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Ask the doctor: How can I tell that my child is depressed? Health By Saada Hassan - https://www.standardmedia.co.ke/evewoman/amp/health/article/2001386564/ask-the-doctor-how-can-i-tell-that-my-child-is-depressed?fbclid=IwAR0L03gDA-JdUCeIW4iNwb7YR1e_TV0aFvM0zaRhv_LPMSAyfRAZFeATaFY

 Depression is caused by genetic predisposition and the environment (Photo: Shutterstock)


Do children get stressed or depressed?

Yes children get stressed and depressed due to many issues - when they witness family wrangles, when they have a lot of school work, when parents are absent or are too busy and have no time for them, leaving them with no one to discuss what they go through, and high expectations from parents and society.

What is the cause?

Depression is caused by multiple factors. There is the genetic predisposition and the environment. With the environment, there is modelling, where a child models how they see their parents cope with stress and anxiety. They can model learnt helplessness.

The other environmental factors could be stress at home and how the parents handle that. Parents sometimes pressure their children to perform and it can also be access to information online, especially now that some schools are doing remote teaching.

When they go online, they could access social media, which brings in comparisons and cyber bullying. There are a lot of factors and with the current policy of staying at home, there are places children cannot be allowed to access to play due to the mode of transmission of the virus. Currently, we are seeing a lot of higher rates of depression and stress among children. They are not going to school, and some are not engaged properly. Parents are also stressed and passing the stress on the children.

Social media can bring in comparisons and cyber bullying (Photo: Shutterstock)

How can I tell that my child is depressed? What are some of the reliable symptoms?

Unlike adults, children show irritability as the first symptom of depression as well as disobedience. They will still show sadness, withdrawal, and a feeling of hopelessness, which can be seen in adults. But with children, the biggest is irritability. Depending on where the child is, sometimes they experiment with substances like glue, cigarettes and alcohol, depending on the environment, supervision and ease of access to the substances.

What should a parent do if they notice their children are stressed/depressed?

A parent should link up the child for care when they notice these signs. First mode of care is to listen to the child. Sometimes children commit suicide, that is why it is important to be non-judgmental when you are listening to them. It is also important to teach them how to take care of themselves. Reach out to a psychiatrist, psychologist or a nurse within your area.

Is it preventable?

There is the biological disposition that may not be altered, but it is possible to alter the environment and prevent depression. The strategy a parent will use is very important. The child needs an avenue that they can be able to release their stress. A parent can try to remold the environment to fit the child. 

A parent should link up the child for care when they notice signs of depression (Photo: Shutterstock)

How fast do children recover from depression and what does treatment entail?

Recovery in children depends on the point of depression. With proper psychotherapy, they can recover fast. In cases of a child who has lost their parent or has been exposed to trauma, they will suffer from anxiety and depression, and they will need proper treatment to recover. Relapse is possible, that is why proper cognitive behavioral therapy is required. Talk therapy will help the child speak out and cope while maintenance therapy will release the ongoing stress. If you help them and fail to make their environment safe, they will likely relapse.

Can my child develop other health complications due to depression?

Yes. If a child is not eating well due to depression, they will suffer from malnutrition. They can be stress eating and result in obesity. A lifestyle learnt in childhood is likely to go on in adulthood. Disorders like Anorexia nervosa are brought about in children who tend to fail to eat due to internal depression or Bulimia, where they overeat and they induce vomiting. With online access, children see what is valued in the west and they end up suffering from such complications.

A child may fail to eat well due to depression (Photo: Shutterstock)

What role should I play as a parent to help my child heal from depression?

Once the child has been confirmed to be suffering from depression, help them get the correct treatment while giving them the right support. Find out from the caregivers what you need to do as a parent. The best thing would be to prevent a recurrence by molding the environment. You may not change the child’s genetic predisposition but you can alter the environment by embracing calmness, teaching them how to deal with problems. But the key thing is being there for the children.

Be present and be able to relate with them while trying fun things. We see parents who only interact with their children when they are disciplining them, which is wrong. It shows there is no friendship. Simple things like participating in what they love, praising them and rewarding good behavior will account for positive parenting and build friendship.

The number of children suffering from depression is rising. Where are we going wrong as a society in addressing these issues? 

A lot has changed within the society. Urbanisation has brought its advantages and disadvantages. For example, when a parent has to work, they are forced to leave their children with caregivers, who might not instill the right values in the child. Social relatedness has reduced due to people being busy and failing to create time for their children. Stressors like Covid-19 have disrupted the lives of children who are not able to play freely or even go to school. While parents who are not able to work from home cannot supervise their children, failing to instill the right values gives room for the child to model values from anyone they see fit.

Parenting is key when it comes to children and bonding with them helps shape their behavior. Children translate spending time with them as love.

By Dr Catherine Syengo as told to Saada Hassan. Dr Syengo is a consultant psychiatrist. If you could pick any place in the world, where would you live?

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Dr. CATHERINE SYENGO MUTISYA, THE #MILLENNIUMCLASSOF2000PSYCHIATRIST- https://simonkigondu.blogspot.com/2020/09/dr-catherine-syengo-mutisya.html?fbclid=IwAR1S8NT9NwCsXNfc8MPo8Y0bzYPrHAMuLQzhdK_wCGGUHYo5xfiD3q3RKUA

 Medical School memory

My medical school memories of Dr Catherine Syengo Mutisya is that she was a front bencher and a very quiet girl. She was the first of my classmates to settle down. She is one of the two of #MillenniumClassOf2000 who specialized in psychiatry. The other Class of 2000 psychiatrist is Dr Wainaina Alex, now a Jesuit priest with the Catholic Church. 

Suicide prevention day

I caught up with her ironically on Suicide Prevention Day as she was creating material on suicide prevention awareness and also finalizing an article for the “Medical Focus (Vol 2 No 2 Sep/Oct issue 2020) titled - Schizophrenia : A Guide to Patient’s Health for Health Care Providers who are involved in HIV, TB and Mental Health. In August 2020 Dr Mutisya presented at one of the Kenya Medical Association (KMA) Webinars for Health care workers. Her discussion on 'How to process Loss and Grief associated with the COVID 19 Pandemic Period' was very informative. 

Office

I often meet Dr Mutisya in the corridors and board rooms of KMA Centre, the headquarters of KMA. Her office is located on the third floor.  She has served in the KMA Housing Committee as an executive. 

Contribution to the society

Dr Catherine Mutisya works as a senior consultant psychiatrist at the Mathari National Teaching & Referral Hospital. At the MOH Medical board she is often called upon to assess patients who need to retire on medical grounds. She also runs the Nairobi Parenting Clinic and Nairobi Mental Health Services. With her team she has been doing mental health promotion by sensitizing parents and teachers on prevention of mental disorders, identification and referral of mental disorders and spreading of anti-stigma messages through the media. She is keen on offering affordable Mental Health Services. Dr Mutisya also does a lot of counseling and detox for victims of substance abuse and addiction, a field I have some interests in. She was a member of the Mental Health Task force that produced and disseminated a report on Mental Health in Kenya amidst the Covid 19 Pandemic. 

Honors & Recognition

For her endevours in creating Mental Health awareness she has been twice  nominated to the Business Daily- Kenya's Top 40 Under 40 Women in 2010 and 2014. She has been featured in Eve’s Magazine in an article titled 'Psychiatrist Dr Catherine Syengo Mutisya: Beyond the call'. She has featured in Nation Media and on Royal media's Strength Of A Woman. She is the vice chairperson of the Royal College of Psychiatrists, African International Division. 

But why did she choose Psychiatry?

Almost as a journey of self discovery Dr Mutisya said “I grew up with an elder brother who had severe intellectual disability. He was more of the 'baby' in the family and needed all the care and attention. My parents struggled to bring him up. In addition, one of my uncles lived with schizophrenia.  My dad would bring him to stay with us whenever he had a relapse as he sought proper medical care for him. They would often have to wake up early to travel from Kitui County to Machakos General Hospital, which at the time was the nearest facility that offered psychiatric services. I chose to specialize in psychiatry to understand and manage the illnesses I encountered as I grew up

Family life

She met her husband who she met at the University of Nairobi.  Of him she says “Mutisya has been my best friend. He is very supportive and I know I can always count on him. I was the most important person in his life. I am confident that as we enter the stage of “empty nest” we are good to go!” 

Their first born is currently pursuing a Masters in Biomedical Engineering and the last born will join University next year.


Trivia
Did you know that Dr Catherine Syengo Mutisya
-  Headed the Substance Abuse Management & Mental Health Promotion at the Ministry of Health
- Has been Deputy Medical Superintendent Mathari National Teaching & Referral Hospital
Has won best worker of the year award at Mathari NTRH
- Was a Chief Registrar Psychiatry
Scored a straight A from Muthale Girls Secondary School

As narrated by Dr Catherine Syengo Mutisya, Psychiatrist

To

Dr Simon M. Kigondu
simonkigondu@gmail.com 







Psychiatric Services resume after Covid-19 Lock down

In the fight of Covid 19 Pandemic, Are Mental Health Professionals immune to mental health problems?

Mental Health Professionals are not immune to Mental Health Problems.


As we manage the Covid 19 pandemic it is a well known fact that Medical staff are the most affected by associated mental health problems including but not limited to  Anxiety Disorders, Depression, Pre-trauma stress, Post-trauma stress, insomnia and other types of distress.

A study carried out in Wuhan showed that  among the health workers, 50 percent had depression, 45 percent anxiety, 34 percent insomnia and 72 percent distress.

In some countries, Specialist Mental Health professionals are being asked to physically attend to those in Quarantines and in hospitals(front line) to manage the mental health problems in addition to managing those with chronic mental health problems in the community and in psychiatric hospitals.

The question is who then takes care of these front line mental health professionals?

Since in some countries mental health is still stigmatized, the mental health professionals are also assumed to be performing magic which the other specialists primary health care workers do not want to understand and do not want to participate in. Those in quarantines are in some places being pushed to psychiatric hospitals when they could be managed in proper Covid 19 quarantine centers just like the other clients with other commodities.

 The first question is if we are not transferring a diabetic or someone with hypertension why should we transfer someone with a mood disorder from a quarantine area to a psychiatric hospital?

All countries are being encouraged to move  mental health services from specialist psychiatric hospitals to the community  and primary care and not vice versa. Mental health services should also be integrated in primary health care and not pushed to specialist long stay psychiatric hospitals. Primary Health care workers should also be able to manage mild to moderate mental health problems

The second question is who takes care of the mental health professionals mental health in the third world countries? Is it assumed that mental health professionals are immune to mental health problems? Considering the fact that specialist mental health professionals, are fewer than primary care providers, it is my opinion that the few specialist mental health professionals should not be loaded with duties that can be carried out by primary health care workers to avoid burn out. Let the primary health care workers consult the specialist mental health professional as need be but not to load the few mental health professionals with primary care duties as well as specialized care duties. If this is done,, then burn out rates among the few mental health professionals in the third world countries will be reduced

We should all remember that Mental Health Professionals are not immune to Mental Health Problems.

 
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