James Donaldson on Mental Health - Watching for Signs of Psychosis in Teens

Catching kids early and supporting them before they're in crisis can delay mental health disorders and reduce impairment

Writer: Juliann Garey

Clinical Experts: Tiziano Colibazzi, MD , Christoph Correll, MD

What You'll Learn

- What is psychosis?
- What are prodromal symptoms?
- What symptoms should I look for in my teen?
- How is early psychosis in teens treated?
- Quick Read
- Full Article
- What are “prodromal” symptoms?
- First step if you feel your child is at risk: An evaluation
- Lifestyle and mental health options
- Treatment for prodromal psychotic symptoms

Psychosis is a condition in which a person loses touch with reality. If a teen has psychosis, they might hear or see things that aren’t there. Psychosis is often a symptom of a disorder called schizophrenia. It shows up in the late teen or early adult years.

But some teens show early warning signs of psychosis. If doctors can catch these early signs, they may be able to delay the development of the disorder and minimize its symptoms. Since psychotic symptoms cause problems in everything from school to friendships to family, acting fast can help teens a lot.

Early signs of psychosis are called “prodromal” symptoms. They include things like not wanting to see friends, feeling like people want to hurt them, not showering, and seeing or hearing things that aren’t there. To a parent, the change in their teen would probably be very noticeable.

The good news is that in the early stages, psychosis in teens can be treated by making pretty simple changes in their habits. These include reducing stress, making sure they have good sleep habits, and getting treatment for other problems like anxiety.

If you’re worried your teen might be having these symptoms, the first step is to take them to their regular doctor. Their doctor will rule out drug use, which can also cause these symptoms. Then, they will send the teen to be examined by a psychiatrist. It’s hard for doctors to know which teens will go on to develop serious psychotic disorders — not all will. But getting your teen to a professional who can watch their symptoms may be the most important step a parent can take.

There are fewer more frightening or challenging psychiatric conditions for a family to face than psychosis, an extreme mental state in which impaired thinking and emotions cause a person to lose contact with reality. This could mean hearing or seeing things that aren’t there (hallucinations), or believing things that aren’t true (delusions).

The disorder most often associated with psychosis, schizophrenia, usually doesn’t show up until very late adolescence or early adulthood. Recently, however, experts in the field have been working to identify high-risk kids who show symptoms that could serve as early warning signs of psychosis, and several academic centers have been set up to focus on this crucial period when it may be possible to change the trajectory of mental health disorders.

Not all the kids who are identified with what experts call “prodromal” symptoms will progress, or “convert” to psychosis. But early intervention has been shown to improve outcomes for those who do. And since psychotic symptoms cause disruption across a teenager’s life, from school to friendships to family, researchers are hoping quick action can prevent impairment and prolong typical functioning.

What’s more, some of the approaches that show promise in delaying onset of psychosis or mitigating symptoms include fairly simple lifestyle changes like stress reduction and sleep hygiene, and managing co-occurring disorders like anxiety. The key: identifying at-risk kids earlier when these low-impact measures are still effective.

What are “prodromal” symptoms?

Prodromal symptoms are “attenuated” or weak symptoms of psychosis. Moreover, “they are a warning sign,” says Christoph Correll, MD, the medical director of the Recognition and Prevention Program (RAP) at Zucker Hillside Hospital in Queens, NY, which specializes in diagnosing and treating early symptoms of mental health disorders in teenagers and young adults. “These signs can happen in people who don’t go on to develop psychosis — but if we follow these people who are in the risk state based on these watered-down versions, one third will probably go on to develop psychosis. That’s a lot more than in the general population.”

Prodromal symptoms occur on a spectrum from very, very mild to severe and can include:

- Withdrawing from friends and family/feeling suspicious of others
- Changes in sleeping or eating patterns
- Less concern with appearance, clothes, or hygiene
- Difficulty organizing thoughts or speech
- Loss of usual interest in activities or of motivation and energy
- Development of unusual ideas or behaviors
- Unusual perceptions, such as visions or hearing voices (or even seeing shadows)
- Feeling like things are unreal
- Change in personality
- Feelings of grandiosity (belief they have a superpower, etc.)

In some cases, these symptoms represent the early stages of a disorder, and will eventually convert. In others, the symptoms actually fade or remain mild. Tiziano Colibazzi, MD, is a psychiatrist at Columbia Presbyterian’s COPE clinic (Center for Prevention and Evaluation), which was established to research and treat prodromal symptoms. “We can identify a group of people that are at clinically high risk,” says Dr. Colibazzi. “What we can’t do is narrow that group down further to identify the 30 percent who will convert.”

First step if you feel your child is at risk: An evaluation

The right treatment for prodromal symptoms depends entirely on how severe they are when they are diagnosed. The first step is a proper and complete diagnosis by a mental health professional with experience in assessing psychotic disorders.

If you see marked changes in motivation, thinking, and/or behavior in your child, the first place to start is with their pediatrician to rule out a medical illness. Substance use also needs to be ruled out as the cause of any behavior changes in adolescents. After that, you’re going to want to have your child evaluated by a qualified psychiatrist or psychologist. This in itself might be a multi-step process.

“You can’t just look at the kid once and get a bit of a history and then know what’s going on,” says Dr. Correll. “Kids develop; symptoms develop. And the trajectory — how things change, get better, or worse, what other symptoms add on to it — will be highly informative in telling us something about the prognosis, what we expect to happen.”

One aid to predicting the evolution and severity of symptoms, notes Dr. Colibazzi, is the patient’s ability to doubt their symptoms. If your child retains the self-awareness to know that their mind is playing tricks on them, it’s an indication that symptoms are still in the very early stages. As symptoms become more severe, the patient’s beliefs (whether paranoid, grandiose, or hallucinatory) become increasingly difficult to challenge.

#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

Link for 40 Habits Signup
bit.ly/40HabitsofMentalHealth

If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

Lifestyle and mental health options

Psychotic symptoms and disorders have been shown to vary quite a bit depending on the environment — the health of our bodies, our interpersonal relationships, our mindset. Healthy living is key. Regardless of the severity of prodromal symptoms, Dr. Correll says that your child’s outcome can be improved by making sure they stick to a routine that includes:

- Eating well
- Getting regular exercise
- Adhering to a regular sleep schedule
- Reducing stress as much as possible
- Staying away from drugs — particularly marijuana, which can interact with prodromal symptoms and increase the risk for psychosis significantly

Also, don’t forget to address depression and anxiety. According to Dr. Correll, “adults who eventually developed schizophrenia identified a three- to five-year period during which they experienced depression or anxiety before developing the prodromal symptoms of psychosis and then developed full-blown psychosis. So treating the depression early,” he says, “might actually interrupt the progression from depression to psychosis in some patients.”

Treatment for prodromal psychotic symptoms

Dr. Correll recommends trying several approaches. Mild symptoms call for more low-key treatments including:

- Psychoeducation: teaching both the child and the family more about the symptoms and the disorder.
- Therapy, particularly cognitive behavioral therapy: “CBT can be good to change one’s thinking patterns,” says Correll, “and also to address developing self-esteem. We have to be careful that kids with a psychiatric diagnosis don’t self-stigmatize and get into a hopeless or negative mode where they feel they can’t achieve.”
- Lifestyle adjustments: Assessing whether the current school environment is best for the child. Perhaps a therapeutic social group to help the child cope.
- Reducing Stress: Stress is often a trigger for symptoms, so reducing stress in kids’ lives is crucial and may prevent or delay conversion to a psychotic disorder.

Understanding prodromal symptoms and monitoring kids who are at high risk for psychotic disorders means that parents can do more for their kids than wait for symptoms to get worse or merely hope for the best. Early monitoring and intervention can give high-risk kids an advantage, which researchers hope will eventually change the odds when it comes to psychotic disorders.

“The duration of untreated psychosis does actually seem to affect the course of the illness,” Dr. Colibazzi says. The longer the disorder goes untreated, the greater the chance that it will cause serious disruption in all areas of the patient’s life. “So it is reasonable to think that just following someone very closely and treating them very early, as soon as they develop symptoms, would be helpful.”

https://standingabovethecrowd.com/james-donaldson-on-mental-health-watching-for-signs-of-psychosis-in-teens/

Catching kids early and supporting them before they're in crisis can delay mental health disorders and reduce impairment

Writer: Juliann Garey

Clinical Experts: Tiziano Colibazzi, MD , Christoph Correll, MD

What You'll Learn

- What is psychosis?

- What are prodromal symptoms?

- What symptoms should I look for in my teen?

- How is early psychosis in teens treated?

- Quick Read

- Full Article

- What are “prodromal” symptoms?

- First step if you feel your child is at risk: An evaluation

- Lifestyle and mental health options

- Treatment for prodromal psychotic symptoms

Psychosis is a condition in which a person loses touch with reality. If a teen has psychosis, they might hear or see things that aren’t there. Psychosis is often a symptom of a disorder called schizophrenia. It shows up in the late teen or early adult years.

But some teens show early warning signs of psychosis. If doctors can catch these early signs, they may be able to delay the development of the disorder and minimize its symptoms. Since psychotic symptoms cause problems in everything from school to friendships to family, acting fast can help teens a lot.

Early signs of psychosis are called “prodromal” symptoms. They include things like not wanting to see friends, feeling like people want to hurt them, not showering, and seeing or hearing things that aren’t there. To a parent, the change in their teen would probably be very noticeable.

The good news is that in the early stages, psychosis in teens can be treated by making pretty simple changes in their habits. These include reducing stress, making sure they have good sleep habits, and getting treatment for other problems like anxiety.

If you’re worried your teen might be having these symptoms, the first step is to take them to their regular doctor. Their doctor will rule out drug use, which can also cause these symptoms. Then, they will send the teen to be examined by a psychiatrist. It’s hard for doctors to know which teens will go on to develop serious psychotic disorders — not all will. But getting your teen to a professional who can watch their symptoms may be the most important step a parent can take.

There are fewer more frightening or challenging psychiatric conditions for a family to face than psychosis, an extreme mental state in which impaired thinking and emotions cause a person to lose contact with reality. This could mean hearing or seeing things that aren’t there (hallucinations), or believing things that aren’t true (delusions).

The disorder most often associated with psychosis, schizophrenia, usually doesn’t show up until very late adolescence or early adulthood. Recently, however, experts in the field have been working to identify high-risk kids who show symptoms that could serve as early warning signs of psychosis, and several academic centers have been set up to focus on this crucial period when it may be possible to change the trajectory of mental health disorders.

Not all the kids who are identified with what experts call “prodromal” symptoms will progress, or “convert” to psychosis. But early intervention has been shown to improve outcomes for those who do. And since psychotic symptoms cause disruption across a teenager’s life, from school to friendships to family, researchers are hoping quick action can prevent impairment and prolong typical functioning.

What’s more, some of the approaches that show promise in delaying onset of psychosis or mitigating symptoms include fairly simple lifestyle changes like stress reduction and sleep hygiene, and managing co-occurring disorders like anxiety. The key: identifying at-risk kids earlier when these low-impact measures are still effective.

What are “prodromal” symptoms?

Prodromal symptoms are “attenuated” or weak symptoms of psychosis. Moreover, “they are a warning sign,” says Christoph Correll, MD, the medical director of the Recognition and Prevention Program (RAP) at Zucker Hillside Hospital in Queens, NY, which specializes in diagnosing and treating early symptoms of mental health disorders in teenagers and young adults. “These signs can happen in people who don’t go on to develop psychosis — but if we follow these people who are in the risk state based on these watered-down versions, one third will probably go on to develop psychosis. That’s a lot more than in the general population.”

Prodromal symptoms occur on a spectrum from very, very mild to severe and can include:

- Withdrawing from friends and family/feeling suspicious of others

- Changes in sleeping or eating patterns

- Less concern with appearance, clothes, or hygiene

- Difficulty organizing thoughts or speech

- Loss of usual interest in activities or of motivation and energy

- Development of unusual ideas or behaviors

- Unusual perceptions, such as visions or hearing voices (or even seeing shadows)

- Feeling like things are unreal

- Change in personality

- Feelings of grandiosity (belief they have a superpower, etc.)

In some cases, these symptoms represent the early stages of a disorder, and will eventually convert. In others, the symptoms actually fade or remain mild. Tiziano Colibazzi, MD, is a psychiatrist at Columbia Presbyterian’s COPE clinic (Center for Prevention and Evaluation), which was established to research and treat prodromal symptoms. “We can identify a group of people that are at clinically high risk,” says Dr. Colibazzi. “What we can’t do is narrow that group down further to identify the 30 percent who will convert.”

First step if you feel your child is at risk: An evaluation

The right treatment for prodromal symptoms depends entirely on how severe they are when they are diagnosed. The first step is a proper and complete diagnosis by a mental health professional with experience in assessing psychotic disorders.

If you see marked changes in motivation, thinking, and/or behavior in your child, the first place to start is with their pediatrician to rule out a medical illness. Substance use also needs to be ruled out as the cause of any behavior changes in adolescents. After that, you’re going to want to have your child evaluated by a qualified psychiatrist or psychologist. This in itself might be a multi-step process.

“You can’t just look at the kid once and get a bit of a history and then know what’s going on,” says Dr. Correll. “Kids develop; symptoms develop. And the trajectory — how things change, get better, or worse, what other symptoms add on to it — will be highly informative in telling us something about the prognosis, what we expect to happen.”

One aid to predicting the evolution and severity of symptoms, notes Dr. Colibazzi, is the patient’s ability to doubt their symptoms. If your child retains the self-awareness to know that their mind is playing tricks on them, it’s an indication that symptoms are still in the very early stages. As symptoms become more severe, the patient’s beliefs (whether paranoid, grandiose, or hallucinatory) become increasingly difficult to challenge.

#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/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite 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

Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth

If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

Lifestyle and mental health options

Psychotic symptoms and disorders have been shown to vary quite a bit depending on the environment — the health of our bodies, our interpersonal relationships, our mindset. Healthy living is key. Regardless of the severity of prodromal symptoms, Dr. Correll says that your child’s outcome can be improved by making sure they stick to a routine that includes:

- Eating well

- Getting regular exercise

- Adhering to a regular sleep schedule

- Reducing stress as much as possible

- Staying away from drugs — particularly marijuana, which can interact with prodromal symptoms and increase the risk for psychosis significantly

Also, don’t forget to address depression and anxiety. According to Dr. Correll, “adults who eventually developed schizophrenia identified a three- to five-year period during which they experienced depression or anxiety before developing the prodromal symptoms of psychosis and then developed full-blown psychosis. So treating the depression early,” he says, “might actually interrupt the progression from depression to psychosis in some patients.”

Treatment for prodromal psychotic symptoms

Dr. Correll recommends trying several approaches. Mild symptoms call for more low-key treatments including:

- Psychoeducation: teaching both the child and the family more about the symptoms and the disorder.

- Therapy, particularly cognitive behavioral therapy: “CBT can be good to change one’s thinking patterns,” says Correll, “and also to address developing self-esteem. We have to be careful that kids with a psychiatric diagnosis don’t self-stigmatize and get into a hopeless or negative mode where they feel they can’t achieve.”

- Lifestyle adjustments: Assessing whether the current school environment is best for the child. Perhaps a therapeutic social group to help the child cope.

- Reducing Stress: Stress is often a trigger for symptoms, so reducing stress in kids’ lives is crucial and may prevent or delay conversion to a psychotic disorder.

Understanding prodromal symptoms and monitoring kids who are at high risk for psychotic disorders means that parents can do more for their kids than wait for symptoms to get worse or merely hope for the best. Early monitoring and intervention can give high-risk kids an advantage, which researchers hope will eventually change the odds when it comes to psychotic disorders.

“The duration of untreated psychosis does actually seem to affect the course of the illness,” Dr. Colibazzi says. The longer the disorder goes untreated, the greater the chance that it will cause serious disruption in all areas of the patient’s life. “So it is reasonable to think that just following someone very closely and treating them very early, as soon as they develop symptoms, would be helpful.” https://standingabovethecrowd.com/james-donaldson-on-mental-health-watching-for-signs-of-psychosis-in-teens/

James Donaldson on Mental Health - Lower education levels linked to higher suicide rates—up to 13 times higher

A research team led by Professor Myung Ki has identified a strong relationship between education levels and suicide rates

Prof. Myung KIview more 

Credit: KU medicine

A research team led by Professor Myung Ki from the Department of Preventive Medicine at Korea University College of Medicine (KUCM) recently published a study examining the link between education levels and suicide rates. The study found that among young men aged 30 to 44 whose highest level of education was elementary school or lower, the suicide rate was 6.1 to 13 times higher than that of men with a university or higher degree across all survey periods (1995–2020). These findings highlight the profound impact of socioeconomic disparities on suicide rates.

In particular, the suicide rate per 100,000 people for men aged 30-44 with a primary school education or less was 288.2 in 2015 and 251.4 in 2020. This is nearly ten times the national average suicide rate of 27.3 in South Korea. It also far exceeds the suicide rate in Nunavut, Canada—home to the Inuit community, which has one of the highest suicide rates in the world—and surpasses the rate of 232 among the Guarani Kaiowa people in the Brazilian Amazon.

The study concludes that suicide rates in South Korea vary significantly by social class, with the lowest education levels corresponding to the highest suicide rates. This pattern aligns with the "deaths of despair" theory proposed by Nobel Prize-winning economist Angus Deaton, which suggests that despair stemming from economic hardship and social disadvantage can drive individuals to suicide. The research highlights that suicide is not merely a personal issue but a consequence of deep-rooted social inequalities and emotional distress tied to class differences.

#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

Link for 40 Habits Signup
bit.ly/40HabitsofMentalHealth

If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

Professor Ki of KUCM emphasized that suicide should not be seen solely as an individual mental health issue but as a broader social problem influenced by economic disparities. He stressed that without proper support systems, social and economic disadvantages can become a stigma of failure, leading to severe psychological distress. Effective suicide prevention policies should take a comprehensive approach, addressing both social crises—such as poverty and rental fraud—and mental health concerns together, rather than handling them separately. A comprehensive approach that considers social vulnerability is essential to reducing the suicide inequalities and strengthening South Korea’s social safety net.

Professor Ki also noted that while South Korea has expanded psychological support programs, such as the "National Mind Investment & Support Project," more robust administrative measures are needed to tackle the social factors contributing to suicide. He added, "Active policies that account for social vulnerability are key to suicide prevention. It is crucial that these efforts are recognized as acts of social respect and care for those who are most vulnerable."

The study’s findings were published in the prestigious journal Social Science & Medicine under the title "Changes in suicide inequalities in the context of an increase and a decrease in suicide mortality: The case of South Korea, 1995-2020."

https://standingabovethecrowd.com/james-donaldson-on-mental-health-lower-education-levels-linked-to-higher-suicide-rates-up-to-13-times-higher/

A research team led by Professor Myung Ki has identified a strong relationship between education levels and suicide rates

Prof. Myung KIview more 

Credit: KU medicine

A research team led by Professor Myung Ki from the Department of Preventive Medicine at Korea University College of Medicine (KUCM) recently published a study examining the link between education levels and suicide rates. The study found that among young men aged 30 to 44 whose highest level of education was elementary school or lower, the suicide rate was 6.1 to 13 times higher than that of men with a university or higher degree across all survey periods (1995–2020). These findings highlight the profound impact of socioeconomic disparities on suicide rates.

In particular, the suicide rate per 100,000 people for men aged 30-44 with a primary school education or less was 288.2 in 2015 and 251.4 in 2020. This is nearly ten times the national average suicide rate of 27.3 in South Korea. It also far exceeds the suicide rate in Nunavut, Canada—home to the Inuit community, which has one of the highest suicide rates in the world—and surpasses the rate of 232 among the Guarani Kaiowa people in the Brazilian Amazon.

The study concludes that suicide rates in South Korea vary significantly by social class, with the lowest education levels corresponding to the highest suicide rates. This pattern aligns with the "deaths of despair" theory proposed by Nobel Prize-winning economist Angus Deaton, which suggests that despair stemming from economic hardship and social disadvantage can drive individuals to suicide. The research highlights that suicide is not merely a personal issue but a consequence of deep-rooted social inequalities and emotional distress tied to class differences.

#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/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite 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

Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth

If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

Professor Ki of KUCM emphasized that suicide should not be seen solely as an individual mental health issue but as a broader social problem influenced by economic disparities. He stressed that without proper support systems, social and economic disadvantages can become a stigma of failure, leading to severe psychological distress. Effective suicide prevention policies should take a comprehensive approach, addressing both social crises—such as poverty and rental fraud—and mental health concerns together, rather than handling them separately. A comprehensive approach that considers social vulnerability is essential to reducing the suicide inequalities and strengthening South Korea’s social safety net.

Professor Ki also noted that while South Korea has expanded psychological support programs, such as the "National Mind Investment & Support Project," more robust administrative measures are needed to tackle the social factors contributing to suicide. He added, "Active policies that account for social vulnerability are key to suicide prevention. It is crucial that these efforts are recognized as acts of social respect and care for those who are most vulnerable."

The study’s findings were published in the prestigious journal Social Science & Medicine under the title "Changes in suicide inequalities in the context of an increase and a decrease in suicide mortality: The case of South Korea, 1995-2020." https://standingabovethecrowd.com/james-donaldson-on-mental-health-lower-education-levels-linked-to-higher-suicide-rates-up-to-13-times-higher/

A research team led by Professor Myung Ki has identified a strong relationship between education levels and suicide rates

Prof. Myung KIview more 

Credit: KU medicine

A research team led by Professor Myung Ki from the Department of Preventive Medicine at Korea University College of Medicine (KUCM) recently published a study examining the link between education levels and suicide rates. The study found that among young men aged 30 to 44 whose highest level of education was elementary school or lower, the suicide rate was 6.1 to 13 times higher than that of men with a university or higher degree across all survey periods (1995–2020). These findings highlight the profound impact of socioeconomic disparities on suicide rates.

In particular, the suicide rate per 100,000 people for men aged 30-44 with a primary school education or less was 288.2 in 2015 and 251.4 in 2020. This is nearly ten times the national average suicide rate of 27.3 in South Korea. It also far exceeds the suicide rate in Nunavut, Canada—home to the Inuit community, which has one of the highest suicide rates in the world—and surpasses the rate of 232 among the Guarani Kaiowa people in the Brazilian Amazon.

The study concludes that suicide rates in South Korea vary significantly by social class, with the lowest education levels corresponding to the highest suicide rates. This pattern aligns with the "deaths of despair" theory proposed by Nobel Prize-winning economist Angus Deaton, which suggests that despair stemming from economic hardship and social disadvantage can drive individuals to suicide. The research highlights that suicide is not merely a personal issue but a consequence of deep-rooted social inequalities and emotional distress tied to class differences.

#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/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite 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

Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth

If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

Professor Ki of KUCM emphasized that suicide should not be seen solely as an individual mental health issue but as a broader social problem influenced by economic disparities. He stressed that without proper support systems, social and economic disadvantages can become a stigma of failure, leading to severe psychological distress. Effective suicide prevention policies should take a comprehensive approach, addressing both social crises—such as poverty and rental fraud—and mental health concerns together, rather than handling them separately. A comprehensive approach that considers social vulnerability is essential to reducing the suicide inequalities and strengthening South Korea’s social safety net.

Professor Ki also noted that while South Korea has expanded psychological support programs, such as the "National Mind Investment & Support Project," more robust administrative measures are needed to tackle the social factors contributing to suicide. He added, "Active policies that account for social vulnerability are key to suicide prevention. It is crucial that these efforts are recognized as acts of social respect and care for those who are most vulnerable."

The study’s findings were published in the prestigious journal Social Science & Medicine under the title "Changes in suicide inequalities in the context of an increase and a decrease in suicide mortality: The case of South Korea, 1995-2020." https://standingabovethecrowd.com/?p=13720

James Donaldson on Mental Health - Loneliness, Fear of Failure, and Suicide Among Young Adults

The world is complicated and the stress of transitioning into adulthood is affecting young adults

Key points
- Loneliness and fear of failure are prominent among young adults.
- Only one-third of young adults feel cared about by others.
- Young adults can feel behind before they even start.

Loneliness and the fear of failure seem rampant among young adults today, and one survey reported that only one-third of young adults feel cared about by others. It's taking a toll. These emotions complicate life and can harm mental well-being. They may even increase the risk of self-harm. It’s important to understand how these issues connect. This knowledge helps us support young adults facing these challenges.

The Rise of Loneliness in Young Adults

Feeling lonely is now more common in general, but especially among young adults. A 2020 survey by Cigna found that 79 percent of Gen Z adults (ages 18-22) reported feeling lonely. This rate is much higher than in previous generations.

Social media now rules our daily lives. Many young adults feel lonely, even while online. This is due to changing social norms and the effects of COVID-19. Social media has a complicated role in loneliness.

Social media can help people stay connected, but it can also create a false sense of connection. Young adults often compare their lives to the perfect moments they see on Instagram, TikTok, and Snapchat. This leads to feelings of inadequacy and disconnection. Studies show that too much social media can increase loneliness and depression (Twenge and colleagues, 2021).

Loneliness isn’t just about being alone; it’s about feeling disconnected. Many young adults wonder, “Why does everyone else seem so put together while I feel lost?” This feeling of being on the outside looking in makes it harder to reach out for help.

Research shows that loneliness is not only emotionally painful but also physically harmful. A study in *Perspectives on Psychological Science* (Holt-Lunstad and colleagues, 2015) found that chronic loneliness is as harmful to health as smoking 15 cigarettes daily. It is also closely linked to depression and suicidal thoughts, which makes it a serious issue.

The Crushing Fear of Failure

Young adults today are under intense pressure to succeed in school, relationships, and their careers. Fear of failure can be overwhelming. It makes many feel they’re falling behind before they even begin. A study in Frontiers in Psychology by Sagar and Stoeber (2009) found that perfectionism and fear of failure can cause anxiety, depression, and distress. Much of this fear comes from unrealistic expectations. Society, family, and even young adults set these standards. Many feel lost while trying to build their future. They worry about getting stable jobs, moving out, or keeping relationships. Their thoughts can feel overwhelming: If I don’t make it now, I never will. Everyone else is ahead of me—what’s wrong with me? Social media often shows others’ successes, making failure seem unacceptable. Watching influencers or friends live perfect lives can make any setback feel devastating. This mindset can lead to avoidance, imposter syndrome, and burnout. Over time, it hurts self-esteem. Young adults may feel hopeless about their futures.

How These Issues Connect to Suicide Risk

When loneliness and fear of failure come together, the effects can be dangerous.

The CDC reports that suicide rates for people aged 15-24 have risen by nearly 60 percent in the last decade.

A study in JAMA Network Open (Twenge and colleagues, 2021) found that lonely young adults often think about suicide. Research in Psychological Medicine (O’Connor and Kirtley, 2018) found that feeling like a failure can lead to worthlessness. This feeling is a major risk factor for suicide.

Many struggling young adults think: If I can’t meet expectations, what’s the point? Or, I don’t belong anywhere, and no one would even notice if I were gone. These painful thoughts often go unnoticed by friends and family. It’s crucial to recognize the warning signs and provide support before a crisis occurs.

With social media constantly highlighting other people’s achievements, it’s easy to feel like failure isn’t an option. Seeing influencers or peers seemingly living perfect lives can make any setback feel like the end of the world. This mindset leads to avoidance, imposter syndrome, and burnout. Over time, it chips away at self-esteem and can leave young adults feeling hopeless about their future.

#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

Link for 40 Habits Signup
bit.ly/40HabitsofMentalHealth

If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

Ways to Help

1. Building Stronger Social Connections

- Prioritizing real-life interactions and joining supportive communities can help ease loneliness.
- Schools, workplaces, and organizations can create mentorship and peer-support programs.
- Group therapy and support networks provide safe places to share struggles. They help young adults feel understood.
- Taking breaks from social media helps. It also lets you focus on positive content. This can lower feelings of isolation.
- Identifying and finding resources for those who struggle with making connections. Radically open dialectical behavior therapy focuses on connections with others.

2. Changing the Way We See Success and Failure

- Schools and workplaces should encourage a growth mindset. They should show that failure is a normal part of learning.
- Parents, educators, and mentors can help young adults see success as a journey, not a single moment.
- Practicing self-compassion can help counter perfectionism and fear of failure.
- Social media literacy helps young adults tell the difference between real life and curated online content.
- Seek therapy for perfectionists and those with overcontrolled tempers. They often struggle with a fear of failure.

3. Expanding Mental Health Support

- Making counseling and crisis resources more accessible can save lives.
- Schools and workplaces should proactively offer mental health education and screenings.
- Making therapy and mental health care normal can help young adults get support before a crisis hits. Find a match for the young adult's temperament.
- Tech companies should improve social media algorithms. This can help promote mental well-being. It’s important to move away from a harmful comparison culture.

Final Thoughts

Loneliness, fear of failure, and suicide in young adults are serious problems. We can't ignore them. Social media can help but also harm. It can connect us, but it can also heighten feelings of isolation and inadequacy. We all play a part in building stronger connections. We need to change how we view success and ensure mental health resources are available for those in need. Together, we can build a world where young adults feel valued, supported, and hopeful about their future.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-loneliness-fear-of-failure-and-suicide-among-young-adults/

The world is complicated and the stress of transitioning into adulthood is affecting young adults

Key points

- Loneliness and fear of failure are prominent among young adults.

- Only one-third of young adults feel cared about by others.

- Young adults can feel behind before they even start.

Loneliness and the fear of failure seem rampant among young adults today, and one survey reported that only one-third of young adults feel cared about by others. It's taking a toll. These emotions complicate life and can harm mental well-being. They may even increase the risk of self-harm. It’s important to understand how these issues connect. This knowledge helps us support young adults facing these challenges.

The Rise of Loneliness in Young Adults

Feeling lonely is now more common in general, but especially among young adults. A 2020 survey by Cigna found that 79 percent of Gen Z adults (ages 18-22) reported feeling lonely. This rate is much higher than in previous generations.

Social media now rules our daily lives. Many young adults feel lonely, even while online. This is due to changing social norms and the effects of COVID-19. Social media has a complicated role in loneliness.

Social media can help people stay connected, but it can also create a false sense of connection. Young adults often compare their lives to the perfect moments they see on Instagram, TikTok, and Snapchat. This leads to feelings of inadequacy and disconnection. Studies show that too much social media can increase loneliness and depression (Twenge and colleagues, 2021).

Loneliness isn’t just about being alone; it’s about feeling disconnected. Many young adults wonder, “Why does everyone else seem so put together while I feel lost?” This feeling of being on the outside looking in makes it harder to reach out for help.

Research shows that loneliness is not only emotionally painful but also physically harmful. A study in *Perspectives on Psychological Science* (Holt-Lunstad and colleagues, 2015) found that chronic loneliness is as harmful to health as smoking 15 cigarettes daily. It is also closely linked to depression and suicidal thoughts, which makes it a serious issue.

The Crushing Fear of Failure

Young adults today are under intense pressure to succeed in school, relationships, and their careers. Fear of failure can be overwhelming. It makes many feel they’re falling behind before they even begin. A study in Frontiers in Psychology by Sagar and Stoeber (2009) found that perfectionism and fear of failure can cause anxiety, depression, and distress. Much of this fear comes from unrealistic expectations. Society, family, and even young adults set these standards. Many feel lost while trying to build their future. They worry about getting stable jobs, moving out, or keeping relationships. Their thoughts can feel overwhelming: If I don’t make it now, I never will. Everyone else is ahead of me—what’s wrong with me? Social media often shows others’ successes, making failure seem unacceptable. Watching influencers or friends live perfect lives can make any setback feel devastating. This mindset can lead to avoidance, imposter syndrome, and burnout. Over time, it hurts self-esteem. Young adults may feel hopeless about their futures.

How These Issues Connect to Suicide Risk

When loneliness and fear of failure come together, the effects can be dangerous.

The CDC reports that suicide rates for people aged 15-24 have risen by nearly 60 percent in the last decade.

A study in JAMA Network Open (Twenge and colleagues, 2021) found that lonely young adults often think about suicide. Research in Psychological Medicine (O’Connor and Kirtley, 2018) found that feeling like a failure can lead to worthlessness. This feeling is a major risk factor for suicide.

Many struggling young adults think: If I can’t meet expectations, what’s the point? Or, I don’t belong anywhere, and no one would even notice if I were gone. These painful thoughts often go unnoticed by friends and family. It’s crucial to recognize the warning signs and provide support before a crisis occurs.

With social media constantly highlighting other people’s achievements, it’s easy to feel like failure isn’t an option. Seeing influencers or peers seemingly living perfect lives can make any setback feel like the end of the world. This mindset leads to avoidance, imposter syndrome, and burnout. Over time, it chips away at self-esteem and can leave young adults feeling hopeless about their future.

#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/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite 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

Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth

If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

Ways to Help

1. Building Stronger Social Connections

- Prioritizing real-life interactions and joining supportive communities can help ease loneliness.

- Schools, workplaces, and organizations can create mentorship and peer-support programs.

- Group therapy and support networks provide safe places to share struggles. They help young adults feel understood.

- Taking breaks from social media helps. It also lets you focus on positive content. This can lower feelings of isolation.

- Identifying and finding resources for those who struggle with making connections. Radically open dialectical behavior therapy focuses on connections with others.

2. Changing the Way We See Success and Failure

- Schools and workplaces should encourage a growth mindset. They should show that failure is a normal part of learning.

- Parents, educators, and mentors can help young adults see success as a journey, not a single moment.

- Practicing self-compassion can help counter perfectionism and fear of failure.

- Social media literacy helps young adults tell the difference between real life and curated online content.

- Seek therapy for perfectionists and those with overcontrolled tempers. They often struggle with a fear of failure.

3. Expanding Mental Health Support

- Making counseling and crisis resources more accessible can save lives.

- Schools and workplaces should proactively offer mental health education and screenings.

- Making therapy and mental health care normal can help young adults get support before a crisis hits. Find a match for the young adult's temperament.

- Tech companies should improve social media algorithms. This can help promote mental well-being. It’s important to move away from a harmful comparison culture.

Final Thoughts

Loneliness, fear of failure, and suicide in young adults are serious problems. We can't ignore them. Social media can help but also harm. It can connect us, but it can also heighten feelings of isolation and inadequacy. We all play a part in building stronger connections. We need to change how we view success and ensure mental health resources are available for those in need. Together, we can build a world where young adults feel valued, supported, and hopeful about their future. https://standingabovethecrowd.com/james-donaldson-on-mental-health-loneliness-fear-of-failure-and-suicide-among-young-adults/

The world is complicated and the stress of transitioning into adulthood is affecting young adults

Key points

- Loneliness and fear of failure are prominent among young adults.

- Only one-third of young adults feel cared about by others.

- Young adults can feel behind before they even start.

Loneliness and the fear of failure seem rampant among young adults today, and one survey reported that only one-third of young adults feel cared about by others. It's taking a toll. These emotions complicate life and can harm mental well-being. They may even increase the risk of self-harm. It’s important to understand how these issues connect. This knowledge helps us support young adults facing these challenges.

The Rise of Loneliness in Young Adults

Feeling lonely is now more common in general, but especially among young adults. A 2020 survey by Cigna found that 79 percent of Gen Z adults (ages 18-22) reported feeling lonely. This rate is much higher than in previous generations.

Social media now rules our daily lives. Many young adults feel lonely, even while online. This is due to changing social norms and the effects of COVID-19. Social media has a complicated role in loneliness.

Social media can help people stay connected, but it can also create a false sense of connection. Young adults often compare their lives to the perfect moments they see on Instagram, TikTok, and Snapchat. This leads to feelings of inadequacy and disconnection. Studies show that too much social media can increase loneliness and depression (Twenge and colleagues, 2021).

Loneliness isn’t just about being alone; it’s about feeling disconnected. Many young adults wonder, “Why does everyone else seem so put together while I feel lost?” This feeling of being on the outside looking in makes it harder to reach out for help.

Research shows that loneliness is not only emotionally painful but also physically harmful. A study in *Perspectives on Psychological Science* (Holt-Lunstad and colleagues, 2015) found that chronic loneliness is as harmful to health as smoking 15 cigarettes daily. It is also closely linked to depression and suicidal thoughts, which makes it a serious issue.

The Crushing Fear of Failure

Young adults today are under intense pressure to succeed in school, relationships, and their careers. Fear of failure can be overwhelming. It makes many feel they’re falling behind before they even begin. A study in Frontiers in Psychology by Sagar and Stoeber (2009) found that perfectionism and fear of failure can cause anxiety, depression, and distress. Much of this fear comes from unrealistic expectations. Society, family, and even young adults set these standards. Many feel lost while trying to build their future. They worry about getting stable jobs, moving out, or keeping relationships. Their thoughts can feel overwhelming: If I don’t make it now, I never will. Everyone else is ahead of me—what’s wrong with me? Social media often shows others’ successes, making failure seem unacceptable. Watching influencers or friends live perfect lives can make any setback feel devastating. This mindset can lead to avoidance, imposter syndrome, and burnout. Over time, it hurts self-esteem. Young adults may feel hopeless about their futures.

How These Issues Connect to Suicide Risk

When loneliness and fear of failure come together, the effects can be dangerous.

The CDC reports that suicide rates for people aged 15-24 have risen by nearly 60 percent in the last decade.

A study in JAMA Network Open (Twenge and colleagues, 2021) found that lonely young adults often think about suicide. Research in Psychological Medicine (O’Connor and Kirtley, 2018) found that feeling like a failure can lead to worthlessness. This feeling is a major risk factor for suicide.

Many struggling young adults think: If I can’t meet expectations, what’s the point? Or, I don’t belong anywhere, and no one would even notice if I were gone. These painful thoughts often go unnoticed by friends and family. It’s crucial to recognize the warning signs and provide support before a crisis occurs.

With social media constantly highlighting other people’s achievements, it’s easy to feel like failure isn’t an option. Seeing influencers or peers seemingly living perfect lives can make any setback feel like the end of the world. This mindset leads to avoidance, imposter syndrome, and burnout. Over time, it chips away at self-esteem and can leave young adults feeling hopeless about their future.

#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/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite 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

Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth

If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

Ways to Help

1. Building Stronger Social Connections

- Prioritizing real-life interactions and joining supportive communities can help ease loneliness.

- Schools, workplaces, and organizations can create mentorship and peer-support programs.

- Group therapy and support networks provide safe places to share struggles. They help young adults feel understood.

- Taking breaks from social media helps. It also lets you focus on positive content. This can lower feelings of isolation.

- Identifying and finding resources for those who struggle with making connections. Radically open dialectical behavior therapy focuses on connections with others.

2. Changing the Way We See Success and Failure

- Schools and workplaces should encourage a growth mindset. They should show that failure is a normal part of learning.

- Parents, educators, and mentors can help young adults see success as a journey, not a single moment.

- Practicing self-compassion can help counter perfectionism and fear of failure.

- Social media literacy helps young adults tell the difference between real life and curated online content.

- Seek therapy for perfectionists and those with overcontrolled tempers. They often struggle with a fear of failure.

3. Expanding Mental Health Support

- Making counseling and crisis resources more accessible can save lives.

- Schools and workplaces should proactively offer mental health education and screenings.

- Making therapy and mental health care normal can help young adults get support before a crisis hits. Find a match for the young adult's temperament.

- Tech companies should improve social media algorithms. This can help promote mental well-being. It’s important to move away from a harmful comparison culture.

Final Thoughts

Loneliness, fear of failure, and suicide in young adults are serious problems. We can't ignore them. Social media can help but also harm. It can connect us, but it can also heighten feelings of isolation and inadequacy. We all play a part in building stronger connections. We need to change how we view success and ensure mental health resources are available for those in need. Together, we can build a world where young adults feel valued, supported, and hopeful about their future. https://standingabovethecrowd.com/?p=13718

James Donaldson on Mental Health - DBT: What Is Dialectical Behavior Therapy?

A treatment for children and teenagers with trouble managing emotions

Writer: Juliann Garey

Clinical Experts: Jill Emanuele, PhD , David Friedlander, PsyD , Lauren Allerhand, PsyD

https://www.youtube.com/watch?v=kJP-Kf6IhDQ&ab_channel=ChildMindInstitute

What You'll Learn

- What is DBT?
- How does DBT work?
- What is DBT used for?
- Quick Read
- Full Article
- Who is DBT for?
- Why is it called ‘dialectical’?
- A brief history of DBT
- How does DBT work?
- What are DBT skills?
- Why does DBT include phone coaching?
- Structured therapy sessions
- DBT, DMDD, and young children
- What happens after DBT?

DBT stands for dialectical behavior therapy. It’s an intensive, structured treatment for children and teens who have trouble handling their strong emotions. Being overwhelmed with emotion can cause a lot of problem behaviors,  including outbursts, aggression, self-harm, substance abuse, and suicidal thoughts.

DBT was first created to treat a condition called borderline personality disorder, but now it’s widely used to help kids with lots of issues that stem from having overwhelming and painful feelings — anxiety, depression, bipolar disorder, eating disorders, and drug abuse, among other diagnoses.

DBT works by combining two sets of skills. The first, called mindfulness, helps kids understand and accept difficult feelings without judgment. The second, a treatment called CBT (cognitive behavioral therapy), teaches them coping strategies to change unhelpful feelings and thought patterns.

DBT is often helpful for kids who have tried other forms of therapy, but need something more intensive, without being in-patient.

In DBT, patients participate in three things: one-on-one therapy, group skills training, and phone coaching from their therapist available 24/7 to help them handle difficult situations without self-destructive behaviors. Parents are taught the same skills the kids learn, so they can help their kids use them outside of  therapy sessions.

If you have a child with emotional or behavior problems, there’s a good chance you’ve heard of mindfulness or cognitive behavioral therapy (CBT), two different approaches to helping kids with anxiety and mood disorders. But there’s another very popular therapy that combines elements of both: DBT, or dialectical behavior therapy. DBT is an intensive, highly structured program that’s been adapted for children and adolescents with serious emotional instability, including self-harm and suicidal ideation.

Who is DBT for?

“DBT is best suited for people who have a core challenge with highly sensitive emotions, and it’s impairing their functioning,” explains Lauren Allerhand, PsyD, co-director of DBT programs at the Child Mind Institute. “The extreme emotions can cause a wide range of symptoms.”

Those symptoms might include explosive anger or outbursts, intense mood swings, physical aggression, conflict with parents and siblings, or impulsive behaviors like self-harm, substance abuse, or risky sex. “Many of these challenges can be viewed as the downstream effect of emotion dysregulation.”

While DBT was first developed to treat people diagnosed with borderline personality disorder, it is now being used to help kids with a wide range of diagnoses, including depression, anxiety, bipolar disorder, eating disorders, substance use disorders, and disruptive behavior disorders.  “Since there are many ways emotional dysregulation can present, DBT is a transdiagnostic treatment,” Dr. Allerhand says.

Why is it called ‘dialectical’?

DBT is “dialectical” because it works by simultaneously addressing two things that might seem contradictory: acceptance of feelings (mindfulness) and learning to use coping strategies to change unhelpful feelings and thought patterns (CBT). It’s basically “‘I’m doing the best I can’ on the one hand, and ‘I need to do better,’” notes Alec Miller, PsyD, a professor in the Department of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine.  “That’s a dialectical truth.”

A brief history of DBT

Dialectical behavior therapy was developed by Marsha Linehan, PhD, in the 1970s to treat adult borderline personality disorder — a disorder with symptoms that include emotional volatility, trouble with relationships, self-destructive behaviors and  suicidal thoughts. These patients were typically thought of as “difficult,” if not impossible, to treat. Dr. Linehan redefined the disorder, reframing it as a specific problem of the emotion regulation system that can be addressed with a structured intervention.

People with borderline personality disorder have trouble regulating their moods, which leads to impulsivity and conflict in interpersonal relationships. That, in turn, often leaves them feeling misunderstood by others around them. First, Dr. Linehan tried traditional CBT, which emphasizes using conscious thoughts to confront and change overwhelming emotions. She was unsuccessful with her patients. So she then tried an acceptance-based approach that came out of her meditation and mindfulness practice. This, too, failed.

“So then she had this brilliant epiphany,” says Dr. Miller. “Blending the acceptance strategies of mindfulness with the change technologies of CBT to create this dialectical behavior therapy.”

How does DBT work?

A comprehensive DBT program involves four components:

- Individual therapy
- Group skills training for managing intense emotions
- 24/7 access to phone coaching from the therapist to help kids and parents manage difficult situations using their skills
- Weekly team meetings for therapists to support each other and consult on their cases

For children and adolescents, parents are involved in skills training so they can encourage their child to use the skills they are learning in real-life situations. “The feedback from parents is, ‘Where have these skills been all my life? I need these skills too,’ ” says Jill Emanuele, PhD, a clinical psychologist who specializes in mood disorders.

The highly structured nature of DBT, combined with the therapists’ stance of acceptance, can make it especially helpful for some kids who have tried other treatment without success and need a higher level of intervention. “A comprehensive DBT program, while still at the outpatient level, is a step up, a more intensive treatment from your standard CBT, which might be a once-a-week therapy,” Dr. Allerhand notes. For some children, DBT offers an alternative to a residential program. Treatment usually lasts from 6 months to a year.

What are DBT skills?

DBT skills training is very structured. For adolescents and children, it consists of five modules:

- Mindfulness skills: Being present, accepting, and non-judgmental in the moment and understanding the signs of unregulated emotions.
- Emotion regulation skills: Coping with difficult situations by building pleasant, self-soothing experiences to protect from emotional extremes. “Especially with teenagers,” says Dr. Emanuele, “there’s a big focus on the physical body: eating properly, getting enough sleep, taking their medicine, and avoiding drug use.”
- Interpersonal effectiveness skills: “It’s often interactions with others that are the negative triggers for impulsive behaviors,” Dr. Emanuele says. The purpose is to teach adolescents how to interact more effectively with other people and enable them to feel more supported by others.
- Distress tolerance skills: “It’s being able to recognize urges to do things that would be ineffective, such as hurting themselves or trying to kill themselves” and consciously controlling them, says Dr. Emanuele. These skills are the crisis survival tools for the most challenging moments.
- Walking-the-middle-path skill: Kids and parents learn how to validate one another, how to compromise and negotiate, and how to see the other person’s side of things. “It has to do with acknowledging multiple truths in the teenagers’ and the parents’ worldview as opposed to ‘I’m right and you’re wrong,’” explains Dr. Miller.

Some clinicians who do individual therapy, but are not part of a comprehensive DBT program, use DBT principles and introduce DBT skills — what’s often called DBT-informed treatment. “That would probably look more like CBT with mindfulness and acceptance-based strategies woven in,” notes Dr. Allerhand, “and it would be probably once a week.”

Why does DBT include phone coaching?

One of the most unusual elements of DBT programs, phone coaching, is designed to support patients’ efforts to apply DBT skills in their lives outside the therapy session, something therapists call “skills generalization.”

As Dr. Allerhand puts it, “How do we actually help people to do the things that we talked about in session when they are in the moments of crisis?” Ideally, the patient calls the therapist when they are tempted to do something self-destructive, to get support in using their DBT skills instead. Emotion dysregulation also leads to ineffective problem solving, and phone coaching can help kids and parents utilize more constructive problem solving skills rather than falling into old, unhelpful patterns.

Structured therapy sessions

Therapy sessions in comprehensive DBT don’t hew to a step-by-step manual, but they do follow structured principles, Dr. Allerhand says.

Each individual therapy session is structured around a diary card that the patient brings to the session, which is like a weekly tracker of their emotions and their urges to engage in whatever their problematic behaviors are.

There is a hierarchy of behaviors: Target 1 are life-threatening behaviors. Target 2, therapy-interfering behaviors.  And Target 3, quality-of-life-interfering behaviors.

The therapist makes it a priority to focus on Target 1 behaviors, giving them the most time in a session. “The point is that you can’t ignore if they’re thinking about hurting or killing themselves,” Dr. Allerhand explains, “and talk about, the test that they got a B- on.”

DBT, DMDD, and young children

DBT programs treat kids as young as 6. Dr. Allerhand says that the younger kids they see include those diagnosed with disruptive mood dysregulation disorder (DMDD).DMDD is a relatively new diagnosis for children who have explosive tantrums — big and emotional responses that are out of proportion to the events that triggered them — and in between outbursts they usually continue to be irritable.

Some of these young kids have behaviors that we usually associate with teenagers — hurting themselves, talking about killing themselves, or trying to kill themselves. “Recent CDC data actually showed that there’s been an increase in suicide attempts and completed suicides for younger kids,“ she notes.

Referrals to a DBT-C program (one structured specifically for children ages 6-12) often happen, she adds, “when the behavior has become so problematic that parents are worried for the safety of the child or other members of the family, or school placement is in jeopardy.”

#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

Link for 40 Habits Signup
bit.ly/40HabitsofMentalHealth

If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

What happens after DBT?

After the 6-12 months of the comprehensive DBT program, most patients continue with individual or family therapy.

“Once they’ve gained control over the behaviors that were really making their life worse, the dangerous behaviors,” Dr. Allerhand explains, “most people still have lots of other goals that they need to work on to truly make their life feel fulfilling rather than just tolerable.” Many continue to do the diary cards, and they are able to focus in therapy on the continuing barriers to them having the things that they want in their life.

Dr. Allerhand notes that, as that Marsha Linehan famously said, “DBT is not a suicide prevention program. It’s a life-worth-living treatment program.  The idea is that people who have the life that they want, the things that they want in their life, and the relationships they want, are much less likely to hurt themselves or kill themselves.”

Frequently Asked Questions

What does DBT stand for?

How does DBT work?

DBT works by combining two sets of skills. The first, called mindfulness, helps kids understand and accept difficult feelings. The second, a treatment called CBT (cognitive behavioral therapy), teaches them how to change their feelings and behavior.

What is DBT used to treat?

https://standingabovethecrowd.com/james-donaldson-on-mental-health-dbt-what-is-dialectical-behavior-therapy/

A treatment for children and teenagers with trouble managing emotions

Writer: Juliann Garey

Clinical Experts: Jill Emanuele, PhD , David Friedlander, PsyD , Lauren Allerhand, PsyD

https://www.youtube.com/watch?v=kJP-Kf6IhDQ&ab_channel=ChildMindInstitute

What You'll Learn

- What is DBT?

- How does DBT work?

- What is DBT used for?

- Quick Read

- Full Article

- Who is DBT for?

- Why is it called ‘dialectical’?

- A brief history of DBT

- How does DBT work?

- What are DBT skills?

- Why does DBT include phone coaching?

- Structured therapy sessions

- DBT, DMDD, and young children

- What happens after DBT?

DBT stands for dialectical behavior therapy. It’s an intensive, structured treatment for children and teens who have trouble handling their strong emotions. Being overwhelmed with emotion can cause a lot of problem behaviors,  including outbursts, aggression, self-harm, substance abuse, and suicidal thoughts.

DBT was first created to treat a condition called borderline personality disorder, but now it’s widely used to help kids with lots of issues that stem from having overwhelming and painful feelings — anxiety, depression, bipolar disorder, eating disorders, and drug abuse, among other diagnoses.

DBT works by combining two sets of skills. The first, called mindfulness, helps kids understand and accept difficult feelings without judgment. The second, a treatment called CBT (cognitive behavioral therapy), teaches them coping strategies to change unhelpful feelings and thought patterns.

DBT is often helpful for kids who have tried other forms of therapy, but need something more intensive, without being in-patient.

In DBT, patients participate in three things: one-on-one therapy, group skills training, and phone coaching from their therapist available 24/7 to help them handle difficult situations without self-destructive behaviors. Parents are taught the same skills the kids learn, so they can help their kids use them outside of  therapy sessions.

If you have a child with emotional or behavior problems, there’s a good chance you’ve heard of mindfulness or cognitive behavioral therapy (CBT), two different approaches to helping kids with anxiety and mood disorders. But there’s another very popular therapy that combines elements of both: DBT, or dialectical behavior therapy. DBT is an intensive, highly structured program that’s been adapted for children and adolescents with serious emotional instability, including self-harm and suicidal ideation.

Who is DBT for?

“DBT is best suited for people who have a core challenge with highly sensitive emotions, and it’s impairing their functioning,” explains Lauren Allerhand, PsyD, co-director of DBT programs at the Child Mind Institute. “The extreme emotions can cause a wide range of symptoms.”

Those symptoms might include explosive anger or outbursts, intense mood swings, physical aggression, conflict with parents and siblings, or impulsive behaviors like self-harm, substance abuse, or risky sex. “Many of these challenges can be viewed as the downstream effect of emotion dysregulation.”

While DBT was first developed to treat people diagnosed with borderline personality disorder, it is now being used to help kids with a wide range of diagnoses, including depression, anxiety, bipolar disorder, eating disorders, substance use disorders, and disruptive behavior disorders.  “Since there are many ways emotional dysregulation can present, DBT is a transdiagnostic treatment,” Dr. Allerhand says.

Why is it called ‘dialectical’?

DBT is “dialectical” because it works by simultaneously addressing two things that might seem contradictory: acceptance of feelings (mindfulness) and learning to use coping strategies to change unhelpful feelings and thought patterns (CBT). It’s basically “‘I’m doing the best I can’ on the one hand, and ‘I need to do better,’” notes Alec Miller, PsyD, a professor in the Department of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine.  “That’s a dialectical truth.”

A brief history of DBT

Dialectical behavior therapy was developed by Marsha Linehan, PhD, in the 1970s to treat adult borderline personality disorder — a disorder with symptoms that include emotional volatility, trouble with relationships, self-destructive behaviors and  suicidal thoughts. These patients were typically thought of as “difficult,” if not impossible, to treat. Dr. Linehan redefined the disorder, reframing it as a specific problem of the emotion regulation system that can be addressed with a structured intervention.

People with borderline personality disorder have trouble regulating their moods, which leads to impulsivity and conflict in interpersonal relationships. That, in turn, often leaves them feeling misunderstood by others around them. First, Dr. Linehan tried traditional CBT, which emphasizes using conscious thoughts to confront and change overwhelming emotions. She was unsuccessful with her patients. So she then tried an acceptance-based approach that came out of her meditation and mindfulness practice. This, too, failed.

“So then she had this brilliant epiphany,” says Dr. Miller. “Blending the acceptance strategies of mindfulness with the change technologies of CBT to create this dialectical behavior therapy.”

How does DBT work?

A comprehensive DBT program involves four components:

- Individual therapy

- Group skills training for managing intense emotions

- 24/7 access to phone coaching from the therapist to help kids and parents manage difficult situations using their skills

- Weekly team meetings for therapists to support each other and consult on their cases

For children and adolescents, parents are involved in skills training so they can encourage their child to use the skills they are learning in real-life situations. “The feedback from parents is, ‘Where have these skills been all my life? I need these skills too,’ ” says Jill Emanuele, PhD, a clinical psychologist who specializes in mood disorders.

The highly structured nature of DBT, combined with the therapists’ stance of acceptance, can make it especially helpful for some kids who have tried other treatment without success and need a higher level of intervention. “A comprehensive DBT program, while still at the outpatient level, is a step up, a more intensive treatment from your standard CBT, which might be a once-a-week therapy,” Dr. Allerhand notes. For some children, DBT offers an alternative to a residential program. Treatment usually lasts from 6 months to a year.

What are DBT skills?

DBT skills training is very structured. For adolescents and children, it consists of five modules:

- Mindfulness skills: Being present, accepting, and non-judgmental in the moment and understanding the signs of unregulated emotions.

- Emotion regulation skills: Coping with difficult situations by building pleasant, self-soothing experiences to protect from emotional extremes. “Especially with teenagers,” says Dr. Emanuele, “there’s a big focus on the physical body: eating properly, getting enough sleep, taking their medicine, and avoiding drug use.”

- Interpersonal effectiveness skills: “It’s often interactions with others that are the negative triggers for impulsive behaviors,” Dr. Emanuele says. The purpose is to teach adolescents how to interact more effectively with other people and enable them to feel more supported by others.

- Distress tolerance skills: “It’s being able to recognize urges to do things that would be ineffective, such as hurting themselves or trying to kill themselves” and consciously controlling them, says Dr. Emanuele. These skills are the crisis survival tools for the most challenging moments.

- Walking-the-middle-path skill: Kids and parents learn how to validate one another, how to compromise and negotiate, and how to see the other person’s side of things. “It has to do with acknowledging multiple truths in the teenagers’ and the parents’ worldview as opposed to ‘I’m right and you’re wrong,’” explains Dr. Miller.

Some clinicians who do individual therapy, but are not part of a comprehensive DBT program, use DBT principles and introduce DBT skills — what’s often called DBT-informed treatment. “That would probably look more like CBT with mindfulness and acceptance-based strategies woven in,” notes Dr. Allerhand, “and it would be probably once a week.”

Why does DBT include phone coaching?

One of the most unusual elements of DBT programs, phone coaching, is designed to support patients’ efforts to apply DBT skills in their lives outside the therapy session, something therapists call “skills generalization.”

As Dr. Allerhand puts it, “How do we actually help people to do the things that we talked about in session when they are in the moments of crisis?” Ideally, the patient calls the therapist when they are tempted to do something self-destructive, to get support in using their DBT skills instead. Emotion dysregulation also leads to ineffective problem solving, and phone coaching can help kids and parents utilize more constructive problem solving skills rather than falling into old, unhelpful patterns.

Structured therapy sessions

Therapy sessions in comprehensive DBT don’t hew to a step-by-step manual, but they do follow structured principles, Dr. Allerhand says.

Each individual therapy session is structured around a diary card that the patient brings to the session, which is like a weekly tracker of their emotions and their urges to engage in whatever their problematic behaviors are.

There is a hierarchy of behaviors: Target 1 are life-threatening behaviors. Target 2, therapy-interfering behaviors.  And Target 3, quality-of-life-interfering behaviors.

The therapist makes it a priority to focus on Target 1 behaviors, giving them the most time in a session. “The point is that you can’t ignore if they’re thinking about hurting or killing themselves,” Dr. Allerhand explains, “and talk about, the test that they got a B- on.”

DBT, DMDD, and young children

DBT programs treat kids as young as 6. Dr. Allerhand says that the younger kids they see include those diagnosed with disruptive mood dysregulation disorder (DMDD).DMDD is a relatively new diagnosis for children who have explosive tantrums — big and emotional responses that are out of proportion to the events that triggered them — and in between outbursts they usually continue to be irritable.

Some of these young kids have behaviors that we usually associate with teenagers — hurting themselves, talking about killing themselves, or trying to kill themselves. “Recent CDC data actually showed that there’s been an increase in suicide attempts and completed suicides for younger kids,“ she notes.

Referrals to a DBT-C program (one structured specifically for children ages 6-12) often happen, she adds, “when the behavior has become so problematic that parents are worried for the safety of the child or other members of the family, or school placement is in jeopardy.”

#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/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite 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

Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth

If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

What happens after DBT?

After the 6-12 months of the comprehensive DBT program, most patients continue with individual or family therapy.

“Once they’ve gained control over the behaviors that were really making their life worse, the dangerous behaviors,” Dr. Allerhand explains, “most people still have lots of other goals that they need to work on to truly make their life feel fulfilling rather than just tolerable.” Many continue to do the diary cards, and they are able to focus in therapy on the continuing barriers to them having the things that they want in their life.

Dr. Allerhand notes that, as that Marsha Linehan famously said, “DBT is not a suicide prevention program. It’s a life-worth-living treatment program.  The idea is that people who have the life that they want, the things that they want in their life, and the relationships they want, are much less likely to hurt themselves or kill themselves.”

Frequently Asked Questions

What does DBT stand for?

How does DBT work?

DBT works by combining two sets of skills. The first, called mindfulness, helps kids understand and accept difficult feelings. The second, a treatment called CBT (cognitive behavioral therapy), teaches them how to change their feelings and behavior.

What is DBT used to treat? https://standingabovethecrowd.com/james-donaldson-on-mental-health-dbt-what-is-dialectical-behavior-therapy/