Parents Can and Do Make Mistakes

Parents Can and Do Make Mistakes

As a psychotherapist who works with children and teenagers, I often hear parents who are worried about making a mistake as a parent. They are afraid that if they make a mistake, this will have a terrible impact on their teenager. There is really no need to worry as much as many parents do. No one is perfect, therefore most parents will make a mistake as a parent at some point during their child’s life. I have written other articles pointing out that when teenagers make a mistake that it can be a learning experience. The same thing is true for parents. However, when a parent makes a mistake they learn a lesson and they also teach their children how to handle mistakes and that they are normal. Therefore, when a parent makes a mistake, both the parent and child learn a lesson.

I recently read a blog by Dr. Macheo Payne. The blog focused on the fact that parents do make mistakes. It also points out how when a parent makes a mistake both the parent and child learn a lesson. His blog focused on fathers making mistakes. This is an important point. When fathers make a mistake and serve as role models to their sons that mistakes are normal, it helps to eliminate the old misguided stereotype about fathers and men that most males in our society learned as the grew up. However, his points apply to both fathers and mothers. Since I hear many parents, in my office, who worry about making a mistake as a parent, I have included his comments below. Hopefully, this will help parents look at parenting mistakes in a new light.

Dr. Payne wrote the following about parenting mistakes:

I’ve done hundreds of trainings over the past 20 years on many different topics, but never the topic of a Fathers’ role in the social emotional development of children. I was intrigued and felt qualified, not because of 10 years experience in youth mental health & behavioral health, nor because I teach child development at the masters level, but I felt qualified because of my two sons and what they have taught me over the past 14 years.

As a father, I felt more qualified than as a professional ‘expert’ because of the vulnerability involved in parenting. In preparation for the training, I outlined a series of discussions & activities that highlighted key research (attachment theories, culturally responsive theories & practices, ACES, Love languages, & other child development theories) but the majority of my preparation involved framing discussions of the failures of parenting.

I introduced the statement that as a father, I fail everyday. And I expect failures, big & small everyday. I gave examples that included yelling, skipping story time because I’m tired, or simply failing to meet any emotional need of my son because of outdated gender expectation (stop crying, etc.). Compassionate readers will quickly normalize such examples but it’s not about the examples as much as it is about the reality of parenting like any other endeavor being filled with success and failures everyday.

How does this make me a good father? It doesn’t, but by acknowledging it, it positions me to be more reflective of my failure, enabling me to make adjustments that I might be yelling at my children to do. If I recognize and acknowledge my failure and mistakes, to myself, and sometimes to my children, I model for them the ability to reflect when we have been wrong and adjust our response next time.

In this way, failure becomes the critical event that can facilitate being a better father. Like a good friend told me when my first son was born: When a child is born, two parents are born also. This resonated with me to be gentle with myself as a new Dad and fostering the kind of emotional patience that helps children develop emotionally in a way that failure is seen and experienced as a lesson not a loss.

It is very important for parents to remember they are not perfect and will make mistakes. In my office, I point out to parents how they handle these mistakes can be very beneficial to teenagers, as you just read above. Also a parent who tries to act like they do not make mistakes, give teenagers an unrealistic perspective about the world and parenting.

Dr. Michael Rubino is a psychotherapist who specializes in treating children and teenagers. He has over 20 years experience working with teenagers. To find out more about Dr. Rubino’s work with teenagers or his private practice visit his website http://www.RubinoCounseling.com

Teenagers can Become Addicted to Online Gaming

Teenagers can Become Addicted to Online Gaming

Many middle school and high school students received new smart phones and computers for gaming this Holiday Season. This brings up the common argument about how much time teens are spending on line. Many parents have concerns that their teenager is addicted to their smart phones and gaming. Teenagers feel that their parents are over reacting and they can’t become addicted to their devices.

However, the truth is teenagers can become addicted to their computer devices. The World Health Organization (WHO) took a step this year and classified “Gaming Disorder” as a formal diagnosis. As I stated, many parents have been concerned about this for years. Also it does not just impact teenagers, as many may think. I have had couples come in for marriage counseling because Gaming was destroying a marriage. For several years the American Psychological Association has said it would be adding Gaming addiction as a formal diagnosis to the Diagnostic and Statistical Manual, however, so far the APA has not been able to decide on the specific criteria for this diagnosis. What the WHO has done is they have acknowledged what many parents have been reporting for years and helping us to take a step so it is acknowledged as a diagnosis.

The United States appears to be behind other countries in identifying that video game addiction does exist and does create problems for individuals and families. During the Winter Olympics this year, NBC showed centers in Tokyo, Japan and Seoul, South Korea, where people were going for gaming addiction. These rehabilitation centers have been open for years and have treated thousands of people over the years. Therefore, other countries have acknowledged Gaming addiction that United States parents have been reporting for years.

As a psychotherapist who treats teenagers, I would have to agree with the parents and I say Gaming addiction is real. I have seen teenagers become violent, punching holes in walls or physically threatening their parents, if there video games or cellphones are taken away as a punishment. Teenagers I told me they cannot function without their video games or cellphones and will do anything to get them back. This sounds like and look like a problem to me. A cellphone or PlayStation should not be a teenager’s life line.

The statement from the WHO states that the Gaming must be interfering with activities of daily life, such as homework, and be present for at least a year. These guidelines seem sensible to me. Also the WHO cautions that issues such as depression and anxiety need to be ruled out before assigning the diagnosis of Gaming Addiction. Many teenagers who are depressed or dealing with severe anxiety do self-medicate with video games. Finally, the WHO states your child needs to be evaluated by a mental health clinician who specializes in treating and assessing children and teenagers. This is very important because typically children and teenagers do not always have the typical symptoms we associate with depression or anxiety. A clinician experienced in assessing children and teenagers can make the appropriate diagnosis.

I have included a link to a segment on Good Morning America which discusses the diagnosis and other issues I have discussed to assist you in understanding what the WHO is referring to with Gaming Addiction, https://youtu.be/axG1tLdutmY.

The World Health Organization has taken an important step in helping us understand and define a problem many parents have been reporting for years. This is not a bad thing. I view it as a positive step. Technology is moving very fast. In fact, it is moving so fast we cannot keep up with all the new issues we need to deal with as a result of new technology. The more we understand this technology the more we all can benefit and avoid potential serious problems.

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

The New High School Drugs

The New High School Drugs

High school students are out of school for the next two weeks for Winter Break. They are looking forward to spending time with their friends at school and those returning from college. This usually means a lot of late nights and parties. Many parents are concerned about the challenges their children will experience in these environments. A common one is peer pressure and drugs. As a psychotherapist who treats teenagers, I hear about what is going on with teenagers and what they are doing. I have been hearing from many teens about new designer drugs they are taking. Many people assume teenagers are primarily using marijuana. However, teenagers are looking for new drugs and ways to modify how they use marijuana. These new drugs can be very dangerous, even deadly. However, many teenagers are not aware of the dangers and risks they are taking.

Winter break is only two weeks so many teens will want to get in as many parties as they can. During winter break for many teenagers this means partying with old and new friends. Drugs are often part of these parties. One major problem facing teens is the fact that many Emergency Room physicians cannot keep up with all the new drugs teenagers are using. Therefore, if a teenager ends up in the Emergency Room due to overdosing or having a bad reaction to one of these new drugs, a teenager may die before an Emergency Room physician determines what the teenager took and how to treat it. The show The Good Doctor had an episode which addressed this issue. The teen had used, Molly, not a new drug but because there were so many options, the teenager almost died before they could determine how to treat him.

Recently I read an article by Angela Chen. The article discusses these new dangerous drugs and how deadly these drugs can be. I have included her article below so parents can be aware of the dangers facing their teenagers. Hopefully, parents will also take this opportunity to discuss this issue with their teenagers.

On a July day a little over a year ago, over 30 people collapsed on a street in Brooklyn. They lay on the ground, vomiting down their shirts, twitching and blank-faced. Some, half-naked, made jerking movements with their arms, eyes rolled back. Others groaned and clutched onto fire hydrants to try to stay upright. Witnesses said the scene was like The Walking Dead. Headlines claimed that people had turned into “zombies,” while police said that the 33 affected were lucky to be alive.

All had smoked an “herbal incense” product called AK-47 24 Karat Gold. Eighteen people were sent to the hospital by ambulance. The situation had all the signs of a drug overdose, and so doctors ordered the usual tests: blood count, urine analysis, heart rate monitoring.

The first patient tested was a 28-year-old man who was slow to respond, but otherwise showed few clear signs of trauma. Heart sounds: normal. Blood count: normal. His lungs were clear and there were no major neurological problems, no excessive sweating or skin lesions. He tested negative for opiates, cocaine, amphetamines. Nothing came up.

The case went to the Department of Homeland Security and the Drug Enforcement Agency. They knew who to call to get a second opinion. They packed blood and urine samples on dry ice and shipped them to a small lab 3,000 miles away in San Francisco, run by toxicologist Roy Gerona. If anyone in the country could figure out what was in 24 Karat Gold, it would be him.

Forty years ago, drugs had easy names: cocaine, meth, heroin. Today, the names can read like an ingredients list for a chemistry class: 5F-AMB, PX-2, MDMB-CHMINACA. Today’s designer drugs are made by synthesizing chemicals and hoping they give you a high that’s strong enough to be worth it, but not strong enough to send you to the hospital.

Designer drugs are volatile. If you tweak just one molecule, you can get an entirely differently substance, one you hadn’t bargained for. They’re also easy to get. There’s no shortage of “research chemicals” vendors on the dark web are willing to sell. And they’re growing more popular. These so-called “novel psychoactive substances” entered the mainstream in 2009. That year, according to the United Nations Office on Drug and Crime, there were about 100 of these substances reported; six years later, there were nearly 500. Because designer drugs don’t show up on traditional drug tests, they’re hard to track and identify. It’s a public health problem that requires a special set of skills to handle.

One of the most prominent categories of designer drugs are those intended to mimic marijuana, called synthetic cannabinoids. Marijuana, or cannabis, is widely considered one of the safest drugs, but synthetic cannabinoids are some of the most dangerous synthetic drugs. The Global Drug Survey (GDS) found that last year, for the fourth year running, the risk of seeking emergency medical treatment was higher after using synthetic weed than for any other drug.

When you smoke a regular joint, a chemical called tetrahydrocannabinol (THC) travels through your blood. It binds with receptors called CB1 and CB2. Because of the structure, there’s “kind of a limit on how stoned you can get,” says Adam Winstock, a London-based psychiatrist who administers the GDS. If you’re smoking a popular cannabinoid like K2 Spice, a chemical travels through your blood, but this time, it’s not THC. It’s something else that also binds with CB1 and CB2 — but unlike with regular weed, we don’t know exactly how these chemicals bind, especially when they’re illicit drugs from the black market. This mystery makes synthetic marijuana likely to lead to “much more extreme responses,” like seizures and psychosis, according to Winstock.

Synthetic cannabinoids originated in a quest to create a better pain medication. A Clemson University chemist named John W. Huffman synthesized hundreds of compounds in an attempt to find a better painkiller, but often created incredibly psychoactive substances with no medicinal properties at all. When he published the results of these compounds — called JWH compounds, after his initials — he made the information available to be copied.

There are more than 300 JWH compounds alone, and around 2004, labs in China began studying old research papers, synthesizing the compounds and distributing them as “herbal incense” products. K2 Spice itself — often partly based off the JWH-018 compound — started in China, became popular in Germany around 2008, and entered the US around 2009.

Labs can also turn to the expired patents — patents that are rich fodder, even if (or perhaps because) there was a good reason said drugs never made it to market. It’s nearly impossible to figure out how to shut down the overseas labs producing these drugs. As soon as you ban one substance, the labs move on to another.

Gerona, a toxicologist with gray hair styled in an undercut, was the one who received the biological samples from the DEA. From a small lab in the Medical Sciences Building at the University of California, San Francisco, Gerona says he and his team are playing a “cat and mouse game” with illicit international drug manufacturers. When an overdose happens, Gerona’s team tries to identify the drug in question — often synthetic substances no one has seen before. But the lab goes one further: Gerona’s lab attempts to identify and classify these substances before the mass overdoses even happen.

Inside, the lab is meticulously neat: rows of spotless tables are covered in bottles with orange rubber caps, all labeled with orange duct tape, and small gray centrifuges. A window overlooking a courtyard has molecular structures scribbled over it in pink and green marker. Near the door sits an enormous freezer, filled with thousands of brightly colored, frost-covered boxes of drug samples kept at -112 degrees Fahrenheit.

Gerona launched his toxicology lab in 2010, in partnership with the San Francisco Poison Control Center. The date wasn’t a coincidence; he says that 2010 was the year that a designer drug called “bath salts” began flooding the market. “Bath salts” is a blanket term for a group of designer drugs made from stimulants; they create a euphoric high like MDMA, sometimes with hallucinations thrown in. The drugs usually come in powdered and capsule form, and can cause freak-outs that were well-documented on YouTube at the time. The most famous of these was a viral story of a 31-year-old Miami resident attacking and then eating a homeless man. (Scientists dispute the drugs’ role.)

For users and the DEA, the spike in bath salts use was a nightmare. For Gerona, the increased interest in designer drugs led to more work and more samples from around the country. Eventually, the lab caught the notice of both Michael Schwartz, a toxicologist at the Centers for Disease Control and Prevention, and DEA pharmacologist Jordan Trecki. A collaboration between Gerona’s lab and the DEA was formed. (Neither the DEA nor the CDC responded to repeated requests for comment.)

The first step in doing an analysis at Gerona’s lab is getting the sample — urine, blood or, rarely, a tiny bit of drug itself — shipped over on dry ice. In traditional drug testing, you check to see if the sample matches any of the known substances: marijuana, heroin, cocaine, and so on. They match, or they don’t. Designer drugs, almost by definition, are made of chemical combinations we haven’t seen before. They almost never match traditional databases, and the chemists often don’t know what they’re looking for. So Gerona’s lab gathers as much information about the substance as possible.

A tiny vial of the biological sample — usually plasma, the colorless part of blood — goes into a bulky, printer-like machine. That machine is called a liquid chromatography mass spectrometer, and very crudely put, it separates out all the different parts of the plasma by mass. (Think of it like an extremely sensitive centrifuge.) That process makes it easier to identify chemicals, and the mass spectrometer then spits out the different measurements in a computer chart with peaks and valleys called a chromatogram.

Then, says Axel Adams, a graduate student in Gerona’s lab, you turn to the so-called “prophetic library.”

“ RESEARCHES LOOK FOR POSTS ABOUT DRUGS ON SUBREDDITS LIKE R/RESEARCHCHEMICALS

Gerona’s “prophetic library,” about three years in the making, is a detailed catalog of already synthesized variants that his team believes is going to be the next big street drug. The library was made possible with the help of Samuel Banister, a synthetic chemist at Stanford University. Banister synthesizes variants of popular street drugs and takes down their chemical information to create “reference standards.” Synthesizing can take anywhere from a few days to a couple of weeks; the lab now has almost 150 variants on file. It’s a side job for Banister, but at one point, he says, “I was pumping out five to 10 a week.” The final products look like white crystalline solids and are kept in drawers in the lab, ready for when a case like AK-47 24 Karat Gold comes along.

In addition, lab members spend hours each week on drug forums, researching trends. It’s more of an art than a science. Researches look for posts about drugs on subreddits like r/researchchemicals. They reference surveys like the Global Drug Survey and survey “trip reports” from experiential documentation sites like Erowid and PsychonautWiki.

They look for terms like synthetic pot, K2, Spice, and sometimes, scientific terms like “cannabinoids,” or a specific popular class of cannabinoids, like “FUBINACA” or “JWH compounds.” Often, the posts themselves will include the name of the chemical. Gerona has ordered drugs off the dark web. In one case, the invoice billed him for “cosmetics,” and the package included lipstick, fake eyelashes, and tabs labeled “powder.” The “powder,” unsurprisingly, turned out to be drugs. But most of the time, the drugs in the powder were not the drug that was ordered.

“ THE INVOICE BILLED HIM FOR “COSMETICS,” AND THE PACKAGE INCLUDED LIPSTICK, FAKE EYELASHES, AND TABS LABELED “POWDER”

If there is a match because the compound is already in the library, finding the right variant is “only going to take 15 minutes,” says Gerona. “Otherwise, it could take a week, or it could not be solved.”

Adams checked the results of a blood sample tied to AK-47 24 Karat Gold against the prophetic library. The computer pulled up a chart that indicated a line — jagged, up and down — that shows the mass of the components of AK-47 24 Karat Gold, versus the same information for AMB-FUBINACA.

Drugs don’t pass through the body untouched. Once they’re ingested, the body processes the compounds. So by the time they’re in the blood or urine, it’s not exactly the same compound as the drug that was ingested. It’s hard enough to find a reference standard for the original compound; it’s even more difficult to find a reference standard for the possible variants. In the case of AMB-FUBINACA, the chemical in the biological sample from Brooklyn wasn’t the parent compound. It was a derivative. Luckily, Banister had already synthesized that variant, too.

The peaks and valleys of the two lines of AK-47 24 Karat Gold and AMB-FUBINACA matched up precisely. It took the team only seven days to identify the substance in the Brooklyn case — and most of that time was spent waiting for the sample to get there.

Gerona’s lab has worked on cases across the country, from New York City to Sacramento to Colorado. The number of cases varies. Sometimes, they’ll get 15 to 25 samples a month. One Mississippi case involving synthetic cannabinoids resulted in over 400 samples. The average turnaround on results is about six months, says Adams. That’s not good enough for Gerona.

And it’s not likely that the problem will go away. Marijuana legalization advocates claim that people will stop with the synthetic stuff once the real thing is okay. But that’s not true in the experience of Andrew Monte, a clinical toxicologist at the University of Colorado School of Medicine who collaborates with Gerona’s lab. Recreational marijuana is legal in Colorado, but he sees patients who are on these synthetic compounds anyway. Monte’s team has surveyed people who come into the ER and even set up at music festivals to ask attendees questions. Synthetic drug users are “taking it for a different reason, to get a different high,” Monte says. “They’re really looking for something different than what pot gives, the same way you might choose cocaine over pot or meth over pot.”

“ ONE MISSISSIPPI CASE INVOLVING SYNTHETIC CANNABINOIDS RESULTED IN OVER 400 SAMPLES

To help address this problem, in 2016 Gerona started a new research consortium called P SCAN, or the Psychoactive Surveillance Consortium and Analysis Network. (Yes, the double entendre is intended.) They’re working with about 10 poison control centers in places like Kansas and Colorado. They’ve had more than 100 cases referred to them and are writing up case reports and manuscripts. (The 24 Karat Gold case was published by the New England Journal of Medicine.)

P SCAN will continue to do the surveillance work Gerona has been doing for years, but also create a database of clinical data connected to the specific synthetic drugs they track and discover. Think of it like a medical version of Erowid. This way, the next time there’s an outbreak like the one in Brooklyn, investigators and researchers can look at specific physical indicators (heart rate, respiratory information, neurological information, and more) and say, “Ah, this matches the symptoms of AMB-FUBINACA” — all without shipping samples across the country.

But even with P SCAN and the prophetic library, the task is huge. “The identity of a lab needs to constantly expand and rework in order for it to stay relevant,” says Gerona.

Gerona is a biochemist by training. Before launching his lab, he didn’t know anything about Spice, or AK-47 Gold, or the dark net. But now, Gerona says, “I have no other choice but to really learn about it, so that I am relevant and retain my relevance in the field.” He’s hoping to work with people in technology to automate this “market research” to glean new insights and make the prediction process even faster. “It would be so great if we could predict the drugs coming in with more accuracy, instead of after people are hurt,” he says.

Weeding out designer drugs is a Sisyphean task, Gerona admits. It may be impossible to shut down the overseas labs, but he wants to have even better methods for predicting what’s going to get big and then, instantly identifying the substances. He compares the endless drug variations to nature: the cold virus is still around because it changes all the time. HIV has never been cured because it continues mutating. “In a sense, they’re reinventing themselves all the time, so reinvention is key to persistence. As long as you’re reinventing yourself, you can persist.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers. He treats teenagers with drug issues and has seen many end up in the Emergency Room because teenagers think they are the experts. For more information about Dr. Rubino’s work or his private practice visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/Drrubino3.

The Importance of Screen Time Agreements

The Importance of Screen Time Agreements

Many children received new IPhones, lap tops & play stations for the Holidays. A family contract about how they will be used can help decrease arguments. Screen-time arguments? Here’s how to reduce family conflict around technology https://www.abc.net.au/news/science/2018-12-26/screen-time-fights-reduce-family-conflict-with-a-media-plan/10567998

Helping a Teenager Grieve a Death

Helping a Teenager Grieve a Death

It is the Holiday Season and many people are grieving for loved ones who past away during this past year. Also many people are dealing with a recent death due to a motor vehicle accident possible as a result of someone drinking while driving. Our society does not deal with death in a healthy manner. Therefore, many people do not know what to do for or what to say to someone who is grieving. Many patients have asked me about what to do in these situations. While doing research regarding grief for patients, I found this information from the grief center. I think it is very good information and very easy to understand. Therefore, I will present the information in three sections.

The 10 Best and 10 Worst Things to Say to Someone in Grief

Sheryl Sandberg’s post on Facebook gave us much insight into how those in grief feel about the responses of others to loss. Many of us have said “The Best” and “The Worst.” We meant no harm, in fact the opposite. We were trying to comfort. A grieving person may say one of the worst ones about themselves and it’s OK. It may make sense for a member of the clergy to say, “He is in a better place” when someone comes to them for guidance. Where as an acquaintance saying it may not feel good.

You would also not want to say to someone, you are in the stages of grief. In our work, On Grief and Grieving, Elisabeth Kubler-Ross and I share that the stages were never meant to tuck messy emotions into neat packages. While some of these things to say have been helpful to some people, the way in which they are often said has the exact opposite effect than what was originally intended.

The Best Things to Say to Someone in Grief

1. I am so sorry for your loss.

2. I wish I had the right words, just know I care.

3. I don’t know how you feel, but I am here to help in anyway I can.

4. You and your loved one will be in my thoughts and prayers.

5. My favorite memory of your loved one is…

6. I am always just a phone call away

7. Give a hug instead of saying something

8. We all need help at times like this, I am here for you

9. I am usually up early or late, if you need anything

10. Saying nothing, just be with the person

The Worst Things to Say to Someone in Grief

1. At least she lived a long life, many people die young

2. He is in a better place

3. She brought this on herself

4. There is a reason for everything

5. Aren’t you over him yet, he has been dead for awhile now

6. You can have another child still

7. She was such a good person God wanted her to be with him

8. I know how you feel

9. She did what she came here to do and it was her time to go

10. Be strong

Best & Worst Traits of people just trying to help

When in the position of wanting to help a friend or loved one in grief, often times our first desire is to try to “fix” the situation, when in all actuality our good intentions can lead to nothing but more grief. Knowing the right thing to say is only half of the responsibility of being a supportive emotional caregiver. We have comprised two lists which examine both the GOOD and the NOT SO GOOD traits of people just trying to help.

The Best Traits

Supportive, but not trying to fix it

About feelings

Non active, not telling anyone what to do

Admitting can’t make it better

Not asking for something or someone to change feelings

Recognize loss

Not time limited

The Worst Traits

They want to fix the loss

They are about our discomfort

They are directive in nature

They rationalize or try to explain loss/li>

They may be judgmental

May minimize the loss

Put a timeline on loss

The above information is meant to be used as a guideline. Everyone goes through the grieving process in their own way. It is very important to understand that point. It is also important to remember while the above is a guideline, the most important thing is your intent. So if you say a worse thing but you said it out of love the person will understand. The guideline will hopefully make you more comfortable to offer support to your grieving loved one or friend. Because someone who is grieving need people to talk to without people feeling awkward. Also everyone is around immediately after the death and through the funeral services. Most people then go back to their normal lives. However, those who were really close to the person are still grieving and trying to figure out how to proceed with life. So don’t forget the person who is grieving can use emotional support for the first year especially. Therefore, do not forget to call, send a card or stop by occasionally. Especially around the holidays and birthdays.

Dr. Michael Rubino has over 20 years experience as a psychotherapist treating adolescents, children and their families. For more information regarding Dr. Rubino visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3 or follow him on Twitter @RubinoTherapy

Is My Teenager Depressed?

Is My Teenager Depressed?

The Holiday Season is here again. There is a myth that suicides increase during the Holidays, however, this is not true. The Suicide rate does not increase, but the number of people feeling depressed or lonely does significantly increase during the Holiday Season (CDC). I have had many more children and teenagers reporting symptoms of depression, anxiety and feeling lonely this year. Since I work with children and teenagers as a psychotherapist, I have had more parents wondering if their child is experiencing depression or anxiety during this time of year. Since I am asked the question often, I was reading an article by Dr. Jerome Yelder, Sr., which outlines many symptoms of depression. He explained them so they are easy to understand and covered all symptoms parents need to be aware of regarding depression. This is important because typically children and teenagers do not act like adults do when they feel depressed. I have outlined his list below for you to review and decide if you feel your teenager needs to see a mental health clinician for depression.

Sleep Problems

Depression can affect your body as well as your mind. Trouble falling or staying asleep is common in people who are depressed. But some may find that they get too much shut-eye.

Chest Pain

It can be a sign of heart, lung, or stomach problems, so see your doctor to rule out those causes. Sometimes, though, it’s a symptom of depression.

Depression can also raise your risk of heart disease. Plus, people who’ve had heart attacks are more likely to be depressed.

Fatigue and Exhaustion

If you feel so tired that you don’t have energy for everyday tasks — even when you sleep or rest a lot — it may be a sign that you’re depressed. Depression and fatigue together tend to make both conditions seem worse.

Aching Muscles and Joints

When you live with ongoing pain it can raise your risk of depression.

Depression may also lead to pain because the two conditions share chemical messengers in the brain. People who are depressed are three times as likely to get regular pain.

Digestive Problems

Our brains and digestive systems are strongly connected, which is why many of us get stomachaches or nausea when we’re stressed or worried. Depression can get you in your gut too — causing nausea, indigestion, diarrhea, or constipation.

Headaches

One study shows that people with major depression are three times more likely to have migraines, and people with migraines are five times more likely to get depressed.

Changes in Appetite or Weight

Some people feel less hungry when they get depressed. Others can’t stop eating. The result can be weight gain or loss, along with lack of energy. Depression has been linked to eating disorders like bulimia, anorexia, or binge eating.

Back Pain

When it hurts you there on a regular basis, it may contribute to depression. And people who are depressed may be four times more likely to get intense, disabling neck or back pain.

Agitated and Restless

Sleep problems or other depression symptoms can make you feel this way. Men are more likely than women to be irritable when they’re depressed.

Sexual Problems

Hopefully your teenager is not sexually active. While they may not have the sexual problems adults do, when they are depressed, they may show a lack of interest in dating or relationships and tend to isolate. They also may feel they are sexually unattractive.

If you’re depressed, you might lose your interest in sex. Some prescription drugs that treat depression can also take away your drive and affect performance. Talk to your doctor about your medicine options.

Exercise

Research suggests that if you do it regularly, it releases chemicals in your brain that make you feel good, improve your mood, and reduce your sensitivity to pain. Although physical activity alone won’t cure depression, it can help ease it over the long term. If you’re depressed, it can sometimes be hard to get the energy to exercise. But try to remember that it can ease fatigue and help you sleep better.

If you feel you child or teenager are experiencing the above symptoms and may be depressed, have them evaluated by a mental health clinician who specializes in treating children and teenagers. Remember, children and teenagers often display different symptoms when they are depressed so it is often misdiagnosed. Also do not be embarrassed or ashamed. The pressure children and teenagers are facing at school can be very overwhelming and can easily cause a depressive episode. The most important thing is if your child or teenager is experiencing depression, get then the treatment they need.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and children. For more information about Dr. Rubino’s work and private practice visit his website http://www.RubinoCounseling.com or his Facebook page http://www.facebook.com/drrubino3 or follow him on Twitter @RubinoTherapy.

The Negative Stigma Applied to Mental Health

The Negative Stigma Applied to Mental Health

In our society there is a huge negative stereotype about mental illness and treatment for mental illness. Given we live in the United States in the 21st century, this is quite surprising. Especially since statistics show the 1 in 5 people could benefit from psychotherapy (CDC, 2014).

Most people when they think about psychotherapy or mental illness, think of someone sleeping in the street or some one with severe schizophrenia. Because of this stereotype many people feel ashamed or embarrassed if they are told they need therapy. Family members also feel ashamed and embarrassed and never mention it to other people if someone in their family needs psychotherapy. People are afraid that other people will think they are “crazy” too, if someone in their family is going to therapy. However, most people who need treatment for a mental illness need treatment for depression or anxiety not schizophrenia.

Research studies show that most depression is due to a chemical imbalance in brain. Diabetes is due to the pancreas not being able to coordinate glucose levels in the body. We don’t make a person with diabetes feel embarrassed or ashamed so why do we make someone dealing with depression feel embarrassed or ashamed?

What is the cost of this stereotype? People who have depression are at risk for suicide. The Center for Disease Control statistics show that suicide is the third leading cause of death for people aged10 to 24. Yes ten year old children are suffering from depression and are killing themselves. One of the most common methods is a gun. People assume this is a guarantee. Wrong, a gun is not a guarantee. Quite often the gun jumps and the person lives. However, they have to undergo multiple surgeries to try to rebuild their face. However, no matter how good the surgeon, the person is left with multiple permanent scars. Psychotherapy and medication might have prevented the suicide attempt.

However, because of our negative stereotype, depression and suicide have never been taken seriously. The Golden Gate Bridge is the most common place in the world for people to jump off when they are trying to commit suicide. It wasn’t until just recently that the Bridge District voted on what type of anti-suicide barrier they are going to build. However, even though they have voted for an anti-suicide net, last week they were still debating the details. The Golden Gate Bridge is 78 years old. It has taken 78 years to do something about a life or death issue and they are still debating over minor details. BART has been around for decades and people have been jumping in front of trains for years. This year BART is starting an anti-suicide campaign. How many lives were lost needlessly to suicide, prior to this campaign and why have they waited so long to put one in place?

Often we assume it is a money issue. Only poor people commit suicide because they cannot afford treatment. The suicide of Robin Williams destroyed that myth. He had plenty of financial resources for treatment and had been in and out of treatment centers for years. In an interview with Dyane Swayer he described how overwhelming depression is, he said, “no matter what there is always that little voice in the back of my mind saying jump.” If that voice is always there but society is saying there is something wrong with you for having depression in the first place or because you have not over come it, are you going to ask for help or keep seeking help? No.

Yes society often blames the patient. Why don’t they try harder? Why didn’t they think of their family? After Robin Williams’ suicide a number of comedians and actors talked about their silent struggle with depression. Rosie O’Donnell stated it best, “when you are that deep down in that black hole with intense emotional pain, the only think you can think about is how to stop the pain. You don’t think about your family or anything else.”

I ask you to think about your opinion or thoughts about mental illness. Think about a 10 year old boy feeling that suicide is the only way out of his pain. Think about the fact that he is dealing with a medical diagnosis similar to diabetes or high blood pressure. If this is right, why is there this negative stigma about mental illness? If a child has diabetes he receives medical treatment, there are summer camps and there is no shame put on the child or the family. Think about the fact that the bill President Trump is pushing would make Depression and anxiety pre-existing conditions so insurance companies could deny people health care.

We need to make a change in how we view or react to mental illness. We live in the United States of America and we are supposed to be the super power in the world. You wouldn’t think that in the most powerful nation in the world that the third leading cause of death for our children is suicide. We must change this ridiculous stereotype we have about mental illness and start providing people and children with appropriate treatment for their mental illness. The life you save might be your’s child’s life or the life of a family member or friend.

We may want to look at England. The Duke and Duchesses of Cambridge and Prince Henry have formed a program called, Heads Together. The goal of the program is to eliminate the negative stereotype about mental health and to make sure people who need psychotherapy receive it. In fact, the Duchess of Cambridge said publicly that if either of her children ever need psychotherapy that they will receive it. We might want to follow their example.

Dr. Michael Rubino is a psychotherapist who specializes in treating children and teenagers. Dr. Rubino has over 20 years experience as a psychotherapist. He is very active in eliminating the stereotype about mental health. He is an active member in Heads Together in London, a non-profit founded by Prince Willam, Henry and Princess Kate to help people understand that people need mental health care. For more information about Dr. Rubino’s practice or his work visit his website at http://www.rubinocounseling.com or follow him on Twitter @RubinoTherapy.