How High School Boys Act

I posted this article a few days ago. However, over the past few days there have been some events that require me to add to and repost this article.

Over the past two years we have been hearing a lot about men in the entertainment industry and politics who have sexually harassed women and teenagers over the past years. As a result, women are feeling strong enough to come forward and tell everyone about the secrets they have been ashamed of for years. What does this tell us about our society? Also what message have children and teenagers been receiving about sexual assault and rape over the last 20 years?

Let me provide some facts about this issue. Every 98 seconds someone in the United States is sexually assaulted. One out of four females and one out of seven males will be sexually assaulted during their life time. Many people who are a victim of a sexual assault are children. Most victims do not report being assaulted or raped. They fail to report the incident because they are afraid no one will believe them and they fear having to prove it happened. For males, they are afraid that people will think they are gay and wanted it to happen. If they did not want it to happen, why did they allow it to occur? This idea that the victim wanted it is applied to women too (RAINN). The following link provides access to many more statistics about victims, their families, and the long term impacts and costs of sexual assaults https://www.rainn.org/statistics

The nomination of Judge Kavanaugh to the United States Supreme Court has once again brought this issue out of the shadows. A woman has accused the Judge and a friend of sexually assaulting her at a party when they were teenagers. While this subject may be uncomfortable to discuss, it is still part of our society and we need to address it. The woman who accused the Judge has kept her secret for 36 years. She was afraid of how people may judge her or blame her. Originally, there was this one accusation, however, this week another woman stated she was assaulted by the Judge while they were in college. Keeping a secret like this can create numerous emotional problems for the victim. In fact, many women who have been victims of sexual assaults or rape often commit suicide because they feel so ashamed. The month of September is dedicated to suicide prevention so this gives us another reason to discuss this issue.

Something else that I heard this week is “many high school boys have done the same thing.” It is not true and even if it was, does it make it acceptable? This statement implies girls safety is not that important and is very insulting to young men in high school. As a psychotherapist who works with high school boys, I have seen many who disagree that this is normal high school behavior. However, the fact that some people believe this statement allows sexual assaults to continue.

What this tells us about society is the old stereotype about how men should “act” is still a very big part of our society and we have continued to teach children the stereotype. This stereotype about what it takes to be “a man” was highlighted in the documentary, “The Mask You Live In.” The documentary discusses how the stereotype about what it takes to “be a man” impacts both boys and girls and discusses options for how to change the stereotype.

Basically the belief is “boys will be boys.” What this is telling boys is that to “be a man,” you must be sexually active. Also men do not need to worry about how they treat women sexually. The only thing men need to be concerned about is having sex. While this is the stereotype for men, girls are told they are not to be sexually active. If you think back to high school, a girl who was sexually active was considered to be “dirty.” However, the boys who were sexually active were considered, “men” and looked at in a positive manner. Another part of this stereotype is that women were not supposed to talk about sex. This was not “lady like.” Therefore, if they were sexually assaulted by a boy they could not say anything. If they did, they would be considered “bad girls” and looked at like prostitutes. So men had all the power and women had no power.

This stereotype hurts both boys and girls. It pressures boys to become sexually active even if the boy is not ready. Also it doesn’t allow boys to learn how to have healthy, mature relationships with girls. The stereotype also teaches girls to deny their sexual feelings and to look at themselves as just objects. They are not given the chance to develop self-esteem or to respect themselves and to insist that they be treated respectfully. This is not healthy for girls and it is not healthy for boys either.

Recently, a number of professionals who work with teenagers have been trying to change this stereotype. This was the point behind the documentary, “The Mask You Live In,” and such programs as Challenge Day and the program, Alive and Free. One of the goals of these programs is to teach boys that being sexually active does not make them a “man” and to respect girls. The other part of the goal is to teach girls it is normal for them to have sexual feelings, but they are not sex objects. No one has the right to force them to do anything sexual they do not want to. Also if someone does force them, a girl has the right to speak up without being labeled a prostitute.

Now that women are starting to speak up, it provides parents with an opportunity. It gives you the chance to speak to your teenager about sexual relationships. You can speak to your sons and daughters and educate them about what is appropriate and what in not appropriate. Also you can discuss with your teenager about what they think makes someone a man or a woman. You can help dispel this stereotype we have believed in for years.

As a society, it gives us the chance to support the women who are speaking up about past abuse they have experienced. It also gives us a chance to educate men that the old stereotype the learned is wrong. We can help re-educate men and for men who have been abusive provide them a chance to apologize and change their behavior.

I know this subject has upset many people. Women who have been sexually assaulted but have tried to deny it may be experiencing symptoms again as these feelings they buried re-emerge. Men who have sexually assaulted women may be experiencing feeling of guilt or fear of being exposed. However, instead of looking at this as a terrible situation. We can look at it as a chance to change a terrible situation that had existed in our society for years. It has also caused a great deal of harm to women and men. Yes men too. No one who has self-respect could abuse someone the way many women have been abused. Therefore, we have a chance to heal old wounds and prevent future ones from occurring. I encourage everyone use the opportunity we have been given.

Dr. Michael Rubino is a psychotherapist who specializes in treating teenagers and victims of sexual abuse. He has over 20 years of experience. For additional information about Dr. Rubino visit his website www.RubinoCounseling.com or follow him on Twitter @RubinoTherapy

Preventing Suicidal Feelings in Teenagers

Different months of the year are dedicated to different issues. For example, May is dedicated to Mental Health Care. This article discusses a number of reasons why teenagers have mental health issues and how we can help. Some of the issues I treat teenagers for are suicide, cutting, bullying, drug abuse, early sexual activity and poor performance at school. A number of these issues can lead to a teenager feeling suicidal. September is dedicated to suicide prevention. Suicide is the third leading cause for death for children 10 to 18 years old. If we are going to prevent suicide we must prevent the issues which can result in suicidal feelings and actions.

I have been working with teenagers for over 20 years. In those years I have seen many teenagers for many different reasons. However, when the teenager tells me why they are doing what they are doing, I often hear very similar answers for a number of different issues. It sounds odd and surprising, but when you look at it from the teenager’s point of view it makes sense.

What I have heard very often over the last 20 years is that the teenagers who are bullying, cutting, depressed, using drugs or having sex, do not feel loved by their families. In fact, they feel no one cares about them and no one cares how they feel or what they do. Therefore, they act out. They have decided negative attention is better than no attention. So if they are bullying someone, coming home high, threatening suicide or having sex, they will get attention for their negative behavior.

Furthermore, teens are now forming friendships with other teens who bully, use drugs, are suicidal or sexually active. This common bond makes them feel someone else understands and cares about them. This is how gangs form and pressure members to do things they usually would not do. The teenager feels they have a family and people who care about them. They are so desperate for love that they will do anything to stay as a gang member. They will do anything to avoid that lonely, empty feeling.

This really should not be surprising. We have seen and heard about this is in the popular media for years. The Disney movie, Frozen, mentions that people make poor choices and mistakes if they do not feel loved. The movies, The Breakfast Club & Good Will Hunting, both demonstrate the point of teens acting out and doing anything for friends so they feel loved. The play, West Side Story, is another good example. Also in her last show Oprah said that one thing she had learned is that everyone wants to know, “am I important to you, do you hear me, do you see me?.” The teenagers that I have worked with all tell me the same thing. Also it is amazing that when they test me enough and they see that I do care how they are willing to try to change.

The problem is that with society today everyone is concentrating on their own lives and they have little time to acknowledge the people around them. Parents are having to work two to three jobs to support their families. Parents assume that their teenagers will see how hard they are working and know their parents are working that hard because they love them. However, teenagers’ brains are not fully developed yet so their reasoning skills are not like an adult’s reasoning. Teenagers need to hear, I love you, from their parents and need one on one time with their parents.

Parents cannot be the only people letting teenagers know that they are important. We are asking too much of parents to be the only ones. Teachers need to show they care by staying after school to help teens who have questions or are confused or need to talk. We need to look at the movies, television and music that teenagers are listening to. Also we need to look at society. Society gives a message of looking at for number one. There are not a lot of role models encouraging teens to accept one another as they are and to support each. Look at the President and how he bullies and insults minorities, women and people who disagree with him on Twitter on a daily basis.

What is the answer? We need to change our priorities and tell our teenagers and children that we love them and care about them. Schools need to bring in programs such as Challenge Day which teach teenagers to accept each other and care for each other. We need to encourage our teenagers to follow the Harlem Globetrotter’s program. They refer to it as the ABC program. A is for being assertive, B is for being brave and C is for compassion. In other words, when you see someone being a bully or harassing someone, speak up and say it is wrong, report it and show the victim some compassion. If every time a teenager notices that someone in their class seems down and they ask the person if they are alright we can make a big change in these negative behaviors such as suicide, bullying and drug use. Also if parents ask their teenager how they are doing without judgement or fear of punishment we could change a lot of these negative statistics. Think about it, why would a teenager say yes I have been using drugs or cutting if they are afraid of getting into trouble?

Summing it up, if we are going to solve issues such as bullying, domestic violence, suicide and cutting to name a few, we need to all work together. We need to let people know that we care and show it. We also need to be brave enough and assertive and speak up when we notice someone being bullied or report when we have noticed someone vandalizing someone’s property. We need to provide teenagers with positive role models and insist that our schools use programs such as Challenge Day and Alive & Free. We all need to work together and speak up about things that are wrong if we want things to change.

Dr. Michael Rubino is a psychotherapist in private practice with over 20 years experience working with teenagers and children. He is considered an expert in the treatment of teens and children. For more information regarding his work or private practice visit his website www.rcs-ca.com or visit his Facebook page at http://www.facebook.com/drrubino3.

Who Are 2E Children?

Many parents are very happy to hear that their child has been classified as “gifted.” They assume that their child will do very well in school and have a very bright future because they are “gifted.” While “gifted” children may excel in certain academic areas, often they have difficulties in other social situations or academic areas. These children are called twice exceptional children. Research by John Hopkins estimates that one out of five children are twice exceptional or 2E which is a more common term. Therefore, John Hopkins estimates that there are approximately 700,000 2E children in the United States.

Wikipedia defines 2E children in the following way:

A 2e child usually refers to a child who, alongside being considered gifted in comparison to same age-peers, is formally diagnosed with one or more disabilities. Although 2e can refer to any general disability, it is often used to refer to students with learning disabilities, although research is not limited to these areas, and a more holistic view of 2e can help move the field forward. The disabilities are varied: dyslexia, visual or auditory processing disorder, obsessive-compulsive disorder, sensory processing disorder, autism, Asperger syndrome, Tourette Syndrome, or any other disability interfering with the student’s ability to learn effectively in a traditional environment. The child might have a diagnosis of attention deficit hyperactivity disorder, or diagnoses of anxiety or depression.[6] Often children with 2e have multiple co-morbid disabilities than present as a paradox to many parents and educators.

Many people may find this hard to believe, however, as a psychotherapist who specializes in treating children and teenagers, I have seen many “gifted” children who do have the disabilities listed above. A common issue I have encountered is that “gifted” children often have difficulties making friends and dealing with social situations. If they had not been classified as “gifted”, parents would see that they do meet the criteria for Asperger’s Syndrome. Another common issue I have seen in psychotherapy with “gifted” children is that they have difficulties organizing their ideas and maintaining sustained attention. These children meet the criteria for ADHD.

One of the primary difficulties for these children is since they have been classified as “gifted,” many schools do not want to offer support services for a “gifted” child who has ADHD or a processing problem. Because they are not receiving the academic support they need, many of these children suffer with depression, anxiety and low self-esteem. I have seen this many times with “gifted” children that I see for psychotherapy. It also creates a great deal of stress for the parents. They can see their child is having difficulties and the child is complaining about difficulties, but the school tells the parents the child is doing fine because they are “gifted.”

The research from John Hopkins University shows us that the two are not mutually exclusive. A child can be “gifted” in one area and have a learning disability in another area of life. Therefore, a “gifted” child may need a 504 plan or an individualized educational plan (IEP). Therefore, if you are the parent of a 2E child and you notice that your child is having difficulties at school, do not be afraid or nervous to advocate for your child. To make this easier, I have included a link which discusses misconceptions about 2E children, 7 Myths About Twice-Exceptional (2E) Students http://u.org/2hp0dNU. I am also providing a link to a newsletter for an organization which helps parents with 2E children and advocates for them, https://www.google.com/url?sa=t&source=web&cd=3&ved=0ahUKEwiv8PmrxYDYAhUH6oMKHbmyD10QFggiMAI&url=http%3A%2F%2Fwww.2enewsletter.com%2Farticle_2e_what_are_they.html&usg=AOvVaw35GmKdn_P9FJzqMBPkMMrD.

If this sounds like your child do not panic. Arrange to have your child evaluated by a mental health clinician who is familiar with 2E children. They can help you develop a treatment plan and let you know if your child needs accommodations at school.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers. In fact, he specializes in treating children and teenagers. If you want to know more about Dr. Rubino’s work or private practice visit his website www.RubinoCounseling.com or his Facebook page http://www.Facebook.com\drrubino3.

How Sexual Assault Impacts Teenage Girls and Boys

The nomination of Judge Kavanaugh to the United States Supreme Court has once again brought this issue out of the shadows. A woman has accused the Judge and a friend of sexually assaulting her at a party when they were teenagers. While this subject may be uncomfortable to discuss, it is still part of our society and we need to address it. The woman who accused the Judge has kept her secret for 36 years. She was afraid of how people may judge her or blame her. Also many women who have been victims of sexual assaults or rape often commit suicide because they feel so ashamed. The month of September is dedicated to suicide prevention so this gives us another reason to discuss this issue.

The Relationship between Bullying and Suicide

September is dedicated to suicide prevention. Bullying, a problem many children and teenagers face on a daily basis, is related to a large number of suicides. In fact, I read an article about a 15 year old girl in Pensilvania who killed herself which had a big impact on me. She was the victim of bullying at school. The family described her as a nice, caring girl. However, the bullying was severe enough to cause her to take her own life.

We need to remember that bullying is no longer just something that happens at school. Also it is no longer just part of childhood. With social media, bullying has become viscous. This 15 year old girl is not the first child to commit suicide due to bullying. It is happening very often in elementary, middle and high school. There are also cases of suicide due to bullying in College students. Furthermore, a child’s suicide impacts a family a part. A parent’s life is never the same after the death of a child especially if it is a suicide

In this girls obituary, the family openly discusses how they have been torn apart by the death of their daughter. The describe how they expect this feeling to last for a while. They also discuss trying to come to terms with this event. They cannot understand why kids would bully one kid so severely so the child be bullied feels that suicide is their only option.

We need to pay attention to what these parents are saying. Bullying has reached epidemic rates and has become very vicious. Besides losing a young person too early, an entire family are victims of the bullying. Parents lose a child, siblings lose a sibling, grandparents lose a grandchild. The worse part is no one can make sense of the death. Why do we have children who feel the need to bully a child so severely that a child commits suicide? We need to think about this issue. I hear many children in psychotherapy reporting being bullied. These children are being bullied at school and at home through social media. And in my opinion, the bullying can be very vicious. Also what makes it worse, is the child never gets a break. They are so embarrassed about be bullied that they are ashamed to tell their parents. They feel they must have done something to deserve the bullying. Therefore, they tend not to tell their parents because they do not want to disappoint their parents.

We can take a lesson from this girl who committed suicide. After expressing their feelings, the parents closed the obituary with a simple request. They asked in lieu of flowers that we be kind to each other. This is the key. If kids who are bullying could put themselves in the shoes of the person they are bullying, they would stop. Also we need to look at the kids doing the bullying. What has happened to them to cause them to be so cruel to another person? Many bullies are victims of physical or severe emotional abuse. In order to solve the problem the person being bullied and the person bullying need to be treated.

In the mean time, we can honor the requests of this girl’s parents and be kind to each other. If you want to read the entire obituary here is the link. Family Of Teen Who Killed Herself Has Message For Bullies In Obituary https://patch.com/pennsylvania/northampton/obituary-pa-teen-who-killed-herself-bullies-its-not-too-late-change-your

Dr. Michael Rubino has 20 years experience treating children and adolescents. For more information regarding Dr. Rubino’s work or his private practice visit one of his websites www.rcs-ca.com or http://www.RubinoCounseling.com.

Why Sleep is Important for Teenagers’ Mental Health

School is back in session but many elementary, middle school and high school students are still trying to adjust their sleep pattern to accommodate school. Many children and especially teenagers have become use to staying up late and sleeping in because they were on summer break. However, this pattern needs to change now that school has started. Sleep is very important for children and teenagers. In fact, research shows that sleep has a big impact on our mental health and physical health. Research has shown that sleep deprivation can cause a person to suffer a psychotic break or if the depreciation is really severe it can even result in a person’s death. I recently received some very good information regarding sleep and mental health. It was provided by Jenny Thompson who is associated with www.bettermattressreviews.com. I think it is valuable information for everyone so I have provided it below.

Mental health and sleep are closely related. Sleep problems frequently accompany mental illness, and can even be the first warning sign of a disorder. In turn, lack of sleep worsens mental health symptoms, creating a vicious cycle.

Mental illness is common, with almost 20 percent of Americans suffering from at least one mental health disorder. While only 10 to 18 percent of the general population experience sleep issues, as many as 50 to 80 percent of people with mental illness have trouble sleeping.

Mental health disorders are the largest cause of insomnia. 40 percent of insomniacs and over 46.5 percent of hypersomnias have a comorbid mental health disorder. On the other hand, only 16.4 percent of people have a mental health disorder without any kind of sleep issues.

Sleep problems are closely correlated with ADHD, anxiety disorders, bipolar disorder, depression, and schizophrenia. Below we’ll review how sleep affects several mental health disorders, and provide tips for getting better sleep.

Schizophrenia and sleep

Schizophrenia affects 1 percent of people, or 3 million Americans. Onset often occurs in late adolescence or the early 20s. Individuals with schizophrenia suffer from psychoses such as delusions and hallucinations, and experience difficulty focusing their thoughts and expressing themselves.

Up to 80 percent of people with schizophrenia have sleep problems, including:

Irregular sleeping hours. They may fall asleep anytime during the day or night rather than during the typical overnight sleep period of most people. They may have consistently delayed melatonin release that shifts their sleep pattern later than normal, slowly shift their circadian rhythm later and later each day, or follow no consistent sleep-wake patterns at all.

Irregular sleep quantity. They may get too much (hypersomnia) or too little (insomnia) sleep, as a result of medication side effects, fear or anxiety due to hallucinations (which may cause them to sleep more to escape, or conversely to be afraid of nightmares), or the irregular sleep hours cited above.

Sleep apnea. Individuals with sleep apnea literally stop breathing during the night, due to blocked airways or a miscommunication between the brain and the breathing muscles.

Less refreshing sleep overall. Due to the issues described above, people with schizophrenia experience less refreshing sleep overall because they have trouble getting sufficient amounts of REM sleep.

For many people with schizophrenia, an onset of sleep problems can be a warning sign that psychosis is starting or returning.

A 2012 study of mice found that abnormalities in the SNAP-25 gene are linked to schizophrenia as well as disrupted sleep-wake cycle, suggesting that resolving sleep issues may less or resolve schizophrenia symptoms.

Anxiety disorders and sleep

Generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social phobias, and PTSD are all associated with having anxious thoughts while trying to fall asleep at night and related insomnia.

Source: The National Academies Press

Panic episodes may waken an individual with panic disorder from sleep, thus disrupting their overall sleep quality. Likewise, individuals with PTSD are prone to vivid re-experiencing traumatic nightmares which heighten their bedtime anxiety and also cause interrupted sleep.

Individuals with mood and anxiety disorders may be prescribed various medications such as antidepressants and mood stabilizers which can further interfere with sleep.

Insomnia not only accompanies anxiety; it can cause it. When individuals experience chronic sleep deprivation, it disrupts their serotonin and gamma-Aminobutyric acid neurotransmitter levels, which can result in anxiety. One study found that having insomnia increased one’s risk to have yet another mood or anxiety disorder one year later.

Depression and sleep

Insomnia is one of the biggest risk factors for depression. Lack of sleep worsens mood, and the effect is even worse for individuals with a mood disorder. Depressed people with sleep issues have a higher risk of suicide than depressed individuals without sleep problems.

Treatment is also complicated. While antidepressants boost mood and alertness to help treat depression, that same alertness makes the insomnia persist – and not addressing the insomnia can make individuals less responsive to treatment. But certain prescription drugs for insomnia, like Rozerem, may worsen depression. The key is to find a treatment plan that helps both issues, but not at the expense of either.

Depression and sleep issues are bidirectional. That means the problems of one can worsen the other. The good news is, that also means the improvement of one often fixes the other. For example, 35 million Americans suffer from mild depression (dysthymia). For many, their comorbid insomnia goes away once they begin taking antidepressants.

Bipolar disorder and sleep

Bipolar disorder affects 3 percent of Americans, or 6 million adults. In addition to severe changes in mood, behavior, and energy levels, individuals with bipolar disorder may also experience the following sleep problems:

Insomnia, or difficulty falling or staying asleep

Hypersomnia, or oversleeping, especially during depressive episodes

General sleeplessness, where individuals feel fine even when they’ve had significantly less sleep, although this abnormal sleeping pattern eventually catches up with them

Delayed sleep phase syndrome, where the individual has a delayed circadian rhythm, causing them to naturally start to fall asleep or wake up later than others and experience excessive daytime sleepiness as a result

Irregular sleep-wake patterns from manic episodes and related hyperactivity at night

REM sleep issues like vivid nightmares

Sleep apnea affects one-third of individuals with bipolar disorder, resulting in less restful sleep overall and excessive daytime sleepiness

For individuals with bipolar disorders, different sleep issues may arise depending on when they are in a manic or depressive state.

In fact, for 75 percent of individuals with bipolar disorder, sleep problems are one of the biggest warning signs that they are about to experience a manic episode. For example, sleep loss from chronic sleep deprivation or even a night of jet lag can induce a manic episode. Manic periods are so arousing that individuals can go for days without sleep, or sleep drastically less amounts than usual and not feel tired. However, that lack of sleep makes its mark in other ways, as they’ll still experience the other symptoms of sleep deprivation felt by everyone, including increased irritability, trouble focusing, reduce judgment, depressed mood.

As they enter depressive episodes, bipolar people may experience insomnia or hypersomnia, both extremes which cause further imbalances in mood and increased anxiety.

In between manic and depressive episodes, individuals with bipolar disorder experience poorer quality sleep, occasional insomnia, and interrupted sleep.

Sleep tips for individuals with mental health disorders

There are various psychotherapies that treat mental illness, sleep therapies for sleep problems, and other behavioral changes that can help individuals with mental health disorders sleep better at night.

1. Practice good sleep hygiene.

It all starts with good sleep habits. Good sleep hygiene includes keeping the bedroom cool, dark, and quiet, and limiting stimulating activity before bed, such as watching television, using the computer, or engaging in heavy exercise. Heavy meals, as well as alcohol, drugs, and caffeine, should be avoided in the early evening and late night hours.

2. Be careful with napping.

For individuals with excessive daytime sleepiness, power naps of 20 minutes can help give a sense of refreshment. However, naps longer than 20 minutes should be avoided as they can contribute to insomnia later that night.

3. Try sleep therapy.

There are various psychotherapy options that assist individuals with mental health disorders. There are also many specific therapies designed to treat comorbid sleep problems.

Cognitive behavioral therapy (CBT) has proven very effective for treating insomnia. CBT first helps the patient recognize their harmful or disruptive thought patterns and habits. Then, they learn to replace them with positive thoughts and better ways to cope so they can calm anxieties surrounding sleep as well as the rest of their lives. One study in particular found that six 20-minute sessions of CBT resulted in a nearly 50 percent decrease in insomnia, 20 percent decrease in depression and anxiety, and 25 percent decrease in paranoid thoughts, and 30 percent decrease in hallucinations.

Sometimes taught as part of CBT, meditation and deep breathing exercises can soothe anxious thoughts and help relax the body for sleep. You can find audio files of guided meditation and relaxation exercises on the MIT Medical website.

Sleep restriction therapy involves setting a strict bedtime and waketime, and only staying in bed for that allotted amount of time, regardless of how much sleep the individual actually enjoys. Eventually the body gets used to the new sleep-wake cycle and begins to sleep and wake at the proposed appropriate time. A small 2013 study found that sleep restriction therapy improved sleep and reduced symptoms of insomnia for patients with bipolar disorder.

Chronotherapy works similarly by gradually adjusting the bedtime and waketime. It’s a newer therapy and the research is still bearing out.

Bright light therapy helps reset a person’s circadian cycle and make them feel more awake in the morning. Exercising outside in the morning in areas of bright sunlight can provide a similar effect.

4. Explore natural remedies.

Melatonin supplements help kickstart melatonin production in the brain. These can be helpful for insomnia or anyone who has difficulty falling asleep due to a period of mania or delayed sleep-phase syndrome. Valerian root can also help induce sleep. Both melatonin supplements and valerian root are widely available at pharmacies.

5. Keep a sleep diary.

If you’re concerned you may have a comorbid sleep disorder, a sleep diary can help you track your sleep habits. Note when you fell asleep and when you woke up, the total amount of time you were asleep, and anything abnormal that happened during your sleep, such as nightmares or snoring. If you find you’re not getting enough sleep, you can meet with a sleep specialist for a diagnosis and share your diary with them.

You may also want to consult a mental health professional for an evaluation and/or your primary care physician.

Dr. Rubino has over 20 years experience as a psychotherapist treating children and teenagers. Many children and teenagers have undiagnosed sleep problems. For more information regarding Dr. Rubino’s work or private practice visit his websites www.rcs-ca.com or www.RubinoCounseling.com or visit his Facebook page www.Facebook.com/drrubino3.

Facts about Teenagers and Suicide

September is dedicated to suicide prevention. Therefore, I decided to write this article. As a psychotherapist who treats teenagers, I work with many parents who are worried that their teenager is depressed and may be suicidal. Many parents worry because suicide is a mental health issue for children and teenagers that often is ignored. In fact, suicide is the third leading cause of death for children 10 to 18 years old. Also it is becoming very common in our society. This past year Kate Spade, a designer, and Anthony Bourdain, the chef from CNN, both committed suicide. Suicide is also common in soldiers who have been deployed over seas. Therefore, it is becoming common in our society, however, there are few resources available to people. Also the negative stigma associated with suicide prevents people and families from taking about the issue. I hope the information in this article helps you understand the issue of suicide. To start off with, I have included an article where six people describe their suicidal feelings and the help they need http://linkis.com/huffingtonpost.co.uk/AlJc2

http://linkis.com/huffingtonpost.co.uk/AlJc2.

In today’s society there has been a significant increase in depression, anxiety and suicide among teenagers and children. As I stated above, suicide is the third leading cause of death in children 10 to 18 years old. Yes 10 year old children are committing suicide daily. The increase is significant enough that Netflix is running a series about teenagers feeling suicidal. The show is called 13 reasons why. The suicide rate for teenagers has been increasing yearly. It is increasing faster in teenage girls and is considered an epidemic. It is estimated 800,000 people a year commit suicide and approximately 25 times that attempt suicide (CDC). Again, suicide remains the third leading cause of death for kids 10 to 18 years old and it rises every year and we are not providing resources (CDC).

In my practice I am seeing more and more children and teens reporting they feel depressed, anxious and overwhelmed. One of the main reasons I hear for these feelings is that children feel a great deal of pressure to succeed in school. I have kids in 5th grade and 6th grade worrying about grades. Not because their parents will get mad because if they don’t get As they wont get into a good college and won’t get a good job and won’t be able to afford a house. They only feel like a success if they can make a lot of money. They don’t even consider how compassionate and caring many of them are and the good they offer our world. In their eyes, compassion is nothing if you are not driving a Mercedes.

This is a great deal for a 5th grader or 6th grader to worry about at their age. It is also a terrible way for them to value theirselves. This is how we create Bullies because compassion is looked at as a weakness.

I also see middle school students and high school students involved in several sports and other activities such as Boy Scouts. The kids are feeling pressured to do extracurricular activities not for fun but for their resume. They are again concerned about getting into a good college and being a success. This pressure is not coming from parents either. It is pressure kids are now placing on themselves.

Recent studies are showing a correlation between lack of fun and time to relax with the increase in depression in children and teenagers. A study in Psychology Today discusses this issue. I have included the link so parents can read this study and think about it. Also so you can look at your children and talk with them. See if they are enjoying life or feeling overwhelmed because they need to succeed. Money pays the bills but doesn’t guarantee happiness https://www.psychologytoday.co.

Many parents are not sure what to look for and do not want to over react. If you notice these signs they are indicators that your teen may be feeling suicidal and needs to be assessed by a mental health clinician. The major warning signs are:

• Aggressive behavior

• Verbal outbursts

• Withdrawal from friends

• Writing or talking about suicide

• Dramatic mood swings

• Reckless behavior

• Refusal to engage in daily responsibilities

• Giving way personal items of worth such as jewelry or furniture

If you notice any of these signs don’t be afraid to ask your

teenager if they are feeling suicidal or thinking about suicide.

Many people have the misconception that if you ask someone

about suicide that you will cause them to think about suicide.

This is not true. By asking someone if they are feeling suicidal,

you are letting them know that it is safe for them to talk about their feelings,

including suicidal feeling. If someone is feeling suicidal it

is essential that they feel safe to talk about their feelings and

thoughts. Therefore, asking if your teen if they are feeling

suicidal will not hurt them, it can help them to talk and possibly

save their life.

I understand that the topic of suicide is scary and something our

society denies and views it as there is something wrong with

anyone feeling suicidal. But the truth is, it is a mental health

issue and it is nothing to be ashamed of. It is also an epidemic for

teenagers. If we want to prevent the number of suicides from

rising and help teenagers who are currently feeling suicidal,

we must talk openly about suicide and seek mental health care for

teenagers who are feeling suicidal.

Another factor related to this issue is family and friends. If someone commits suicide, family

and friends tend to feel guilty and ashamed. They blame themselves for the suicide and feel they

should have prevented it. However, if the person doesn’t express their feeling and there are few

resources, how do you prevent it? Also because of the huge negative stigma associated with

suicide, family and friends are embarrassed to talk about the death. As a result, many families

and friends fail to get help after a suicide and their lives may be ruined for the rest of their lives.

We seldom consider the impact that suicide has on the family and friends. I have included a link

to an article which discusses the impact suicide has on family and friends

https://nypost.com/2018/06/06/after-kate-spades-death-think-of-the-survivors/. We need to

consider these issues and start to provide more resources for people feeling suicidal and family

and friends who survive a suicide.

Dr. Michael Rubino is an expert psychotherapist who works with children and teenagers for over 20 years. For more information about Dr. Rubino and his work visit his website www.RubinoCounseling.com, www.rcs-ca.com or follow him on Twitter @RubinoTherapy.

The Deadly Drug Pink

Parents this is a follow up on an article I wrote about the drug Pink. This drug is in the San Francisco Bay Area. I am hearing teenagers mention it to me. Also if I try to warn teenagers about this drug, I hear them tell me that they already know about it. So parents please pay attention to the following information.

Therefore, the name you need to know right now is Pink. This is the street name of a new synthetic drug being used by teenagers and college students. The legal name for this drug is U4. The DEA of the United States has banned the sale of this drug in all 50 states. However, the drug is still for sale on the internet. It is being sold by companies in China and it is being sold at a very cheap price. Therefore, teenagers can get it very easily.

This drug is twice as strong and heroin and seven times as strong as morphine. People often die the first time they use it. So far 100 deaths in the U.S. have been linked to Pink. It is currently mainly on the east coast but it is spreading across the country very quickly.

The drug comes in a white powder. Many teens assume they can use the same amount as if they were using morphine or heroin. However, this assumption is wrong. The drug is so deadly that the amount equivalent to a few grains of sand can kill someone. They call it Pink because teenagers typically snort it off their pinky. Teenagers who are buying this drug online often ignore the warning on the website that this drug is not for human consumption.

The DEA became aware of the drug two years ago and put a temporary ban on it. Now after further studies they have banned the sale of U4 or the street name for the drug, Pink, in all 50 states. Remember this drug is twice as strong as heroin and seven times as strong as morphine. We already have an epidemic of accidental overdosages from heroin in the U.S. The CDC estimated that in 2014 there were 50,000 deaths due to accidental heroin overdosages and a majority of these deaths were teenagers. Furthermore, the CDC statistics show a 62% increase over the past ten years in the number of accidental heroin deaths. Again most of the deaths are teenagers and children as young as 12 years old. Pink has the possibility to be far more devastating than any other drug.

As parents you need to go online and educate yourself about this drug. You also need to educate your teenagers and children in college about how dangerous this drug is in reality. Maybe they have already used it and nothing happened so they think people are exaggerating how dangerous this drug can be. However, this is the point you really need to understand this drug comes as a powder and using the amount of one grain of sand too much can kill. There is no way to tell if you have too much on your pinky. Also since it is very new, we do not know the long term effects of this drug.

So again as parents educate your children about this drug and point out it states not for human use on many of the websites. Also if you notice any packages or bank charges by your teenager for buying items in China, check it out. This drug is not for sale in this country and the main way that people are obtaining it is via the internet from companies in China who still sell this drug.

Dr. Michael Rubino specializes in treating high risk teenagers. Those are teens who are suicidal, engage in cutting and drug use. These are a few examples but he is also an expert in providing psychotherapy to children and teenagers in general. For more information regarding his work or private visit his website at www.RubinoCounseling.com or follow him on Twitter @RubinoTherapy.

Teenagers use Cough Medicine as a Drug

Many parents who are raising teenagers know they need to be concerned that their teenager may abuse alcohol, marijuana, ecstasy and many other drugs. However, many parents do not think they need to worry about their teenager abusing cough medicine. Some parents may be concerned because some cough medicines contain alcohol. However, teenagers are abusing Robitussin on a frequent basis. They are not abusing it for the alcohol, they are abusing it for the dextromethorphan (DXM). This substance is high dosages can cause hallucinations and symptoms similar to using LSD.

Teenagers have been using Robitussin for a while and the amount of teenagers abusing DXM has been increasing. A study in 2008, showed the overall use of DXM since 2000 increased by a factor of 10. However, for teenagers the increase is by a factor of 15. In order for a teenager to have hallucinations from DXM, they have to use 10 to 50 times the recommended amount to use. Many parents may wonder will this amount of DXM be enough to cause their teen to overdose. Most teenagers do not overdose on DXM. However, many teenagers typically use alcohol or other drugs along with DXM. This combination can be lethal.

DXM has been around since the 1950’s. However, as I stated above since 2008 the amount of teens using DXM has increased by a factor of 15. Also DXM is used in many over the counter drugs for the cold and flu. So Robitussin is the most common over the counter medication teenagers are using, there are many other over the counter drugs that contain DXM and that teenagers are abusing. The increase has been occurring since 2008, I have had teenagers talking about how they sneak it out of their house, get it from a friend or steal it from CVS or Walgreens.

One of the primary reasons teenagers are abusing DXM is that it is cheaper than LSD or other drugs that create hallucinations. Also because these medications are over the counter it was a very easy way for them to obtain the DXM. However, now most drugs containing DXM are kept behind the pharmacy desk and in order to buy them you need to show identification to the pharmacy. Most pharmacies require people to be 18 years or older in order to purchase medicine containing DXM.

Even with these medicines being kept behind the pharmacy counters, many teenagers have figured out ways to obtain over the counter medications containing DXM. Many teenagers know that pharmacists are aware that they are watching Robitussin so they are using other over the counter medications containing DXM. Teenagers have developed their own terms for these medications so parents may not know if their teenager is using DXM because their teenager is using different terms than referring to specific medications. I have included a link to the slang terms that teenagers are using to refer to DXM. The slang terms can be found in the following article https://www.webmd.com/parenting/glossary-dxm-drug-abuse. Parents I would strongly recommend reading this article so you can be aware if your teen is using DXM but referring to it with a different name.

Since DXM has been around for a while and more and more teenagers are using it because it is cheap and easy to get, in addition that it is in many over the counter medications, parents may have a difficult time knowing if their teenager is abusing DXM. Therefore, I have also included a link to an article which lists the symptoms you would see when someone is under the influence of DXM. Besides listing the symptoms of being under the influence, this article also lists the daily behavior changes you will see in a teenager who is abusing DXM. Here is the link to the article with the symptoms and behavior changes associated with DXM abuse https://drugabuse.com/library/dextromethorphan-abuse/#signs-and-symptoms.

As a psychotherapist who specializes in treating teenagers, I can say I have seen a significant increase in the number of teenagers using DXM. Ten years ago, occasionally one of the teenagers I would be working with had a history of using or were currently using DXM. Today it is very common. In fact it is almost as common as marijuana. Therefore, my recommendation to parents is to take the time and read the links I have provided and do your own research. While by its self alone DXM is not typically lethal, teenagers combine this drug with other drugs which can cause someone’s death. Also what I have observed is that DXM tends to lead to teenagers trying other drugs that can be very deadly.

Dr. Michael Rubino is a psychotherapist with over 20 years experience. He is recognized as an expert in the treatment of children and teenagers. For more information regarding his work or private practice visit his website www.rcs-ca.com or follow him on Twitter @RubinoTherapy.

Teenagers need to feel Loved

It seems that many adults do not really understand what children want from them. It also seems from what I have seen and heard that many adults do not understand that children are not bad. Children are not born bad, typically we make them bad by how we treat them. Yes you can have a child with loving parents and a loving family who makes very poor choices in their lives. As a result, they may end up in jail or living on the streets. Some children are born with psychiatric issues such as schizophrenia or Bipolar disorder and some children regardless of how much love they receive still choose to make poor choices. While these situations do happen, they are not the norm.

The most important relationships in a baby’s life is his/her relationship with his/her parents. A baby wants love and to feel wanted by their parents. Parents are a baby’s safety net. As long as Mom and Dad are okay then they are okay. If their parents are not okay, then a baby’s safety and life is in danger. Children cannot tolerate this fear. Therefore, if their parents have a problem instead of seeing their parents with problems, a child changes the situation so their parents are great and the baby is the bad person.

I have seen this many times with foster children. Their parents are usually great people and Social Services are being mean to their parents. They can be living is the best foster home in the world and if you ask them if they want to return to their natural parents, they say yes. They are desperate for that validation from their parents.

The problem is many parents do not know how to express love to their children because they never experienced it themselves as children. Therefore, they do the best they can do and feel they are good parents because they are better than their parents. However, when they hear their children asking for more, they get mad at their children. The parents get upset because they would have liked what their children are asking for too, when they were children. Also at times parents want their children to validate them for being good parents. They do not understand that a child doesn’t have the cognitive abilities to do so and that the children do not understand their parents need. However, it is a normal desire to be validated by someone and people will seek this validation from where ever they can find it.

Therefore, a child tends to feel unloved, unwanted and form a belief they are useless. They tend to hang around people who reinforce this belief. They are afraid of people who might love them. They are afraid these people will discover the truth about them and leave them. They feel safer with the people who tell them they are worthless.

Walking around with this feeling can hurt a great deal. As a result, kids start to do drugs, alcohol and hang out with gangs. The drugs and alcohol help to numb out the pain of feeling worthless while at the same time it reinforces the belief that they are worthless.

Most often these kids act out at school and tend to get arrested for stealing or drugs. Some people try to help but the child pushes people away. It is better to leave someone than to be left. Most people get tired and say there is nothing else they can do and give up. Once again, reinforcing the child’s belief.

These are the children and teenagers who really need our help. The harder they push us away, the harder we have to say we won’t go. There have been many times that I have had to Juvenile Hall to do sessions. The teenager is shocked! I tell them that I told them they can push as hard as they want, but I won’t believe they are bad or walk out. At times this is difficult because they often test me over and over to see if I am for real. If they see I am for real, I am only one person, they need other people in their lives to stay.

What I have seen in working with teens who act out for over 20 years, is they are looking for someone to say I care and you are important. They prefer that it comes from their biological parents, but once they accept their biological parents cannot provide this, they look to other people or substances.

Those of us who work with acting out teenagers as therapists, teachers or foster parents need to understand how severely these children have been hurt by their biological parents and the hard work it takes helping them over come that wound.

Extended family such as aunts and uncles, you too need to understand how deep the wound is for these kids. If you are not dealing with your own wounds, they need you to be in it for the long run.

This may seem like I am asking for a great deal, but look at how many teens are dying from suicide, drug overdose, shootings etc. When you see the number of young lives being lost you can see that it is worth the effort.

Yes it takes a great deal of effort but when you communicate to a teen that yes you are worth something, you are love able and I care about you. Watch how they go out into the world and help others and share love with others. So the price is worth seeing a teen full of life and going out and sharing it with the world. On You Tube search for an organization called Challenge Day. Watch some of Challenge Day’s videos to see how a teenager can change if we give them love and validate them.

Dr. Michael Rubino has over 20 years experience working with high risk teenagers & foster children and is an expert in this area. For more information on Dr Rubino visit his website at www.rcs-ca.com or follow him on Twitter @RubinoTherapy.

Dr Michael Rubinio

Understanding Your Teenager

Month: September 2018