"It started to surface when I was 12. There were a lot of small indications, I guess."
Now 43, Leif Gregersen has had a lot of opportunity to reflect on his mental health and many of the challenges that he has faced over the years, including those as a youth in St. Albert.
And face them he has. He has spoken and written aplenty about them too, through books, blogs, and public speaking engagements.
Having bipolar disorder and depression meant an added facet to the struggles of his adolescence. He said he felt isolated and had erratic behaviour and a poor sense of hygiene. He was "a bit of a misfit," he noted. He loved to wear his army uniform, kept his hair short and was "always in a down mood, always moping around."
But there were other things too.
"One of the things I recall, starting at that age, was when I would go to cadet camp. They were always ordering you around here and there. I would come home at the end of the camp and I would hear my name being called, and it would slowly go away."
"I was under a lot of stress. I was very tired. You fill up your whole week and the cadets filled up your whole weekend so you're just under a lot of pressure."
Compounded with that was the fact his mother had her own psychiatric issues for which she had been receiving treatment for a number of years. That, and his father was a bit of a drinker, he continued. He argued with his father pretty much all the time – "He seemed to have it out for me," he said – and it often got pretty intense.
Still in junior high, Leif's life seemed to be spiralling out of control. At 14, his parents intervened and took him to a psychiatric facility to be assessed, and he was subsequently diagnosed.
In reflection, he said his teen years were very tough, and for reasons much less obvious than many external disabilities.
"I had to try to act normal," he said. "It was like there was a black cloud raining on top of my head."
Parents' perspective
Mental illness is obviously no easy thing for any teenager to endure, and it can be equally hard on their family.
Kelly Hrudey, renowned for a successful career as a hockey player and broadcaster, knows all too well how difficult it can be to watch a loved one go through this process. His youngest daughter Kaitlin, now 22, has been living with mental illness for more than half her life, and has now gone public with her story – a story they will share at the Arden Theatre in St. Albert on Sept. 25.
Hrudey said their story began when Kaitlin was about 11 years old; they began noticing her displaying some odd behaviours like excessive blinking, becoming much more attached to her parents, and withdrawing from many of the social activities she had previously enjoyed.
"She was a very social child; she loved to go to dance, she loved school, she loved sleepovers," he said. "Those became very difficult for her to go to. She begged off all her sleepovers, and wanted to be with her mom a ton."
He said the family was hoping it was all just a phase, until everything came to a head on the first day of Grade 7. Kaitlin could barely manage to leave the vehicle to go to class. Then, on the second day, she simply couldn't do it.
As a family, the Hrudeys sought an immediate appointment with a child psychologist who would ultimately diagnose her with an anxiety disorder and obsessive-compulsive disorder (OCD). Even after that appointment and diagnosis, he didn't fully understand this wasn't something that could be quickly and easily cured.
"My feeling when I left there was quite optimistic – because I wasn't familiar with this stuff – that we'd be done with this in no time and it would be in the rear-view mirror," he said. "Then I was to learn later that it is a life-long thing she has, and hopefully she has all the tools and she's able to manage it."
Hrudey said it wasn't until years later he looked back and saw a dozen different signs and symptoms that could have indicated there was a deeper problem – he just didn't put it all the pieces together at the time.
A common story
It's a story that's not as unusual as we might think. Despite the stigma that makes many feel the need to keep quiet about mental illness, the available statistics are plentiful and are quite telling.
Figures from the Canadian Mental Health Association show nearly one in five children and youth in Canada – roughly 1.5 million people – suffer from a psychiatric disorder with just one in five of those receiving any sort of therapeutic intervention.
While specific data isn't available for St. Albert, information from Alberta Health Services shows only about 75 per cent of Edmonton-zone residents perceived their mental health as being excellent or very good in 2013. This leaves one in four residents identifying themselves as having poor, fair or good mental health.
And the problem is as significant for St. Albert youth as it is for anyone. A recent city-administered survey showed 70 per cent of youth reporting that mental health is the most significant challenge they face.
Mental illness is by no means a catch-all term describing a uniform set of ailments with a uniform set of symptoms and uniform set of treatments or solutions, but there are some conditions that are far more prevalent than others.
Dr. Michael Trew, Alberta Health's chief addictions and mental health officer, said roughly 80 per cent of diagnosed mental illnesses fall into the four categories of anxiety, depression, addiction and attention deficit disorders (ADD/ADHD).
Thomas Holmes, a psychologist who works with the Sturgeon School Division, said those same conditions tend to be the most prevalent within the school system as well.
"Anxiety would really top the list," he said, adding the one-in-five figure is fairly accurate in local schools and beyond.
"Taking a snapshot at any given moment it wouldn't be one in five, necessarily, but over the course of the school year. I think that would be very similar for all schools in Alberta."
And this is a concern that affects children and teenagers more than those in older age groups – about 70 per cent of currently known mental disorders have an onset during childhood or adolescence.
Root causes
Trew said while it's important to acknowledge that the human brain – and the ailments that afflict it – are not yet fully understood, there are certain factors that can increase the likelihood of developing mental illness, beginning with biology.
Mental illness can run in the family much the same way cancer, heart disease and diabetes run in a family. With anxiety and depression, for example, the parts of the brain that regulate emotional responses may have problems getting messages back and forth.
"We believe that in some of those circuits, some of the neurotransmitters – the chemicals that provide a message from one cell to the next – are not working very well," he said.
This potential biological predisposition can be compounded by environmental factors, Trew said. Children who undergo hardships in the first five years of life tend to be more likely to develop mental illness as they grow older.
"That's things like being separated from your parents by death or divorce, and it includes things like various forms of abuse or neglect," he said.
Signs and Symptoms
Teenagers are, with few exceptions, prone to some degree of moodiness, reclusiveness and emotionality – this is simply part of growing up.
Trew said there are some things that can serve as warning signs not just of typical teenage angst, but also of deeper psychological problems.
"It's really when you see kids getting stuck in a state that really isn't very good for weeks that we need to start questioning if there's something going on here that's not just being a teenager," he said.
Specific things to watch for are a significant change in school function, and when teenagers begin to avoid family and friends and just want to be on their own. If there's a prolonged change in mood state, where a teenager is sad or angry or anxious in a way that's different than their typical personality, that's another potential warning sign.
Likewise, physical symptoms such as changes in appetite or sleeping patterns can be an indication of a deeper problem, as can paying too much attention to weight or physical experience.
"A certain amount of that is absolutely normal as part of adolescence, but we can see when it becomes over-the-top," Trew said.
When parents or friends begin to have concerns these symptoms may be a result of a deep-seated problem, it's time to get involved.
"I think the first step is trying to connect with the teen themselves, to get some agreement that there's something going on that doesn't make sense," he said.
Understandably, coming to grips with one's own mental illness can be an overwhelming process, with teens feeling helpless and not knowing what to do.
Some potential treatment options may work, others may not, but the first step is to acknowledge there's a problem and beginning to seek treatment.
"The main thing is to keep looking until you find something that looks like it's got a chance to do something useful," he said.
