Understanding Children’s Emotional Responses to Mental Illness in the Family

0:00 [Music] 0:07 thank you 0:15 hello Dr Seema Segal so you are a 0:20 practicing psychiatrist in Fremont can 0:23 you give me a little bit of introduction 0:24 about you 0:26 sure 0:27 um rupali it's so good to do this again 0:29 with you I'm a psychiatrist in practice 0:32 in Fremont and I have over about 25 0:35 years of practice dealing with a wide 0:38 range of mental health disorders from 0:42 The Chronic severely ill people who have 0:45 schizophrenia bipolar disorder severe 0:48 depression with or without psychosis all 0:51 the way to people with dealing with 0:53 anxiety generalized social anxiety 0:57 and everything in between so I'm so 1:00 happy to have this opportunity to 1:03 educate and share some of my experiences 1:06 with your viewers thank you so much so 1:09 today we were going to tackle some of 1:12 the stories that have been shared on a 1:13 platform and one of the questions I had 1:17 about growing up in a family where one 1:21 of the family member or a parent or a 1:24 sibling has some kind of a mental 1:27 illness 1:28 so what are some of the emotional 1:30 responses that a child when they grow up 1:32 in this kind of a household what are 1:35 they feeling 1:36 you know this is 1:38 um a really really important topic 1:40 rupali because I see patients who either 1:44 as youngsters have grown up in our 1:47 family where one parent or a family 1:50 member has suffered you know a major 1:53 mental illness and they themselves have 1:56 then grown up you know to have 1:59 um sort of difficulties and challenges 2:01 with their own mental health as they you 2:04 know went into adult life but as a child 2:06 some of the emotions that you know they 2:09 can feel is 2:10 a spectrum that can include fear 2:14 confusion worry uh feelings of guilt 2:18 feelings of Shame not understanding 2:21 really what is happening uh within the 2:24 family uh within the family system 2:26 because you know one family member it 2:29 could be a parent it could be a sibling 2:31 is suffering from a major mental illness 2:34 which is a really disruptive event in 2:36 the family and uh you know depending on 2:40 the age of the child when they are 2:43 exposed to this the responses can also 2:46 vary because if you think about it you 2:48 know the maximum time of brain 2:50 development is happening till the age of 2:53 five and at that time the most essential 2:57 um you know things that the growing 2:59 toddler needs is bonding strong 3:01 attachments continuity consistency 3:04 dependability predictability of the 3:07 parental figure being there and when 3:10 this is disrupted it can lead to a 3:12 variety of mental health challenges 3:14 if it is an older child if it's an 3:17 adolescent at that age what you need is 3:20 you want parental approval you want 3:22 reassurances you want structure you want 3:26 sort of the uh you know the accolades 3:29 from your parents that you're doing a 3:30 good job because you're building your 3:32 self-esteem and self-worth in this time 3:35 so uh you know depending where you are 3:38 in your own development when you have to 3:41 face something like this in the family 3:42 the responses can vary 3:45 yeah wow that is 3:48 I mean you know the stories that we have 3:50 done I think it's really important to 3:52 hear what you just said so even for a 3:56 partner or a spouse who is supporting 4:00 um a partner who has mental illness 4:03 right how do they take care of 4:05 themselves you know how do they keep 4:07 their sanity and what are the signs that 4:09 they need help if it yeah um you know 4:13 this is an important question because 4:15 again 4:16 um you know unfortunately in this 4:18 country and in many others there is not 4:21 the concept of treating the whole family 4:24 you know as one unit because you can 4:27 imagine how disruptive it is for every 4:29 member of the family and the you know 4:31 family system is a very closed system so 4:35 stress in one part of that system 4:37 automatically impacts every other you 4:40 know piece of that system and the the 4:43 spouse or the well parent you know if 4:46 you will uh ends up having uh to carry 4:50 double the burden of not just taking 4:52 care of you know his or her spouse who 4:55 is struggling or suffering and needing 4:57 their help but also making sure that the 4:59 children are doing fine and keeping 5:02 their school and activities going along 5:04 with their job because Financial 5:06 insecurity becomes a real issue when 5:08 there is Parental Mental Health 5:10 challenges so as a result of this there 5:14 is a high risk of caregiver burnout 5:17 there is a high risk of you know the 5:20 well-parent not even being aware that 5:23 they need help and support of their own 5:26 so some of the you know signs to watch 5:28 out for are lack of sleep irritability 5:32 you know snapping at the parent or the 5:35 spouse absenteeism from from work 5:38 because you're too tired to really show 5:41 up at work difficulty focusing attending 5:44 concentrating on your work tasks uh 5:47 sometimes the men will resort to 5:49 substance use or maladaptive ways to 5:52 deal with this amount of stress so 5:55 anything that signals to you that you 5:58 are not at your Baseline not where you 6:01 are used to normally finding yourself 6:03 every day is something to be aware of 6:06 and so to have you know supports for 6:08 yourself in place having a trusted 6:11 friend or family member it could be you 6:15 know a friend at work it could be a 6:18 family member here or in India even 6:21 someone from your religious community 6:23 sometimes can step up to you know help 6:25 and for that it's really important to 6:29 talk about your struggles because people 6:30 can't help you if they don't know what's 6:33 happening with you yeah yeah no I think 6:36 I totally agree about talking about it 6:38 and I think that's why we are also 6:40 creating this whole platform about 6:42 sharing stories 6:43 so that really validates it let me ask 6:46 you one more question so that you talked 6:48 about the wellspouse but what about the 6:51 children right as they are growing 6:52 growing up what do they carry over when 6:56 they become an adult right like if they 6:58 have a parent like what are you know 7:01 thought let's talk about a little bit of 7:03 impact on these children as an adult 7:05 okay you know that again is an important 7:09 uh point because uh I always feel that a 7:13 penny of prevention is better than an 7:16 ounce of you know of cure and you want 7:19 to come in and prevent mental illness 7:22 from occurring in the first place so you 7:24 know mental hygiene mental health is not 7:27 the absence of mental illness it's about 7:30 what we do every single day to keep 7:33 ourselves mentally well and when a child 7:36 is growing up in an environment where 7:38 there is not Clarity of what is 7:42 happening you know around them all they 7:44 can see is that there is 7:47 unpredictability they don't understand 7:49 what's happening there are difficult 7:51 emotions you know in the home parents 7:54 look worried uh nobody's talking about 7:57 where the worry is coming from they see 7:59 a change in behavior in their parent or 8:01 family member and yet they have to 8:04 continue pretending everything is okay 8:07 when they're outside of the house 8:08 because they feel ashamed they have a 8:11 sense of guilt and when there isn't open 8:13 communication the fear generates a 8:16 feeling in the child that in some way 8:19 they must have been responsible for the 8:21 distress the family is experiencing so 8:24 this leads to low self-esteem it leads 8:26 to a sense of you know low self-worth 8:29 and you can see at this child you know 8:32 goes on to become an adult not only are 8:35 they under sort of you know have the 8:37 risk of inheriting the mental illness 8:40 because there is you know there are 8:42 mental illnesses like schizophrenia 8:44 bipolar disorder that have a very high 8:47 uh genetic uh predisposition and so they 8:51 have that they also have you know 8:53 they're facing adverse childhood 8:55 experiences their environment is not 8:58 conducive to uh you know to giving them 9:01 that sense of self that they can you 9:04 know take into adult life with them so 9:06 they are more prone a third of the 9:08 children of parents who have a serious 9:11 mental illness are at risk of developing 9:14 a mental illness themselves 9:16 so you know anxiety depression low 9:19 self-esteem social anxiety all of these 9:22 are you know things to watch out for as 9:25 this child becomes an adult on the other 9:28 hand though you know if there are 9:31 um resources and there is help that is 9:34 put in place for this child you know 9:36 they are we do explain to them what's 9:39 happening we uh we sort of let them talk 9:42 about their fears we give them answers 9:44 that they're looking for we Define their 9:47 role in what is happening in the family 9:49 that can build actually resilience 9:52 growth we see that these children 9:54 actually grow up to be more 9:56 compassionate more empathic and end up 9:59 being much more sensitive parents 10:01 themselves to children when they have 10:03 them so again it's really important in 10:06 how we deal with the children as they 10:08 are going through the stress themselves 10:10 so when you talk about this thing right 10:13 when you say VV as in professionals 10:15 right the professional field of 10:17 psychiatrists and the healthcare 10:19 providers right that's what you mean the 10:20 counselors you know the yes I mean that 10:24 primarily but you know a society where 10:27 there is so much stigma attached uh to 10:30 talking about mental health issues 10:32 oftentimes it ends up being family 10:34 members that step in and have to be that 10:38 you know de facto counselor for the 10:40 child because access to someone trained 10:43 to do this often doesn't happen yeah and 10:46 so again you know if the parents are 10:48 really sort of engaged in dealing with 10:51 this major stress in the family to then 10:54 enlist the help of a trusted adult which 10:57 could again be a sports coach it could 10:59 be you know a priest it could be a 11:01 family member but some Dependable 11:04 responsible trusted adult who can step 11:07 in and be that sounding board and just 11:09 help the child sort through what is 11:12 happening it could be a teacher or 11:13 counselor at school even yeah yeah great 11:16 I'm so glad that you could answer you 11:20 know I think it's a much needed thing 11:22 whenever you talk to somebody about this 11:25 everybody has like Okay so this person 11:27 in my family has it but we don't know 11:29 how to deal with it so I think with your 11:32 insights I think we will be able to make 11:34 it a little bit more uh you know 11:37 resource friendly uh would you also 11:40 share some of the resource at the end of 11:42 the video uh sure sure I will and you 11:45 know rupali I could not agree more how 11:48 important this uh topic really is 11:50 because you know we um talk about the 11:53 stigma in sort of you know in a way that 11:56 the person suffering from the mental 11:58 illness is the one who is feeling 12:01 stigmatized and trying to protect 12:03 themselves from feeling stigmatized from 12:06 society or you know even within their 12:08 family or community and you know I 12:12 really feel for the parents that I see 12:14 in my practice because I'll have mothers 12:17 who um you know have a major Mental 12:20 Health issue that they are dealing with 12:22 they are in treatment and yet the fear 12:25 of being an unfit mother is somehow even 12:28 stronger and more powerful than the 12:31 stigma of having a mental illness and so 12:34 a lot of times you know they will they 12:36 will not talk about it just from the 12:39 fear of you know Legal Services child 12:42 protective services you know the school 12:44 system sort of picking up that something 12:46 is amiss in the house and they may be 12:48 separated from their children and and 12:50 you know I want to really emphasize the 12:52 fact that even though these mental 12:54 health disorders you know a lot of 12:56 people don't know the details and how 12:58 severe they can be I just want to 13:01 Clearly say that they are treatable you 13:03 know they have symptoms which when 13:06 untreated can lead to you know a lot of 13:09 disruptive behavior and a lot of 13:10 symptoms that are hard to understand but 13:13 if you educate yourself and help this 13:16 person get the treatment they need 13:18 oftentimes I would say about you know 70 13:21 80 percent of the time 13:23 we can go back to a very healthy family 13:25 again yeah so the timely intervention is 13:29 really the key it is it is yeah great 13:32 thank you so much Dr Seema Segal 13:34 appreciate your time you're welcome 13:36 rupali and look forward to chatting 13:38 again with you thank you 13:40 [Music] 13:52 thank you 13:57 foreign