The Impact of Parental Depression on Teenage Children - Dissertation Example

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The impact of parental depression on teenage children between the ages of 15 and 19 years of age in relationship to the cultural history of the disease Name University Class Table of Contents Abstract Chapter One - Introduction 1.1 Introduction 1.2 Key Terms 1.3 Research Questions Chapter Two - Literature Review 2.1 Introduction 2.2 Depression during the Middle Ages 2.3 Depression during the 16th through the 19th century 2.4 Depression during and beyond the 1950’s 2.5 Public perception 2.6 The effect on teenage children of parents with depression 2.7 Summary Chapter Three - Methodology 3.1 Introduction 3.2 Secondary Research 3.3 Procedures 3.4 Justification for Qualitative Study 3.5 Limitations 3.6 Summary Chapter Four - Conclusions 4.1 Discussion and Findings 4.2 Conclusions Bibliography Abstract The following study was conducted with the intent of drawing a parallel between the public perception of mental disease and the ways in which children suffer from the affects of having a parent with depression. Living with someone who has a disease that changes their perception of reality can exhaust a family, leaving the development of children, particularly in their teen years, without a stable foundation. With a disease that is defined by its condition as a mental disease, a child may have to deal with additional feelings of guilt and shame, their lives becoming about the secret of mother or father’s illness. This study was conducted using relevant literature, both primary resources and secondary literature in order to frame the conclusion to the questions posed by the work. Through a qualitative approach, the relevant literature is examined for the experience that has been present in the human condition concerning the incidence of mental illness. Through understanding this experience, the researcher can come to conclusions based upon an understanding of the concept that stretches beyond that which can be quantified. Chapter One Introduction As a child, the development of curiosity for this condition in parents came from exposure to a friend whose mother suffered from deep bouts of depression. Knowing this girl from the age of eight through high school made a deep impression about the concept of the disease that her mother seemed to suffer from through long torturous months of unpredictable days for this child. The girl, who may or may not have been similarly afflicted, displayed a series of behaviours that were curious and encouraged a need to find an understanding for what she was going through at the time. She horded large amounts of food in her locker at school, always afraid she would go home and have nothing to eat. She gained large amounts of weight, only to lose the same until she was thin as bone. She also began to cut herself when she was sixteen, a secret that was never revealed to any adult. The level of secrecy that her life held and the ways in which she expressed her own anxiety created a high level of curiosity about how much her mother’s mental disease was affecting her life in comparison to any disease that she might have had on her own. The actions that were in rebellion to her own situation, hording food until it sat in piles of mold in her locker, in comparison to her acts of cutting her skin always created wonder at her own levels of depression, whether from an inherited condition, or from her exposure to behaviours of depression as they were exhibited by her mother. In this qualitative study, the research will be gathered through an investigation of secondary research and primary resource literature in order to understand the historical understanding of depression and the stigma that the disease has developed within society. While society tends to have a compassion for those who are afflicted with depression, there is still a pervasive opinion that it is merely a sadness, a disease that could be controlled if the afflicted would just try harder to not be afflicted. This creates a stigma that proposes that secrecy and silence rule within a family where one of the parents suffers from such a disease. The affect of this upon teenage children as they cognitively develop can create problems that must be recognized in order to find ways in which to cope with them. 1.2 Key Terms: Depression: “Major depression is a condition of the brain and nervous system that causes a loss of both pleasure and interest in life. It is usually characterized by sadness, pessimism and hopelessness. However, depression is more than a change in emotions: it is a real medical illness with physical symptoms such as disturbed sleep, loss of appetite, change in weight, decreased energy, slowness, and difficulty focusing” (Burgess 2009, p. 2) Teenager: The teenage years create the bridge between childhood and adulthood. Because of this span, this period of time cannot be considered through the lens of one aspect of the changes that occur during the teen years. The time period that is being discussed in this study is between the ages of 15 and 19 in order to create a period within the period of teenage years. Therefore, whenever a teenager is mentions, this is the age span that is being referred to for the purposes of this study (Berry 2006, p. 57). Mental Illness: “Mental illness is a medical disorder whose manifestations are primarily signs or symptoms of a psychological (behavioural) nature, or if physical, can be understood using only psychological concepts” (Moore 2004, p. 211). 1.3 Research Questions The following questions have been used in order to focus the study and create a piece of work with the intent of finding conclusions about the topic. 1. In what way has history provided a framework in which Western culture has defined mental illness? 2. What was the perception of mental illness before the nineteenth century? 3. What advances were made, first through the Renaissance, then through the 1950’s that provided for the field of psychology as it is known in this post-modern era? 4. What effects does the perception of depression provide in regard to the way in which a family will cope with the issue? 5. How do children in their teenage years between the ages of fifteen and nineteen cope with the issues of a parent who has depression? 6. How does society best address the issues that a child will have from the effects of having a parent who has depression? 1.4 Summary The key concepts in this study are depression, teenager, and mental illness, all being used to form a framework in which an understanding is reached about how children of those who are suffering from depression are coping with this event. Through looking at the relevant research questions, the study will be able to focus the ways in which it will achieve conclusions to these goal concepts, thus allowing for a more richly threaded understanding of the concept into the general knowledge about the effects of depression. Chapter Two Literature Review 2.1 Introduction Creating an understanding of the historical context in which depression has been assessed requires a cultural understanding of several different time periods. The ways in which depression has been approached by the medical profession also bears evidence of the cultural perception of the disease in any given time period. It is the cultural perception of the disease in conjunction with the displayed behaviours that are experienced by teenager children when bearing witness to the effects of the disease that creates an impression upon the lives of those children. In this literature review the ways in which history has defined depression and the cultural perception of the disease throughout the ages will be assessed. As well, the ways in which the medical profession has approached treatment of the condition is studied in order to see how the perception of the nature of the disease is perpetuated throughout society. Primary texts as well as secondary literature is reviewed in order to provide this assessment. 2.2 Depression during the Middle Ages During the Middle Ages, many of the events within life were explained through supernatural concepts that were invented to provide answers to questions that medical science had not yet developed a rational perception from which to create solutions to the problems of the body. According to Ainsworth (2000), during the Middle Ages the causes for depression where considered to be either through God’s punishment or possession by the devil or a demonic spirits. Often there were punishments met out for the afflicted, their condition being blamed upon the sin that was upon their soul (p. 49). However, some herbal remedies were made during this time that was intended to combat the effects of depression St John’s Wort was used to alleviate anxiety which often was identified with symptoms of depression. St John’s Wort has been shown to alleviate some symptoms of depression, thereby offering a mild amount of remedy that would have been significant to those suffering in a time with little understanding of psychology and the physiology of the mind (Barry and Farmer 2002, p. 430) Not all philosophers and theologians believed that mental illness was the result of a sin, punishment, or association with an evil spirit. Thomas Aquinas (1225 - 1274) believed that the soul could not be ’sick’ therefore, mental illness was the result of a physical causal factor (Plante 2011, p. 35: Thompson 2007, p. 9). Aquinas further theorized that stressed that there was a mind-body unity with a biological foundation for psychopathology. Aquinas also attributed mental illness to a deficient use of reason which interfered with the passions or was a part of at dysfunction of the body (Stein, Leventhal, and Trabasso 1990, p. 360). 2.3 Depression during the 16th through the 19th century The sixteenth century was a time in which renewed interest was made in searching for scientific reasons for the maladies of the mind. The evidence of the Salem Massachusetts witch trials that were conducted because of the ‘fits’ that were displayed by teenage girls with claims of causes from witchcraft proves that the time period was still not free of the superstitions. However, in Europe the trend towards finding scientific meaning for causes for illness was on the upswing and the world of medicine was being treated with a sense of reason. Medical reductionism was being used to discover the causes of illness, which included experimentation in finding out the causes of mental illness (Plante 2011, p. 35). Through most of the sixteenth, seventeenth, and eighteenth centuries, mental illness was treated through hospitalization with barbaric methods of experimentation providing for treatments that were often cruel and tortuous. It wasn’t until the 19th century that any real advances were made towards modern mental illness care. Rudolf Virchow and Louis Pasteur made discoveries that provided links between illness and dysfunctions at the cellular level, thus providing the beginnings of the understanding of how illness was a result of a biological problem within the body (Plante 2011, p. 36). The evidence of the discoveries that Virchow was making can be found in some of his lectures. He states that illness can be carried from one person to another, either through exposure in a closed room or on clothing and the person themselves, thus making the connection between external forces creating changes within the body that create illness (Virchow 1868, p. 41). 2.4 Depression during and beyond the 1950’s The advances in mental illness culminated in the 1950’s when there was still as social stigma that permeated the cultural landscape with feelings of blame and accusation, but the advances since the beginning of real psychiatric study in the late nineteenth century were impacting the way in which the medical profession was approaching mental disease. Pharmaceutical remedies were being explored and options that included new medications were beginning to be part of the way in which mental illness was approached. As well, hospitalization was no longer considered the only appropriate way in which to treat those with mental issues, but outpatient care was also considered a very worthwhile method of treatment (Nolan 1998, p. 113). According to Paykel (2001), the treatment of depression became relevant to the truth about the condition in the 1950’s when anti-depressant drugs became available. The first milestone occurred with a clinical trial run for the drug imipramine in 1959, but the success that was detected for monoamine oxidase inhibators (MAOI’S). This led to the advances made in electroconvulsive therapies (ECT) because of widespread opinion that the initial ways in which it had been used was barbaric and less helpful than it was hurtful. Psychotherapy wasn’t in wide use in the U.K. until the 1980’s, despite its rise in popularity within the United States beginning in the 1960’s. Behavioural therapy and cognitive therapy have also both risen in popularity with cognitive therapy become very popular in the 1990’s (Paykel 2001, p. 138). In nursing those with depression, Norman and Ryrie (2004) suggest that according to studies done in the U.K. on alternative methods of therapy, such as massage, aromatherapy, yoga, and acupuncture, found that in combining holistic remedies with pharmaceutical and psychiatric therapy created a more nurturing environment for healing from the condition (p. 336). However, in the United States, the use of alternative therapies is discouraged by the American Medical Association, thus curbing the use of these types of care for patients suffering from depression. The AMA did pass a resolution in 1995 to start testing and considering alternative therapies in a cautious stance of openness towards the possible value some of these therapies might offer (Baer 2004, p. 95). 2.5 Public perception Public perception of mental illness leads to a series of social responses that are not conducive to healthy recovery. Some of these responses include bias, distrust, fear, stereotyping, embarrassment and avoidance (Ritter and Lampkin 2010, p. 12). Comer sites two examples of American politicians who were affected by the public’s perception of the disease from two different decades. In 1972 when George McGovern was running for president, the news was leaked that his running mate, Thomas Eagleton, had once suffered from depression and had undergone ECT. Eagleton resigned from the campaign in disgrace, his past haunting the road to the oval office that he had attempted to ride with McGovern. However, in 1996 when Colin Powel was contemplating an attempt at the presidency, rumors emerged that his wife had suffered from a bout with depression. Powel announced that he would not be running for president, but straightforwardly addressed the issue of his wife having suffered from the disease. His desire not to run for office was not because of this revelation, but it was an opportunity to provide a platform from which to discuss the issues that surround mental illness. He was able to openly discuss treatment and encourage others who have had such illness to seek help without shame or secrecy, his openness serving as the inspiration (Comer 2004, p. 238). One of the problems within the U.K. is that there is not enough mental health care education provided within the general care phycisions, thus many of the signs for mental illness are lost before they can be treated (Maj 2005, p. 260). As well, there is no real public policy that has been created by legislators in order to support the needs of those afflicted with mental health (Cattan and Tilford 2006, p. 197). As one looks as these two aspects of neglect where mental health care is concerned, it is clear that this area of medical help has been neglected within the U. K. Mental health concerns should be addressed in order to provide a more stable cultural acceptance of the disease as well as to provide deeply needed services to those who are suffering from the disease. In a study done in France it was determined that perceived health and actual health were closely related (Goldberg, Gueguen, Schmaus, Nakache, and Goldberg 2001, p. 233). This relates to the sense of mental health that is throughout Europe. The general sociological undercurrent is that mental health could be controlled by the afflicted if that person so chose to not be affected by the perceptions of the world that the disease gives to them. A similar study concluded that flight attendants suffered from depression when they perceived themselves to be depressed (Ballard, Romito, Lauria, Vigiliano, Caldora, Mazzanti, and Verdecchia 2005, p. 33). 2.6 The effect on teenage children of parents with depression In early childhood, the National Council on Family Relations (2007) relates that children of parents with depression exhibit behavioral problems such as anxiety disorders, depression, attention deficit or oppositional defiance disorders (p. 1162). According to Olfson, Marcus, Druss, Pincus and Weissman (2003) children of depressed parents are twice as likely to have mental problems of their own and 2.8 times as likely to use mental health services (p. 716). From the perspective of these studies it would appear that some aspects of mental illness can be developed through learned behaviours. 2.7 Summary The perception of mental health care is central to the first problems that children in their teens will encounter when having to cope with the depression of a parent. The stigma that is attached invades all aspects of trying to cope with the illness, creating a sense of secrecy and shame that must be navigated in order to continue family life. Other problems are born in early childhood and by the time they are teens, the damage may have already been done. These children spend a lifetime trying to navigate an instability that they cannot possibly understand, thus they act out and develop their own issues, whether through heredity or through their own perception of their state of mental health. Chapter Three Methodology 3.1 Introduction The purpose of the study is to research relevant literature in order to find the ways in which depression in children between the ages of fifteen and nineteen has been defined, experienced, and treated throughout the generations of the last one thousand years. Depression is an illness that has been greatly misunderstood throughout the ages. Through a thorough examination of available literature, this study will show the advances that have been made and the way in which the illness has been redefined and understood through the passage of time. An emphasis will be put on creating an understanding of how parents who are suffering from depression impact the development of their children. In order to study how depression has been viewed throughout time, an investigation of relevant literature will provide the richest resource for historical information. The literature will be used to find common elements that link the overall transmutation of the understanding that medical professionals have had about the disease and the way that treatment approaches have changed to accommodate those changes. The study will be developed through a qualitative approach as secondary resources are used to create a framework for understanding the phenomenon of the development of the understanding about the disease of depression. According to Eisner (1991), the intent of a qualitative study is to “understand a situation that would otherwise be enigmatic or confusing” (p. 597). Qualitative techniques will be used to narrow the understanding of the topic and to create a resource for understanding the human experience of depression throughout the last one thousand years and then relate that understanding to how parents who suffer from depression impact the lives of their children. 3.2 Secondary Research Secondary research will be used as a resource for creating the data within this study. According to Steward and Kamins (1993), secondary research provides a series of advantage that primary research cannot always provide. Secondary research has the advantages of a larger framework of data that has been created by multiple researchers who collect evidence to support a variance of conclusions. Secondary data that has been collected by qualified researchers can be used for the purposes of comparisons and understanding through the use of the clarity that other researchers have found within their own research (1). When researching facts that are concerned with historical understanding of a topic, secondary research provides the best resource for creating understanding. Within the secondary research, primary resources can be used in order to help frame the literary study of the topic. Within this paper, primary resources in the form of literary works by people of prominence will be used in order to frame the understanding and experience of depression within the last one thousand years. Secondary research, especially when it includes primary literary resources, creates a basis from which to discover the ways in which the disease has been framed for treatment. 3.3 Procedures In order to provide the research for this study, internet based libraries were searched for journal entries and books that are relevant to the issues of the topic. Google books provides a valuable sets of resources from which books from a vast set of cultures which includes the United States, India, and the European nations can be found. This provides a global perspective on the topic, creating a broader sense of the concept and a greater depth of an understanding of the issues. Once the appropriate texts were gathered, the similarities and arguments provided were put together so that they created a framework in which conclusions could be assessed. 3.4 Justification for Qualitative Study Qualitative theories on research are used within this study. According to Bowen (2005), an analysis of patterns from within the data can provide thematic codes that are then translated into appropriate sections of data. Bowen stated that “At successive stages, themes moved from a low level of abstraction to become major, overarching themes rooted in the concrete evidence provided by the data. These emerging themes, together with substantive-formal theory of development-focused collaboration became the major findings of my study”. According to this framework of qualitative study, collaboration between the secondary literature creates spheres of relevant evidence that come together to form an overall understanding of the experience. The phenomenological approach in qualitative study is used as a framework in which to analyze the collected data. According to Gubrium and Holstein (2002), this approach is appropriate when creating a sensitized concept of a research topic so that the subject can be analyzed for its relative experiential relationships. Polkinghome (1989) is quoted in Shram (2006) for suggesting that the qualitative researcher creates knowledge through the events of experience rather than creating data that is analyzed numerically as in quantitative data. Phenomenological research will provide the opportunity to create research that is rich in experience and depth of knowledge that is not as available in quantitative study. 3.5 Limitations Because this research study will be limited to textual research, there will be limitations on understanding the experiences of children who have parents with depression. Since this topic is a difficult one to breach without access to patient information, primary research regarding children of parents with depression would be difficult to obtain. However, looking at the relevant history and research that has been conducted will provide a framework for finding a way in which to understand the topic. 3.6 Summary This study will be researched through resources found through secondary research and primary literature resources. Through a review of the relevant literature, a framework of understanding the experience can be reached so that conclusions can be drawn from the similarities and arguments that are found within the texts. The research will be limited to the work of others through secondary research and primary resources of literature so that an understanding of the history of depression can be related to current theories of the effect of the disease when parents are afflicted as it relates to their teenage children. As the history of the disease is revealed, the perception of the effect that the disease has on those teenage children exposed to parents who are affected by the condition can be assessed in relationship to how the disease has come to be understood through both a medical and a cultural level of understanding. Chapter Four Conclusions 4.1 Discussion and Findings Depression is a terrible disease that affects an entire family when one member must suffer the consequences of the condition. From a historic perspective, a thousand years of opinion mostly focused on the condition rising from some fault or action of the afflicted, thus assigning a sense of blame to the one who is suffering from the pressures of the symptoms of the disease. A thousand years ago the disease was being blamed upon a devil or demon entering the body, a turn from God that caused some malevolent spirit to enter the body and claim residence. The existence of any mental disease was considered to be the problem of the host, a sin that was infecting the soul, thus making it impossible for anyone with a clean soul to be afflicted. This, in fact, made anyone without mental illness part of a boast that they were free of sin as they were free of mental health. This type of cultural belief is difficult to fully eradicate, no matter how many studies prove that mental disease is a medical issue. There is a cultural tone that taints the idea of mental illness, an underlying fear that the eradicate and out of control behaviours seen in those with mental illness could afflict anyone who must watch on in horror. A cultural survivor’s guilt manifests in blame, suggesting that because the person is to blame, those who are blameless need not suffer from such an affliction. Therefore, because of fear, belief in the truth of mental illness as being caused by biological factors is not often the foremost cultural attitude. This creates a separation between what is understood and what is culturally believed, thus allowing fear to rule the way in which a person will behave in regard to understanding how a person with depression has become afflicted and how he or she must cope with the illness. The infrastructure of mental health care facilities across the world are not designed to support the current wealth of knowledge that has been developed since the inception of the mental hospital. It is well known now that these facilities do not carry the right atmosphere in order to successfully facilitate coping with mental illness. More so, according to sociological studies done by Erving Goffman as early as 1961, who “described the infrastructure of the institutions that encouraged the status quo” as a major part of the problem with public perception, the way in which treatment is given creates fear of having to end up receiving treatment (Christenson and Levinson 2003, p. 285). Cook, Cohler, Picket, and Beeler (1997) further this argument by suggesting that the movement to deinstitutionalize the treatment of patience with mental illness has led to both sides of the bias, those with an understanding and those who are driven by fear, to have their causes enhanced (p. 427). Phares and Renk (1998) suggest that the anthropological culture of mentally ill are disenfranchised, their culture developing around whatever social resource they can find as they lose the social circles from which they came due to the changes in their behaviour. This alienation also occurs within the family, the secrecy and shame coupled with the desire to deny that the illness exists overriding the desire to seek out help. This problem creates and perpetuates the development of poorly adjusted people who are susceptible to developing a mental illness. 4.2 Conclusions The state of mental health care is the center of this problem. When services are provided to help children who must face the mental illnesses of their parents, the issue is handled externally, providing a much more emotionally safe environment from which the child can grow. When the home is full of secrecy with mother or father’s illness part of a closed world from which there is no stability, children will find ways to cope and stabilize the world as they can, hording foods or cutting themselves to open up some sort of conduit to the outside world. The secrecy that often accompanies depression is the key to unlocking the world for teenage children who have been keeping a secret that tears their own mental health up as well as the life of their family. Being a caretaker for a parent who is mentally ill can cause long-term problems for the entire family, especially when the disease can be managed through medication and therapy If the family opens up their willingness to accept the help that is available. That is not to say that governments are doing all they can to succeed, but it takes a willingness to become healed in order to heal. Therefore, the secrecy must be ended and the nature of mental illness brought into the light. 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