Transcription:

Maggie McKay (Host): - Welcome to BayCare HealthChat. I'm Maggie McKay. Being a child or adolescent can be a rough time to navigate during normal times. But during the past few years of pandemic and lockdowns, it's been especially hard. Adolescence and children's wellbeing or mental health has been challenged by these unique circumstances.

So in this episode, we're going to talk about what to know about kids' mental health, the differences between mental illness and mental health, how to improve mental health, how to identify and treat mental illness and more. My guest today is Dr. Brandon DeLiberato, Medical Director for Child and Adolescent Psychiatry at BayCare. Welcome, doctor. We're so excited to have you here today.

Dr. Brandon DeLiberato: Thanks for having me.

Maggie McKay (Host): So this is a huge topic, very important. To begin with, what is the difference between mental health and mental illness?

Dr. Brandon DeLiberato: So to start off, I think it would be helpful to shine a light on what we're actually talking about from a definition perspective. So mental health is all about wellbeing. And the World Health Organization defines it as someone who is mentally well, can realize their potential, cope with normal stressors and contribute to their community in a productive way. External factors can influence mental health, even in the absence of mental illness. And those such things include trauma, discrimination, poor physical health, environmental issues, family conflict and, obviously, the pandemic, which we'll talk about a little bit later. As far as mental illness, these are diagnosed conditions that affect emotions and behaviors. So the definition from the American Psychiatric Association for what is psychiatry is a branch of medicine focused on diagnosis, treatment and prevention of mental, emotional, and behavioral disorders, and psychiatrists are physicians.

Maggie McKay (Host): And so what role does psychiatry play with mental illness?

Dr. Brandon DeLiberato: So the main goal is to identify and treat mental illness. And what you're really looking for is improving function. Not necessarily just improving happiness, but actual functional impairments that are brought on by the illnesses that we identify and treat.

Maggie McKay (Host): Doctor, what influence has the pandemic had on society regarding mental health? You mentioned it and that is a huge topic right now.

Dr. Brandon DeLiberato: The pandemic has influenced mental health and mental illness in a number of ways. We've seen increased rates of substance use disorders. We've seen increased rates in teenagers with suicide attempts and self-injurious behavior, and we've seen a lot of family conflict and domestic violence that contributes to both mental wellness and mental illness.

Maggie McKay (Host): And how could we as a society improve mental health?

Dr. Brandon DeLiberato: From the societal level, we can do a number of things, stabilize environments, which includes reducing violence and improving education and access to information, provide access to healthcare, not just psychiatry, but all specialties because physical health matters as much as mental health, decrease disparities in marginalized groups and, from a more personal level, teaching children how to think about their thoughts more clearly, right? Practicing how to actually live in the reality they're in to be mindful, to identify what we would consider thought distortions or impressions of things that are occurring around them.

Maggie McKay (Host): What are some common examples in childhood of mental illness?

Dr. Brandon DeLiberato: The most common disorders that we treat in child psychiatry include attention deficit hyperactivity disorder, major depressive disorder, generalized anxiety disorder, post-traumatic stress disorder.

Maggie McKay (Host): So ADHD is a mental illness?

Dr. Brandon DeLiberato: It is.

Maggie McKay (Host): Wow. I never knew that. We've talked a lot about the pandemic and the effects on children. What age group do you think has been most affected in a negative way? Because I've heard so many reports about the kindergarten group and the high school group and the in-between. Do you think it's all equal or are there some worse than others? Like I'm thinking adolescents, because it's already such a rough time during your life, and then you missed out on all those things and now they're gone. Like, just for example, I don't know, prom, graduations, the drive-by graduations, things like that.

Dr. Brandon DeLiberato: That's a really good question. Actually, I don't have a direct answer as far as which group has suffered the most, but I'd like to actually reframe this question and talk more about the myth of missed opportunities and/or lost years. I think it's easy as adults to look at this time and say, "Wow, this must be traumatic. This must be a problem. This must be a huge loss. There's all sorts of different stressors involved, but the truth of the matter is this is the reality that we're all living, right? And our children are much more resilient than we even anticipate or sometimes just from an instinctual level think. And this obstacle is an opportunity to be the actual path of their life. So whenever we get into what they missed out on, maybe it's better to think about what sort of skills they've gained or what they have survived or what they've experienced in these moments, because these years still happened, right? And the ramifications will move on forever. So I think it's very important we hone in on what is actually happening.

Maggie McKay (Host): Are there any other critical things we should know about mental health and mental illness, doctor?

Dr. Brandon DeLiberato: Yeah. In summary, when it comes to looking at how psychiatry and mental illness fits into mental health, I want to say that anyone can experience times of low mental health, but not everybody is mentally ill. And more importantly, individuals who are mentally ill can also experience extended periods of mental wellness.

Maggie McKay (Host): When it comes to mental illness versus distress and suffering, what are some examples of depression versus sadness? Because parents need to know what to look for and maybe we don't know the difference.

Dr. Brandon DeLiberato: This is a really great question. And I think this is something that any provider, any parent really struggles with if they're not familiar with all of the criteria of the different disorders. So, first thing, I think it's important to understand that as humans we're all working on the same project, right? That project is survival. And oftentimes in modern society, it can be translated into satisfaction versus happiness or avoiding discomfort. Sadness is a normal human emotion, and this can be experienced for a number of different reasons, circumstantial reasons, problems of living, some just genetic reasons, but that experience of that emotion does not equal depression as an illness.

Depression as an illness is a multifactorial genetic problem that is defined by five out of nine symptoms for two weeks or more every day with again a functional impairment. Some of these symptoms include low mood, difficulty with appetite, trouble sleeping, loss of pleasure, sense of worthlessness or excessive guilt, poor concentration and suicidal thoughts. Again, we're not looking at just emotional expression. We're looking at how those symptoms play a role in causing a functional impairment in their day to day. So as a parent, what you're really looking for is how is my child acting at home and in school? How are they acting with social relationships? Are they doing the things they normally like to do? Are they more irritable or agitated or slowed down? And you're looking at that change from their normal baseline function. Whereas sadness can be a little bit more transient and situational.

Maggie McKay (Host): And what if you get the answer that so many parents get when they ask their children how they're doing, "I'm fine. I'm fine," but you know they're not? How do you approach them?

Dr. Brandon DeLiberato: So you consider their subjective response. However, as a parent, you're with them all the time and you can see if there's an objective change, right? So even a child can say, "I'm fine," but not be functioning. And again, you're really putting the emphasis on how do they function day to day.

Maggie McKay (Host): Can you talk about the importance of collaboration between schools, families, healthcare, and behavioral health providers, social services and law enforcement? Because it's a lot of groups that have to come together to help, right?

Dr. Brandon DeLiberato: Yes, this is the most essential piece. The days of working in silos has to be over. And I think what BayCare and our community has really done really well, is come together to create more specialized teams, so it isn't just the police responding to a call or the schools identifying some sort of behavior or symptoms in the students and then the population. But we're all working together to educate, to pool our resources and brainstorm how we can better serve the community. And because the idea of mental health versus mental illness and how they all go together is so complicated and large, it isn't just the role of a singular provider or, you know, just a parent, but it has to be the entire community come together to manage this problem.

Maggie McKay (Host): Dr. DeLiberato, this has been so informative and helpful, and I'm sure parents got a whole new perspective on new things that we could put in our toolbox to help our kids. So thank you so much for sharing your expertise today.

Dr. Brandon DeLiberato: Thank you Maggie.

Maggie McKay (Host): That's Dr. Brandon DeLiberato, Medical Director for Child and Adolescent Psychiatry at BayCare. And that wraps up this episode of BayCare HealthChat. Head on over to our website at baycarebehavioralhealth.org for more information, and to get connected with one of our providers, Please remember to subscribe, rate and review this podcast and all the other BayCare podcasts. For more health tips and updates, follow us on your social channels. If you found this podcast informative, please share it on your social media and be sure to check out all the other interesting podcasts in our library. I'm Maggie McKay. Thanks for joining us and stay well.