Families including someone with mental illness can experience deep despair. They need support
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In the aftermath of the tragic Bondi knife attack, Joel Cauchi’s parents have spoken about their son’s long history of mental illness, having been diagnosed with schizophrenia at age 17. They said they were “devastated and horrified” by their son’s actions. “To you he’s a monster,” said his father. “But to me he was a very sick boy.”
Globally, one out of every eight people report a mental illness. In Australia, one in five people experience a mental illness in their lifetime.
Mental illness and distress affects not only the person living with the condition, but family members and communities. As the prevalence of mental health problems grows, the flow-on effect to family members, including caregivers, and the impact on families as a unit, is also rising.
While every family is different, the words of the Cauchis draw attention to how families can experience distress, stress, fear, powerlessness, and still love, despite the challenges and trauma. How can they help a loved one? And who can they turn to for support?
The role of caregivers
Informal caregivers help others within the context of an existing relationship, such as a family member. The care they provide goes beyond the usual expectations or demands of such relationships.
Around 2.7 million Australians provide informal care. For almost a third of these the person’s primary medical diagnosis is psychological or psychiatric.
It has long been acknowledged that those supporting a family member with ongoing mental illness need support themselves.
In the 1980s, interest grew in caregiving dynamics within families of people grappling with mental health issues. Subsequent research recognised chronic health conditions not only affect the quality of life and wellbeing of the people experiencing them, but also impose burdens that reverberate within relationships, caregiving roles, and family dynamics over time.
Past studies have shown families of those diagnosed with chronic mental illness are increasingly forced to manage their own depression, experience elevated levels of emotional stress, negative states of mind and decreased overall mental health.
Conditions such as depression, anxiety disorders, bipolar disorder, and schizophrenia can severely impact daily functioning, relationships, and overall quality of life. Living with mental illness is often accompanied by a myriad of challenges. From stigma and discrimination to difficulty accessing adequate health care and support services. Patients and their families navigate a complex and often isolating journey.
The family is a system
The concept of family health acknowledges the physical and psychological wellbeing of a person is significantly affected by the family.
Amid these challenges, family support emerges as a beacon of hope. Research consistently demonstrates strong familial relationships and support systems play a pivotal role in mitigating the adverse effects of mental illness. Families provide emotional support, practical assistance, and a sense of belonging that are vital for people struggling with mental illness.
My recent research highlights the profound impact of mental illness on family dynamics, emphasising the resilience and endurance shown by participants. Families struggling with mental illness often experience heightened emotional fluctuations, with extreme highs and lows. The enduring nature of family caregiving entails both stress and adaptation over an extended period. Stress associated with caregiving and the demands on personal resources and coping mechanisms builds and builds.
Yet families I’ve interviewed find ways to live “a good life”. They prepare for the peaks and troughs, and show endurance and persistence. They make space for mental illness in their daily lives, describing how it spurs adaptation, acceptance and inner strength within the family unit.
When treating a person with mental illness, health practitioners need to consider the entire family’s needs and engage with family members. By fostering open and early dialogue and providing comprehensive support, health-care professionals can empower families to navigate the complexities of mental illness while fostering resilience and hope for the future. Family members express stories of an inner struggle, isolation and exhaustion.
Shifting the focus
There is a pressing need for a shift in research priorities, from illness-centered perspectives to a strengths-based focus when considering families “managing” mental illness.
There is transformative potential in harnessing strengths to respond to challenges posed by mental illnesses, while also supporting family members.
For people facing mental health challenges, having loved ones who listen without judgement and offer empathy can alleviate feelings of despair. Beyond emotional support, families often serve as crucial caregivers, assisting with daily tasks, medication management and navigating the health-care system.
As the Cauchi family so painfully articulated, providing support for a family member with mental illness is intensely challenging. Research shows caregiver burnout, financial strain and strained relationships are common.
Health-care professionals should prioritise support for family members at an early stage. In Australia, there are various support options available for families living with mental illness. Carer Gateway provides information, support and access to services. Headspace offers mental health services and supports to young people and their families.
Beyond these national services, GPs, nurses, nurse practitioners and local community health centres are key to early conversations. Mental health clinics and hospitals often target family involvement in treatment plans.
While Australia has made strides in recognising the importance of family support, challenges persist. Access to services can vary based on geographic location and demand, leaving some families under-served or facing long wait times. And the level of funding and resources allocated to family-oriented mental health support often does not align with the demand or complexity of need.
In the realm of mental illness, family support serves as a lifeline for people navigating the complexities of their conditions.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Amanda Cole, Lead, Mental Health, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Human Connection In An All-Too-Busy World
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Many of us, in many ways, have more discretionary time than ever… On paper.
But rather than the 8-hour block of work of yesteryear, nowadays the things that take our time often come in a series of short bursts that punctuate our day.
This means that while in theory, we have n hours of “free” time per day, we actually have 9 minutes here, 23 minutes there, 1 hour 6 minutes somewhere else, and so on.
Social commitments, meanwhile, tend to require not only that we have time in a block, but also, that the time around that block also be sufficiently free, for travelling, preparation, etc.
The result? “We must do this again, and not leave it so long next time!” we say, sincerely, to the friend whom we will next see again in approximately 17 months’ time.
The problem is how our many theoretically-small obligations reduce the rest of our time to “time confetti”, and that happens on the large scale like we saw above, as well as on the small scale of “Ah, I have an hour to relax between these two things” and then suddenly the time is gone, once again reduced to time confetti:
Time Confetti and the Broken Promise of Leisure
So, how to maintain human connection with people beyond those with whom we live?
Some is infinitely better than none
Let’s say you want to call a friend or relative. There may be generational differences in how much one is expected to arrange this by text first, vs just calling, but either way, you don’t have to have an open-ended block of time, and sometimes, it’s better if you don’t.
Establish, at the start of the call, “Before we get into catching up, how are we for time, by the way? For my part, I’ll have to go by such-and-such a time”, and then work with that.
The benefit of doing this is that you’ll both know enough about the time constraints to use the time appropriately; you won’t run out the clock on smalltalk before getting to something big, and you’ll both come away feeling satisfied that you shared and were shared-with in a meaningful fashion.
In contrast, guessing at time constraints can leave big things clipped off, or else result in someone “looking for a way to politely end this conversation that stopped being interesting a while ago but it’ll seem rude if I say I have to go now”, of the kind that results in someone not being so open to a call next time.
Don’t rush to dismiss texts as a medium for meaningful connection
When text messages were first a thing, you’ll remember how we were all working within a very short character limit and a cost-per-message. It was telegrams for the modern age, basically.
Nowadays, that isn’t so; we can write as much or as little as we like, and this has two benefits:
- We can have longer, meaningful conversations around the other stuff in our life. We can reply in seconds, or after making a cup of tea and thinking about it, or after our grocery-chopping trip, or whenever suits us. Suddenly, time confetti isn’t such a barrier to human connection. Writer’s example: my prime social time in this manner is when I’m cooking dinner (which is often about an hour). There’s no way I could have a phonecall while doing that; my bad hearing notwithstanding, I just have my hands full too often with much else going on. But texting? I can do that in the several-minute gaps between assorted culinary tasks, while I’m waiting for the kettle to boil or the onions to brown or whatever.
- Sometimes, the brevity makes it easier. A quick text saying “Hey, just to let you know I’m thinking of you, and hope your day is going well!”, or “Unrelated to anything: I was just thinking about how I’m glad to have you in my life; you’re a good friend, and I appreciate that more than I often remember to say. Anyway, that’s all; it was just on my mind. I hope your day is going well!”
(The cheery closing words in those last two text message examples help signify: “don’t worry, I’m fine and am not looking for anything from you”, which will help the recipient to relax, and counterintuitively, more likely to reply with some kind words of their own, knowing that they’re not signing up for a potentially deep talk when they also have time confetti issues going on)
Seize the moment (and also let it go)
You probably have many small interactions with strangers, most days. In the store, walking the dog, at the doctor’s office, etc. So, two things:
- Make smalltalk. And if you’re not one for traditional smalltalk topics (weather etc), or even if you are, a level-up is:
- Compliment sincerely. Straight out of “How To Win Friends And Influence People”, of course, but it creates a moment of genuine connection; you say a thing, their day is improved, they smile, you complete your business with a smile of your own and go about your day.
(of course, do steer clear of anything that could be interpreted as flirting, if that is not your intent, and really it should never be your intent when it comes to the captive audience of someone who will get fired if they’re not nice to you)
But, with a little practice, these little moments add up to a lot more human connection than if we treat the strangers with whom we interact as though they were merely part of the scenery.
Want more than that?
Check out:
How To Beat Loneliness & Isolation
Take care!
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What’s the difference between autism and Asperger’s disorder?
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Swedish climate activist Greta Thunberg describes herself as having Asperger’s while others on the autism spectrum, such as Australian comedian Hannah Gatsby, describe themselves as “autistic”. But what’s the difference?
Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD.
Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.
When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of autism spectrum disorder is made.
Where do the definitions come from?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders.
Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4.
In 2013, the DSM-5 collapsed both diagnoses into one autism spectrum disorder.
How did we used to think about autism?
The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder.
Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress.
Kanner and Asperger described different thinking patterns in children with autism.
Roman Nerud/ShutterstockBetween the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism.
The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech.
Today, as a legacy of the recognition of the autism itself, the majority of people diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability.
What changed with ‘autism spectrum disorder’?
The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term.
It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things.
The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”.
The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in.
Why do some people prefer the old terminology?
Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism.
The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, Tony Attwood and Carol Gray, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges.
What about identity-based language?
A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”.
The neurodiversity rights movement describes its aim to push back against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism.
Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.
Alex and Maria photo/ShutterstockThe movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments.
However the social model contrasts itself against a very outdated medical or clinical model.
Current clinical thinking and practice focuses on targeted supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism.
A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.
Andrew Cashin, Professor of Nursing, School of Health and Human Sciences, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Diet Myth – by Dr. Tim Spector
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Why are we supposed to go low-carb, but get plenty of whole grains? Avoid saturated fat, but olive oil is one of the healthiest fats around? Will cheese kill us or save us? Even amongst the well-informed, there’s a lot of confusion. This book addresses these and many such topics.
A main theme of the book is howa lot of it relates to the state of our gut microbiome, and what is good or bad for that. He also discusses, for example, how microbes predict obesity better than genes, and the good news is: we can change our microbes a lot more easily than we can change our genes!
In the category of criticism, he repeats some decades-old bad science in some areas outside of his field (i.e. unrelated to nutrition), so that’s unfortunate, and/but doesn’t detract from the value of the book if we keep to the main topic.
Bottom line: if you’d like to understand better the physiology and microbiology behind why dieting does work for most people (and how to do it better), then this is a great book for that.
Click here to check out The Diet Myth, and learn the science behind the confusion!
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Nicotine Benefits (That We Don’t Recommend)!
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Does nicotine have any benefits at all? I know it’s incredibly addictive but if you exclude the addiction, does it do anything?❞
Good news: yes, nicotine is a stimulant and can be considered a performance enhancer, for example:
❝Compared with the placebo group, the nicotine group exhibited enhanced motor reaction times, grooved pegboard test (GPT) results on cognitive function, and baseball-hitting performance, and small effect sizes were noted (d = 0.47, 0.46 and 0.41, respectively).❞
Read in full: Acute Effects of Nicotine on Physiological Responses and Sport Performance in Healthy Baseball Players
However, another study found that its use as a cognitive enhancer was only of benefit when there was already a cognitive impairment:
❝Studies of the effects of nicotinic systems and/or nicotinic receptor stimulation in pathological disease states such as Alzheimer’s disease, Parkinson’s disease, attention deficit/hyperactivity disorder and schizophrenia show the potential for therapeutic utility of nicotinic drugs.
In contrast to studies in pathological states, studies of nicotine in normal-non-smokers tend to show deleterious effects.
This contradiction can be resolved by consideration of cognitive and biological baseline dependency differences between study populations in terms of the relationship of optimal cognitive performance to nicotinic receptor activity.
Although normal individuals are unlikely to show cognitive benefits after nicotinic stimulation except under extreme task conditions, individuals with a variety of disease states can benefit from nicotinic drugs❞
Read in full: Effects of nicotinic stimulation on cognitive performance
Bad news: its addictive qualities wipe out those benefits due to tolerance and thus normalization in short order. So you may get those benefits briefly, but then you’re addicted and also lose the benefits, as well as also ruining your health—making it a lose/lose/lose situation quite quickly.
As an aside, while nicotine is poisonous per se, in the quantities taken by most users, the nicotine itself is not usually what kills. It’s mostly the other stuff that comes with it (smoking is by far and away the worst of all; vaping is relatively less bad, but that’s not a strong statement in this case) that causes problems.
See also: Vaping: A Lot Of Hot Air?
However, this is still not an argument for, say, getting nicotine gum and thinking “no harmful effects” because then you’ll be get a brief performance boost yes before it runs out and being addicted to it and now being in a position whereby if you stop, your performance will be lower than before you started (since you now got used to it, and it became your new normal), before eventually recovering:
In summary
We recommend against using nicotine in the first place, and for those who are addicted, we recommend quitting immediately if not contraindicated (check with your doctor if unsure; there are some situations where it is inadvisable to take away something your body is dependent on, until you correct some other thing first).
For more on quitting in general, see:
Addiction Myths That Are Hard To Quit
Take care!
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Brazil Nuts vs Cashews – Which is Healthier?
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Our Verdict
When comparing Brazil nuts to cashews, we picked the cashews.
Why?
Looking at the macros first, Brazil nuts have more fat and fiber, while cashews have more carbs and protein. So, it really comes down to what you want to prioritize. We’d generally consider fiber the tie-breaker, making this category a subjective marginal win for Brazil nuts—and especially marginal since they are both low glycemic index foods in any case.
When it comes to vitamins, Brazil nuts have more of vitamins C, E, and choline, while cashews have more of vitamins B2, B3, B5, B6, B7, B9, and K, so while both are great, this category is a clear by-the-numbers win for cashews.
The category of minerals is an interesting one. Brazil nuts have more calcium, magnesium, phosphorus, and selenium, while cashews have more copper, iron, manganese, and zinc. That would be a 4:4 tie, but let’s take a closer look at those selenium levels:
- A cup of cashews contains 109% of the RDA of selenium. Your hair will be luscious and shiny.
- A cup of Brazil nuts contains 10,456% of the RDA of selenium. This is way past the point of selenium toxicity, and your (luscious, shiny) hair will fall out.
For this reason, it’s recommended to eat no more than 3–4 Brazil nuts per day.
We consider that a point against Brazil nuts.
Adding up the section makes for a win for cashews. Of course, enjoy Brazil nuts too if you will, but in careful moderation please!
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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Cleaning Up Your Mental Mess – by Dr. Caroline Leaf
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First of all, what mental mess is this? Well, that depends on you, but common items include:
- Anxiety
- Depression
- Stress
- Trauma
Dr. Caroline Leaf also includes the more nebulous item “toxic thoughts”, but this is mostly a catch-all term.
Given that it says “5 simple scientifically proven steps”, it would be fair if you are wondering:
“Is this going to be just basic CBT stuff?”
And… First, let’s not knock basic CBT stuff. It’s not a panacea, but it’s a great tool for a lot of things. However… Also, no, this book is not about just basic CBT stuff.
In fact, this book’s methods are presented in such a novel way that this reviewer was taken aback by how unlike it was to anything she’d read before.
And, it’s not that the components themselves are new—it’s just that they’re put together differently, in a much more organized comprehensive and systematic way, so that a lot less stuff falls through the cracks (a common problem with standalone psychological tools and techniques).
Bottom line: if you buy one mental health self-help book this year, we recommend that it be this one
Click here to check out Cleaning Up Your Mental Mess, and take a load off your mind!
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