Book Review: Mental Wellness in Adults with Down Syndrome –A Guide to Emotional and Behavioral Strengths and Challenges

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mentalwellness1Parents of teens and adults with Down Syndrome will find this book most useful. It is comprehensive and provides a lot of information on how to build resilience, nurture mental wellness, note moods and emotions, and identify symptoms of mental illness.

It creates an awareness for how social circumstances (family and social support, peers, school or workplace situation) of an adult with Down Syndrome can affect his mental well-being, and suggests how mental and physical health assessments for them can be arranged.

This is vital as not everyone has access to experienced multi-disciplinary teams that can offer one-stop evaluation and treatment/intervention.

Social service, education, and healthcare professionals will find the topics in this book highly relevant. It can help facilitate better engagement with the client/patient’s family caregiver in managing a particular behaviour or situation.

Even if you are not regularly seeing clients/patients with Down Syndrome; reading this book will sensitise you to their needs and prepare you for such consultations should these arise.

Common Physical Health Problems and Behaviours

Understanding the issues that impact the lives of adults with Down Syndrome can help prevent a wrong diagnosis about their mental health.

For example, adults with Down Syndrome sometimes face physical health problems in unique ways that impact their mood and emotions. Understanding this means that it is important to include a physical health check even as you go about seeking a mental health assessment for them. Such checks will help rule out physical causes for behavioural changes. (See Chapter 2: Assessing the Physical/Mental Health Connection)

People with Down Syndrome also usually have a reduced ability to perceive pain (because of an increased pain tolerance), and difficulty in communicating what they are experiencing to you. This may result in a delay in getting the appropriate treatment and lead to discomfort or agitated behaviour. Detecting the source of the pain and treating it on time, may offer relief and reduce the agitation rapidly. It is also important to note that chronic pain may lead some to experience depression.

Some “normal” behaviours in people with Down Syndrome should not be mistaken for mental health problems. These include:

  • self-talk
  • language delays
  • lack of flexibility
  • slower processing speeds
  • difficulty in understanding time concepts
  • tendency toward sameness or repetition

Many people with Down Syndrome have a tendency to prefer sameness or repetition. Called the “groove”, this tendency offers many advantages as it helps the person maintain order in his life and optimise on the use of his skills. In this context, repetition should not be considered as an obsession or compulsion. In truth, unless the behaviour disrupts a person’s ability carry out his usual activities or function in his roles (at work or home), it should not be considered a problem.

Mental Health Issues to Look Out For

Adults with Down Syndrome experiencing mental health issues, however, often tend to be under-diagnosed and under-treated because their problems are ignored -assumed to be, or “written off” as “just part of Down Syndrome.”

The two ways that mental illness may be precipitated are:

  1. Physical causes, such as an illness (see Chapter 4: What is Normal?: Understanding “Normal”, “Usual” and “Common” Behavior in People with Down Syndrome) or biochemical or structural differences in the brain (see Chapter 13: Treatment Approaches for Mental Illness
  2. Stresses, such as learned helplessness,  as well as the lack of opportunity and respect. People with Down Syndrome will also challenged by stressful events that can be expected or unexpected. Expected, but stressful events include graduating from the school they have been in for many years. Unexpected stressful events include medical crisis, death, divorce in the family. Last of all, people with Down Syndrome are not immune to grief as well. (see Chapter 11: Mental Illness and Its Precipitants)

Read the book to find out more. The authors are experts in the field. Dr Dennis McGuire is Director of Psychosocial Services, and Dr Brian Chicoine is Medical Director of the Adult Down Syndrome Center at the Lutheran General Hospital in suburban Chicago.

Mental Wellness in Adults with Down Syndrome  –A Guide to Emotional and Behavioral Strengths and Challenges by Dennis McGuire Ph.D. and Brian Chicoine M.D. is available in Singapore’s public libraries.


About the Author: The COH Resource Team comprises volunteers, content writers and experts, including psychologists, counsellors, educators and social service professionals.

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