media really worried me (old fogey really) but before our children and grand-children had access to them they TALKED. Round the dining table, on long walks, long car rides - anything from 'what is death' (6 year old in a traffic jam in Kent) to cricket and football scores. And they wanted to be 'involved' cooking especially, parties (great favourite) and dressing up. I really think Face book has killed all that. This really does show my age, there is NO going back. I was told by the head of a major boys' school that long walks were excellent for teen-agers - releases the testosterene - gets them talking and 'deep-down' stuff will come out. Anybody any theories on this?

Jane Tue, Jan 17th 2017 @ 9:41pm

Hi Gardener, I agree about the pitfalls of social media, it has killed a lot of face to face interaction. I eat dinner with two of my kids every night and all three on Sundays (my eldest has left home). But I find out most thought provoking talks are when we are alone, any of us, 1-1 in the car! A long car trip with my 17 year son last year resulted in one of the most frank, open and enlightening I've ever had with him!

Jane Tue, Jan 17th 2017 @ 9:42pm

Oops missed a word! Enlightening conversations!

Adrian Tue, Jan 17th 2017 @ 10:41pm

Thank you everyone for these very positive and helpful comments - this really is a wonderful community (as Sarah yellow rose says).

I am not saying giving better parenting guidance will fix everything; behaviours are hard to change, and mental illness causation can also be due to genetics, other life experiences and early drug use. But I do agree very much with 'the room above the garage' comment comparing the way we as a society treat driving (mandatory education and test before you can do it) with the way we do Not educate parents-to-be about how to best parent for the future mental health of their child. It's amazing really... I think even some basics would help some people do a much better job (http://tinyurl.com/jdlvqfg).

But prevention is broader, and we need to explore the best ways. For instance giving school age children some education on CBT ('some of my thoughts may not be fully rational') and on the damage drugs do to young brains could help many cope much better.

Thanks again, and any further comments very welcome...

Leah Wed, Jan 18th 2017 @ 5:01am

Adrian, thanks fro your reply. I was hoping you may address a point g made in her comment "We do not know yet but if genes were the only culprit would you forbid these individuals from procreating ?" I wonder if parents knew they were having a baby with a gene for mental illness would they consider not going ahead with the pregnancy. So many implications. I think comparing parenting to learning to drive can have a few problems. there is an agreed legal way to drive as we have road roles but parenting does not have this. Will parents who choose to do something different like bring up their children as vegans be considered to need retraining if they live in a society of omnivores? Thanks again. I look forward to your response.

Adrian Wed, Jan 18th 2017 @ 10:42am

Hi Leah, good to be talking. I think some mentally ill people may choose not to have children, such as Anne above, perhaps for their own or the child's good. Others may decide to go ahead but to try very hard to parent well, and to break generational parenting patterns that have not helped, such as to keep their expectations of the child low, to prevent abuse, etc.. A particular point is * choice of partner *; if your partner also carries mental illness genetic risk, then you increase the risks of your joint child being mentally ill. Thus mentally ill people might deliberately choose a very mentally healthy partner, to reduce risk. So no I would not forbid. I would though go as far as proposing that no-one receives any child benefit payments unless they have passed a parenting certificate. I agree parenting can be done in various ways, but I believe underlying these are some basics that all styles should do; love and attachment, no abuse, reasonable expectations, no early drug use. (Although it's unusual in the West, in Asia and LatAm benefits payments are often conditional on actions, e.g. child benefit only paid if your child shows up regularly at school (see https://en.m.wikipedia.org/wiki/Conditional_cash_transfer)). I'd be interested in your view? Again let me emphasise I think mental illness can have many mixes of causes. Some may be pure 'out of a blue sky' genetic risk, with no life trauma etc, and unpreventable, but in my experience these are fairly rare. I'm not saying we can prevent all mental illness at this stage, but I think we could prevent a large amount if we did some basic interventions and education.

Sheena Wed, Jan 18th 2017 @ 9:40am

Have to add here that the best part of 50 years ago I was told NOT genetic (BP that is) but 'runs in families'. This morning I have heard on Radio that CBT works more effectively than drugs whereas in the past surgery was used ... Let's aim to bring up children to respect themselves and others so as to use their own talents effectively. Sheena

Mary Wednesday Thu, Jan 19th 2017 @ 11:51am

Coming in late to the discussion. BP Certainly runs in families... father had it, one cousin has it. Mine possibly triggered by witnessing my father's suicide at age 4. I have said before that, if I'd known what it was before I had children I would have thought a lot harder about it. But I have two wonderful girls znd we talk about mental health in the same way as physical health. As far as I can, I'm doing a good job with them. And lucky enough to be married to their father who is mentally so solid and stable. He is my rock.

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