#JamesDonaldson On #MentalHealth – Misdiagnosis Of #MoodDisorders In #TeenagersOfColor

What we know about it, and how #parents can help #kids get the right diagnosis

Photo by August de Richelieu on Pexels.com

Writer: Tonya Russell

Clinical Expert: Heather Bernstein, PsyD

What You'll Learn

- Why might #kidsofcolor who have a #mooddisorder get the wrong diagnosis?

- What are the signs that a #child might have an underlying #mooddisorder?

- How can #parents help #kids get the right diagnosis?

- Quick Read

- Full Article

- Challenges in diagnosing #mooddisorders

- Misdiagnosis among #kidsofcolor

- The role of bias

- How to avoid misdiagnosis

#Mooddisorders are a category of #mentalhealthdisorder that includes #depression, #bipolardisorder and other disorders with similar symptoms. Symptoms of #mooddisorders can be difficult to recognize. Research shows that #kidsofcolor may be more likely than #white #kids to get the wrong diagnosis when they show signs of a #mooddisorder. They might get written off as misbehaving. Or they might be wrongly diagnosed with a different disorder like #conductdisorder or #schizophrenia.

One important cause of misdiagnosis of #kidsofcolor may be unconscious bias on the part of clinicians. #Kids of different #races who have the same symptoms might get different treatment. For example, a clinician might assume that a #Black #child who won’t participate in class is just misbehaving. But if a #white #child shows the same symptoms, they might get diagnosed with #depression.

Cultural differences can also lead to misdiagnosis. If a clinician doesn’t know what kinds of #behavior or emotional expression are normal for a child’s culture, they might miss signs of #mooddisorders. In some cases, #peopleofcolor might be less willing to share information with a #white clinician due to fear of being judged or punished. And with less information, the diagnosis is less likely to be accurate.

Despite the risk of misdiagnosis, it’s still very important for #kidsofcolor to get care when they’re dealing with a #mentalhealthchallenge. #Parents can help by knowing common signs of #mooddisorders. And if you’re concerned that your #child may have a #mooddisorder, look for a clinician who has experience working with #kids who share your child’s #racial identity. Clinicians should also consider the role of #racism and other systemic stresses when evaluating the #child. By taking time to get to know your #child and the bigger picture of their life, a clinician can make an accurate diagnosis and get them the help they need to thrive.

The #adolescent years can be tough, especially for #teens dealing with #mentalhealthchallenges, who often struggle to be heard and to feel like themselves. #Mooddisorders usually begin in the #teenage years, but their symptoms can be hard to interpret, and #kids may be overlooked or misdiagnosed. This is especially true for #childrenofcolor, who research suggests are less likely to get an accurate diagnosis when they show signs of a #mooddisorder.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

www.celebratingyourgiftoflife.com

Challenges in diagnosing #mooddisorders

#Mooddisorders are a category of #mentalhealthdisorder that includes #depression, #bipolardisorder and other disorders with similar symptoms. The National Institute of Mental Health estimates that about 14.3% of #teens have a #mooddisorder, and #girls are almost twice as likely to develop them as #boys. Many factors influence the development of a #mooddisorder. These can be genetic, but they can also be environmental, with #trauma being a significant trigger. This #trauma can come from sources including strife at home, a significant death, #bullying and even neighborhood violence.

Symptoms of #mooddisorders can be difficult to recognize. While people usually think of sadness as the main characteristic of #depression, anger, irritability and #behavior problems can also be signs of underlying #mooddisorders. For example, when a kid who acts out a lot in #school doesn’t get a careful evaluation, they might be written off as just misbehaving or seeking attention when they’re really dealing with #depression.

If they do get #mentalhealthcare, they may get the wrong diagnosis. In particular, if a #child with a #mooddisorder shows a lot of disruptive #behavior or anger, a clinician who misses the signs of the underlying disorder might misdiagnose them with #conductdisorder. #Conductdisorder is a pattern of behavior in which a #child intentionally hurts other people and acts out in extreme ways. Being diagnosed with conduct disorder can have serious consequences, including challenges finding clinicians who will work with the #child and increased risk of incarceration. And when #kids get the wrong diagnosis, they miss out on appropriate treatment for the disorder they do have, which leads to worse outcomes in the long term.

Misdiagnosis among #kidsofcolor

While #kids of any #race can receive the wrong diagnosis, research suggests that #peopleofcolor and particularly #Black people are less likely to be diagnosed with #mooddisorders than #white people, even when their symptoms are the same.

One study found that #Black #male #teenagers receiving #psychiatric care were more likely to be diagnosed with #schizophrenia than any other group, while #white #adolescents were more likely to be diagnosed with #depression. #Black #teenagers of any #gender were also more likely to be diagnosed with conduct disorder than #white #teenagers. Studies of #Black #adults have found that they are much more likely than #white #adults to be diagnosed with #psychoticdisorders including #schizophrenia, even when they show clear signs of severe #depression. Another study suggests a similar pattern of misdiagnosis for #Black people with #bipolardisorder.

More research is needed to clarify these apparent patterns and their causes. But in the meantime, it’s helpful for clinicians and #parents alike to be aware of these trends and take care to ensure that #teenagersofcolor get the correct diagnoses they need to thrive.

The role of bias

While there can be many causes of a misdiagnosis, one important factor may be unconscious bias on the part of clinicians.

Even when patients’ issues are the same, there can be a disparity in how #youthofcolor are diagnosed when compared to #white #youth. “Research shows that when clinicians are given descriptions of the same symptoms labeled with different #racial groups, there tends to be a bias to provide certain groups with certain diagnoses and other groups with other diagnoses,” says Heather Bernstein, PsyD, a clinical #psychologist at the #ChildMindInstitute. For example, she explains, clinicians may unconsciously assume that a #Black #child who won’t participate in class is being defiant, while they might diagnose a #white #child with the same symptoms with #depression.

Psychotherapist Jaynay C. Johnson, LMFT, runs a practice focused on helping #Black #teenagers navigate #depression and #suicidalideation, and she explains exactly how that bias can be insidious. In addition to facing more scrutiny for apparent misbehavior, she explains, #childrenofcolor face the added challenge of dealing with stresses that the #white people often diagnosing them don’t understand. For example, a #Black #girl who gets into a fight may be labeled a #behavior problem when really her actions stem in part from the #stress of dealing with #racism. Johnson explains that “a lot of people aren’t understanding systemic #racism and microaggressions and how that can make a #Black #child frustrated. Instead, they may label it as anger.” She notes that in her Philadelphia practice, she’s often seen #Black #children be diagnosed with conduct disorder when they’re instead battling #depression and #anxiety.

Johnson adds that different cultural norms can also contribute to misunderstandings of children’s behavior. “The #adults interacting with #kids at #school often don’t understand their culture,” she says. “So when #children are acting within their culture, a lot of people will say that they’re behaving abnormally.” This #behavior could include preferring to speak a language other than English, using certain verbal expressions, or even laughing at times that seem inappropriate. In cases like these, even #kids with signs of possible #mooddisorders may be written off as just misbehaving, instead of getting the #mentalhealthsupport they need.

Language barriers are another factor that can contribute to misdiagnosis. Lack of trust in clinicians or medical systems can also lead to misunderstanding when, for instance, #parents or #childrenofcolor might withhold pertinent information out of fear of being judged or persecuted.

How to avoid misdiagnosis

Despite the risk of misdiagnosis, it’s still very important for kids of color to get care when they’re dealing with a #mentalhealthchallenge. If you think that #depression or another #mooddisorder might be troubling your #child or be behind #behavior that’s getting them in trouble, the best thing you can do for them is seek an accurate diagnosis and appropriate treatment. And if you think your #child has been misdiagnosed or written off by an authority figure, getting a second opinion can help.

You can learn more here about what #mooddisorders often look like in #teenagers, and you can read more here about ways to tell if your child’s anger might be due to #depression.

When you do seek help or a second opinion, working with the right clinician can make a big difference. Finding a clinician of color can help with the issues of bias and cultural awareness discussed above, but it’s not the only way to get an accurate diagnosis and quality care. Less than 15 percent of #psychologists are #peopleofcolor, so finding a non-white clinician can be a challenge. #White clinicians can also be well-equipped to help your #child, especially if they have experience working with other #kids with similar symptoms and cultural backgrounds. It’s appropriate to discuss potential clinicians’ experience and training before choosing to work with them.

“Asking about the clinician’s level of cultural competence is a fair question, and it’s important for both the #child and the caregiver,” says Dr. Bernstein. “You want to feel comfortable with the individual that they are seeing, and to know that that person has sufficient training and understands how intersecting identities are going to affect both who your #child is and the type of treatment that’s going to be the most effective.” For instance, you could ask about the clinician’s understanding of the struggles faced by #youth who share your child’s #racial identity, or about their experience working with people from communities similar to your own.

Here are a few more ways to tell whether the clinician you’re working with is likely to give your #child an accurate diagnosis:

- They consider systemic stressors. Research shows that experiencing #racism leads to increased #stress levels and adverse health outcomes. Clinicians should be aware of the way that this kind of #stress impacts #kids and their #behaviors, as well as the way that systemic #racism can create obstacles in #kids’ lives. “We should be looking at what else could be going on in their lives,” says Johnson. “I think that sometimes we aren’t acknowledging that there may be systemic or poverty issues contributing to their symptoms.”

- They look at the whole picture. Medical issues like diabetes or chronic pain — which could both impact mood — should also be taken into account, as well as the social determinants of health. For example, a grumpy, argumentative #child may be hungry, and #Black #children are more likely to live in food deserts than their white peers. Also, in high crime areas, #trauma is more likely to be a cause of a child’s symptoms.

- They listen to your #child without jumping to conclusions. An accurate diagnosis relies on getting information directly from the #child as well, not just from #teachers or other authority figures, who may misinterpret their #behavior.

- They take their time. “Make sure that you’re working with a clinician who is open to not just putting a stamp on the diagnosis,” says. Dr. Bernstein. “The clinician should be willing to continue gathering information before making that diagnosis, and to really understand the child’s experience and take a more holistic view.”

- They use evidence-based methods based on up-to-date research. Dr. Bernstein notes that clinicians whose practice is based on well-researched tools will be better equipped to give appropriate diagnoses to #kids of any #race.

Photo by August de Richelieu on Pexels.com
https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-misdiagnosis-of-mooddisorders-in-teenagersofcolor/