Sleep is Important to Children’s Mental Health

Sleep is Important to Children’s Mental Health

School is back in session and the Holidays are upon us and we are no longer on daylight savings time. The excitement of the Holidays, days off from school and changing the clocks may disrupt the sleep pattern of many elementary, middle school and high school students. Many children and especially teenagers will have activities where they need to stay up later. This can disrupt their sleep pattern and they may be getting less sleep during the Holidays. 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 http://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 http://www.rcs-ca.com or http://www.RubinoCounseling.com or visit his Facebook page http://www.Facebook.com/drrubino3.

How To Cope with the Holidays after A Divorce

How To Cope with the Holidays after A Divorce

The Holiday season is usually a difficult and stressful time for many families. Everyone trying to make plans and trying to see grandparents and other family members. It can be especially difficult for divorce families. After a divorce the issues often become even more stressful.

One thing that parents need to remember is that they decided on the divorce the children did not. I often hear arguments about parents want their time or wanting to continue their family’s holiday traditions. However, they often ignore what the children want to do.

Many times a divorce may be finalized, but the parents are not done fighting with each other. Therefore, the use the Holidays as a reason to continue to argue or try to hurt each other. What they forget is they are really hurting their children more than each other.

Based on dealing with families who are divorced, I would make the following recommendations to parents. First, parents need to remember that Holidays are more about the children and family not their divorce. Next they need to develop a plan together regarding the Holidays. The first step is for the parents to talk together about what the children seem to enjoy the most about each Holiday. Also parents should also ask the children what they enjoy most about the Holidays.

After you have this information then sit down civilly and see how you can allow the children to do what they enjoy most about the Holidays. Another thing to remember is the children should not be forced to choose between Mom and Dad. Come up with a plan where the children have equal time with both parents. Also they should have equal time with grandparents, cousins and other Extended family from Mom and Dad’s side.

The other thing is don’t turn the Holidays into a competition. Gifts should not be used to influence the children. You should discuss with each other what your children want and what you plan to get the children. When you were married you discussed what to get them so even after the divorce you can coparent and discuss what is realistic and what is not.

Finally, remember the Holidays are a time to get together as a family and enjoy each other. Therefore, for the sake of your children put your divorce aside and decide how this can be a happy family time for everyone. If you can do things together, that would be the ideal situation. If you can’t then being kind to each other and making the Holiday season fun for the children is the goal for you as parents. Stated another way, the children should still feel like they have one family during the Holidays not two. Maybe things are being done a little differently because of the divorce but they still have a mother and father.

If you achieve this goal, it will make you feel better too. A divorce should not wreck your lives. Obviously, your lives will change after a divorce but you can still be a family.

Dr. Michael Rubino has over 20 years experience as a psychotherapist working with children/teenagers and families. For more information about Dr. Rubino’s work or private practice visit his website at http://www.rcs-ca.com or Facebook page http://www.Facebook.com/drrubino3.

The Holiday Season and Finals a Stressful Time for Teenagers

The Holiday Season and Finals a Stressful Time for Teenagers

The end of the Fall semester is around the corner and it is a time of year that students panic because it’s Finals time. Your teenagers are probably very stressed or getting stressed. There is a lot going on right now. Seniors are trying to complete college applications, seniors and juniors are worried about grades because these grades will impact which colleges they can go to. In addition, there is time off for Thanksgiving and Christmas so many teenagers are focusing on spending time with their friends. However, they also need to allow for time with their families too.

As I stated besides finals, teenagers are having to balance between friends and family. In addition to spending time with friends there are the parties that occur over Thanksgiving and Christmas break. Besides having to balance time between family and friends, they still have to keep the homework current and study for finals or complete semester projects.

In many classes the final may be worth fifty percent of the students grade. The final grade in a class is very important. This grade will be part of their overall GPA which can affect what colleges Juniors can apply to and their ability to get scholarships. Also for seniors these are the grades colleges will be using to determine who they accept or reject. Seniors know they need a decent Fall semester GPA to have a chance of being accepted by a college.

As you can see there is a great deal of pressure on high school students during this time of year. Also since the competition to get into colleges has increased and the competition for scholarships have increased so has the stress on high school students.

Many students will do what ever they need to in order to survive this time of year. This includes using alcohol or weed to help them relax or sleep. They will also take friends ADHD medication, use cocaine, or start taking caffeine pills or start drinking a great deal of coffee or energy drinks so they can stay awake and study. They don’t realize how much caffeine those energized drinks contain. Also the combination of weed to sleep and caffeine to stay awake can cause mood changes, psychosis and even death.

Most teens want to do things on there on so they will tell you everything is fine and they have it covered. They think it is fine because of the substances they are using. Remember a teenagers prefrontal lobes are not fully developed yet. Therefore, they only focus on the here and now and not on the future. They also do not always think about the long term consequences about some of the things they are using.

If your teenager is getting anger very easily or crying easily this is a sign that something is going on. If you notice a change in their eating habits such as going from eating a lot to eating nothing, this is another sign. Also if you notice a change in their sleep pattern such as awake all night and falling asleep at odd times this is also a sign.

What do you do if you notice anything that is making you worry, you should sit down and talk to your teenager. Explain you know there is a lot of stress right now and point out the changes you have noticed and what you are concerned about. Reinforce you are not having this conversation because you are mad or they are in trouble, you are having this conversation because you love them. If they are using things or doing things because they think it will help them study, let them know you are there to help. Explain some of the dangers associated with what they are doing. Remind them no grade is worth their life.

One thing you may want to do, is say to your teenager you know the end of the semester is a stressful time. Ask them if they need any help studying or help organizing their time. Let them know if there is any way you can help, you are there to help. Remind them, all they need to do is ask you for help and you will help.

Hopefully they will listen to you and confide in you. If they continue to deny everything, then go to any local pharmacy and buy a drug testing kit. Explain you are only doing this for their safety and they are not in trouble. They may be afraid or embarrassed to tell you. They may feel like a failure in your eyes. As their parent they really need your love and support right now not a lecture. Again remember when you were in high school and how difficult it was to tell your parents certain things. Good luck.

Dr. Michael Rubino specializes in working with teens and has over 20 years experience and his work is nationally recognized. To find out more about Dr. Michael Rubino visit his website at http://www.RubinoCounseling.com or his Facebook page at Facebook.com/Drrubino3

Why Are We Ashamed about Mental Health?

Why Are We Ashamed about Mental Health?

When people hear about mental health they often think about people sleeping in the street or eating out of garbage cans. However, this is not the reality. Mental health issues are the same as physical health issues. They need to be treated. Diabetes is caused by a chemical imbalance, the chemical being insulin. Depression is caused by a chemical imbalance. The amount of serotonin is off for a person dealing with depression. Therefore why should we treat them differently?

This stigma does result in people succeeding at Suicide and it can destroy families because someone does not seek mental health care. If they commit suicide, this impacts the entire family. The shooting in Thousand Oaks is an example of what can happen when people don’t receive mental health care. The mother said she had been afraid of her son for a long time and tried to seek help. The mother lived for years in fear of her son and now she has to live with the fact that her son murdered 12 people and injured many more. All because of the negative stigma associated with mental health care and the lack of mental health care.

I have included a link to a video by Heads Together where a husband and wife discusses how the stigma associated with mental health impacted their family. https://www.facebook.com/201404780244288/posts/671244049927023/

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers. For more information about Dr. Rubino visit his website http://www.RubinoCounseling.com or http://www.Facebook.com/drrubino3.

How to Screen Your Teen at Home for Substance Abuse

How to Screen Your Teen at Home for Substance Abuse

Parents here is something you may find very useful – online screening developed by the NIMH for assessing if your teenager is using drugs. Screening Tools for Adolescent Substance Use via @NIDAnews https://www.drugabuse.gov/nidamed-medical-health-professionals/screening-tools-for-adolescent-substance-use#.W-S067JO194.twitter

Ways to Avoid Stressful and Angry Situations on Thanksgiving

Ways to Avoid Stressful and Angry Situations on Thanksgiving

The Holiday Season is coming up fast and for many people instead of a happy time it is a very stressful time that they wish they could avoid. The Holidays can bring up family issues that have not been resolved and these issues can make everyone uncomfortable. They are like the elephant in the living room that no one discusses. Another issue is that everyone is trying so hard to make the day prefect that it becomes a stressful day and no one enjoys the day.

Thanksgiving is coming up first so let’s deal with that day.

Thanksgiving dinner with multiple family members can create chaos and stress. Having a Thanksgiving plan can reduce anxiety, decrease the likelihood of arguments and increase the likelihood that everyone has a happy and enjoyable Thanksgiving that they were expecting.

Lori Lite who writes about stress uses the acronym G-R-A-T-E-F-U-L as her Thanksgiving stress guide. It helps her and others get through the day in a peaceful manner. Each letter reminds you of something to do or a way to view the day so you do not get upset.

So here is how to use Gratitude as your Thanksgiving Stress Reliever.

G- Gratitude is the opposite of stress. It is difficult to feel stressed out when we are feeling gratitude.

R- Relax your expectations and let the day unfold. You might be surprised by the outcome.

A- Acceptance is the opposite of judgment. If we accept our family member for who they are and what they are capable of we can relax and enjoy ourselves.

T- Teens can be a part of Thanksgiving. Ask them what they would like to bring to the table. Let them bring it.

E- Empower children and let them help with age appropriate assignments. Putting the nuts out or making the centerpiece. Let them do it their way…not your way.

F– Focus on family for this day. Put all work and worries on the shelf

U– Unplug the electronics for dinner so that everyone can be fully present.

L- Love is often overlooked when we are busy. Cook with love… Speak with love… Show your love and gratitude for your family on this Thanksgiving Day.

Since the day can be stressful, it can lead to anger and arguments. Another acronym you can use to help with stress and anger is H-A-L-T. Here is what Halt stands for:

H – Hunger, if someone feels hungry they are more likely to become stressed or angry.

A – Anger, if someone is already angry, they can easily become stressed or have their anger increased by some small event because they are already agitated.

L – Lonely, if someone is feeling ignored or left out of the group, this lonely feeling can turn into anger or stress.

T – Tired, if someone is tired, their defenses are down and they can become agitated or angry very easily.

If you remember HALT and monitor yourself for these feelings or if you notice these feelings in someone else, you can try to do something for yourself or someone else to change the situation creating this feeling and hopefully avoid an angry incident.

This might seem very simple and obvious, but at times the best solutions are rather simple. Also you may want to practice using these acronyms in your daily life. It may seem simple, however it may be harder than you think because you are accustomed to doing things and viewing life in a certain way. This idea may challenge you to reassess how you approach life in general. Therefore, these acronyms may be helpful in your daily life.

Many of us are not use to looking at our lives in terms of what we have to be grateful for. Also many of us have a hard time relaxing and not worrying about work or other things occurring in our lives. I have found that just being in the moment is difficult for most people. Most of us believe we always have to be doing something. This can create stress and disappointment because we miss important family time. Finally, since we feel we must always be doing something, disconnecting from cellphones and other electronics can be very difficult for many people. However, think about it? How can you have fun and enjoy the day with your family, if your mind is not fully present? You can’t. Furthermore, this can create tension for others because they feel ignored and for you because you feel they don’t respect how important what you are doing at the moment is to you. As a result, you have stress which can turn into an argument and everyone is upset. A day we planed as a happy day can become a day of anger and disappointment easily.

Therefore, in order to avoid this possibility try using the acronyms GRATEFUL and HALT following the guidelines for the day. What do you have to lose?

Dr. Michael Rubino specializes in working with children, teenagers and their families. He has over 20 years experience. For more information about his work or private practice visit his website at http://www.rcs-ca.com or visit his Facebook page at http://www.facebook.com/drrubino3.

The Epidemic of Mental Health Issues in Children

The Epidemic of Mental Health Issues in Children

I have been seeing this for 2 yrs. This is why kids need access to mental health care without feeling ashamed that they need help. More kids are showing up in ERs with mental health crises. Parents please watch this video by NBC. https://www.nbcnews.com/health/health-news/more-kids-are-showing-ers-mental-health-crises-n930506 via @NBCNews

The Truth about Suicides during the Holiday Season

The Truth about Suicides during the Holiday Season

The Holiday Season is just around the corner. Many people assume the Holidays and depression go together. In addition to assuming the Holidays and depression go together, people assume that suicide rates increase during this time of year. Well according to the statistics from the CDC, suicide rates actually drop during the Holiday Season. The study by the CDC is not sure why they drop but they do. May be they drop because during this time of year we pay more attention to depression and suicide. There are a number of ads and social media posts where people can call if they feel suicidal.

What the CDC did find is that loneliness increases during this time of year. During the Holidays there are songs and plenty of television shows regarding getting together with family and friends. You also have people talking about all the Christmas parties that they have to go to. However, this is not the case for everyone.

If you are a military family, a loved one may be stationed overseas and won’t be home for Christmas. Also during the year some close friends or loved ones may have died during the year. It is during this time when most people are talking about family and friends that you remember the people you have lost over the year. The first Holiday Season without a close loved one or friend can be very difficult. You may not feeling like celebrating or you may have to change Holiday traditions which can make some one feel sad and lonely.

Another common difficulty during this time of year is money. Many people feel like they need to spend a great deal of money to show love. They may just be able to pay their monthly bills and cannot afford Holiday gifts. Why do we need to spend money to show that we care? What if you write a letter to someone telling them how important they are to you and how much you appreciate them. Isn’t that the real purpose of the Holiday Season? Isn’t this the time of year we take to tell people in our lives how much we appreciate them. Also it’s an opportunity to tell people we tend to ignore, people sleeping on the street or who are dealing with mental illness that they are important too?

As a psychotherapist, I have seen that people dealing with mental illness feel lonely and out of place during this time of year. They don’t often feel the joy of the season. Sometimes they struggle just to make it through the day. Also mental illness is something we don’t discuss as a society. We tend to act like it doesn’t exist so we ignore the issue. Also since it is an uncomfortable issue for many people the feelings of shame and embarrassment become associated with mental illness. This makes it less likely for people dealing with it or families who have a family member dealing with it to talk about it or seek help. This can make people feel lonely and isolated especially during this time of year.

We seldom acknowledge the daily struggle that people and families dealing with mental illness go through on a daily basis. It is important to acknowledge that mental illness is not a weakness it is a medical condition. There is no reason to look down on someone with mental illness. We offer encouragement and support to people with cancer, why can’t we do the same for people with mental illness?

I have included a link to a video where a teenager discusses dealing with depression https://youtu.be/dAzqGcOLXBs. Listen to what he has to say and answer the question, does he deserve to be looked down upon because he is depressed?

Also remember the Holidays can be a lonely time for people. So if you see someone who looks like they are having a hard time or know someone who is struggling during this season, try to help. Do something kind for them. Another thing to remember, being kind to people should be a year round activity for all of us. We should not just be kind during the Holidays. If we try to be kind all year, we may be able to decrease how many people feel lonely and depressed. Also if we are kind and offering support year round may be we can eliminate the negative stereotype associated with mental health.

Dr. Michael Rubino specializes in treating depression and suicide especially depressed and suicidal children and teenagers. For more information about Dr. Rubino visit his website at http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/drrubino3