After helping my sons, Alex and Sammy, recover from two different mental disorders that hit them in their teens, I spent a decade looking into what is known about preventing mental illness in babies and young children for my book, A Lethal Inheritance, A Mother Uncovers the Science Behind Three Generations of Mental Illness.
Here's the best advice I got from leading psychological researchers around the world for protecting your children (and yourself) from mental disorders. If symptoms of psychological distress are already present in a child, there are things you can do to stop them from getting worse.
In recognition of National Children's Mental Health Awareness Week from May 6-13, 2012, take a few minutes now to review these ten steps. You'll be making a solid investment in your child's future and your own peace of mind.
1. Chart a "tree" of your family's mental health history, including both sides of the family, going back three generations. Include all known or suspected mental disorders and addictions. If relatives balk at your digging into the family's possibly murky past, point out that it's for the good of your children and grandchildren. Use the U.S. Surgeon General's online form for recording and storing your family's mental (and medical) history and make it a shared ongoing family project to maintain. Take a print out with you to any mental health evaluation and insist that it be a part of your own or the child's diagnostic process.
2. Plan your pregnancies! Begin a strict physical fitness and mental wellness regime three months before you start trying to conceive. In addition to practicing optimal nutrition and staying physically healthy, strongly consider your mental and emotional health before and during pregnancy. If you are currently on an antidepressant, talk to a mental health professional before making a decision about whether to stay on it during pregnancy. Medication may pose fewer risks to your child than would your severe depression -- especially during the first trimester. Studies have tied a mother's prenatal emotional trauma and extreme stress to a higher risk for childhood depression and anxiety, even to schizophrenia.
3 Learn about environmental and infectious agents that may cause miscarriages, birth defects or raise a child's risk for mental disorders later in childhood. The source may be a disease such as chickenpox, a prescription drug or a chemical -- including oil-based paints, mercury and, recent research suggests, certain chemicals in plastics (phthalate and bisphenol A or BPA), used in a variety of products including toys, cosmetics and water bottles. Sensitivity is highest during periods of intense brain growth; as an embryo (between two and eight weeks) and during the second trimester. A good web resource for the latest information is the March of Dimes.
4. Take paternal risk factors into account. Studies show that older fathers are associated with higher rates of schizophrenia and autism in their offspring. A variety of occupations with prolonged exposure to radiation, anesthetic gases and other toxic chemicals can alter a father's chromosomes, increasing the risk of miscarriage or genetic defects. A man's alcohol intake and drug use is also associated with higher miscarriage rates. As is the case for the higher risk mother, age, lifestyle and occupational risks should be weighed along with other factors, such as family history, to consider when and whether to father a child.
5. Treat yourself first. You may have put off getting a diagnosis but now is the time to make an appointment with a mental health professional and seek treatment if you have symptoms of a common adult mental disorder such as depression, anxiety or addiction. Think of your actions as an act of prevention for your child's mental health. If your child already has similar symptoms, research has shown that by treating the mother, a depressed or anxious child will get better too -- without direct treatment.
6. Monitor your child's behavior for early symptoms. If there is a high density of any single mental illness among your relatives in your family, learn about the early signs for that disorder. Some examples include social withdrawal for depression, irritability or anxiety or ADHD. If you see early signs like these, closely monitor your child's behaviors. If symptoms are present for a month or more keep a daily log to document them. Then, if the problem behaviors continue or worsen, bring this log to your pediatrician or mental health professional that treats children.
7. Talk about thoughts and feelings. As soon as your child begins to recognize and name her own thoughts and feelings and those of others, start an age-appropriate conversation about how our human emotions and minds work. Explain that feelings and thoughts exist on a broad spectrum (compare it to a rainbow). Within reason (which excludes tantrums or aggression against others), make it clear that unusual thoughts and strong feelings are not right or wrong; more often, they simply represent individual differences. This "normalization" of differences makes it more likely that your child will confide any future psychological problems to you and be less inclined to stigmatize others.
8. Have zero tolerance towards bullying. Whether your child is the victim or the bully, do whatever it takes to stop it. This is not a "wait and see" option. Even if your child begs you not to make a fuss, understand that the potential psychological damage (including suicide) for him or her if the abuse continues is far worse than any temporary embarrassment.
9. Make self-esteem a family priority. Self-esteem has gotten a bad rap because it's been confused with having an outsized and incorrect sense of one's positive qualities and abilities. Self-esteem in a child comes from parents who model empathy, honor individuality and reward real effort, not false achievement, in their children. True self-esteem is the basis of emotional resiliency, which gets severely tested at several points in childhood -- especially around early parent-child separations. As a resilience building strategy, bring back family dinners as many nights as possible, divide up chores and use the time to communicate.
10. Build up your family, community and online support system. Social isolation isn't good for mother or baby. Before giving birth, take stock of who you can call on for emotional and practical support among physically close-by friends, neighbors and family. Then check out any of the hundreds of web-based communities of new mothers from whom you can count on finding a friendly ear and a good laugh at virtually any time of the day or night. Find the right fit for you.
Victoria Costello blogs on mental health and parenting on MentalHealthMomBlog.