Some time ago, I was asked to see a seven-year-old girl who was exhibiting signs of extreme anxiety. She had taken to pulling out clumps of her hair and wetting the bed.
Her parents were baffled as to why this had started happening, assuring me that although they had just divorced it hadn’t affected their daughter at all.
But it only took a few minutes of us all being in the same room before they started bickering and making snide comments to one another. Was it any wonder that their daughter – caught in the middle of this and feeling torn and confused over which parents to side with – felt overwhelmed and unable to cope? That sort of psychological turmoil has to manifest itself in some way.
That little girl came to my mind this week when I read about Brad Pitt and Angelina Jolie. Already, their impending divorce has turned ugly, with allegations about drink, drug-taking and physical violence being thrown around.
Divorcing: Brad Pitt and Angelina Jolie with two of their six children. She has filed for divorce
The question that interests and worries me, though, is what effect such a public separation will have on their six children, some biological, some adopted.
Separation for anyone is a process of practical decisions and stressful ‘he said this’, ‘she did that’ conversations in solicitors’ offices. But among the legal battles and the shouting matches, the emotional fallout of divorce for the families involved is routinely underestimated.
The psychological effects are brutal because it’s not an exaggeration to say that divorce is like a bereavement.
Even in cases where it is clear separation is the best option, people still feel a profound sense of loss. Partly it’s a lament for the days when the relationship was happy. And partly it is a grieving process for the loss of a future that might have been, but now never will.
Yet many people feel unable to express this. Often, sadness is eclipsed by anger instead. The mourning, sometimes unspoken and unacknowledged, happens later. And, as the dust settles, bitterness can also set in. It’s this resentment, I think, that is so toxic not just for the adults involved, but for any children, too.
As a doctor, I am tired of seeing the collateral damage of feuding parents. In the worst cases, the adults use their innocent children as pawns in the battle, and make no efforts to disguise their ill-will towards their ex-partners.
Of course I completely accept that sometimes relationships don’t work. Even those couples who do stay together can often be unhappy: a new study this week showed that the number of people living in deeply troubled relationships has doubled in five years.
I also know that it is often better for children’s mental health to be brought up by separated parents rather than enduring a tempestuous home life with two warring adults.
Even so, the potential for damage to the children in acrimonious divorces is considerable. For children of school-age, teachers regularly say that they can immediately tell if a pupil’s parents are divorcing – the child begins behaving badly, or their school work suddenly suffers, or both.
But it is not just the actual process of divorce that impacts negatively on children. It’s also long after the divorce, when the parents are faced with the long vista of time stretching out before them as single people, and they attempt to assemble a new life for themselves.
All too often, it seems that divorced parents have a capacity to act with staggering selfishness. ‘I’ve given the best years of my life to my kids, now it’s my time’ seems to be the overriding mantra as people seek exciting new relationships to make them feel better about themselves, or distract from their sudden loneliness.
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I do not doubt that divorce can make individuals feel fragile and alone, and that setting up another stable home with someone else can be good for children – indeed, the evidence supports this. But time and again I have seen parents of both sexes ignore the effects of the instability that they bring on their children’s lives in the desperate bid to find a new partner.
Even worse are fathers – and it does tend to be men – who set up home with another woman with children, find themselves with a ready-made second family and cut their own offspring adrift or give them only fleeting attention.
Research shows that the sense of rejection this inflicts triples the risk of emotional problems in the children, who are already at increased danger of behavioural problems, anxiety and depression as a result of having divorced parents.
So, what’s the solution? It sounds obvious, but it is crucial for divorcing parents to understand that despite their complex – and often furious – feelings towards their former partner, for their children that person is still a parent.
Speak to a therapist, let off steam to your friends, but don’t drag the children into it. It sounds easy, but it’s incredibly hard to consistently protect your children from the emotional turmoil of divorce and life as a divorcee.
It takes a lot of hard work to have a good marriage, it takes just as much to have a good divorce.
Why doctors have to use a chemical cosh
Hundreds of care homes are still regularly using antipsychotics – dubbed the ‘chemical cosh’ – to manage difficult dementia patients, a study revealed this week.
WHY I BACK PUSH-UP CRAZE
I’m not usually one for internet crazes, but I am a great supporter of the 22 push-up challenge – the latest thing on social media.
If you’ve not seen it, people are challenged to do 22 push-ups (or press-ups, as most people call them) every day for 22 days. They then post videos of their attempts online before challenging friends to do the same thing, and donating £5 to charity. David Beckham has already been filmed doing his press-ups.
The chilling story behind this new challenge is that in the U.S. an estimated 22 veterans kill themselves each day. Tragically, the mental health of those in the services who have seen action is equally worrying in this country.
The UK veterans’ mental health charity Combat Stress, which has backed the challenge, revealed that more than 6,000 people contacted them last year asking for help – a 13 per cent increase on the previous year.
I know from my time working with homeless people – many of whom had been in the Army – that veterans can easily slip through the net of NHS services. Drugs, alcohol, depression and post-traumatic stress disorder mean that many struggle to adjust to civilian life. One in ten prisoners in our jails have been in the Army. This should shame us all. Despite them having put their lives on the line for us, we fail them when they need our help.
This is despite promises for several years from the government to curb the practice. It is undeniably a scandal that dementia patients – more than 140,000, it is estimated – are still sedated in this way.
This type of medication is not used to treat the dementia itself; rather, it manages the more disruptive symptoms of the condition. There are times when this can be of use – people with dementia who become, for example, paranoid or very distressed can get great relief from small doses of antipsychotic drugs.
However, too commonly it is not given with the patients’ best interests at heart, but to make caring for them cheap and easy.
Research has shown that this medicine can double the chance of death, and it is estimated that 1,800 people every year die early because of the drugs. So it’s something that needs our urgent attention.
Words, however, are cheap – action isn’t. Psychiatry beds, specialist nurses and well-trained carers are expensive and, unfortunately, it’s precisely these things that are needed to reduce the use of antipsychotics. So far, I’ve heard nothing like this as a plan of action.
The fact is doctors don’t prescribe antipsychotic medication because they want to – they do it because they have to.
What is a doctor to do? To my mind, it would be crueller to not sedate these patients, and so allow them to live in a world that is so confusing and alien. Dementia makes some patients paranoid, angry or violent: it can be a living hell for them – and those who care for them.
I have come across several cases where one spouse with dementia stops recognising their husband or wife, and has woken in the night and – assuming the person lying next to them is an intruder – has attacked them.
It’s easy to condemn the prescription of these drugs, but actually the real scandal here is that services for older people – especially in dementia care – have been serially cut year after year.
Lavender oil can really beat anxiety
Lavender oil has long been used to help calm and relax people, but I always dismissed this home remedy as little more than a placebo.
However, this week I went to a fascinating talk by a psychiatry professor who was visiting from the Medical University in Vienna, Austria, and apparently there’s more to it than that.
On the Continent, lavender oil – an essential oil extracted from lavender – has long been ingested in capsules as an over-the-counter remedy for anxiety.
Research is now emerging that suggests there’s sound evidence for this, with several large, placebo-controlled trials showing how effective the capsules really are. One study compared it to paroxetine – an antidepressant that is routinely used to treat anxiety – and found the lavender capsules were just as effective, but without the side-effects.
Another study compared it to lorazepam – a medication that used to be prescribed to treat anxiety but is now rarely done so because it is so addictive. Again, lavender oil was more effective, but without any risks of addiction.
It’s been shown to work directly on the nerves in the brain to help makes them less excitable, and therefore reduce whirring, worried thoughts. This happens when the oil is sniffed, but even more so in capsule form. I was quite flabbergasted.