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What is it about ?
People with intellectual disabilities often have mental health problems from a variety of causes.
Disturbed psychological development
Intellectual disability has an influence on the personality and on the acquisition of skills and comprehension capacities. The relationships that a person with an intellectual disability has with their parents and other family members can be disrupted. The disability is not accepted or is hidden, or the person with an intellectual disability may be overprotected. It can also be the object of a feeling of shame, contempt or violence.
It is often difficult to fully understand the capabilities of a person with an intellectual disability and to adapt their expectations and requirements accordingly. The need for daily help influences its evolution towards autonomy. In addition, intellectual disability often goes hand in hand with physical disabilities. The person is separated from their parents for hospitalization and for hospital examinations, which they may perceive as a threat.
Friendship and sex are often complicated and difficult for others to accept. Having children is often out of the question, even if the person with an intellectual disability loves them.
Physical causes
Pain (related, for example, to ear infection, stomach ulcer, sinusitis, etc.) can cause a state of restlessness.
Some medications can have side effects that lead to mental symptoms.
the Down syndrome is often associated with a disorder of thyroid function. An underactive thyroid (hypothyroidism) can cause symptoms that resemble depression. While an overactive thyroid (hyperthyroidism) rather causes restlessness.
Traumatic experiences and life changes
People with intellectual disabilities are easily confronted with experiences of failure, physical and moral violence and sexual abuse. It is not uncommon for them to experience harassment and discrimination because of their difference.
Life changes and crises have a long lasting influence and the symptoms sometimes appear only after a long delay, for example in the event of changes in the family (arrival of a newborn baby, illness, death), after moving to an institution or a protected home.
Communication problems
Often people with intellectual disabilities have difficulty communicating and making themselves understood clearly. They sometimes have difficulty speaking or do not know the right words.
Changes within the community
People with intellectual disabilities are part of a community, sometimes even of several: the family, the institution, the sheltered workshop. However, each community has its own organization and its own rules. Position in the group may change, staff may vary, staff members may have a different approach, …
People with intellectual disabilities may have an abnormal reaction to the concrete situation, to attract attention or to be favored (and, for example, to be relieved of a task).
What is their frequency?
Between 30 and 50% of people with intellectual disabilities suffer from mental problems. This is at least 2 to 3 times more than among people without intellectual disabilities.
Psychic complaints are sometimes difficult to recognize, especially due to limited communication skills.
What psychological problems can we encounter?
- The autism spectrum disorders manifested in complicated communication and social skills, as well as a stereotypical and repetitive repertoire of interests and activities. They are more common in people with intellectual disabilities than in others.
- the attention deficit hyperactivity disorder (ADHD) is characterized by excessive activity, difficulty concentrating, impulsive gestures and restlessness. People with ADHD are very easily distracted and unable to focus on the same activity for a long time.
- The mood disorders (eg depression, loss of joie de vivre) are difficult to express for people with intellectual disabilities. Irritability, aggression, self-harming facts, trouble concentrating, and trouble sleeping can also indicate depression.
- THE’aggression and self-harm can also come from a physical problem, such as pain, or a communication problem.
- The behavioral disturbances are characterized by inappropriate and repetitive behavior, marked by outbursts of anger, aggression and destructive behavior.
- the rumination disorder may coincide with refluxed inflammation of the esophagus (regurgitation of stomach acid and food), which needs to be treated.
- The unsuitable forms of sexuality manifested, for example, by masturbation in the presence of other people.
What can you do ?
This complex problem requires teamwork involving a doctor, a psychologist, a psychiatrist, a nurse, the accompanying persons, the family, etc. It will be necessary to determine whether the symptoms are due to a physical illness or to a psychiatric problem. Caregivers have a number of rating scales to do this.
The underlying conditions will of course be treated first. Sometimes it will be opted for treatment with drugs with the same products and applying the same principles as in people without disabilities. Psychiatric treatments will of course only be given after a clear diagnosis of a psychiatric condition. This is generally not the case with a behavioral disorder. The doctor always prescribes the lowest possible dose of a drug and avoids the use of several drugs at the same time.
The result of the treatment is systematically evaluated. Medicines provide support for other forms of treatment, such as physiotherapy, speech therapy, occupational therapy, music therapy, psychological support and the careful planning of a stable network allowing a useful occupation of the days.
Supporting and caring for a person with an intellectual disability can be overwhelming for the family and caregivers. They should receive special attention and optimal support. It is essential for everyone to be clear about who does what and to give yourself enough time for yourself.
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