Final Thoughts

As I reflect over the past few months and all that I have read and learned a few things stand out in my mind that i would like to share.

The first is that one can never assume they know a person from first glance.  People's life story are complicated, filled with unknown reason and influenced by not only those around them by society in general.  One can not know the hidden potential that lies dormant in those we see at the grocery store or at the gas pump.  No one knows the the joys or the sadness of another by a mere glance.  It when we go out of our way to lovingly serve and help another that we begin to see them clearly.  Sometimes what we may see will startle us as we realize they are not what they seem to be.  Everyone has a story to tell and a life lesson worth the price of listening and respecting.  Not all stories have happy endings but they all have meaning.   Mother Teresa said that "The poverty of being unwanted, unloved and uncared for is the greatest poverty".  This kind of poverty occurs within every social class regardless of ethnicity, culture, race, creed, religion or other social system structure.  Unbiased caring is the remedy.  While I will never be as unselfish as Mother Teresa, she is still an example of how a willing pair of hands can make a difference across the world.  If everyone felt wanted and loved would we have the crime, substance abuse, physical and emotional abuse or any other negative social issue today?  I can not say that they would completely disappear but I do believe their prevalence would decline.  So, the moral is that being non-judgmental is really love in action.

The next lesson I learned is that one has to seek for knowledge or understanding, it does not grow on any tree or magically appears from out of nowhere.  As I have read and read and read and read, ideas and question come to my mind that lead me to conclusions and more questions.  Asking questions and seeking others impressions are also helpful.  To truly understand a phenomena one must first believe they know nothing so as to be able to learn something.  Beginning in this manner one is open to possibilities that otherwise would be hidden from bias or preconceived notions.  Truth will always be true, so with patience one may obtain knowledge.  Knowledge has the power to change actions which decide destiny.  So, if you want to change your destiny or future, seek for understanding and you will make wise choices that will improve your  self and your future. 

Last lesson learned is that success is allusive and not easily obtained.  Substantial success requires time, patience, perseverance, and  most of all hard work.  The age old adage of nothing is life worth acquiring comes easily applies to success.  Growing up my Dad would always tell us that actions lead to opportunities.  Knowing what actions lead to the desires outcome can guide us today and in the future.  Hard work is suppose to be hard.  Our desire and fortitude  are tested as obstacles along they way trip us up.  At times we will feel like giving up, but if we just move forward towards a goal that goal with every step is that much closer.  Success's sweetness comes from the price each of us personally pays, and that price is high. 

In the end, I learned that life is a journey with a million destinations and I get to chose the path and how I travel.  I am including the video below as a reminder that once person can help another feel wanted and loved.  We do not have to settle for a lonely world but we can move forward and use our abilities to help another.  Knowledge that does not serve to lift others is knowledge wasted and opportunities lost.  The choice is ours.  One person can make a difference.

Depression and Family Life

   I recently read two articles that brought forth two different dimensions of how depression affects family life. The first article was from the perspective of the ill parent and the second was from the child viewpoint of the affected parent. Both of these perspectives combined can give insight into the dynamics of depression within the family. Both of these studies were conducted by the sane research team in Sweden as part of a larger study that focused on Major Depressions per DSM IV criteria and the effect on family life. 

   The first study focused on the ill parent and their perceptions and feelings in order to find the meaning of major depression (MD) on family life.  Researchers found those parents with MD feel a constant struggle that is external as well as internal (Ahlstrom, Skarsater & Danielson, 2009). The daily battle or struggle faced by those affected by MD caused feelings of worthlessness, insecurity, hopelessness, and unsatisfied with life.  While family means a lot to those suffering with MD the fact that they let people down as well as feeling unneeded were deeply felt (Ahlstrom, Skaraster, & Danielson, 2009).  The internal battle to feel self-worth created a limited focused around personal flaws or issues placing family life in the back seat.  This is not to say that family unimportant but that their intense struggle within themselves inhibits them from seeing the outside effect on others. As moments of clarity occur, the ill parent often becomes overwhelmed from  negative consequences inflicted from depression on loved ones.  This may increase suicidal thoughts while deepening depression perpetuating a cycle that destroys perceived family and personal happiness. It is important to remember that depression is not always self-inflicted. Genetics and environment influence depression and are out of the control of those with MD.  Depression as seen by suffers is an illness that was not wanted but always there.  Dissatisfaction with life intensified as daily tasks went unaccomplished creating questions of usefulness and personal meaning.  One surprising aspect was the feeling of losing dignity as suffers sought treatment. The fact psychiatric services were required but not always  accessible augmented the lack of dignity and worth they desire to achieve.  The idea that asking for help is a weakness that diminishes dignity while not true may feel true when one must swallow pride and self-worth(which is lacking already) in order to receive treatment from strangers.  Out of everything I read, the fact dignity was what was desired really caught my attention.  Isn’t that what every soul is seeking, validation of worth in the sight of themselves and those important to them?  This struggle is real but for some the battle is  perceived as impossible and difficult win. 

    The second article also by Alhstrom, Skarsater, & Danielson (2011) sought the child’s perspective on family life with a parent who suffers from major depression.  The children all have feelings of love and care for the parent affected by major depression.  Children suffered when their parent suffered.  Feelings of fear that they might lose their parent were keenly felt and always in the back of their mind.  The environment created by depression co-existed with them like a “dark shadow on everyday life” (p. 562)  and is felt into adulthood as a sense of powerlessness.  Children desired to help but were unsure of how to be useful.  Children knew to look for signs of their parent’s depression worsening and changed their expectations to match the signs identified.  Signs such as finding their parent asleep from doing nothing, their parent withdrawing from participation in family life, or noticing the sadness felt by their parent all changed how the child felt.  Children whose parent suffers from MD live in fear of depression worsening or another attempt to commit suicide. Fear of not being there when needed caused mixed emotions in them as they grew older.  Lack of social activities may increase feelings of being miserable at home while intensifying feelings of responsibility to their parent suffering from MD.  Lack of family interaction created doubt in children about their ability to connect as a family as they felt excluded from the depressed parents life (Alhstrom, Skarsater Danielson, 2011).  Children were seen to have “a sense of responsibility accompanied by sensitivity and compassion, and as sense of loneliness accompanied by emotional imbalance and lack of familiarity. MDD pushes children into the position of the observer, and diminished reciprocity” (Alhstrom, Skarsater, & Danielson, 2011, p. 565).  Alhstrom et al. (2011) noticed the importance of reciprocity between the affected parent and their children. The children desire for interchange of communication and actions untainted by depression.  The lack of interaction diminishes level of closeness felt.  Children yearn to feel close to their parent and when they do not have that bond, loneliness may deepen.

   From this study, one may begin to see why children of depressed mothers are more inclined toward depression versus those whose mothers who do not experience depression. The lack of interaction and engagement with the desire for validation is felt for years and can cause children to feel deep loneliness and powerlessness as they long for their mother to recover.  

From these two studies one can begin to see how family life within the perspective of depression.  As parents seek dignity and children long for parental reciprocity, family life suffers from inattention and inability to change or fix issues that are deeply personal and difficult to alter.  What both seek is acceptance and actions of love from each other.  What I find is sad is that on both sides guilt is felt from the lack of connectedness between each other.  Family life is altered and becomes in a sense a burden and the answer.  They parents and children lack the knowledge of how to help each other because communication lines are shut down and may even be non-existent. Depression is a personal issue with real effects on family life.

References

Alhstrom, B. H., Skarsater, I., & Danielson, E. (2009). The meaning of major depression in family life: the view of the ill parent. Journal of Clinical Nursing, 19, 284-293. doi: 10.1111/j.1365-2707.2009.02851.x

Alhstrom, B. H., Skarsater, I., & Danielson, E. (2009).  Children's view of a major depression affecting a parent in the family.  Issues in Mental Health Nursing, 32, 560-567. doi: 10.3109/01612840.2011.579689

Research and Servce Learning Project

As a student at UAB I have the opportunity to actively participate a service learning research project.  This project has taken many different turns and at times I wonder if I will ever be active or experience research at the level I desire.  I have learned a few things as I have waited.  Research takes time and requires a lot of thoughtful preparation and perseverance.  If the IRB approval process is not enough don't worry, there will be issues that will come up requiring time and patients.  Research may also benefit from a community partner who can assist on multiple levels and serve as a liaison for your research project on a community level.  The choice of a community partner is crucial for success, especially if interventions are being tested.  When research questions initially are written, the input from your community partner can assist you in making the questions culturally appropriate and with words that convey desired meaning. Community partners can also bring with them knowledge of the community that will help the researcher understand the population holistically. 

While I have not yet been able to accomplish my intended goal, learning does not have to stop or stagnant until then.  Continuously reviewing literature regarding the research subject can enhance understanding of various aspects.  The subject I chose was maternal depression and the effect on children.  I have read articles about maternal depression, social determinants, poverty cycles, teen pregnancy, internalizing behaviors of children whose mothers are depressed, family support effects, and various other aspects affecting the depression cycle of individuals and their children.  From this review, I have come to a few conclusions or perhaps biases.  One conclusion is that no intervention can solve all the internal and external factors that perpetuate depression and its effect on society.  Another conclusion is that depression affects all of society; no one is immune to the effects of depression.  The last conclusion is that depression does not have to be a multigenerational cycle.  The cycle can be stopped. 

While my SLP goals are not yet accomplished, I am learning and striving to achieve my goals.  Perseverance until that time is the goal.  Keep your fingers crossed that this semester does not end before my goals are realized. 

Social Media and Social Well-being

I found this article that took me by surprise.  It is from Deseret News writer Mandy Morgan.  The article is about research that has been done on the affects of social media.  I have inserted the link to the article for you to read.

 http://www.deseretnews.com/article/865562692/Social-well-being-of-tween-girls-negatively-affected-by-use-of-social-media.html?pg=all

So, the question what does this have to do with depression and women?  Nothing right this instant.  I do have questions though.  If women are more social than their male counterparts and they suffer from depression more often---what will lack of personal social contact do to depression rates?   The article stated that the more tween girls spend with social technology the more unhappy they are.  Social eye to eye contact does more than just communicate here I am.  The ability to interact and understand others body language is a skill that if not developed could have serious ramifications as a working adult.  The social skills for the 21rst century are different from the last. Today, the ability to use technology is absolutely a mandatory requirement.  Yet, the implications on how technology motivates and stagnates society is yet to be determined.  Will there be an increase in depression rates across the board from the decreased personal interaction, perhaps.  How many people have groaned at the mindless postings of friends on Facebook about how they just filled their car with gas?  Meaningful communication can occur via social media but is it an equal substitute for personal interaction?  Even the articles study findings found that when friends are present with you, the relationship is ranked as more important than a social media friendship.  For somethings, technology just can not improve on the real thing.  
 

Teenage Depression

I am sure you have heard or seen the commercial stating that "Depression hurts".    While at first you might wonder, "Depression.......hurting???"  Once the light bulb goes on,  you realize that mental anguish is also physical so yes, depression can hurt.   So, what do teens have to be depressed about?   By simply remembering your teenage years, you know why teenagers can become depressed.   The constant need to perform and to live up to expectations permeates the teenage life.  Not every teenager is going to feel that they measure up to the level of expectations placed on them by their parents, family, friends, school, and society.   Teenagers might also not know that what they are feeling is depression  versus a phase that will go away.  The lack of knowledge about available resources is also a concern that needs to be addressed.  One interesting fact is that 14-17 year old teenage girls have higher incidence rates than boys that same age.   Whether this has to do with hormone levels and gender differences, is not known.  One interesting issue is that teen depression does not present in the same way as adult onset depression.  For this reason I have included the following video that shows how depression differs with age.  I learned a lot and I hope you do as well.

A friend of mine told me of an experience she had with a young teenager who was prescribed medication to help with sleep.  Two side effects of the medication are suicidal ideation and tartive dyskinesia.  The teenager after taking this new medication for a week developed both.  Why do I bring this up?  Because the chemistry within the brain is sensitive to changes or imbalances.  These imbalances or changes can result in symptoms that are not of the individuals creation but from stimulus out of their control.  I found this one piece of information astounding.  I had never connected the fact that sometimes people experience their symptoms side effects.  Medications are chemicals and when ingested and metabolized they will change the user by producing either a desired effect or one that is unintended.  For this reason it is extremely important for clinicians to listen to their patients about how medications are making them feel.  Good education about the medications prescribed is extremely important in order for individuals to take medications appropriately and responsibly.  There are a lot of wonderful medications that enhance and enable people to live happier purposeful lives.  We should not throw the baby out with the bathwater, but rather be proactive in seeking information regarding the medications we take.   Today depression is treatable with medications that less than 20 years ago did not exist.  These new medications have given clinicians options in treating depression and other mental illnesses.  While depression hurts, there are options available that stop the pain.

Teenage Pregnancy in the United States in 2012

Teenage pregnancy has long been an issue in the United States.  Other countries similar to the US have drastically lower rates of teenage pregnancy.  Why is their such a difference?  Is it because European schools talk openly about sex and options for prevention?  Perhaps, it is because parents in other countries communicate more openly about this topic.  Then again, it could be that religion plays a greater part in the lives of teenagers outside of the US.  Why teenage pregnancy happens is a BIG question that is as varied as the teenager’s pregnancy story. 

The Candies Foundation is committed to prevention of teenage pregnancy.  On their website, you can read the stories of young girls who became mothers at a young age.  Some became pregnant on purpose but for most it was a total life altering shock (Real stories, 2011). The reality in America is that 3 out of 10 girls will become pregnant by 20 years of age (Shuger, 2012).  Teenagers between the age of 18-19 have higher prevalence rates than their younger counterparts.  They are also more likely to state they are in a serious relationship more than those between 14-17 years of age.  Teenagers in their senior year of High School are making decisions that will affect them the rest of their life.  Where they go to school, what their major will be, will they leave the state or stay close to home, financial concerns on how to afford their college education, do they even want to go to college, what about their first job, and the car they dream about owning are just a few of the choices they are faced with.  This stage of transition into young adulthood is characterized with fear, stress, optimism, and a growing realization that reality is not what you thought it was. Just imagine putting a newborn into the mix and the potential stress level is astounding.  The level of responsibility for these young mothers changes overnight.  They were hanging out with friends and then instantly they are different from their peers.  It is the perfect set-up for depression to sneak in and grab hold.  Maternal depression affects girls that are young, have little education, poor perceived support, and are relatively poor.  I do not know a single teenage girl that has earned a doctoral degree and their first million by the time they are 19 years old.  Some young women are incredibly smart and go to graduate school early compared to their peers.  Most teenagers just want to be “normal” and do what their friends are doing.  Acceptance is a term used with this age group.  They don’t want to be the one that is left out or different because they are too smart, have glasses or an acne issue.  They definitely feel the influence from their friends and peers at this age and will make some decisions that are not wise or prudent.  Yet, life lessons learned through the prism of failure can keep teens moving in a positive forward manner.    

According to The National Campaign to Prevent Teen and Unplanned Pregnancy, a teenagers parents influence them to a greater degree than perhaps parents realize.  In fact when teenagers are asked who influences them the most they say their parent’s followed by their friends.   Parents and teenagers may not know how to talk about this sensitive subject with each other.  This difficult subject may make young girls uncomfortable and uneasy when their parents talk to them openly about it.  They may act as if they don’t care but if they become pregnant it is too late to talk about prevention.  Parents have a difficult time as well addressing the possibility that their teenage daughter might one day become pregnant.  They may not have the right words or be able to confront their daughter about the possibility of pregnancy.  For this reason The National Campaign to Prevent Teen and Unplanned Pregnancy has created a discussion guide titled “Too Young” to help parents be prepared to talk openly about this sensitive subject (Too young, 2004).  Perhaps this will help open communication lines and allow young girls to talk more openly with their parents about not only sex but also drugs, their friends, and their emotional well-being.   

I have included the following two video because it shows just how devastating teenage pregnancy is  with facts.  I also wanted to show that these are real people just like you and I, dealing with real overwhelming problems.  You may say that they should have known better, but that doesn't change the fact that they will live with their choice the rest of their life.  It also shows just how prevalent teenage pregnancy is in the United States in a very effective way.  So watch and let me know what your thoughts are on this issue.  

References

Real stories: Diary of a teen mom. (2011). Retrieved from http://www.candiesfoundation.org/RealStories1/realstories.html

 

Shuger, L. (2012).  Teen pregnancy and high school dropout: what communities are doing to address these issues.  Washington, DC: The National Campaign to Prevent Teen and Unplanned Pregnancy and American’s Promise Alliance

Too young (2009) The National Campaign to Prevent Teen and Unplanned Pregnancy  http://www.thenationalcampaign.org/tooyoung/too_young_discussion_guide.pdf 

I left the hyper links active so that you can access this guide  and any of the websites if you need to.