Kind words can be short and easy to speak, but their echoes are truly endless.
-- Mother Theresa

Remember there's no such thing as a small act of kindness. Every act creates a ripple with no logical end.
-- Scott Adams

Kindness is in our power, even when fondness is not.
-- Samuel Johnson

Dual Diagnosis
By Amy Tobolski

Mental illness was once thought to rarely, if ever, occur in people with mental retardation. We now know that these individuals experience mental health disorders with equal, possibly even greater, frequency than than the general population. In fact, some stufies have estimated that MH disorders occur three to six times more frequently in the MR population. The most commonly identified MH disorders in the mentally retarded include Anxiety Disorders, Psychotic Disorders, and Personality Disorders.

There are two main challenges to diagnosing mental illness in a person with Mental Retardation: first, doctors are often reluctant to diagnose. In one survey of psychiatrists, 75 percent felt they had not received sufficient training in dual diagnosis (Lennox and Chaplin, 1996). The second challenge is the difficulty involved in identifying symptoms and making a diagnosis of a mental health disorder in a person with mental retardation. Often, "overshadowing" may occur. This refers to the consideration of symptoms as charactersitic of mental retardation ("behavioral") or due to institutionalization, rather than due to mental illness. Also, many common symptoms of mental health disorders often present somewhat differently in a person with mental retardation. Symptoms may be expressed in a more concrete manner. For example, "I'm sick" (versus "I'm sad"), sleep disturbances, and challenging behaviors.

Accurate diagnosis is frequently dependent on caregivers' abilities to identify symptoms, particularly when the person has limited verbal skills and cannot communicate what they are feeling. Doctors will need to rely on information regarding behavioral changes over time, especially in terms of the onset of changes and increases in the frequency of behavioral symptoms. It will be helpful to note any significant stressors, such as a death of a loved one, or a recent move, as stress is a common trigger for many mental illnesses.