Mental Health Bulletin

Published by
the Montana Mental Health Association
An Affiliate of the National Mental Health Association

BULLYING

Adapted from an article by William Boors, LCS, and published in Paradigm, Winter 2003.

Is Bullying a Problem?

Adults disagree about how much it affects kids, but the fact is that 160,000 kids in this country miss school every day just to avoid being targets of bullying. This form of abuse is one of the leading social problems among young people today, and has alarming long term effects on both targets and bullies.

What Is Bullying?

Bullying can be physical, verbal, or relational and is more intense than normal conflict. All children face conflict and need to learn how to handle it. Normal conflict crosses the line into bullying when:

• It's a repeated and consistent negative behavior. A single occurrence of a cruel taunt, ostracism, or even physical abuse is unacceptable, but it not considered bullying until it happens again and again in a predictable pattern.

•There are contrasting feelings between the target and the bully. While the bully may feel excited, empowered and enjoy the experience, the target child feels fear, humiliation, and shame.

•There is an imbalance of power. The child who bullies is more powerful either physically, with their ability to hurt through words, or even in popularity, and uses that power against the target.

What Is the Harm in Bullying?

Maine Attorney General Andrew Detterer's Civil Rights Division found that the most severe and brutal hate crimes in that state were almost always committed by someone who had participated in years of bullying. Bullies are more likely to become violent adults, to abuse their own children, commit serious crimes, and be substance abusers.

Recipients of chronic bullying often carry that shame into adulthood. Many adults suffering from depression, anxiety, low self-esteem, and fear of social relationships link these problems with having been bullied.

How Can We Stop Bullying?

Your child can...

• Stay with friends: Friendship skills can both improve the child's self concept and being in a group-especially in places such as locker rooms, restrooms, or empty classrooms-will reduce the chances of being targeted.

•Act confident: Standing tall, holding his/her head up while walking and looking people in the eye while talking will help avert bullying.

•Ask for help: your child should talk with you or another trusted adult if he or she doesn't know how to handle a situation.

You can...

•Dispel the myths about bullying. Bullying does not make kids tougher. Ignoring or participating in abusive behavior is not acceptable. Bullying is not harmless, nor are kids "just playing around."

•Spend lots of time with your child and be a positive role model. Let him or her know by words and deeds that bullying is never okay. Treat the child with respect and demonstrate how to treat others the same way regardless of differences.

•Help your child understand how others feel. Kids who bully have a lack of empathy. Talk about feelings and ask questions such as, "How do you think that person felt when..."

•Cooperate with the school. If your child is the bully, you may feel shocked, angry, or deny that your child would engage in bullying others, but the school is trying to help. Your cooperation will help your child become a happy well-adjusted adult.

SOCIAL ANXIETY DISORDER

By Chris Southall, Ph.D.

It is as if people who suffer with social anxiety disorder are always thinking, "Oh no! Everyone is watching me and I'm sure to mess up and humiliate myself."

Social anxiety is a psychological disorder characterized by overwhelming anxiety, fear and excessive self-consciousness in daily social situations. This intense and persistent worry about being observed and negatively judged by others causes individuals with social anxiety to go to great lengths to avoid the social situations they fear. They also fear being embarrassed by their own feelings and responses and frequently feel inferior and inadequate. People with social anxiety disorder may know at a rational level that others are not always watching, judging, or evaluating them, but their feelings are contrary to this knowledge. The anxiety may be so severe it interferes with work, school attendance or performance.

Physical symptoms often accompany social anxiety and may include blushing, profuse sweating, rapid heart rate, dry throat and mouth, difficulty swallowing or talking, trembling and twitching muscles,and nausea or other stomach discomfort. Those physiological reactions further heighten the fear of evaluation or judgment by others and can create a vicious self-fulfilling prophecy in which worry about experiencing these symptoms increases the likelihood of developing them.

Social anxiety is the third most common psychological problem in the United States. According to the National Institute of Mental Health, almost four percent of the population between the ages of 18_54 suffer social anxiety in any given year. This amounts to approximately five million people. When figures for children and elderly are included, some estimates put the number as high as 15 million. The disorder appears to occur twice as often in women as men, though a higher percentage of men seek help. This disorder typically begins in childhood or early adolescence and rarely develops after age 25.

Social anxiety disorder is not well understood by the general population and often not by medical and psychological professionals. In fact, this disorder is often misdiagnosed as depression, personality, panic or bipolar disorder or even schizophrenia. As a result of the lack of popular knowledge about social anxiety, many suffer in silence, thinking they are the only ones in the world struggling with these troublesome symptoms.

In addition to the psychological impact and physical discomfort of social anxiety disorder, there are also significant personal costs. Many keep jobs that are well below their capabilities out of fear of job interviews or avoid being promoted because they would have to supervise and interact more with others. Even if someone struggles through the feared situation, there are often days of worry and rumination about perceived awkwardness and performance flaws. In its most extreme form, a person may isolate to the degree that he or she no longer leaves home or goes to work-and may come to the point of interacting only with family or with no one at all.

The cause of social anxiety disorder is currently under investigation. There is some evidence to implicate the amygdale, a small structure in the brain that controls the fear response. Recent NIMH animal research suggests social anxiety disorder may be inherited; others are exploring the possibility that people with social anxiety acquire their fear by observing and interacting with significant others in their lives or that there is a biochemical basis for the disorder.

Even though individuals with social anxiety disorder frequently face their fears, typically symptoms do not abate. The good news is that there is effective treatment. the most well-researched psychological treatment for this disorder is cognitive-behavioral therapy. The central component of this treatment is gradual and gently supported exposure to these situations. Social skills training and help in thinking about these situations in new, more rational ways can also help the person to successful experiences that increase confidence. When the worst fears are realized, the therapist can help the individual employ strategies for coping more effectively with criticism, rejection or disapproval.

Although certain medications have been shown to be effective for some individuals suffering from this disorder, in my opinion, they should rarely be used alone. Medication may help calm and regulate the disorder and thus allow greater tolerance of the stress of social situations. Useful medications include antidepressants such as the selective serotonin reuptake inhibitors (SSRI's)-two have been proven in clinical trials and approved by the FDA-and monoamine oxidase inhibitors (MAOI's) as well as some benzodiazepenes. Some people with a form of social anxiety-performance anxiety-have been helped by beta-blockers, more commonly used to treat high blood pressure. Often medications alone are not enough to resolve the problem, but they can take the edge off the anxiety so that people can utilize psychotherapy more effectively. Another helpful treatment is an anxiety disorder support group. This can help people realize they are not alone and provide the opportunity to practice new behaviors in a safe, supportive atmosphere. In some situations, family or couples therapy can help family members gain a better understanding of the problem and their role in it.

Typical experiences that cause significant emotional distress in those with social anxiety disorder include being:

•introduced to others

•teased or criticized

•the center of attention

•being "watched"

•meeting people in authority

•social encounters with strangers

•sharing information in a group setting

Women and Depression

excerpted from the National Mental Health Association website: www.nmha.org

"Depression is a very common illness with very successful treatments. There's no reason it should stand in the way of a woman's success in the workplace."-Lee Ann Browning- McNee, Senior Vice President of Public Affairs and Community Development, NMHA.

A survey released in November 2003 by the National Mental Health Association and the American Medical Women's Association revealed that 83 percent of working women with depression found it to be the number one barrier to success in the workplace. The women who participated in the survey identified behaviors such as leaving work early, not returning from lunch, avoiding contact with coworkers and being able to face work as common problems associated with illness.

•89% who quit or lost a job while living with depression attribute the loss to their condition.

•Nearly 1/3 of respondents said their depression "completely interferes" with their ability to do their job.

•94% of women surveyed noticed improvements at work after seeking help for depression.

•68% of respondents reported reestablishing relationships with coworkers after treatment.

Although an array of successful treatments exists for depression, less than half of working women with depression who received treatment sought it immediately. These women stated that they did not know where to go for help, felt pressure from work-related time constraints, feared their insurance would not cover the costs and worried that they could lose their jobs. Others attributed their delay in seeking treatment to the stigma associated with depression or to feeling that depression was a sign of weakness or a character flaw.

"Although the stigma associated with depression is decreasing, it continues to be a major factor in preventing women from seeking treatment," said Browning-McNee. "By raising awareness about the the impact of depression on working women, we hope to help women understand that help is available."

Depression affects about five million employed American women each year. Untreated depression significantly impacts working women, becoming one of the greatest obstacles to professional success, along with child and elder-care responsibilities, pregnancy and sexual harassment.

www.nmha.org/newsroom/surveys.cfm