HIV and Mental Health

I was recently approached by a writer for Yahoo's Associated Content to answer a few questions about HIV and mental health in children and youth and it's been published at this link.

Here's a good chunk from the interview, let me know what you think!

What type of a mental and emotional impact does HIV on a child?
"A child who is HIV positive has to cope not only with his or her own uncertainty of their future health but also their parents' anxiety. The stigma associated with HIV makes it extremely difficult for the child and their family to be open about the illness to relatives, friends, and loved ones. In fact, in many cases, the child him or herself may not be aware of their own diagnosis. As a therapist and social worker, I met many mothers who were concerned their child would let it slip that they were HIV positive or that someone in their family was HIV positive to teachers, school friends, or fellow church goers. The burden of holding such a painful secret follows the child through each of their milestones particularly as they enter adolescence and the world of dating and the inevitable questions of sexual intercourse. It's not uncommon for HIV positive youth to be dealing with depression, suicide, anger, and self-imposed isolation."

How can a child with HIV cope with their condition?
"First, parents or guardians can create an environment that actively refutes the stigma of HIV, whether or not the child is aware of his or her diagnosis. When the parent feels the child is old enough to have good judgment regarding disclosure of the diagnosis to others, it is important to very sensitively and carefully explain the HIV status to the child and allow the child to ask any and all questions he or she might have particularly surrounding the concept of mortality. Make it clear to the child who he or she can turn to for support and make certain these individuals are prepared and able to answer tough questions. Families may find that there are support groups for HIV positive children and their HIV negative siblings at their hospital or clinic, which can provide an outlet for youth to talk with peers who have a unique understanding of one another. There are also many summer sleep-away camps that have medical facilities on site to care for children with illnesses, allowing these kids to have a typical summer camp experience that they may not have been allowed to have otherwise. It's important for the child to be given opportunities to be a kid, first and foremost."

What type of professional help is available for a child infected with HIV?
"Unfortunately, the answer to this question is somewhat dependent on the personal financial resources of the family. For youth who can afford it, they can certainly seek out a psychotherapist who can be a non-judgmental sounding board, someone who the child doesn't have to worry about worrying. Therapy can help the child to develop strong, positive coping mechanisms and encourage self-esteem even in the face of societal stigma. However, youth with limited resources may not be able to access mental health services so readily. Particularly now, when public and foundation funding is moving more and more towards prevention and away from direct services. It is becoming more difficult to find qualified professionals in non-profits who provide free or low-cost mental health care. Moreover, health departments often pay more attention to the mental health needs of adults over children, again, limiting the resources available to HIV positive youth."

Wanna talk to Amy Chua?

Guess what DC? Amy Chua is going to be Politics and Prose doing a book signing and answering questions. If only I was going to be in town for this! But sadly, no. Anyone interested in heading over, checking it out, and reporting back?!


For more details on her appearance here in DC, check out this link.

Great Expectations

I saw an interview a while back with Amy Chua, the woman who wrote, "Battle Hymn of the Tiger Mother." It seems that people are getting mighty huffy about the book and what she contends is a commendable style of parenting. And I happen to be one of those people. I have several disclaimers before I continue any further.

1. I have not read the book
2. I am not a parent
3. I don't always know what I'm talking about though I might think I do.

Given all of that, I'm still going to get up on my soapbox here and you're welcome, as always, to disagree with me if you choose.

For those of you who haven't heard of the book, check out an article Chua wrote for the Wall Street Journal entitled, "Why Chinese Mothers Are Superior." From what I gather, the book is a personal memoir of a journey through motherhood (though it does seem to be a bit premature of a memoir as her oldest child is only 15 years old). Her style of parenting appears particularly harsh in an American environment. For example, she didn't allow her children to have playdates, called them names like "garbage," told them they were lazy, cowardly, self-indulgent, and pathetic, were not allowed to not be top of their class in all subjects but gym and drama, etc., etc. However, she also states that she does all that she does because of her love and dedication to her children and is quick to lavish praise on them when they succeed. And due to her "motivation" and their natural gifts and talents, they are often in a position to receive praise because they usually do succeed. Apparently, the book takes a slightly ironic tone in which Chua mocks her own extremity and perhaps learns that her way is not always the best way by the end of the book. But even keeping her own personal journey in mind, it does not seem that she would change anything she did in the past. At the heart of things, she feels that her style of parenting is preferred over what she defines as "Western" parenting.

As you know, I'm a Korean-American born in the United States of parents who immigrated here from South Korea. Some things I read in Chua's article and from what I heard from her interview were a bit familiar, for example, I grew up playing piano and violin. Almost every Asian kid I knew played piano and violin as well, though there were a few outliers that played the viola or cello along with the piano. There was even one girl who, gasp!, played the clarinet! While each one of us was encouraged to practice daily by our parents, it was pretty rare to find any parent who forced their child to practice through the night at the age of seven and when a piece was too difficult, call their child "pathetic!" We were all encouraged to excel and hopefully be the best but were also allowed to be in school plays, have friends, participate in sports, etc.

One of the first things I did after learning about Amy Chua's book was to call my mother. Her response to Chua's article was that she understands where she is coming from but that she created almost a caricature of her style of parenting. Note, I don't say "Chinese" or even "Asian" since I know plenty of people of different race and ethnicities who pushed their children to succeed in a manner that was perhaps above the norm. My mother and plenty of other Asian mothers believed that academic excellence is paramount to future success and certainly harped on it over and over again. Likely, most Asian mothers tend to be a bit more strict with their children based on their cultural viewpoint and do push their children to work hard at school. But she also valued supporting my interests and encouraging me to become a well-rounded individual with academic, athletic, musical, and social skills. Like my mother said, Chua employs an extreme view of parenting and most Asian mothers sit on a bit of a spectrum of parenting that usually does not go so far as calling their child "worthless." So, in that vein, I feel like we're all paying a bit too much attention to her memoir. While it may seem like she's speaking for all Asian mothers, she's not.

I get a bit huffy with her statements that her style of parenting is preferred over others in molding children to become successful adults. She goes so far as to suggest that her style of parenting is indicative of almost greater love and sacrifice than a more permissive style in that she, and others like her, are willing to roll up their sleeves, grit their teeth, and tough out the pain all for the sake of her children. I commend her dedication but question her conclusion that children parented in her style won't ever result in anxious, traumatized, socially-inept adults. I searched for Chua on Wikipedia and found out that not only is she a Yale law professor but her sister is a Stanford professor and another sister holds two Special Olympics medals! Clearly, she's got some good genes. I would also venture a guess that she wouldn't choose to marry an unsuccessful, less-intelligent man. The results of their union are predisposed to be pretty genetically gifted. Which makes it possible for her to demand of her kids, not just excellence, but superiority over her classmates. So her parenting style has resulted in kids with straight As who have won music competitions, bravo! But where I look askance is how she suggests that this style of parenting would be effective for all children. If your child just isn't as gifted, then what is setting impossibly high standards going to do to that child during youth and afterwards in adulthood? Having high expectations of your children is certainly a positive thing and it's important to encourage them to do their best, but what happens if your child doesn't become a violin virtuoso and you continue to tell him or her that they're just being lazy or self-indulgent. That child never has a chance to succeed in the face of his or her parents and their self-esteem plummets. Quite possibly, they become anxious and depressed adults. You can't always will your kids to be musical prodigies and straight-A students, you have to take your child's talents and gifts individually and nurture them as they come. Yes, it's important to believe in your kids and yes, sometimes, you have to push them beyond what they might themselves be interested in doing, but it's also important for your children to believe they still have your love and respect even if they get a B+ on yesterday's math test or flub a measure in a piano composition.

Being a parent isn't easy, I'm amazed at my mother's strength and fortitude, mentally, emotionally, and physically. And it's because of my mother's support and love that I am who I am today.

Genetic Predisposition for Depression?

I've often been struck by how prevalent depression, anxiety, bi-polar disorder, addictions, etc are in the extended families of clients suffering from one or more of the above. From a purely non-scientific observational basis, I've conjectured that somehow mood disorders may be a genetic trait passed on from generation to generation. Today I came across an article from Science Daily that suggests new and overwhelmingly supported research that identifies a connection between a gene and an individual resilience to painful emotional traumas. University of Michigan researchers found, "The U-M analysis supports previous findings that individuals who had a short allele on a particular area the serotonin gene had a harder time bouncing back from trauma than those with long alleles." This news may be very welcome to individuals suffering from depression on anxiety for a couple of reasons. Firstly, this illuminates the possibility for more effective medical treatment and prevention for mood disorders. While there are scores of folks who take medications currently available and have great success with these pills, there are many others who are unable to tolerate side effects or simply do not gain as positive effects from the meds as others. And secondly, it could prove a relief to some people that their suffering may have a biological foundation. Many people dealing with depression or anxiety feel powerless and ashamed at their inability to control their own emotions. To those on the outside, it's easy to wonder why one's loved one isn't able to just "snap out of it." The depressed individual is left feeling judged not only by others but by him or herself. Effective self-soothing and coping skills that come so easily to others simply may not be as accessible to individuals suffering from depression due to differences in genes. Clearly more research is needed and we're a ways off from being able to take practical measures to prevent or treat mood disorders from a genetic level, but it's a heartening start!

Resurrecting the So-Called 'Depression Gene': New Evidence That 

Our Genes Play a Role in Our Response to Adversity

ScienceDaily (Jan. 4, 2011) — University of Michigan Health System researchers have found new evidence that our genes help determine our susceptibility to depression.

Their findings, published online in the Archives of General Psychiatry, challenge a 2009 study that called the genetic link into question and add new support to earlier research hailed as a medical breakthrough.

In the summer of 2003, scientists announced they had discovered a connection between a gene that regulates the neurotransmitter serotonin and an individual's ability to rebound from serious emotional trauma, such as childhood physical or sexual abuse.

The journal Science ranked the findings among the top discoveries of the year and the director of the National Institute of Mental Health proclaimed, "It is a very important discovery and a real advance for the field."

To read the rest of the article, click here.