Your child or teenager starts to change – a lot. A compliant child becomes defiant. A teen stops hanging out with old friends and becomes reclusive, or develops a new and less appealing group of peers.
Maybe the child is “just being a teenager” or maybe it’s a sign something more is going on.
Mental illness sometimes manifests itself early. And early intervention is the key to achieving a good outcome for the patient. When in doubt, seek professional help, said Monica Smith, director of Behavioral Health at UCHealth Northern Colorado.
Early intervention for mental health issues helps improve outcomes
Smith, who is a nurse by profession and has a master’s degree in nursing leadership, has been with the organization for 20 years, the past 17 as director.
“Early intervention just means getting help before the symptoms are so devastating that you have to be hospitalized,” she said. “The first sign is that something is not quite right.”
Maybe the child is not sleeping or eating well or has no energy, “vague symptoms that can be attributed to a lot of things, but also can signal depression or other problems,” Smith said. “In children or adolescents, maybe they are suddenly doing poorly in school, isolating themselves from friends, breaking all the rules, showing changes in the way they dress or in their demeanor.” As a parent or loved one, “you want to start paying attention.”
Often, nothing is done until a child starts getting in trouble with school or even the law, she added.
“As soon as you start having concerns or arguments, think ‘Is there something else going on here?’” Smith said.
She added that although “it could be just the normal teenage rebellion, it also can mean something else is going on, like drug abuse, or early signs of bipolar or depression.”
The same thing is true with adults, she noted. Maybe someone who is usually physically active and outgoing becomes lethargic and introverted — a change from who they used to be. Maybe they stop talking to you, drink more, eat less or sleep a lot.
Signs of mental illness often do manifest themselves in the young, but not always, she said.
“It can happen at any age.”
She gives the example of someone who loses his or her job. That person may become depressed or suddenly socially isolated.
Don’t say, “Oh, he’ll get over it,” she said. “That might be the prime time to seek counseling. If you ignore it, it can get worse and worse till it gets to the point where they’re drinking more, maybe becoming more withdrawn, and it’s interfering with relationships.”
Untreated, the patient may reach a point where they can’t take it anymore, even thinking about suicide.
“At that point, you’re past early intervention,” Smith said. “Ignoring that first symptom can trigger bigger problems.”
Early on is the time to evaluate, perhaps prescribe an anti-depressant or other medication, or get counseling.
It’s a time to say, “‘Let’s go talk — find out if it’s more than just the blues.’” Because “when it’s the fourth week you’ve got the blues, then you need help,” she said.
Depression is the most common illness treated at the outpatient clinic, followed by anxiety.
“They’re probably the two things where early intervention can help the most,” Smith said. “And for people who are bipolar, if you intervene early on, the outcome is more positive with fewer disruptions in their daily lives. If not, it makes it much harder for them to get back on their feet.”
Intervening at any point helps, she said, but “the sooner you intervene, the more the duration [of symptoms] can be shortened, or the fallout can be eased – before it impacts their entire life.”
The causes of bipolar disorder are organic, she said.
“A biological salt called lithium is missing in the body, and that helps us to modulate mood and to sleep normally. You may be predisposed and not even know it. There’s definitely a genetic component, just like other diseases.”
The sooner there is intervention with mental illness, the less disruptive it will be, Smith said. “People with hypertension, if they take meds, are less likely to have a stroke or heart attack. If they don’t take their meds, the results will be more debilitating. Mental illness is very much like that.”
The stigma of mental illness keeps many people from seeking health care early enough, she said. It’s something that society needs to overcome.
“People are no more choosing to be that way than they would to be diabetic or hypertensive,” she said.
Early intervention – when symptoms first present themselves – is like treating any other disease.
“For example, when you feel like you’re coming down with a cold and you take some vitamin C , drink fluids and get some extra rest,” she said. “We treat it before it gets too bad.”
Patients often come to UCHealth’s behavioral health facilities through referrals – from a medical doctor or even a school counselor.
“Early intervention usually starts in children, so it’s usually the school that recommends it, long before a parent thinks it is necessary,” she said.
If identified early enough, most forms of mental illness can be treated on an outpatient basis. The duration and frequency of visits will vary widely depending on how early the illness is caught, which illness the patient suffers, and how faithful they are in following the prescribed regimen. Visits can vary from several times a week to once a year, once symptoms are under control.
Most insurance plans have some sort of mental health coverage, but if not, help is available, she said. A person’s primary care physician also may be a resource with early identification and treatment, she added.
“The big key to all this is helping society move away from the stigma of getting help for a mental illness,” she said.
Right now, mental illness is among the top five causes of death in America, Smith said.
“The tragedy is — it’s treatable.”