Stuttering & Mental Health – What You Should Know
Stuttering & Mental Health – What You Should Know
Is stuttering all about repetitions, blocks, and prolongations? Definitely not!
Although, DSM-V (Diagnostic and Statistical Manual of Mental Disorders) categorizes stuttering as a communication disorder now, stuttering and anxiety disorders overlap in more than 75% of the cases. So, here is a look at stuttering and mental health – what you should know.
Stuttering and the Signs of Social Anxiety Disorder
Social anxiety disorder (SAD) is exhibited by signs such as –
- Excessive sweating and blushing while talking to someone
- Increased heart rate
- Nausea and dizziness
- A tendency to escape or avoid social situations
- Avoidance behaviour
- Inability to speak or feeling of a lump in the throat
These symptoms can occur with stuttering or independent of speech dysfluencies.
There Exists A Strong Link between Stuttering & Mental Health Disorders
In a study by Ross G. Menzies et al involving 32 adult participants, nearly 60% had social anxiety disorders in addition to stuttering.
A similar study led by Lisa Iverach et al states that more than 66% of the 64 adult participants had mental health disorders alongside stuttering.
Another study conducted on 94 adult stutterers and 920 adults who didn’t stutter revealed that stuttering individuals are three times more likely to develop personality disorders and other mental health problems.
It might seem strange until we consider the fact that social anxiety disorders and stuttering have one factor in common – higher than normal levels of dopamine production in the brain.
It is no coincidence that several researchers have stumbled upon positive results from the use of dopamine antagonists in treating chronic and severe stutter in several patients.
There are no FDA-approved drugs to treat stuttering at the moment.
However, multiple antipsychotics that are considered appropriate for treating a myriad of social anxiety disorders & personality disorders work well for increasing fluency among people who stutter.
Recent neuroimaging studies have provided evidence that people who stutter and those with a social anxiety disorder (SAD) have different dopamine (D2) receptors in their brains.
Although the direct interaction between dopamine (neurotransmitter) molecules and the D2 receptors have not been studied due to limitations in technology, the differences in D2 receptors may imply that people who stutter and those with SAD process dopamine differently from people who neither stutter nor have SAD.
Why Does Stuttering Treatment for Adults Include CBT?
The treatment for stuttering in adults often addresses SAD.
Speech therapy is more effective for adults who stutter when it is coupled with cognitive-behavioural therapy (CBT).
Evidence comes in the form of at least one study involving 25 participating adults who stutter. The study involved one and two years follow-ups at the Institute for Stuttering Treatment and Research (ISTAR) program.
Here is what the researchers found –
- There is no relationship between the severities of stuttering and the negative emotions of the participating adults.
- The ones who stutter with the most severity had the biggest gains, but also suffered the highest regression.
- Post-treatment, the differences in negative emotions of the groups consisting of people who stuttered mildly and severely disappeared. It may have been due to the significant decrease in the negative emotions of the latter group.
Is Stuttering a Mental Health Problem?
Stuttering has remained the centre of research in the areas of psychiatry, neuroscience, psychology, human behaviour, and speech-language pathology.
Sadly, the etiology of stuttering is still not fully understood by speech-language experts.
Speech-language pathologists and neurologists have already established that anxiety and fear of social interaction don’t cause stuttering.
If you know someone who stutters, you may have noticed that speaking in a social gathering makes his/her stuttering worse.
If you stutter, you may have felt anxiety or the fear of being ridiculed or ignored creep up before you speak. That might worsen your dysfluency. However, emotions don’t cause dysfluency.
As a result, DSM-V doesn’t categorize stuttering as a psychiatric disorder, but a communication disorder.
Stuttering has its roots in genetics. Anomalies in certain genes cause disrupted neural connections between brain centres responsible for speech processing and production.
The latest research on mice models shows that the corpus callosum – a structure similar to a highway made of neurons that connects the left and right hemispheres, in mice that “stutter” have fewer astrocytes.
Researchers may not know exactly how many genes are involved in stuttering. However, we have enough evidence to confidently state that stuttering is NOT a mental health problem.
Why Do PWS Face Mental Health Challenges?
Nevertheless, people who stutter have always faced discrimination, bullying, and more. The resulting negative emotions including shame, fear, embarrassment, self-doubt, and anxiety takes a considerable toll on their mental health.
Some psychiatrists have also shown how some adults who stutter show symptoms akin to post-traumatic stress disorder (PTSD) when placed in a social set up.
Are You Suffering From Mental Health Challenges Due to Stuttering?
Mental health is crucial for anyone who stutters. Even children who stutter can become victims of SAD from the time they begin attending school.
If you know someone who stutters, support them by being patient. Let them finish their sentences and don’t rush them.
A healthy argument is a sign of respect. Always let them finish before you counter their points.
What Should You Do if You are Suffering from Mental Health Issues as well?
If you stutter, don’t shy away from telling people about resources that will help them understand stuttering better.
If you find it challenging to complete everyday tasks, you should consider consulting a cognitive behavioural therapist along with a speech therapist.
Remember, mental health problems can be sneaky.
Sometimes, they present themselves as excessive sleepiness beyond your normal sleep hours.
If you find yourself avoiding certain situations or planning to avoid social interactions every day, it’s time to seek CBT.
Speech therapy can be expensive in every part of the world.
Before you begin your sessions with an SLP, why don’t you try a dedicated speech therapy app like Stamurai to practice your daily speech exercises?
A little improvement in speech fluency can go a long way in boosting your confidence and alleviating your fear in social setups.
