Mental Health Concerns and Psychosocial Stressors in Individuals Who Have Down Syndrome
Common behavioral and mental health concerns:
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Impulsivity and ADHD type behaviors
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Self Talk (coping strategy used to process information)
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Anxiety
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Depression
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Obsessive Compulsive Disorder
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Autistic Spectrum Disorders
Many times symptoms are interpreted as behavioral issues but often behaviors can be symptoms of a mental health issue. Individuals who have Down syndrome are at higher risk of having expressive and or receptive language difficulties, leading to acting out of symptoms thus, making it difficult to diagnose a mental health problem based on self reporting of symptoms .
Medical problems can also alter the behavior of an individual with Down syndrome as it does with any individual. The increased risk of expressive and receptive language difficulties can make it very difficult for the individual to express how they are feeling and the symptoms they are experiencing thus, leading to the acting out of symptoms.
What to do if a loved one has Down syndrome and is showing signs of decline or is having a change in behaviors:
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Consult with the individual’s primary care physician to rule out a medical cause. Common medical causes can include but are not limited to:
- Heart disease
- Thyroid disorders
- Atlanto-axial instability/ dislocation
- Celiac disease
- Sensory issues
- Vision or hearing changes
- Dental issues
- Sleep apnea
- Gastro-intestinal issues
- Seizure disorders
- Alzheimer’s disease/dementia
- Medication side effects
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Obtain a psycho-social assessment from a professional that has experience working with individuals with Down syndrome. Many times assessments are strongly reliant upon behavioral symptoms.
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A neurological evaluation may also be recommended to rule out a neurological cause.
Treatment:
Treatment for mental health problems in individuals with Down syndrome is very similar to the treatment provided to the any individual struggling with a mental health issue.
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Medication: Medication with anti-depressants or other psychiatric medications can be very effective in decreasing symptoms.
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Psychotherapy: Psychotherapy or counseling is also an effective treatment with or without medication. Individuals with Down syndrome have an ability to learn skills and process feelings just like any other individual.
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Behavioral/Environmental changes: Caregivers can play an important role in facilitating change by working with their loved one and therapist in order to make changes in the home, work, etc.
Caregiver Stress:
With caregiving one can experience ongoing joy and celebrations of accomplishments and growth. However, caregiver stress can become a very real challenge. It is important for loved ones to develop a very strong network of supports. There are many groups that offer families opportunities to participate in activities and social events in order to foster a support network. Sometimes caregivers may also need to participate in therapy to decrease stress and learn behavioral interventions.
The bottom line is that individuals whom are diagnosed with Down syndrome should not be treated as a syndrome. They are individuals that are as diverse as the general population and assumptions should not be made about their health and mental health just because they have been diagnosed with Down syndrome.