A Normal Divorce or Separation: How do you know if you need help?
During divorce and separation, sometimes it is hard at times like these to know what is normal and what is not. Everybody hurts during a separation, the whole family. Most get through it all with only a manageable amount of pain and stress. But normal problems, when they persist, can develop into bigger ones. A problem that feels too big, or lasts too long, might be better off being dealt with “upstream” before it gets worse.
You or your child may well feel depressed, lonely, helpless and afraid. Or someone in the family may turn to alcohol or other substances for escape or comfort. Many parents feel guilty and ashamed, and a large number of children assume that it was all caused by something they said or did. Interacting with former friends can be awkward and/or embarrassing, and the sum total of all the changes can be very overwhelming.
Children don’t often talk much. They “act out” what they think and feel by:
- Poor grades and/or other problems at school.
- Being angry and oppositional.
- Clinging a lot and crying excessively.
- Fighting with friends or getting picked on.
- Difficulty eating and sleeping.
- Blaming themselves for the problems.
- Difficulty concentrating or attending.
- Excessive sibling fighting.
Whether it is the children depressed, acting out, or you yourself getting stuck, if the problem persists, handling it alone can be as foolish as trying to do your own taxes in a year when everything changes.
They say that clinical depression is one psychological disorder that most people already have some ideas about since we all have been sad. A “rich full mood of sadness”- as Winnicott describes normal depressive phenomena, is nothing to be avoided. Although Winnicott was writing about children’s depressive experiences, it also applies to adults. Perhaps a sad mood should even be embraced from time to time! But clinical depressive experiences are far from normal. Several different symptoms are noteworthy and they must persist for a substantial period of time, as well as significantly interfere with work or other important functions. People who are clinically affected stop enjoying things, and typically just have trouble facing each day.
Children can get depressed clinically as well, however, it doesn’t always look like adult depression. Additionally, childhood depression is noteworthy for some age-specific features, including acting out. Many children who get picked on routinely can be depressed. You might be surprised at the relatively high number of children who are suicidal and whose parents may not even suspect it. The best (in our opinion) measure of childhood depression is by Dr.David Berndt and Charles Kaiser, however, there are other good measures as well. More can be found on this in the pages on psychological testing.
So how in Divorce, does one know when the sad mood has gone beyond mere normal sadness?
For one thing, if it is brief and gets better, you probably don’t have to worry. However, if it persists..get help….see more at what is normal?.
There are many theories of affective disorders. Depending on their theoretical understanding, one clinician may prefer one mode of treatment, like medication, while another may be equally fervent about another, like family therapy. A National Collaborative Study at the National Institute of Mental Health found a number of talk therapies and drug therapies worked, but that they are not significantly better than one another. In other words. Drug therapies are effective, (at least the one studied), as are at least 2 of the major talk therapies, but that none was superior. There was some indication that one of the talk therapies was slightly better at a one-year follow-up, but that study has not been replicated and should be viewed with caution.
Depression can become clinically significant if it lasts long enough and interferes with your life. Many different kinds of mood disorder have been observed, but most require that the symptoms last at least a week. There are two major kinds of affective disorders, Dysthymia and Major Depressive Disorder. Additionally, Bipolar Disorder (Manic Depressive Disorder)is also a related problem. It consists of extreme mood swings, typically from very high or irritable, to very low.
There are many elements or aspects of affective disorders that stand out, and you don’t need to have all of them to be clinically depressed. One prominent symptom is loss of interest. You wake up in the morning and don’t want to get out of bed. The things you used to do no longer seem to matter. Sad mood and loss of interest are among the most prominent symptoms. You can be depressed without both of these, but you would normally have one or the other.
Other depressive symptoms include helplessness, hopelessness, guilt, poor self-esteem, irritability, social withdrawal, difficulty concentrating, difficulty making decisions, and suicidal thoughts.
Childhood Depression, a Developmental Discussion
Depression in children rarely looks like it does in adults. Children of different ages have different symptoms, often reflecting their cognitive and developmental maturity. Clinically depressed children are not experiencing normal sad mood; rather they are as affected as their parents can be, with school, friendships, family and even live itself at risk.
Children who are depressed, especially young ones, do not have the vocabulary of adults. They don’t know how to say “I am sad” or I am lonely” as well as they know how to say “my tummy hurts” or “I don’t want to go to school”.The sad mood is not present nearly as often in children, who tend to either somatize (get sick) or act out their depression.
Children who are picked on a lot are almost always depressed. They get the bully to act out their own disregard for themselves. Some bullies are also depressed. Children who fight a lot, run away from home, get involved in delinquent activities, break windows, etc. should be evaluated for depression.
When Dr. Charles Kaiser and I developed the children’s version of the Multiscore Depression Inventory, we knew that we had to have it written in the children’s own language. Twelve children, all in all, wrote nearly all the items. The subscales allow a clinician to assess not only depression but which aspects of depression are most pronounced. Subscales measure guilt, low self-esteem, anxiety, suicidal ideation, social introversion, oppositional defiant behavior, hopelessness (pessimism), instrumental helplessness, and sad mood.
Psychological testing and tests discussed by an inline clinical psychologist
Psychologists are trained to do psychological tests, and this testing often can tell you a great deal about your self. While you may be able to take some self-help kinds of psychology tests online on the internet, only a trained (and licensed) clinical psychologist is qualified (or able) to give you a comprehensive, well-selected battery of tests designed to get at the questions with which you a concerned. Dr. Berndt is the author of a major test of depression, the Multiscore Depression Inventory (MDI) published by Western Psychological Services in Los Angeles. With Charles Kaiser, he also co-authored the children’s version of the same test (MDIC), although children wrote the bulk of the items. What are some of the questions a psychological test battery might address? One or more of the following are typical uses:
- Intellectual functioning. IQ, knowledge, achievement, memory capacity, learning disabilities, Alzheimer’s and other dementias, and intellectual strengths and weaknesses, neuropsychological impairment.
- Personality: introversion/extraversion, self-esteem, coping styles, defenses, complexes, conflicts, sexual and aggressive impulses, sensitivity, hardiness, proneness to stress, psychosis, sensation seeking, compulsivity, hysteria, Hypochondriasis, narcissism, borderline personality, personality disorders, creativity.
- Psychopathology. Psychosis, Schizophrenia, Mania, thought Disorders, delusions, reality testing, Diagnoses according to DSM lV, Depression, Anxiety, Post Traumatic Stress Disorder, Alcoholism.
- Career Interests. Preferences as they match similar workers, Enterprising, Realistic, Social, Investigative, etc.
Parental fitness, Custody Evaluations
Psychological test batteries are often given as a part of a custody evaluation. The main use of testing in this situation is to understand the strengths and weaknesses of an individual as they might relate to parenting. Another use of testing in custody evaluations is to understand any special needs that a child might have or developmental issues that might impact an aspect of the evaluation. Finally, when there is an allegation that one or another parent might have a mental illness that impacts the child, this is typically explored in the fairest way by giving the same tests to both parents. For more on custody issues in general, click here. Parental fitness is when the state wants to take sole custody of your child, and stop all visitations permanently. The state DSS typically has to present evidence strong evidence against you. Although the exact role varies from state to state, most often it includes a referral for evaluation of mental illness.