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Month of September Topic - Mental Wellness in Teens and Adults

Our September Coffee Talk brought us information about mental wellness in teens and adults with Down syndrome. Depression, anxiety, loneliness and other changes in behavior are not just feelings had by people without Down syndrome. People with disabilities experience the same emotions as people without disabilities, perhaps even more frequently. Lee Bascom, MSW, LCSW has shared the following things to keep in mind when thinking about mental wellness with teens and adults with Down Syndrome. Lee can be reached for consultation and private counseling at, or 314.991.9058.

  1. Always rule out the medical first.  If your loved one is exhibiting a new symptom or behavior, make sure it is not caused by a physical problem.  These problems could include dental, vision, hearing, pain, constipation, hypothyroidism, medications, and menstrual problems.
  2. Difficult behavior can be communication that something isn’t working for the person.  Briefly, behavior can be to get something, to avoid something, a need for sensory input, or for attention.  Finding a mental health professional to partner with you in understanding a behavior’s function can be helpful before immediately resorting to medication to control or blunt the behavior.  
  3. Consider the environment when thinking about causes of a behavior change or an emotional reaction.  People with Down syndrome can often react to others’ emotional expressions, conflicts, stresses, and tensions in their families, living environments, workplaces, and schools.
  4. “Loneliness is the only real disability.”  Building and maintaining connections around natural supports of friends, family, work, religious communities, and neighbors can be a place to start when combating the isolation experienced by adults with Down syndrome.
  5. Mental illness is common but not inevitable in people with Down syndrome.  At least half of all children and adults with Down syndrome will experience a major mental illness during their life.  Depression, anxiety, obsessive compulsive disorder, regression with decline of cognitive and social skills, and sleep difficulties are some of the most common concerns. Many can be treated successfully with a combination of therapy, medication, exercise, and participation in daily activities.
  6. Change in routines or people can trigger grief reactions for people with Down syndrome. The death of a pet, loss of a caregiver, staff changes, the death of a family member or moving to a new residence can cause major stress and trauma in ways that might be difficult for people without disabilities to understand.  It can often be hard to adapt to change.  Seemingly insignificant losses (death of a hamster) can trigger deeper reactions to more significant events (death of a parent).  Many people with Down syndrome do not grieve until 6 months after the event.
  7. Diet, exercise, sleep, and social opportunities play a large role in mental and physical wellness.  Eating nutritious food, going for a daily brisk walk, and getting an adequate amount of uninterrupted sleep help people with Down syndrome stay healthy.  Self-care in these areas is vital to mental health.
  8. A caregiver’s ability to understand a person with Down syndrome’s non-verbal communication is related to the person having a mental illness diagnosis.   The person with Down Syndrome’s ability to express wants, needs, and feelings (either intelligibility or ability to express thoughts and feelings) are directly tied to his/her mental health.  Speech therapy, visual supports can ease some communication difficulties.  Visuals and social stories can help abstract concepts become “real.”
  9. Know the signs of caregiver burnout.  Caregivers are susceptible to depression and anxiety at high rates.  When caregivers burn out, they often cannot respond to the needs of their teens and adult children with disabilities in adequate ways.  See #3 on the list.
  10. Self-talk can be developmentally appropriate for many adults with Down syndrome. Without hallucinations, delusions, or paranoia, withdrawal from reality, or unusual affect, self-talk is not part of a mental illness.
  11. A “groove”— a tendency towards sameness or repetition - is not necessarily a sign of a mental illness.  Unless a groove interferes with a person with Down syndrome’s ability to function efficiently in daily life, grooves can be helpful, soothing, and within the range of “normal”.

Additional Resources

For more information about specific topics related to Down syndrome, visit the resource section of the DSAGSL website or check out books from our lending library. The library name is DSAGSL and you do not need a password.

If you have specific questions or concerns about this topic, feel free to contact our office at 314.961.2504 or join our private Facebook group “DSAGSL Sharing Our Strategies.”

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