Alana Baldwin knows the value of getting help when she is struggling to cope. An 18-year-old senior at River Rouge High School, she has anxiety and depression, challenges she links to low self-esteem and difficult family circumstances.
"I've been dealing with depression for quite a bit. I felt hopelessness, and it was physically straining. I didn't want to come to school," says Baldwin, who lives in southwest Detroit. "It started in sixth grade, maybe when I was about 11. I was bullied a lot in middle school. ... Then I had to go home where I didn't have anyone to talk to. And it grew as I got older."
Her teachers weren't aware of how she felt, or why, because she buried her emotions. Baldwin was slowly shutting down.
Baldwin may have been experiencing trauma, an emotional response to a serious event, like maltreatment, abuse, violence, or even a natural disaster, as defined by the American Psychological Association
. More than two-thirds of children experience a traumatic event by the age of 16, and it's more common than not for kids to be exposed to more than a single event.
Jeanne Miller - courtesy of Oakland Family Services
"[Trauma] is caused by something that was done to them, or that they experienced or observed," says psychologist Jeanne Miller, director, Specialized Services for Youth at Oakland Family Services
in Pontiac. "[The hurricanes] recently in Houston and Florida could be traumatic if a child doesn't know what is going to happen to their home. Some of those children will have traumatic exposure that will stay with them for a long time."
A child's response to trauma is as individual as the child. Some express rage or defiance, show little interest in school, have difficulty concentrating, experience separation anxiety, or even physical symptoms, like headaches or stomachaches, with no apparent medical cause. Others inflict self-harm by cutting their skin with razors or pencil sharpener blades.
"Sometimes, instead of the child acting out, you see the opposite," says Miller. "This is the child who is compliant, tries to please, yet something isn't quite right. Sometimes it takes some sensitive detective work to uncover."
Miller says of the 700 families Oakland Family Services supports each year, there is definite trauma in at least 75 percent, and a degree of trauma in as high as 90 percent.
Trauma can even weave its way through generations. "As we get to know a child's family better, sometimes a significant person in their life, a parent or a sibling, has had trauma as well," says Miller. "It becomes evident that it's gone through generations. They have survived, but not been treated."
Trauma, if recognized by a healthcare professional or therapist, can be treated, and children can recover.
"It's never too late," Miller says.
Reach out and begin to heal
For years, Baldwin wasn't aware that help was down the hall, right in her own school. Through an art class assignment, Baldwin learned about the Beaumont Teen Health Center
"I drew a picture for the lobby of the center. A doctor and a kid, together. And that's when I met Justin," Baldwin says.
She's referring to Justin Follebout, social worker at the Beaumont Teen Health Center—River Rouge, a high school-based clinic that is open to any Wayne county child aged 10 to 21. For many kids who lack reliable transportation, this center provides their sole source of accessible medical care.
Drawing by Alana Baldwin that now hangs in the waiting room at Beaumont Teen Health Center
Justin Follebout, social worker at the Beaumont Teen Health Center
Each student who walks through the clinic door needing more than a band-aid is screened for possible trauma. Social workers administer a 15-question test, all yes or no answers, which seeks to determine if the patient feels suicidal, if they're sexually active, abuse substances, exercises, and more. When a student admits to feeling hopeless, additional conversations follow.
"They check yes for a reason," says Follebout. "When kids are educated about trauma and its impact, they acknowledge that it can be a byproduct of anxiety and sleepless nights. Many of these kids have witnessed murder, or a grandparent dying, more than I care to say. They are victims of sexual abuse in a higher number than I anticipated."
The traumatic event may have occurred months or years ago, and in many cases, unaddressed trauma doesn't just go away. "Maybe it doesn't get noticed until later, with developmental delays in the learning process," says Follebout. "I believe down the road, there is significant later onset of health problems."
Researchers believe that trauma rewires the developing brain. When a child feels unsafe, his brain focuses on survival, making him feel overwhelmed by even minor stressors, according to the Institute for Safe Families
. While the brain is able to rewire, depression, substance abuse, and high levels of stress hinder trauma recovery. Trained therapists use several treatment methods to help kids develop new skills to cope.
"The earlier a child seeks help, the better," says Miller. Trauma-focused cognitive behavioral therapy
, led by a certified therapist, is supported by clinical research, and can show positive outcomes. Other treatments include group therapy using a format called Seeking Safety
, and Real Life Heroes
, which is geared toward younger children.
Focus on a positive future
Baldwin says Follebout is the only adult she feels comfortable talking with about her feelings and experiences. "I almost always come away feeling better," she says. "Justin always brings a positive outlook to the issues I deal with. He gives me a sense of direction. I really appreciate that."
Together, they strategize coping skills. Baldwin has learned to replace negativity with positive thoughts, and finds solace in music that expresses her feelings. Among the students who seek help from the teen health center, improvement comes when kids begin to see the bigger picture in their lives, and they show interest in a college visit, or are motivated to complete a job application.
Baldwin and Follebout
"The obvious signs would be self-reported decrease in suicidal thoughts or cutting. Or a willingness to put themselves out there socially," says Follebout. "We might see subtle improvement with eye contact, or how they address an adult accordingly. Just how they get their needs met without breaking down."
Baldwin's advice to kids who are struggling is to seek help. "It's super important to focus on your mental health. A lot of people view it as something that doesn't need attention, but it really does," she says. "Find someone you can confide in and let it all out. It may be hard to find someone, but keep trying and that will make you feel better."
Baldwin aspires to what she calls "a normal life": attending college, and then getting a job. Eventually, she'd like to get married and have kids of her own.
"Hopefully I'll be happy and have a group of people in my life who build me up, instead of tearing me down."
This article is part of "Children of Michigan," a series on the importance of health and wellbeing for Michigan's children. It is made possible with funding from the Children's Hospital of Michigan Foundation.
All photos, except where mentioned, by Nick Hagen.