Newsletter – January, 2004

**Companion Resources Newsletter**

edited by Paul D. Leichty

Volume 6, No. 1 January 2004

Greetings in the new year! The Companion Resources Newsletter is now in its sixth year. I appreciate all of you readers who have remained encouraging of these humble efforts.

Most of you are aware that this newsletter as well as the Companion Resources website have primarily addressed the needs of two groups of people, those with developmental disabilities and those with mental illness. While not ignoring physical disabilities and other conditions which marginalize people, those whose minds are affected are particularly vulnerable in our technological society.

For many people, it is difficult to talk about developmental disabilities and mental illness in the same forum. Parents of children with developmental disabilities don’t want people confusing their children with those who are mentally ill. They point out that these lifelong disabilities begin during the developmental years and are the result of physical or biological factors present very early in the child’s life. Mental illness comes later, usually starting in late adolescence to early adulthood and is the result of chemical factors in the brain. There is more sympathy for persons who function differently from little on up than for those who seem “normal” but then turn “crazy.”

At the same time, persons with mental illness don’t want to be identified with persons who are “retarded.” They are quick to point out that their intelligence is not affected by their mental illness. There is a greater awareness that they simply have a disease of the brain, but they don’t want to think of themselves as “impaired.”

These broad generalizations point out that what each group seeks to avoid are the negative stereotypes that society has of the other group. It is difficult enough dealing with the stereotypes of their own group without taking on those of another group.

And yet, since both deal primarily with conditions of the brain, the lines between mental illness and developmental disabilities get blurred at points. There are several reasons for that.

First, there are a greater variety of conditions that get looked at in both “camps.” A major condition is Attention Deficit Disorder (with or without hyperactivity), sometimes simply referred to as ADD or ADHD when hyperactivity is present. Because ADD manifests itself in early childhood during the developmental process and often affects a child’s ability to learn, it is often considered a mild developmental disability. Yet many children with ADD appear to be “normal” to most people and are actually quite intelligent. It’s hard to classify them together with those with Down syndrome and cerebral palsy. ADD usually responds well to medicine that alters the brain chemistry; hence it can be thought of as a mental illness.

Considering the possibility that a child has a mental illness like ADD has also opened up the thinking of psychiatrists to diagnose children with other mental illnesses that were once actually defined as occurring only in adults. Bipolar disorder (manic depression) is one increasingly common example. Some specialists are even talking about childhood schizophrenia as being a reality after years of thinking that was just an old term for what we now call autism or pervasive developmental disorder. So when we are dealing with children, how do we define what is a developmental disability and what is a mental illness?

During our three years of working at Goldenrod, I was awakened to the further reality that many persons with developmental disabilities and particularly autism have the most trouble functioning as they develop into adulthood due to mental illnesses that often accompany their disabilities. Depression and bipolar disorders are quite common at some point in the life of a person with developmental disabilities. Schizophrenia and related conditions can also become a factor for some.

In the middle of the 20th century, the enlightened medical community wanted to clearly separate “the retarded” who could be helped with an educational model (training schools and special education) and the mentally ill who could be treated with psychotherapy and medication. Yet, gradually the factors noted above led psychiatrists to recognize the increasing prevalence of a “dual diagnosis” of mental illness along with the earlier developmental disability.

An interesting article by Frank P. Bongiorno, MD, describes this historical movement, particularly as it relates to a pioneering institution in Southgate, Michigan, for treating patients with this kind of dual diagnosis (which sometimes needs to be distinguished from the dual diagnosis of mental illness and chemical dependency). You can read an abstract of Dr. Bongiorno’s article.

For some of us, we need to look at developmental disabilities and mental illness together simply because persons and families face similar challenges in relating to each other, the extended family, the community, and the church. Too often, a condition of the brain defines these folks and we find it difficult to discover their gifts and abilities and seek out ways in which they can contribute positively to society.

Building community is precisely about making the effort to include all people. So in this new year, we again take up the challenge to include persons who live with the internal challenges of a brain that functions differently than most. May you experience grace and courage and the surrounding presence of others to face whatever challenges life brings your way!

Blessings!

Paul D. Leichty

PDLeichty@cresources.org

Phone/Fax: 1-877-214-9838 (toll free)

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Dual Diagnosis: Developmental Disability Complicated by Mental Illness

by Frank P. Bongiorno, MD, Southgate, Michigan

http://www.sma.org/smj/96dec2.htm

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