If you ever see someone prioritise their internet bill over groceries and a phone upgrade over clothes and other necessities, it will not come as a surprise. With how dystopian our society has become, children, too, are not safe from this plague.
Advertisements
Empty streets, vacant eyes, and dissociated children are a sight normalised to a disturbing extent. Let’s face it, today, we need no zombie apocalypse to be absent-minded; the internet does it well enough for us. Now, I am not saying that the internet alone is to blame.
Like these negatives, we cannot remain oblivious to how it helps academically and plays an important role in entertainment. But before we know it, this entertainment can take a turn for the worse when unaware children accidentally stumble across inappropriate content online. What must one do when faced with such a situation?
For starters, parents must stay on the lookout for warning signs to decide whether their child has become one of many young people exposed to explicit material online (Children’s Commissioner for England, 2025). But what can these signs be? They start as negligible quirks that you might dismiss as them growing up and finding themselves.
However, what happens is that them hiding their screen when you enter the room or being secretive about what they are doing on their phones can be covering some serious issues around their internet usage.
Not only that, but if you randomly also see your child being anxious when online or deflecting unnecessarily when asked questions, these red flags must be paid heed to. Since your lack of consideration towards these can ultimately devolve into serious mental health issues. Be it suicidal ideation, self-harm, depression, or stress, young minds are adversely impacted by this.
With you, now, having noticed that something is off, the next step is to encourage open dialogue. The discussion can be as simple as you talking about how their time is going on a specific website or app.
You can further ask them open-ended questions about their views on a particular trend to gauge where they stand and the type of content in their vicinity. When they begin to answer, you must listen attentively and make them feel like their feedback matters.
Once done, you can then offer your views, mind you, without being imposing, and then conclude the discussion by reiterating how they can always come to you for anything good or bad that they come across online.
Now, an extremely high percentage of parents have children who started using the internet by the age of 4 years (Bravehearts, n.d.). While not an inherently bad thing, the lack of supervision can reap concerning results. In situations like these, the Xnspy parental monitoring app can be used.
Xnspy is a software designed to help parents see their child’s complete online and offline activity. For online activity, features like internet history, keylogger, screen recorder, and social media chats for over 13 apps are provided in real-time.
While Xnspy’s internet history monitoring feature clearly captures all the visited URLs with relevant details, bookmarks, and activity analysis, the search history from keylogs shows the exact queries a child is looking up alongside the timestamps.
Then, to offer deeper insight into what actions they are taking after visiting a page, it shows the kind of content consumed. The screen recorder takes screenshots of the activity every 5-10 seconds.
Xnspys also includes screen time, instant keyword alerts, app blocking, etc. Using all the data made accessible on its web dashboard, you can gain insight into your child’s internet usage without having to access the phone.
But a parental monitoring app can only get you so far. Therefore, you must pair it with healthy online habits. For that, you should take a subtle approach. Rather than downright banning devices at home, you can help your child build habits like scheduling screen-free times.
The designated time can be a portion of the day where the whole family gets together and talks without any distractions, such as dinner time. But for this to be accepted with minimum backlash, you must model ideal behaviour in front of them and also ask for their input when making rules. With the child seeing their parents following all the set rules too, they will show more willingness to give it a try.
Another beneficial measure can be teaching kids to think critically about what they see online. Every now and then, you should sit with them and explain how everything on the internet is not created to be helpful or stand true. Sometimes, people can be devious and publish false claims.
Exemplify what you are talking about with facts, like how the bite-sized content on social media is designed to keep users hooked and grab attention. When armed with an understanding of the algorithm and trends, your child will be more likely to question what they see, fact-check information, and take breaks when it gets too much.
Nonetheless, it will be unfair if you expect your child to consume less content on the internet without offering alternatives. In addition to all the rules and awareness, you can further introduce physical activities like running, riding, swimming, etc., for your child.
Overall, with them engaging with other children face-to-face and having creative hobbies outside, they will be more alert and maintain a sharper mind. Though it does not necessarily have to be physical sport, since you can also encourage them to partake in board games, drawing, cooking, baking, and more. As long as the activities in question are substituting screen time, they are good to go.
All these steps, however, cannot suffice since you must provide your child with emotional support too. If you overreact and punish them when they encounter something upsetting online, they will focus more on hiding their mistakes the next time rather than coming to you.
Instead, you should talk to them calmly and reassure them when such a situation occurs. They should know that as long as they are learning from a mistake, they are doing the right thing. To establish that, you can start by thanking your child for trusting you when they bring something concerning, and then having an open discussion with them.
In conclusion, while the internet is a tricky place for young children, cutting it off entirely will just lead to a rebellion that will be hard to contain. Instead, by smartly reducing a child’s exposure to online content and supervising them, parents can address all their concerns while letting their children create a self-identity. After all, when a child’s sense of self is fragile, they are easily swayed by what they see.
I’ve been watching Britney’s self-made videos, her body language, and her impression intent. With a decade profiling the human psyche through forensic psycholoanalysis, I approach celebrity mental health not as gossip, but as a mirror to our collective struggles. Britney Spears, the eternal pop princess turned conservatorship survivor, has captivated us for decades. Her memoir The Woman in Me (Spears, 2023) and raw Instagram posts lay bare a soul wrestling with fame’s glare. Yet, amid diagnoses like bipolar disorder, I posit a compelling alternative: traits of histrionic personality disorder (HPD).
Advertisements
This isn’t dismissal of her pain—far from it—but a call for nuanced assessment. Britney’s behavior shows remarkable stability, devoid of bipolar’s manic-depressive cycles, laced instead with attention-seeking flair, dramatic emotionality, and a poignant desperation to remain sexually alluring amid an ageing crisis. Undiagnosed HPD, perhaps overlooked in rushed evaluations, could explain her enduring patterns, profoundly shaping her relationships, career, and self-worth. Let’s unpack this with evidence, empathy, and a forensic lens.
Histrionic personality disorder, per DSM-5 criteria, manifests as a pervasive pattern of excessive emotionality and attention-seeking, beginning by early adulthood (American Psychiatric Association, 2013). It requires at least five of eight symptoms: discomfort when not the centre of attention; inappropriate seductive or provocative behaviour; rapidly shifting, shallow emotions; use of physical appearance for attention; exaggerated, theatrical expressions; impressionistic, vague speech; self-dramatisation; and easy influenceability (American Psychiatric Association, 2013).
Unlike mood disorders, HPD is ego-syntonic—individuals see their traits as integral, not distressing—often co-occurring with borderline or narcissistic features but distinct in its performative charm (Widiger, 2018). Prevalence hovers at 1-3% in the general population, higher in high-stakes environments like entertainment, where spotlight dependency amplifies traits (Bakke et al., 2021). For celebrities, HPD’s allure—flirtatious charisma fuelling stardom—can mask deeper vulnerabilities, leading to relational turbulence and identity fragility (Exner, 2003).
Britney’s trajectory aligns strikingly with HPD markers. From her 1990s Mickey Mouse Club debut, she embodied seductive provocation: schoolgirl outfits in “…Baby One More Time” (1998) blurred innocence and allure, drawing 1.3 billion views and cementing her as a teen icon (Knapp, 2023). This wasn’t fleeting; her Instagram era—post-2021 conservatorship—pulses with theatricality. Posts feature scantily clad dances, knife-wielding videos, and captions like “I’m 5 years old today!” on her 43rd birthday, blending whimsy with provocation (USA Today, 2024).
Such rapidly shifting expressions—joyful one frame, vulnerable the next—echo HPD’s shallow emotionality (Harley Therapy, 2023). Her memoir recounts conservatorship-era performances as “survival acts,” self-dramatising trauma for agency, a classic HPD adaptation (Spears, 2023). Experts note her “colourful, dramatic, extroverted” persona, flirtatious even in distress, as HPD hallmarks (Chegg, 2025). Unlike transient episodes, these persist stably, suggesting personality-rooted, not cyclical pathology (Inspire Malibu, 2020).
Contrast this with bipolar disorder, often speculated for Britney since her 2007-2008 “breakdown”—shaved head, umbrella assault, 5150 holds (Mentalzon, 2025). Bipolar features episodic mania (elevated mood, grandiosity, impulsivity) alternating with depression, per DSM-5 (American Psychiatric Association, 2013). Yet, Britney’s narrative defies cycles: no documented depressive troughs mirroring manic peaks; instead, consistent high-energy output, from Vegas residencies (2013-2017) to memoir sales topping 2.4 million (Psychology Today, 2023).
Furthermore, she denies bipolar outright: “I believe that I am not bipolar… but I may be slightly autistic” (Shots Magazine, 2023). Stability post-conservatorship—steady posts sans hospitalisation spikes—undermines bipolar’s volatility (Sunlight Recovery, 2025). Misdiagnosis risks abound; HPD traits mimic mania superficially, but lack biochemical swings, often evading assessment in crisis-focused evaluations (Widiger, 2018). Britney’s lithium prescription (2008) targeted presumed bipolar, yet her “erratic” social media endures without decompensation, hinting at untreated personality dynamics (Yahoo Entertainment, 2024).
Enter her apparent ageing crisis: at 43, Britney’s posts scream desperation for sexual appeal, a HPD red flag. Bikini-clad reels, captioned “Still hot at my age?”, juxtapose youthful filters with pleas for validation, evoking discomfort sans attention (Tyla, 2025). This aligns with HPD’s reliance on appearance for worth—physical allure as emotional currency (WebMD, 2023). Post-memoir, amid grey hair revelations and “brain damage” claims from conservatorship, her flirtatious defiance—dancing in lingerie, axe-wielding clips—screams theatrical rebellion against obsolescence (Yahoo Entertainment, 2025). Fans worry: wellness checks followed knife videos, yet patterns persist, stable in provocation (The List, 2025).
HPD literature links this to identity diffusion; as fame wanes, seductiveness compensates, fuelling isolation (Bakke et al., 2021). Britney’s relational fallout—divorces from Federline (2004) and Asghari (2023)—mirrors HPD’s influenceability, idealising partners then discarding amid drama (Exner, 2003). The toll? Profound. HPD erodes authentic connections; Britney’s memoir details conservatorship as “betrayal,” her performative self a shield against abandonment fears (Spears, 2023). Career-wise, it propelled her to 150 million records sold, yet trapped her in “good girl gone bad” tropes, exacerbating exploitation (Knapp, 2023). Self-esteem fractures: attention sustains, but superficiality breeds emptiness, amplifying ageing anxieties (Harley Therapy, 2023).
Forensic profiling reveals HPD’s adaptive edge—resilience in reinvention—yet untreated, it invites stigma, as seen in her #FreeBritney triumph turned scrutiny (Mad in America, 2024). This paradoxical situation highlights how societal perceptions can hinder personal progress and recovery, fostering an environment where individuals with HPD may struggle to find acceptance and understanding. Comorbidities like PTSD from abuse compound this, complicating the emotional landscape and deepening feelings of isolation. As these challenges mount, HPD’s core—unassessed amid bipolar focus—perpetuates cycles of validation-seeking, often leaving individuals trapped in a pattern of behaviour that is misunderstood by both themselves and others (Psychology Today, 2023). Ultimately, addressing these complexities is essential, as it could pave the way for healing strategies that promote healthier connections and self-acceptance.
In profiling Britney, I see not pathology to pity, but humanity to honour. Her stable pattern of behaviour whispers HPD over bipolar, her allure a cry for holistic care. Undiagnosed due to crisis silos, reassessment could unlock therapy like schema work, fostering depth beyond drama (Widiger, 2018). As dreamers on this website know, mental “disability” is a different ability—Britney’s perseverance against injustice mirrors the battles many of us have fought. Let’s amplify empathy, not speculation. Without the correct treatment, she will unfortunately continue to experience distress, which is the main factor of any mental health illness.
Widiger, T.A. (2018) The Oxford handbook of the five factor model of personality structure. Oxford University Press. Available at: https://academic.oup.com/edited-volume/34385 (Accessed: 1 November 2025).
Epileptic psychosis—often termed psychotic epileptic disorder—is a condition where epilepsy intersects with psychotic symptoms. This essay explores its classification, clinical features, real-life examples, and correlations to historical cases misinterpreted as demonic possession requiring exorcism. Through rigorous review, I aim to highlight medical realities over stigma, advocating for integrated care in mental health and neurology.
Advertisements
Psychotic epileptic disorder, or epileptic psychosis, refers to psychotic episodes occurring in individuals with epilepsy, where symptoms like hallucinations and delusions arise in temporal relation to seizures (Mental Health, 2025). It affects 3-7% of epilepsy patients, significantly higher than the 1% schizophrenia prevalence in the general population, with elevated risk in temporal lobe epilepsy (TLE) and uncontrolled seizures (Mental Health, 2025; Epilepsy Action, 2025a).
Classification includes pre-ictal psychosis (PrP), occurring hours to days before seizures with anxiety and derealisation; ictal psychosis (IP), during seizures featuring fear and automatisms; interictal psychosis (IIP), between seizures resembling schizophrenia but with better prognosis; postictal psychosis (PIP), following seizures after a lucid interval with emotionally charged delusions; and forced normalisation (FN), paradoxically triggered by seizure control (Wang et al., 2024; Epilepsy Action, 2025a).
Clinical features encompass delusions, hallucinations, paranoia, social withdrawal, disorganised thinking, and mood swings (Mental Health, 2025; Epilepsy Foundation, n.d.). For instance, in PIP—the most common type—symptoms like violent behaviour or self-harm emerge 12-72 hours post-seizure, lasting up to two months (Epilepsy Action, 2025a). Causes involve neurobiological mechanisms: structural changes like hippocampal volume loss, neurotransmitter imbalances (e.g., reduced glutamate and GABA), neuroinflammation via cytokines (IL-1β, IL-6, TNF-α), and genetic factors such as mutations in GRM1 or CNTNAP2 (Wang et al., 2024). Anti-seizure medications (ASMs) like topiramate or levetiracetam can precipitate psychosis, especially in those with family history (Epilepsy Action, 2025a). Diagnosis requires specialist assessment, including EEG to link symptoms to seizure activity, distinguishing it from primary psychoses (Mental Health, 2025).
Treatment emphasises coordinated neurology-psychiatry care, balancing seizure control with antipsychotics. For IP and PrP, seizure management suffices; PIP often resolves spontaneously but may need benzodiazepines; IIP and FN require antipsychotics like olanzapine or risperidone, with ASM adjustments (Mental Health, 2025; Wang et al., 2024). Early intervention teams and psychosocial support—case management, vocational rehab—aid functioning, as untreated episodes worsen cognition and independence (Mental Health, 2025).
Historically, epileptic psychosis has been misinterpreted as demonic possession, leading to exorcisms instead of medical intervention. In ancient times, epilepsy—termed the “sacred disease”—was attributed to supernatural forces, with seizures and psychotic symptoms seen as divine or demonic invasions (Trimble and Reynolds, 1976). This persisted into modernity, correlating with cases where TLE-induced hallucinations were deemed possession. The most infamous is Anneliese Michel (1952-1976), a German woman diagnosed with TLE and psychosis at 16, experiencing convulsions, hallucinations of “devil faces,” auditory commands of damnation, self-harm, and aversion to religious objects (Wikipedia, 2025). Despite treatments like Dilantin, Aolept, and Tegretol for five years, symptoms worsened, leading her devout Catholic family to interpret them as possession by demons like Lucifer and Hitler (Wikipedia, 2025; Goodman, 2005).
Real photos from Anneliese Michel.
Michel underwent 67 exorcism sessions from 1975-1976 by priests Ernst Alt and Arnold Renz, authorised by Bishop Josef Stangl, involving rituals where she growled, screamed curses, and refused food, dying of malnutrition at 30kg (Wikipedia, 2025; Duffey, 2011). Autopsy confirmed dehydration, pneumonia, and broken knees from genuflections, not supernatural causes (Wikipedia, 2025). Her 1978 trial convicted her parents and priests of negligent homicide, with probation, as experts attributed symptoms to untreated epilepsy and psychosis exacerbated by religious upbringing (Wikipedia, 2025; Getler, 1978). This case, inspiring films like The Exorcism of Emily Rose, exemplifies how TLE’s temporal lobe involvement—causing religious delusions and hallucinations—mimics possession, delaying care (Forcen, 2016).
Scene from The Exorcism of Emily Rose.
Modern examples show the impact of the disorder. In postictal psychosis, a patient experiences confusion, delusions, and hallucinations after partial seizures, resembling schizophrenia and causing social isolation if it happens often (Mental Health, 2025). Ictal psychosis occurs briefly during seizures, showing symptoms like auditory hallucinations and agitation in TLE cases, resolving after the seizure but can recur without treatment (Mental Health, 2025). Interictal psychosis, common in chronic uncontrolled TLE, leads to persistent threatening voices and cognitive decline, especially in patients with hippocampal sclerosis who show EEG abnormalities and need long-term antipsychotics (Wang et al., 2024). A Korean family with a specific genetic deletion showed epilepsy and schizophrenia-like psychosis, pointing to genetic factors (Wang et al., 2024). After temporal lobectomy, about 7% of patients over 30 experience temporary delusions that can be treated with medication adjustments (Mental Health, 2025).
Other historical examples include 17th-century European “possession” epidemics, where convulsive symptoms now recognised as epilepsy or conversion disorder led to exorcisms (Schwarz, 2014). In Christian contexts, epilepsy’s association with demons stemmed from biblical accounts, like Yeshua casting out spirits causing seizures (Mark 9:14-29, n.d.; KJV), influencing interpretations (Young, 2016). A 2013 thesis links such misdiagnoses to cultural fears, with “demonic” behaviours aligning with PIP’s aggression or IP’s automatisms (Snyman, 2025). In non-Western cultures, similar correlations persist, with epilepsy stigma leading to spiritual interventions over medical (Trimble and Reynolds, 1976).
Forensic profiling reveals these misinterpretations stem from limited medical knowledge, cultural-religious frameworks, and stigma, profiling “possession” as undiagnosed epileptic psychosis (Epilepsy Action, 2025b). Modern neuroimaging confirms brain-based origins, advocating evidence-based treatment over exorcism (Wang et al., 2024).
In conclusion, psychotic epileptic disorder underscores epilepsy-psychosis interplay, with real examples like post-surgical flares and historical cases like Michel’s highlighting risks of misdiagnosis. This should be profiled as a call for destigmatisation and integrated care, preventing tragedies through science over superstition.
Problem Solving Treatment (PST) is a structured therapeutic approach that aims to enhance an individual’s problem-solving abilities with a view to improving their mental health and overall well-being. Originally developed for individuals experiencing depressive symptoms, PST has shown versatility and effectiveness across various psychological issues, including anxiety disorders and post-traumatic stress disorder (PTSD). This article delves into the key components of PST, its underlying principles, therapeutic frameworks, and the evidence supporting its efficacy.
Advertisements
Understanding Problem Solving Treatment
At its core, PST is predicated on the belief that many mental health challenges stem from an inability to effectively navigate life’s difficulties. Individuals often find themselves overwhelmed by problems, leading to feelings of helplessness, hopelessness, and, consequently, psychological distress. PST seeks to break this cycle by equipping individuals with the skills to approach their difficulties in a systematic and pragmatic manner.
The treatment typically involves several stages, including problem identification, brainstorming potential solutions, evaluating these solutions, and implementing the chosen course of action. Each stage encourages individuals to actively engage with their problems rather than avoiding them, fostering a sense of empowerment and control over their circumstances.
Underpinning Theories
PST is grounded in cognitive-behavioural principles, notably the notion that thoughts, feelings, and behaviours are interconnected. Negative thought patterns often exacerbate problems, leading to a cycle of avoidance and helplessness. By altering these thought patterns through structured problem-solving, individuals can improve their emotional responses and behaviours. The treatment draws heavily from cognitive-behavioural therapy (CBT) techniques, emphasising the importance of developing a proactive mindset and enhancing coping strategies.
Key Components of PST
Problem Identification
The first step in PST involves identifying specific problems or stressors that the individual wishes to address. This may range from everyday challenges, such as work-related stress, to more profound issues, like relationship difficulties or persistent feelings of sadness. Through guided discussions, individuals are encouraged to articulate their concerns clearly, allowing them to gain clarity about what they want to change in their lives. This identification phase is crucial, as it sets the stage for the subsequent steps in the treatment process.
Generating Solutions
Once problems have been identified, the next step is to brainstorm potential solutions. This stage is characterised by creativity and exploration, wherein individuals are encouraged to think broadly about various approaches to their identified problems. The therapist plays a key role in facilitating this process, helping individuals to consider options they may not have previously contemplated. This can also include considering the consequences of each solution and how feasible they may be in practice. The aim is to expand the individual’s repertoire of potential responses to challenges, reinforcing the idea that multiple pathways can lead to resolution.
Evaluating Solutions
After generating a list of potential solutions, the individual must evaluate each option’s effectiveness and practicality. This involves assessing the pros and cons of each solution and predicting potential outcomes. The therapist aids in this evaluation process, offering insights and guiding the individual to reflect on their preferences and values. By actively engaging in this analysis, individuals learn to weigh their options critically and make informed decisions.
Implementing Solutions
Following a thorough evaluation, individuals are encouraged to select the most suitable solution and develop a clear implementation plan. This may involve setting specific goals, determining necessary resources, and identifying possible obstacles that may arise. The implementation phase is crucial; it provides a tangible way for the individual to apply their problem-solving skills in real-life situations. Furthermore, this stage reinforces the concept of self-efficacy, as individuals witness their efforts produce positive change.
Reviewing and Reflecting
Finally, PST involves reviewing the process and reflecting on outcomes. Individuals are encouraged to assess whether their chosen solution effectively resolved the identified problem and whether they feel better equipped for future challenges. This stage promotes a continual learning process and encourages individuals to adapt and refine their problem-solving strategies over time.
Key Skills Embedded in PST
Prioritisation: When multiple problems exist, rank by urgency, impact, and controllability to avoid diffusion of effort.
Distinguishing solvable vs. unsolvable elements: Focus action where influence is possible; use acceptance or coping strategies for uncontrollable parts.
Behavioural activation synergy: Small, scheduled actions reduce avoidance and improve mood, enhancing motivation for further problem solving.
Communication planning: Many practical problems are interpersonal. PST often includes rehearsal of requests, boundary-setting, and negotiation skills.
Self-monitoring: Brief tracking of efforts and outcomes helps make progress visible and guides adjustments.
Who Benefits from PST
PST is well-suited for individuals experiencing mild-to-moderate depression or anxiety linked to identifiable life problems. People who feel overwhelmed by multiple practical stressors and struggle to prioritise. Clients seeking a concrete, action-oriented approach with measurable progress. Settings needing brief, scalable interventions (primary care, IAPT-style services, college counselling, occupational health, tele-mental health).
It may be less suitable for acute crises requiring stabilisation, unmanaged severe mental illness, or situations where cognitive capacity to engage in structured tasks is severely limited—though even then, PST elements can be adapted once safety and stabilisation are addressed.
The PST Process: Seven Steps
The heart of PST is a clear, repeatable sequence. Different manuals vary slightly in wording, but the logic is consistent.
Problem Orientation
Aim: Build a constructive mindset toward problems—seeing them as solvable challenges rather than insurmountable threats.
What it involves: Normalising setbacks, emphasising skill-building, and cultivating self-efficacy. The support worker reinforces that incremental progress counts and missteps are data, not failure.
Problem Definition and Goal Setting
Aim: Translate a vague stressor into a specific, controllable problem with a concrete goal.
How: Use SMART goals (Specific, Measurable, Achievable, Relevant, Time-bound). Clarify what is within the person’s influence. For example, “My workload is crushing” becomes “Reduce weekly overtime from 10 hours to 4 within four weeks by renegotiating deadlines and batching email.”
Brainstorming Alternatives
Aim: Generate a wide range of possible solutions before evaluating.
Rules: Quantity over quality initially; defer judgement; invite creativity; include small experiments and social supports. This combats the cognitive narrowing that accompanies stress and depressed mood.
Decision Making
Aim: Evaluate options using clear criteria—feasibility, resources, risks, potential benefits, and alignment with values.
Tools: Pros/cons grids, rating scales, or weighted criteria. Choose one or two options to test as first-line steps rather than searching for a perfect solution.
Action Planning
Aim: Translate chosen solutions into a step-by-step plan.
Elements: Define the first smallest actionable step, set timelines, identify needed resources, and anticipate barriers with “if–then” plans (implementation intentions). Assign responsibility and schedule the steps.
Implementation
Aim: Do the plan, track completion, and note any barriers in real time.
Supports: Use calendars, reminders, accountability check-ins, and brief skills as needed (e.g., communication scripts for a difficult conversation, micro-breaks to manage stress).
Review and Refinement
Aim: Evaluate what happened, what worked, what didn’t, and why.
Approach: Treat each cycle as a learning loop. Reinforce any progress, adjust goals or tactics, and sequence the next step. This builds mastery and resilience.
Evidence of Efficacy
Research surrounding PST has indicated its effectiveness in treating various populations and mental health conditions. Studies have shown that PST can significantly reduce depressive symptoms, enhance coping mechanisms, and improve overall quality of life. Its structured framework allows for flexibility, making it applicable across diverse settings, including clinical environments, community mental health programmes, and individual therapy sessions.
Moreover, meta-analyses have demonstrated that PST is a valuable intervention, particularly for individuals facing stressful life circumstances. Longitudinal studies suggest that the benefits of PST extend beyond the end of treatment, equipping individuals with lifelong problem-solving skills that foster resilience. This enduring impact underscores the treatment’s potential as a preventative measure against future mental health issues.
Measuring Success
Symptom reduction: Lower scores on depression/anxiety scales.
Functional gains: Improved attendance, productivity, social engagement, or self-care routines.
Self-efficacy: Increased confidence ratings in handling future problems.
Problem resolution: Concrete milestones achieved (e.g., debt payment plan initiated, conflict meeting held, medical appointments scheduled).
How to Get Started Right Now
List your top 3 current stressors. Choose one that is both important and realistically changeable in the next two weeks.
Define the problem in one sentence and write a SMART goal.
Brainstorm at least 8 possible actions, including micro-steps and people you could ask for support.
Select 1–2 options to test this week. Create a simple action plan: what, when, where, with whom, and what you’ll do if a barrier appears.
Schedule a brief review date to learn and adjust. Use depression and anxiety scales to measure improvement.
Conclusion
In summary, Problem Solving Treatment (PST) represents a vital approach in the spectrum of therapeutic interventions available for mental health issues. By focusing on enhancing problem-solving skills, individuals can gain greater control over their lives, fostering resilience and improving well-being. Through structured phases of problem identification, solution generation, evaluation, and implementation, PST empowers individuals to address their challenges proactively.
Supported by robust evidence of efficacy, PST stands out as a versatile and transformative tool in the realm of psychological treatment, offering hope and practical strategies for those navigating the complexities of life’s challenges. As mental health continues to be a global priority, the application and further development of PST will remain critical in promoting psychological resilience and well-being.
I decided to go into forensics because since I was a child, I had a natural gift of dealing with troubled individuals so as to keep myself safe. I grew up in Colombia during the 90s, a time when the Constitution of 1991 was established, and a time when violence, narco-cartels, the paramilitary, satanic sects, death squads, and fresh magnicides took place. Indeed, utter political chaos was the status quo. Yes, Colombia was in deep crisis during this decade, and psychological deviations were all over the place. What seemed normal everywhere, was also a hyper-manifestation, and hypernormalisation of what now is classified as abnormal.
Among the many ills of Colombia, were sexual deviations. And that’s how my ‘career’ into forensic psychoanalysis began when I was only six years old.
As I write this update on Tuesday, May 6, 2025, I’m struggling to find the courage to publish this blog post, overwhelmed by fear and self-doubt that have resurfaced after a series of messages from my perpetrator over the weekend. One message, in particular, has thrown me off balance: he mentioned his relative contacting me, thanked me for wishing him well, and pleaded for one last try at couple’s therapy, offering to pay for counselling and claiming it’s confidential, so I’d have “nothing to lose.” He denied that his actions—like ghosting me for two days due to a hangover—constituted abuse, accusing me of mislabelling them and implying I’ve made him seem like a physical abuser by not providing “details.” He ended by saying he’d never contact me again if I didn’t reply, but his words have left me spiralling, feeling like the abuse is my fault all over again.
Advertisements
This message, along with others he sent over the weekend, has reignited the fear that’s kept me from sharing my story. I’m terrified that if I publish this post, he’ll see it and retaliate, especially since the Non-Molestation Order I applied for through the National Centre for Domestic Violence (NCDV) is still being fast-tracked and isn’t yet in effect. The NCDV has been working diligently since I contacted them on May 1, 2025, but the process has taken longer than expected, leaving me vulnerable to his ongoing harassment. His past threats—like saying “Big mistake” on April 13 when I set boundaries—make me worry he’ll escalate, perhaps by showing up or intensifying his smear campaign, as he did with the local community. I’m scared he’ll twist my words, claiming I’ve misrepresented him, and that others will believe his gaslighting over my truth. As someone with health problems, I’ve already battled self-doubt, and his accusations exploit that vulnerability, making me fear I’ll be seen as “deluded” or “overdramatic,” labels he’s used to undermine me.
The emotional toll has been immense—my panic attacks have worsened, and my mental health team increased my Diazepam prescription this week because my emotions have become so intense, teetering on the edge of stupor and catatonia. I’m also afraid of his manipulative pull; his suggestion of therapy tugs at the part of me that once hoped he could change, despite his emotional abuse in our past sessions with Stephanie. But I’m determined to publish today, knowing that the support of PDAS, JWA, and the First Response team, along with the Clare’s Law disclosure that validated my experience, gives me the strength to speak out and help others break free.
The traumas will take time to heal. I’m working on rebuilding my self-esteem, reminding myself that my schizophrenia and depression don’t make me “disgusting”—they’re part of my journey, and I’m stronger for surviving them. I’m reclaiming my love for theology, finding solace in the texts that once brought me joy, refusing to let his threats taint that part of me. I’m also channelling my experiences into something positive: I’m reviving my plan to turn my website into a platform for emotional support for women, sharing resources, coping strategies, and a safe space for others to heal, just as I am.
If you’re reading this and recognise these signs in your own relationship—the withdrawal, the gaslighting, the threats—please know you’re not alone. Reach out to support services like Women’s Aidor your local First Response Team. You deserve to feel safe, to be loved without fear, to break free from the possession of abuse. I’m still healing, but I’m free now, and that freedom is worth every tear I’ve shed. I hope my story gives you the courage to find yours.
Geriatric depression, a significant mental health concern among older adults, manifests as a range of depressive symptoms that impair quality of life, functional capacity, and overall well-being. In Colombia, a country marked by socioeconomic challenges, historical violence, and a growing ageing population, geriatric depression presents unique complexities. The prevalence of depression among older adults in Colombia is notably high, with studies indicating that up to 41% of individuals over 60 report depressive symptoms (Ministerio de Salud, 2013). This essay explores the prevalence, risk factors, social resources, and interventions for geriatric depression in Colombia, drawing on recent studies to provide a comprehensive analysis. It also addresses the social resources available to mitigate this condition, emphasising their role in fostering mental health resilience.
Advertisements
Prevalence of Geriatric Depression in Colombia
Depression among older adults in Colombia is a pressing public health issue. According to the Encuesta Nacional de Salud, Bienestar y Envejecimiento (SABE; Ministerio de Salud, 2015), approximately 41% of Colombians aged 60 and older exhibit depressive symptoms, a figure significantly higher than global estimates, which range from 10-20% for older adults (World Health Organisation, 2017). A study conducted in three Colombian cities—Bogotá, Medellín, and Cali—utilising the Yesavage Geriatric Depression Scale (GDS) reported a prevalence of 15% for clinical depression among community-dwelling older adults, with higher rates among women (Gómez et al., 2019). This discrepancy in prevalence estimates may stem from methodological differences, such as self-reported measures versus clinical diagnoses, and the exclusion of rural or institutionalised populations in some studies.
The high prevalence is compounded by underdiagnosis, with nearly half of geriatric depression cases remaining undetected due to stigma, prioritisation of somatic complaints, and limited access to mental health services (Giebel et al., 2023). Colombia’s history of armed conflict, spanning over seven decades, has further exacerbated mental health challenges, with older adults often reporting trauma-related depressive symptoms due to exposure to violence, displacement, or loss (León-Giraldo et al., 2021). The ageing population, projected to increase from 18.7% to 39.5% of the total population by 2050, underscores the urgency of addressing geriatric depression as a public health priority (Guo et al., 2025).
Risk Factors for Geriatric Depression in Colombia
Several risk factors contribute to the high prevalence of geriatric depression in Colombia, encompassing demographic, psychosocial, health-related, and contextual elements. These factors include advancing age, which inherently brings about a decline in physical health and social support networks as older adults often experience the loss of loved ones and friends. In this complex interplay of factors, contextual elements, including societal attitudes towards ageing and mental health stigmas, further complicate the landscape of geriatric depression, emphasising the urgent need for targeted interventions and support systems in Colombia.
1. Demographic and Socioeconomic Factors
Gender is a significant determinant, with women consistently showing higher rates of depression than men. A Bogotá-based study found that being female was associated with a higher risk of depression, potentially due to gender-specific social stressors such as caregiving responsibilities and economic dependency (Rodríguez et al., 2020). Low socioeconomic status and limited education also increase vulnerability, as they restrict access to resources and exacerbate feelings of helplessness (León-Giraldo et al., 2021). Only 23% of Colombians over 60 receive a pension in 2015, leaving many in financial strain, which is a known correlate of depression (SABE, Ministerio de Salud, 2015). However, there is progress as President Gustavo Petro has recently implemented policies targeting these crucial, and problematic factors.
2. Psychosocial Factors
Social isolation and poor social support are critical risk factors. Older adults in Colombia often experience shrinking social networks due to retirement, bereavement, or health decline, which heightens loneliness and depressive symptoms (Ayalon & Levkovich, 2019). Low social support networks were strongly associated with depression, particularly among women. Additionally, exposure to historical violence, including forced displacement and loss of loved ones, has left lasting psychological scars, with older adults reporting persistent trauma (Giebel et al., 2023).
3. Health-Related Factors
Chronic illnesses, such as diabetes, cardiovascular disease, and cognitive impairment, are prevalent among older Colombians and are closely linked to depression. The SABE survey indicated that 15% of older adults with depression also reported functional deficits, which further impair their ability to engage in daily activities (Gómez et al., 2019). Cognitive decline, assessed using tools like the Montreal Cognitive Assessment Test (MoCA), is another risk factor, as it compounds feelings of helplessness and reduces coping capacity.
4. Contextual Factors
Colombia’s history of armed conflict and ongoing localised violence contribute significantly to mental health challenges. The 2016 Peace and Disarmament Agreement reduced large-scale conflict, but localised violence persists, perpetuating stress and trauma among older adults (Tamayo-Agudelo & Bell, 2018). The COVID-19 pandemic further intensified these issues, with restrictive measures like physical distancing disproportionately affecting older adults, leading to increased isolation and depression (Ministerio de Salud y Protección Social, 2020).
Social Resources for Addressing Geriatric Depression
Social resources play a crucial role in mitigating geriatric depression by fostering social connectedness, providing instrumental support, and reducing isolation. In Colombia, several initiatives and programs target older adults’ mental health, though challenges in accessibility and coverage persist.
Colombia Mayor: A social pension program that improves social participation but has limited impact on depression due to household resource sharing.
Community Health Centres: Use tools for screening, though rural access is limited.
NGOs and Volunteering: Organisations like Fundación para el Bienestar del Adulto Mayor offer social activities, reducing depressive symptoms.
Digital Support: Internet usage reduces depression by fostering connections, but adoption is low due to digital literacy barriers.
The Above Programmes Explained
The Colombia Mayor program, a social pension initiative, provides cash transfers to low-income older adults to alleviate poverty and improve well-being. The study using the 2015 SABE data found that while the program improved social participation and reduced food insecurity, it had no significant effect on depression levels, possibly due to high levels of intergenerational co-residence, where benefits are shared within households rather than directly benefiting the recipient (Hessel et al., 2020). This highlights the need for targeted mental health components within such programs.
Community-based initiatives, such as those offered by public community health centres, provide screening and support for older adults. A South Korean study, which shares similarities with Colombia’s community-based approach, screened 609 older adults and found that social support moderated the relationship between daily living activities and life satisfaction, suggesting that similar interventions could be effective in Colombia (Kim et al., 2020). In Colombia, community health centres use tools like the Geriatric Depression Scale Short Form (GDSSF-K) to identify at-risk individuals, though coverage is limited in rural areas (Gómez et al., 2019).
NGOs and volunteer programs offer social engagement opportunities that can reduce depressive symptoms. A study on volunteering and depression found that older adults who volunteered reported fewer depressive symptoms, particularly when engaged in religious or community activities (Musick & Wilson, 2003). In Colombia, organisations like the Fundación para el Bienestar del Adulto Mayor provide recreational and social activities, fostering a sense of purpose and community. However, these programs are often urban-centric, limiting access for rural older adults.
Digital Support is based on the fact that internet usage has emerged as a potential tool for reducing depression among older adults. A study from the China Health and Retirement Longitudinal Study, applicable to middle-income contexts like Colombia, found that internet usage reduced depression levels by 1.41% by facilitating social connections and access to information (Guo et al., 2025). In Colombia, initiatives like the Ministry of Information and Communications’ digital literacy programs aim to bridge the digital divide for older adults, though adoption remains low due to limited access and technological literacy.
Interventions and Treatment Approaches
Effective interventions for geriatric depression in Colombia must address both the depressive syndrome and underlying social adversities. Several evidence-based approaches show promise.
Psychosocial: Problem-solving treatment (PST) combined with case management shows promise for low-income older adults.
Pharmacological and Integrated Care: Community-based antidepressant management improves outcomes.
Home-Based Care: Depression care management in home healthcare settings enhances functioning.
Now, let’s explore these in more detail:
Psychosocial Interventions
Problem-solving treatment (PST) combined with case management has shown feasibility in addressing geriatric depression among low-income older adults. A model developed by UCSF and Cornell University integrates PST with case management, teaching patients to identify problems, set goals, and create action plans while linking them to social services (Areán et al., 2010). In Colombia, such interventions could be adapted for community health centres, where nurses are well-positioned to deliver depression care management (DCM).
Pharmacological and Integrated Care
Antidepressant medication management integrated into primary care settings has improved depression outcomes in older adults, with benefits lasting up to two years (Hunkeler et al., 2006). In Colombia, the transition from hospital-based to community-based mental health care, initiated by the 1990 Declaration of Caracas, has increased access to such treatments, though rural areas lag behind (Caldas de Almeida & Horvitz-Lennon, 2010).
Home-Based Care
Home-based care is particularly effective for older adults with mobility limitations or disabilities. Studies integrating mental health care into home healthcare (HHC) settings have shown reduced depression and improved functioning (Rabins et al., 2000). In Colombia, HHC nurses could be trained to implement DCM, leveraging tools like the OASIS-C depression screening to identify and manage cases (Pickett et al., 2022).
Challenges and Recommendations
Despite the availability of social resources and interventions, several challenges hinder effective management of geriatric depression in Colombia. Limited mental health infrastructure, particularly in rural areas, restricts access to care. Stigma surrounding mental health discourages older adults from seeking help, and the prioritisation of physical health over mental health in clinical settings exacerbates underdiagnosis (Giebel et al., 2023). Additionally, the lack of integration between social programs like Colombia Mayor and mental health services limits their impact on depression.
To address these challenges, the following recommendations are proposed:
Enhance Community-Based Screening: Expand the use of validated tools in community health centres and train healthcare workers to recognise atypical presentations of depression in older adults.
Integrate Mental Health into Social Programs: Incorporate mental health components into programs like Colombia Mayor, such as peer support groups or counselling, to directly address depressive symptoms.
Promote Digital Inclusion: Increase investment in digital literacy programs to enable older adults to access online mental health resources and social networks.
Strengthen Rural Access: Develop mobile health units and telehealth services to reach rural older adults and ensure equitable access to mental health care.
Combat Stigma: Launch public awareness campaigns to reduce stigma and encourage help-seeking behaviours among older adults.
Conclusion
Geriatric depression in Colombia is a multifaceted issue driven by socioeconomic disparities, historical trauma, and health challenges. While social resources like Colombia Mayor, community health centres, and NGO-led initiatives offer valuable support, their impact on depression is limited by accessibility and integration issues. Evidence-based interventions, such as PST, integrated care, and home-based DCM, show promise but require broader implementation. By addressing structural barriers and leveraging social resources, Colombia can enhance mental health outcomes for its ageing population, ensuring that older adults live with dignity and resilience.
References
Areán, P. A., Raue, P., Kanellopoulos, D., Sirey, J. A., & Alexopoulos, G. S. (2010). Treating depression in disabled, low-income elderly: A conceptual model and recommendations for care. International Journal of Geriatric Psychiatry, 25(8), 765–769. https://doi.org/10.1002/gps.2556
Caldas de Almeida, J. M., & Horvitz-Lennon, M. (2010). Mental health care reforms in Latin America: An overview of mental health care in Latin America and the Caribbean. Psychiatric Services, 61(3), 218–221. https://doi.org/10.1176/ps.2010.61.3.218
Giebel, C., Zuluaga, M. I., Martinez, R., Castro, S., & Gomez, D. (2023). “Mental health has been left behind”: A qualitative exploration of stakeholders’ perceptions of older adults’ mental well-being in Colombia. Journal of Aging & Social Policy, 35(4), 512–530. https://doi.org/10.1080/08959420.2023.2201818
Gómez, F., Corchuelo, J., Curcio, C. L., Calzada, M. T., & Mendez, F. (2019). Depression in the elderly: A study in three cities of Colombia. Revista Redalyc, 21(3), 45–56. https://www.redalyc.org/articulo.oa?id=10557689004
Hunkeler, E. M., Katon, W., Tang, L., Williams, J. W., Kroenke, K., Lin, E. H., & Unützer, J. (2006). Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care. BMJ, 332(7536), 259–263. https://doi.org/10.1136/bmj.38683.710255.BE
Kim, J., Lee, S., & Chun, S. (2020). Depression, loneliness, social support, activities of daily living, and life satisfaction in older adults at high-risk of dementia. International Journal of Environmental Research and Public Health, 17(20), 7648. https://doi.org/10.3390/ijerph17207648
León-Giraldo, S., Casas, G., Cuervo, J. D., Florez, F., & Botero, J. (2021). Mental health outcomes among older adults in Colombia: The role of conflict and socioeconomic factors. PLoS ONE, 16(3), e0248484. https://doi.org/10.1371/journal.pone.0248484
Rabins, P. V., Black, B. S., Roca, R., German, P., McGuire, M., Robbins, B., & Brant, L. (2000). Effectiveness of a nurse-based outreach program for identifying and treating psychiatric illness in the elderly. JAMA, 283(21), 2802–2809. https://doi.org/10.1001/jama.283.21.2802
