Child Abuse May Change Brain Structure And Make Depression Worse

Author Article

A study of over a hundred people’s brains suggests that abuse during childhood is linked to changes in brain structure that may make depression more severe in later life.

Nils Opel at the University of Münster, Germany, and his colleagues scanned the brains of 110 adults hospitalised for major depressive disorder and asked them about the severity of their depression and whether they had experienced neglect or emotional, sexual or physical abuse during childhood.

Statistical analysis revealed that those who experienced childhood abuse were more likely to have a smaller insular cortex – a brain region involved in emotional awareness.

Over the following two years, 75 of the adults experienced another bout of depression. The team found that those who had both a history of childhood abuse and a smaller insular cortex were more likely to have a relapse.

“This is pointing to a mechanism: that childhood trauma leads to brain structure alterations, and these lead to recurrence of depression and worse outcomes,” says Opel.

The findings suggest that people with depression who experienced abuse as children could need specialised treatment, he says.

Brain changes can be reversible, says Opel, and the team is planning to test which types of therapies might work best for this group.

Journal reference: Lancet Psychiatry, DOI: 10.1016/S2215-0366(19)30044-6

This May Be The Best Way To Help Kids Who’ve Been Through Trauma

Author Article

Why do some children who experience trauma seem to recover naturally over time whereas others develop symptoms of post-traumatic stress disorder and even depression? A new studypublished in the Journal of Child Psychology and Psychiatry has identified one key factor: seeing their own emotional reaction as “not normal.”

Researchers assessed over 200 kids between ages 8 and 17 who’d experienced a traumatic event, such as a car crash, assault, or medical emergency. They interviewed the kids twice, once two to four weeks after the event and again two months after the event, asking them questions about how they’ve been coping with what happened. The kids also completed a survey about what their general emotional well-being and cognitive skills were like before the event had ever happened.

What does a “normal” healing process look like?

The study found PTSD symptoms were actually pretty common earlier in the recovery process, at the two- to four-week mark. “Symptoms of PTSD can be a common reaction to trauma in children and teenagers,” said Richard Meiser-Stedman, a clinical psychology professor at the University of East Anglia in England who led the study, in a news release. “These can include distressing symptoms like intrusive memories, nightmares and flashbacks. Health professionals steer away from diagnosing it in the first month after a trauma because, rather than being a disorder, it’s a completely normal response. … These initial reactions are driven by high levels of fear and confusion during the trauma.”

Generally speaking, though, the majority of the kids healed naturally over the course of the two months without any professional help or interventions.

How much social support they had in their lives and the presence of other life stressors didn’t actually affect their likelihood of having lingering PTSD symptoms. What did? It was the tendency to view their own response to the trauma as being abnormal, a sign of weakness, or a sign that they were “permanently damaged.” That self-judgment was the key predictor of PTSD.

“The young people who didn’t recover well, and who were heading down a chronic PTSD track two months after their trauma, were much more likely to be thinking negatively about their trauma and their reactions—they were ruminating about what happened to them,” Meiser-Stedman explained. “They perceived their symptoms as being a sign that something was seriously and permanently wrong with them, they didn’t trust other people as much, and they thought they couldn’t cope.”

That means one of the biggest ways we can support young people who are recovering from trauma is to normalize their pain. It’s vital to make sure they know that there is nothing wrong with feeling deeply distressed by what’s happened to them and that it will likely take some time before those emotions settle. Trauma certainly can change you, but it by no means “permanently damages” you.

The difference between ruminating and grieving.

Importantly, the study also found that “overthinking” the trauma was also linked to worse PTSD: “The children who didn’t recover well were those that reported spending a lot of time trying to make sense of their trauma. While some efforts to make sense of trauma might make sense, it seems that it is also possible for children to get ‘stuck’ and spend too long focusing on what happened and why,” Meiser-Stedman explained.

Past research has shown our minds generally have a tendency to ruminate on negative events, and that rumination can be disastrous for our mental health. The researchers were hesitant to give any recommendations related to how to process trauma since the risk of “overthinking” can lead to worse outcomes, but at the same time, not processing your pain at all is generally a ticket to growing up with unresolved emotional issues that lead to more reactivity, relationship problems, and poorer health as an adult.

Transformation coach Sheryl Paul offers a good way to understand the difference: Replaying scenes over and over from the negative events in our lives and thinking about why they happened isn’t necessarily the same as emotionally processing your trauma.

“Ruminating isn’t grieving. Thinking isn’t grieving,” she writes at mindbodygreen. “Grieving is an embodied experience that moves the pain out and through, whereas ruminating is a ‘head’ experience that keeps the pain stuck. Ruminating—that is, obsessively going around and around in your mind on one particular storyline, like thinking about what you or the other person did ‘wrong’—creates mental stagnation and prevents the grief from moving through you, thus preventing you from moving on.”

To help kids (or anyone) heal from trauma, make sure they know it’s OK to sit with their pain and feel it. They shouldn’t spend all their time dwelling on what happened—it’s important to be able to also resume life’s activities to be able to access a brighter mood again and reconnect with their other emotions—but normalizing the grieving process is absolutely necessary.

Childhood Trauma Exposure Is All Too Common

Author Article

A long-term study of 1,420 people finds that childhood trauma is more commonplace than is often assumed, and that its effects upon the transition to adulthood and adult functioning are not only confined to post-traumatic stresssymptoms and depression, but are more broadly based.

These conclusions were reported on November 9, 2018, by a team led by 2009 BBRF Young Investigator William E. Copeland, Ph.D., of the Vermont Center for Children, Youth and Families at the University of Vermont. He and his colleagues are part of the Great Smoky Mountain Study, a study of children in 11 mainly rural counties in North Carolina.

Beginning in 1993 and continuing through 2015, the study annually observed 1,420 children, selected randomly from a group of 12,000 local children, through age 16, and again when they reached ages 19, 21, 25 and 30. Results are based on analysis of over 11,000 individual interviews. The sample was designed to over-represent frequently overlooked rural and Native American communities.

One striking perspective emerging from the study is that “it is a myth to believe that childhood trauma is a rare experience that only affects few,” the researchers say. Rather, their population sample suggests, “It is a normative experience — it affects the majority of children at some point.” A surprising 60 percent of those in the study were exposed to at least one trauma by age 16. Over 30 percent were exposed to multiple traumatic events.

“Trauma” for the purpose of the study included violent events (e.g., the violent death of a loved one, physical abuse or harm, war or terrorism, captivity); sexual trauma; witnessing a trauma that caused or could have caused death or severe injury; learning about a traumatic event involving a loved one; and other traumas, such as diagnosis with a serious illness, serious injury, or fire.

“Our study suggested that childhood trauma casts a long and wide-ranging shadow,” the researchers say, associated with elevated risk for many adult psychiatric disorders affecting many “important domains of functioning,” with impacts in the form of diminished health, financial and academic success, and social life.

The impact of trauma across the lifespan has been noted in many past studies. The newly reported study, appearing on the website of the Journal of the American Medical Association (JAMA), differed, because it followed children from year to year. Prior studies relied upon memory-based reports of childhood events made by participants during their adulthood, which tend to be less accurate. The new study also statistically compensated for the presence of other childhood factors that often co-occur with childhood trauma, such as poverty and family instability or dysfunction.

The researchers say their results are consistent with an “accumulation” model of trauma that assigns increased lifetime risk of psychosocial impact with each additional traumatic exposure during childhood. While they do not shed light on the question of which children are more likely to experience trauma, the team hopes the results will inform public policy, via “interventions or policies that broadly target this largely preventable cluster of childhood experiences.”

The research team included: E. Jane Costello, Ph.D., 2009 Ruane Prizewinner and 2007 BBRF Distinguished Investigator; and Edwin J.C.G. van den Oord, Ph.D., 2002 BBRF Independent Investigator.

For Childfree Women, the Personal is Political

Author Article

In our book A Womb of Her Own (Routledge, 2017) author Adi Avivi writes as follows:
The fourth and last construct presented in this discussion addresses the political aspects of child freedom. The construct’s title is drawn from the feminist mantra “the personal is political,” a phrase attributed to different writers of the second feminist wave. Although its exact origin might not be clear, its meaning is important. The phrase indicates that people’s personal decisions and private conduct have profound political implications. When a woman makes a decision regarding work, family, dress code, or choice of language, she is choosing to express her acceptance or rejection of social norms. This is, of course, a simplistic view, as the choice to perform similar acts can have different meanings for different people. For example, choosing to get married could be a defiant act if family or society disapprove of the pairing; marriage could also be an act of submission to the most rigid and oppressive social norms.

Intersubjective Theory: Social and Political Implications
Benjamin (1988) discusses the social and political implications of her intersubjective theory. She claims that in U.S. society, the narcissistic fear of surrendering one’s power over other humans is the source of political, social, and personal cruelty and oppression. Our society idealizes the father-image, which includes aspects of individualism, separation, and domination and devalues the mother-image of connectedness, closeness, and dependency. However, both needs exist in every human, regardless of their sex and gender. The masculine image requires men to maintain rigid separation from others, and in doing so, reject their need for connectedness and closeness. If they address these “feminine” needs, they will have to acknowledge their identification with the maternal. They, therefore, can only tolerate rigid definitions that will simplify their relationships with others. Such definitions help maintain hierarchy by engendering a sense of omnipotence among those who believe they are fitting the only permissible role in the absence of choices. Other options can be classified as deviant or in some cases rejected altogether or even declared illegal. Allowing others to be different but similar, close but separate, independent but needed is impossible when one depends on narcissism and a fantasy of omnipotence in order to maintain a coherent sense of self.
However, the other continues to exist. The participants expressed a desire to contribute to the growing knowledge about CF women, adding that they wanted their voices to be heard. They hoped to dispel misconceptions and misunderstanding, helping non-childfree individuals, policymakers, religious leaders, and mental health professionals to see childfreedom for what it really is: a diverse and rich community with culture and values, made up of individuals who cannot be fully understood or explained by their childfreedom alone.

Comments by Participants
They hoped that social acceptance would reduce the resentment and bitterness some childfree individuals felt while inviting people who might benefit from CF life to entertain it as an option:
S8: “On a less realistic note, I’d like to think that research like this is a big step in changing the way people talk to and about the childfree and the choice to reproduce. It would be nice if people asked ‘are you going to have kids?’ instead of ‘when are you going to have kids?’ and say ‘If you have kids’ instead of ‘when you have kids’. If the dreaded ‘bingo’ went away tomorrow, it would make life so much easier.”
S13: “I’m hoping to bring attention to the cruel and dismissive remarks (‘bingos’ and otherwise) we childfree experience on the Web and real life, and to dispel the myths behind the most common bingos. I hope research shows that we are just as human as the next woman, that there is nothing missing or wrong with us, and that parenthood is not for everyone nor should it be.”
S15: “I am eager to see more exposure of the experiences of those living childfree. My hope is that as information about CF living grows, that more young people will take the time to consider the choice to have children rather than just having kids without thought. So many people are brainwashed into thinking it’s a rite of passage…”
Most participants talked about being discriminated against or misunderstood, and those who did not feel this way still mentioned incidents in which they were met with bewilderment and disbelief. All participants reported that other childfree individuals they met online constantly talked about the discrimination, insults, and rejection they felt. This was especially true when the women were in their mid-twenties to mid-thirties, if they had recently married, or if they lived in smaller, more rural locations.

Tolerating the “Other”
Allowing others to be different requires a capacity to tolerate pain, because seeing other options puts a spotlight on one’s limitations. This, according to Benjamin (1988), is true on the individual level, the community level, and the state and country level. Throughout history, the inability to tolerate the “other” and the need to make “me” the only option have pushed nations to wipe out other groups, to deny human rights, and to demand conformity explicitly and implicitly. Benjamin states that both patriarchal hegemony and some feminist worldviews demand that women be mothers and color the maternal role as the source of feminine power. If a woman is not a mother, the patriarchal social order is in danger. Also, the unique power of reproduction as a defining symbol of female supremacy is threatened when capable individuals live fulfilling lives without reproducing. However, the participants of this study conveyed that having childfreedom as an equal option will not ruin humanity or take away feminine power. In fact, it will allow for the definition of what is human to be expanded and offer greater choice for women.
For example, some participants expressed moral and political concerns, saying that while the pronatalist culture ostensibly focuses on children, it actually centers on the concept of future children rather than already living children who are in need. When thinking of the consumption of resources created by every Western child in comparison to children in Third World countries, the moral implications of pronatalism in industrial countries is disconcerting. Promoting motherhood as the preferred choice for everyone is actually a failure to recognize the needs of millions of other, less visible children, in communities whose resources are often abused by Western countries.
Indeed, public and political forces are involved in reproduction. That involvement manifests in campaigns around abortion rights and access, controversy over economic entitlements, workplace policies and employment benefits, and religious freedoms. Because the CF choice is not valued or even accepted in many cases, CF women suffer discrimination both socially and legally. For example, sterilization laws in many places do not support women’s desire to cement their childfreedom (Richie, 2013).

If You’re Not Interested In Having Kids Ever, You’ll Notice These 3 Things About Yourself

Author Article
Sarah Ellis

Hello, my name is Sarah and I really don’t want kids. I’m getting to the age where a lot of my friends have baby fever, and even if they aren’t considering children just yet, they’re excited about the prospect of being a parent down the road. But as for me, I’m not interested in having kids ever, and I’ve always felt this way. Does this make me totally unusual or abnormal? Sometimes, I wonder. But I just don’t feel like parenthood is part of my calling in this world.

Thankfully, I’m not alone, according to the therapists I spoke to for this story. It’s completely OK not to want children, despite the pressures society sometimes puts on us to feel otherwise. Listen to your instincts! “If your gut is screaming ‘no’ even when everything around you (your partner, your parents, society) are saying yes, do yourself a favor and listen,” says Rachel Zar, AMFT, relationship and sex therapist. “Being honest with yourself and with your partner … is the best way to make an authentic and intentional decision.” There are several signs to pay attention to that might signal you’re not interested in having kids. Here are three of the major ones.

YOU WANT TO KEEP YOUR LIFE EXACTLY AS IT IS.

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“If having your life turned upside down for another person does not feel worth it, it [parenthood] may not be for you,” says Nicole Richardson, LPC. Having kids is a huge change in so many ways, and if you don’t see that happening, you may not want to take that step. If your career is thriving, your relationships are thriving, and you really don’t want to shift things around, it might not make sense to bring kids into the equation.

YOU FEEL A STRONGER PULL TOWARD OTHER PASSIONS.

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Got other things in your life that feel like a priority? You do you! “If you experience a pull to focus your life energy in other ways, such as career path, social relationships, traveling the world, or life with your partner, and don’t see children as a piece of that picture, you must give yourself permission to want that life and know that it’s OK,” says Liz Higgins, MS, LMFT. Higgins notes that sometimes people feel judgment from others about their decision not to have kids, simply because other people may not understand it. But you have to trust yourself and do what feels right for you.

YOU ONLY WANT KIDS BECAUSE YOU FEEL PRESSURE FROM OTHERS.

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I could say this a million times, but your life is up to you! There’s nothing worse than feeling like you have to do something to live up to other people’s expectations. “If you know in your heart of hearts that you don’t need children in order to feel fulfilled in life, or if you believe that you contribute to the world and gain satisfaction in other ways, then don’t rush or force yourself into parenthood because you think it’s the next step you’re supposed to take,” Higgins advises. “Don’t succumb to pressure from friends or family if you know there’s a voice inside leading you to another path.” No one know you better than yourself, so do what feels best for you and your life.

Whether or not you choose to have kids, there are so many ways to feel fulfilled and contribute positively to the world around you. For me, I know that writing is what I love more than anything, and I want to keep space open to help others through my words. For you, maybe it’s travel, or career, or even prioritizing a relationship with your partner! You don’t have a make a decision right now, and that’s totally okay, but just know that you are whole and complete no matter what you decide. Trust your gut!

25 Thoughtful Anxiety Books For Kids

Author Article
By ALICE NUTTALL

I was always a nervous kid. I spent a lot of time at school worrying about whether my friends actually liked me, and then, when I moved to a new school, about whether I would make any friends at all. When I grew up, I was eventually diagnosed with general anxiety disorder, along with a dollop of social phobia just to spice things up a little. Finding anxious characters in books has helped me process my own feelings. Here’s a list of excellent anxiety books for kids, which deal with all forms of worry and fear, and which can help young readers realise that they’re not alone.

1. HOW BIG ARE YOUR WORRIES, LITTLE BEAR? BY JAYNEEN SANDERS

How Big Are Your Worries, Little Bear? coverIn this gorgeously illustrated picture book, the worrier Little Bear is afraid of lots of different things. With the help of Mama Bear, he learns to work through his fears, and realise that his worries aren’t as big as he initially thought.

2. SAM WU IS NOT AFRAID OF GHOSTS BY KATIE AND KEVIN TSANG

Sam Wu has a long list of fears – ghosts, sharks, the dark, and much more. But he’s determined to prove to his classmates that he’s not a scaredy-cat, and that he can, in fact, be a hero. Written by a husband and wife team, this laugh-out-loud series explores childhood fears that might look a bit silly and funny to outsiders, but are very real to the kids experiencing them.

3. WHAT TO DO WHEN YOU’RE SCARED AND WORRIED BY JAMES J. GIST

This nonfiction guide for kids can help them learn strategies to deal with worries, anxiety, and even panic attacks. Giving them plenty of resources to deal with small fears on their own, it also serves as a useful reminder that kids can always seek help from adults for larger problems.

4. BOY IN THE TOWER BY POLLY HO YEN

Ade has to deal with the disappearance of his best friend, and a species of evil plants that are trying to destroy humanity – but he also has to manage the fact that, following an attack, his mother is so anxious that she can no longer bring herself to leave their flat. This book is ideal for children with family members who suffer from severe anxiety.

5. I CAN DO HARD THINGS BY GABI GARCIA

This book of mindful affirmations is another useful resource for kids who are learning to deal with general anxiety. With accompanying downloads and other activities, Gabi Garcia’s book is a great way for parents or teachers to help kids work through their anxieties, and come up with strategies to deal with their fears.

6. WHEN MY WORRIES GET TOO BIG BY KARI DUNN BURON

Another nonfiction book for young kids, this one focuses on relaxation techniques that children can learn so that episodes of anxiety or nervousness don’t derail their entire day.

7. JONATHAN JAMES AND THE WHATIF MONSTER BY MICHELLE NELSON

By turning worries into a (quite cute and cuddly) creature, Michelle Nelson’s book helps children identify their worries as being just thoughts, rather than a reality. Young readers will learn that “What if?” doesn’t have to be a scary question.

8. TIFFANY SLY LIVES HERE NOW BY DANA L. DAVIS

One for older children, this story deals with grief, loss, and complex family relationships. Tiffany is recovering from the death of her mother, and has to leave the town she’s lived in all her life to move in with her estranged father. To move forwards and thrive, Tiffany has to learn to manage the grief, stress and anxiety that she is experiencing.

9. AM I NORMAL YET? BY HOLLY BOURNE

First in a trilogy about three fantastic, feminist friends, Am I Normal Yet? follows Evie, a teenager attempting to live a “normal” life in the face of her ongoing struggle with OCD. Written by an author who worked with kids who deal with mental illness, this teen novel takes a frank look at the effects of severe anxiety and OCD.

10. OUTSMARTING WORRY BY DAWN HUEBNER

Aimed at ages 9–13, this manual for dealing with anxiety and worry is invaluable to any kid who often finds themself caught in an anxiety spiral. It’s also a useful resource for any adults who want to find ways to support their anxious tween.

11. WILLIAM WOBBLY AND THE VERY BAD DAY BY SARAH NAISH

In this book for parents of very anxious young children, the main character William deals with attachment disorder following traumatic experiences in his early life. This picture book is a great resource for when anxiety affects the whole family.

12. THE LION INSIDE BY RACHAEL BRIGHT

A great read for kids who feel a bit too small, this story about a brave mouse finding his voice is a fantastic way to approach the idea of courage taking different forms. The Lion Inside is the ideal book for children who are anxious about speaking up.

13. THE TRUTH PIXIE BY MATT HAIG

Matt Haig has written about depression, anxiety and other mental illness in his adult books, but The Truth Pixie translates these concepts into a fun, rhyming story that young readers can understand. Following the story of a pixie that can only say true things (unsurprisingly), this story looks at how anxiety-inducing, but ultimately necessary, it can be to face up to the truth.

14. THE 10PM QUESTION BY KATE DE GOLDI

Frankie Parsons has a head full of questions, many of which worry him. His mother is the only person he can talk to about them, but she’s also the source of his greatest worry. The 10pm Question is an excellent, heartfelt examination of ways that two anxious people can love and support each other while taking care of their own mental health.

15. BOYS DON’T CRY BY MALORIE BLACKMAN

Another great resource for kids with an anxious family member, this teen novel focuses mainly on the trials and tribulations of being a very young father. However, there’s also a strong element of dealing with anxiety in a subplot featuring Adam, the younger brother of main character Dante, who has to grapple with anxiety following a homophobic attack.

16. ANXIETY RELIEF FOR KIDS BY BRIDGET FLYNN WALKER

A great resource for anxious kids and their families, this CBT-based workbook offers a great deal of advice, and helps families come up with strategies to help children manage anxiety. The author is a mental health professional who has worked extensively with children.

17. A QUIET KIND OF THUNDER BY SARA BARNARD

Aimed at teen readers, this novel features two protagonists with disabilities, and doesn’t shy away from exploring the anxiety they face living in an ableist world. With a strong central romance, A Quiet Kind of Thunder is a fantastic read for teens.

18. THE SCIENCE OF BREAKABLE THINGS BY TAE KELLER

This middle grade novel, with a sparky, science-loving heroine, is another great read for kids who have family members who live with mental illness. Protagonist Natalie tries to “save” her mother from depression and anxiety, and discovers that supporting someone isn’t always an exact science.

19. FACE BY BENJAMIN ZEPHANIAH

In this book for teens, protagonist Martin has to deal with the emotional fallout after his face is badly scarred in a car accident. Martin goes from popular and confident to reclusive and anxious, and has to try to regain his confidence in a hostile world.

20. COPING SKILLS FOR KIDS WORKBOOK BY JANINE HALLORAN

With over 75 anxiety-busting strategies, and plenty of worksheets and resources, this workbook is a useful primer on CBT, and a fantastic resource for children and their families.

21. FREE VERSE BY SARAH DOOLEY

Sasha Harless is dealing with the loss of her brother, and finds refuge in writing poetry. This highly acclaimed teen novel shows readers creative ways of processing their anxiety, grief, and other emotions.

22. KITE SPIRIT BY SITA BRAHMACHARI

Kite is dealing with the aftermath of her best friend’s death by suicide, and has gone from a happy, confident teen to living with guilt, anxiety, anger and frustration. After a move to the countryside, Kite processes her feelings, finding the time and space to grieve.

23. THE ANXIETY SURVIVAL GUIDE FOR TEENS BY JENNIFER SHANNON

Aimed at older readers than the previously mentioned nonfiction guides, The Anxiety Survival Guide for Teens is another useful, CBT-based resource for youngsters dealing with anxiety, panic, and social phobia. The book teaches strategies for ending anxiety loops and dealing with worry.

24. FINDING PERFECT BY ELLY SWARTZ

One of a startlingly small number of books about OCD for middle graders, Finding Perfect tells the story of 12-year-old Molly, who tries to keep control of her world through tidying, organising and routine. Molly is a relatable protagonist not just for kids with OCD, but any child struggling with anxiety and worry.

25. GHOST BY JASON REYNOLDS

Castle Cranshaw, also known as Ghost, is a speedy sprinter on his middle school track team, but he feels like he’s been running his entire life – particularly from the memory of his violent, abusive father. Dealing with PTSD and the aftermath of violence, this book is an important read for teens dealing with anxiety following trauma.

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