Teenagers Continue to Experience Vicariously Trauma Daily

Many people tend to assume only people who were directly exposed to a trauma will experience issues related to the trauma and may develop Post Traumatic Stress Disorder (PTSD). However, this is not the truth. Many people may not have lived through the trauma, but they may know someone who did or they were exposed to very explicit images of the trauma or have been hearing about the trauma a lot on the news. It may also trigger memories of a trauma they experienced in their lives or in their family. This can cause what is referred to as vicarious trauma. Vicarious trauma is when someone is traumatized by an event but they did not experience the event themselves. Simply knowing about or hearing about the event is traumatizing to them. This is happening to many children and families in the United States. However, when are we going to pay attention to the way children in the United States are being traumatized over and over?

If this sounds confusing, let’s look at what children and teenagers have been dealing with and living through the last few years. This last year teenagers and children have been living with the trauma of the Coronavirus. Their schools were closed without warning and so were the sports and other after school activities stopped suddenly. In addition they were not able to hang out with friends and had to go to school remotely.

In addition to these changes, many children and teenagers had family members they could no longer see, such as grandparents and many had family members who died due to the Coronavirus. However, they were not able to attend funeral services and say goodbye. Over 525,000 Americans died to the Coronavirus. All of those people had family members and friends who are grieving for them still. A fact we tend to overlook. However, children and teenagers are dealing with it daily especially if they lost a parent, grandparents or a sibling.

While children and teenagers are still dealing with how poorly the Pandemic was handled by the government, now many are being told we are reopening states including schools. Therefore, they no longer have to deal with remote school now they will be back in their classrooms. This brings up anxiety about how school will be because they still need to be cautious so they don’t contract the Coronavirus. Many children and teenagers have told me they are very worried about being exposed to the Coronavirus or their parents being exposed to the Coronavirus.

In addition to the Coronavirus, children and teenagers now have to worry again about mass shootings. We just started opening the Country and already there have been two mass shootings. This brings up the anxiety and vicarious trauma children have been exposed to regarding school shootings for years. They have been increasing every year since 2010 (CDC) and in 2019 by November there had been 336 mass shootings averaging out to a mass shooting every 1.2 days (Gun Violence Archive). These are overwhelming statistics for adults and we are expecting children and teenagers to cope with them. The students know there have been no changes to the gun laws. Therefore, they are having to return to school and worry about mass school shootings.

Look at what they are returning to when they return to school. Today in most United States schools, the classroom doors are kept lock while class is in session and no one can enter a school campus without checking in with the main office and they must wear an identification badge while on campus. In fact, all school employees must wear official school identification badges while at work. Many elementary students noticed these changes and have asked why the door must be locked? Students are told it is for their safety. The school is preventing any people who do not belong at the school from getting near the students. No one mentions someone with a gun, but children have heard about and remember all the mass shootings and they know why the door needs to be locked. I have many elementary students mention this to me during their therapy sessions.

Now when we were in school we had fire alarm drills in case there ever was a fire in the school. No one thought much about them. Some students felt the fire alarm was too loud but no one really worried about a fire happening at school. We never worried about it because we never heard about any school fires and people dying.

Today students face more than fire alarm drills. Schools routinely have active shooter drills. During these drills students are taught to shelter in place and to remain very quiet so the shooter will not enter their room. Therefore, besides having heard about and remembering mass school shootings, school students know they are returning to a place where they could be killed. They know they are practicing what to do in case there is a shooter at their school trying to kill them. Therefore, they worry about could a shooting happen at their school and could they die. As a result of these fears, the CDC has documented that anxiety disorders and depression had significantly increasing in children since school shootings increased and they have documented a further increase in anxiety and depression due to the Coronavirus.

To add to the trauma students now face, if there is an incident, such as a bank robbery, involving someone with a gun near a school, the police put the school on lock down. The students must shelter in place and they don’t know if the person with the gun will come to their school or not. This creates a significant amount of anxiety for children and many are traumatized by the incident. Here is another incident causing trauma for children and teenagers. How many do we expect them to cope with at their ages? When will we provide mental health care for the children, teenagers, their parents, the school staff and the first responders? All of these people are being exposed to trauma regarding the Coronavirus and mass shootings on a regular basis. This creates traumatic reactions and exacerbates old traumatic reactions.

Another issue which adds to this trauma is gun control. Since the shooting in Florida many students have been actively campaigning for sane gun control. However, nothing has been done to enact sane gun control laws. High school students know nothing is being done and elementary children are hearing nothing is being done about guns. This makes them worry because they know guns are still out there that can be used to kill them. The shooting which occurred in New Zealand cause high school and elementary students to wonder why our Country does nothing about gun control. Our government has done nothing even though students and parents are demanding safe gun laws. While our government debates the issue, more students were killed and may be killed. Just look at the two mass shooting this past week. However, New Zealand in a matter of 3 weeks after a shooting banned all assault weapons. This makes students wonder why we have not done anything when we have a bigger problem with mass shootings. Also it doesn’t make them feel safe at school because they do not feel like a priority. Some people will say children and teenagers are not aware of such issues. However, remember with their Smartphones they have instant access to the news and this generation of teenagers are politically active.

Working with teenagers and children I have seen that anxiety and trauma reactions have

increased significantly for children. Also children are afraid of returning to school because they might be killed. These are responses to the mass shootings. Every time there is a mass shooting children become more anxious and afraid. We had two mass shootings this last week and as I am writing this article another mass shooting is occurring in the Florida Keys. We have just started to open the Country and we already have had 3 mass shootings. This will exacerbate previous traumatic reactions and create new ones. We are expecting children and teenagers to cope with the Coronavirus and mass shootings at the same time. For those children and teenagers not directly effected by the virus or shootings, they still have to cope with the issues which results in vicarious trauma.

Furthermore, if we want to reduce the vicarious trauma children and teenagers experience, we must be honest and not lie to children and teenagers. Remember, they have their smartphones phones and easy access to news and videos clips of the news. The best example is when the US Capital building was attacked by people trying to prevent President Biden from winning the Presidential Election. There have been Republican Congressmen and Senators saying they were safe and down playing the event. However, police were killed and injured and people were chanting “hang Pence”. To me that doesn’t sound safe. Additionally, despite the video showing these protesters breaking windows, spraying police with pepper spay and beating officers with flag poles, the former President Trump went on television saying the protesters were hugging the police, waving hello and walking calmly into the Capital. This type of blatant lie causes teenagers not to trust authority figures because they may be lying and it can cause them to second guess what they saw in the video. This creates a situation where teenagers do not know who to trust and this exacerbates their fear and traumatic reactions because they feel they have no one to trust. Children and teenagers need the truth in age appropriate terms. The truth is easier to handle than their emotions.

Summing up, children and teenagers in the United States have been traumatized and vicariously traumatized by mass shootings and the Coronavirus. As we start to open up the Country, they continue to have to deal with the Coronavirus and mass shootings. Therefore, they continue to be traumatized and vicariously traumatized. Many will need psychotherapy to help them with these issues. The American Association of Children and Adolescent Psychiatry has put out the following guidelines. If you notice any of these signs or symptoms in your child or teenager it explains how to start to talk to your child or teenager and how to find the appropriate psychotherapist for your child. It is important to get a therapist who specializes in anxiety disorders and trauma issues http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Talking-To-Children-About-Terrorism-And-War-087.aspx.

One final aspect about vicarious trauma that has emerged regarding mass shootings and the Coronavirus is suicide. Family members and survivors of mass shootings are feeling survivors guilt and as a result committing suicide. There was a report of 3 people who committed suicide who either survived a mass shooting or their child died in one. This has been occurring for a long time. It has been occurring since Columbine. Family members feel they can no longer cope with the pain. Survivors can’t cope with the guilt of surviving. Family and friends of some one who was killed or injured in a mass school shooting have had their lives changed forever! People, family members and first responders, especially hospital workers dealing with the Coronavirus are also committing suicide. They are dealing with depression, anxiety and trauma reactions on a daily basis. However, we do not have adequate mental health resources to help these people. Also people assume after a few months, most people may be grieving but can handle their situation. This is not true. They are experience anxiety and trauma that for many of them is very confusing. This only increases the anxiety and trauma. The children experiencing the shooter drills are also confused by their anxiety and traumatic reactions. They do not know what to do and this causes isolation and the feelings increase.

We must eliminate the stigma associated with mental health issues. We also need to make sure that anyone who is even remotely exposed to a mass shooting (including first responders and emergency room physicians) or anyone who has had to deal with the Coronavirus have access to mental health care. Not just for a month or two but for as long as they need psychotherapy and they should be able to receive the therapy without worrying about the cost.

We have a generation of children growing up with anxiety and traumatic reactions. If we don’t help them now, they will only get worse as time goes on. May be we need to take a lesson from New Zealand and how they responded to a mass shooting. They banned assault weapons after one shooting. We have been having shootings for 20 years and have done nothing, why? We have a great deal of information about the Coronavirus and we are arguing about wearing masks. Why?

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers and specializes in treating trauma. For more information about his work or private practice visit his website www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Is it stress or a mental health issue?

With all the stress teens have in their lives now, how do parents determine the difference between stress and a mental health issue and the need for therapy? Stress Response or Mental Health Disorder? How to Tell the Difference https://www.healthgrades.com/right-care/mental-health-and-behavior/stress-response-or-mental-health-disorder-how-to-tell-the-difference

The Pandemic has Exacerbated Teenage Camouflaging Behavior

There is a behavior that is becoming common in teenage and tween girls that has been identified by an adolescent psychologist who specializes in treating teenage girls. The behavior that has been identified is called “Camouflaging.” This behavior left unidentified can lead to low self-esteem, depression, cutting, abusive relationships etc. It is becoming very common in teenagers right now. When I was a guest co-host on the Street Solider Radio Show on KMEL, and the teens were talking about how they change the beliefs and how they change how they dress because they are afraid of being rejected by their friends is Camouflaging. Covering up their outside person so no one can identify the true person inside. Friends are a very important issue for teenagers right now. Remember due to the Coronavirus most teenagers have not had contact with their friends in over a year. Many teens are worried about how their friends have changed over the year and are afraid of losing their friends.

Therefore, Camouflaging is when an adolescent girl changes how she looks in terms of make up and how she dresses, her opinions and things about herself she is willing to deny or things she will start doing in order to be accepted by her friends. The real problem occurs when the girl is changing so much about herself or does it for so long that she forgets or losses track of her real self. Besides changing how she feels, she may forget her core beliefs and do things she doesn’t believe in.

While this behavior has been identified in girls and the research appears correct, I believe this behavior applies to boys too.

Many adolescent boys change the way they dress, their beliefs and the way they act to be accepted by their friends. I hear many of these boys telling me in therapy that they feel lost. They tell me they no longer have an idea of who they really are or believe in or feel. These boys often turn to alcohol, drugs, sex and cutting. They usually turn to these behaviors to numb out their lost feeling or to try to remember their real selves. Often they turn to these in order to forget the shame and guilt they have due to something they did in order to fit in with their friends.

As a result, many teens start acting like someone they are not just to be accepted. This fear of not being accepted and forgetting their real self because they has been covering their true self up for so long or denying their true feelings for so long can result in boys and girls having low self-esteem and/or feeling depressed. It can also result in girls or boys getting involved in emotionally or physically abusive relationships because they don’t feel they are entitled to anything more. They no longer love themselves so how could anyone else love them.

As I stated this behavior can result in low self-esteem and depression in addition to behaviors as cutting, eating disorders, drug use, becoming sexually active etc. Often boys and girls cut just so they can feel as I stated above. The constant denying of their emotions or values can cause boys and girls to lose a sense of their true feelings. Therefore, cutting can occur so boys and girls feel or can cope with denying themselves. Denying their feeling or who they are can result in boys and girls feeling very confused or lost. Therefore, they look for behaviors that help them remember who they are or will numb out the list and confused feelings. They also seek behaviors that help them deal with changing their beliefs. Again this can trigger eating disorders, drug abuse or other self-destructive behaviors. This helps numb out the confusion and disappear of denying their feeling and trying to forget their true self. This can cause feelings of depression and anxiety too.

What should parents look for in their teens? If your son or daughter tries to stop wearing his or her glasses or if he or she all of a sudden changes how he or she dresses or acts these are possible warning signs. Another change could be not doing as well in their classes because they are afraid of looking too smart. Basically, if you see signs indicating that your teenager is trying to deny who they are so they will be accepted by others. It’s more than the common issue of trying to be accepted by friends, they are forgetting themselves and beliefs to fit in.

While it is normal for teenagers to make changes in their attitudes or how they dress, we are talking about something that goes far beyond normal self-expression. We are referring to changes where a teenager is trying to deny who they are because they feel they are unacceptable.

This is what we are talking about. If teenagers are changing their hair or how they dress as a way to express themselves that is normal teenage behavior. However, if teenagers are doing it just to fit in and they end up losing a sense of their true self this is camouflaging.

As I stated, Camouflaging results in depression or low self-esteem because the teenager is forgetting their true self. If they are doing it as a way of trying to experiment with their self expression, the teenager is happy and confident as stated above. This is the main point to understand. Experimenting with their dress and beliefs etc. is normal for teens and helps teenagers identify themselves, however denying or camouflaging their feelings results in teens losing themselves and many behavior problems. This is the main thing for parents to watch for in their adolescents behavior.

If you go onto Yahoo and look up Camouflaging you will find a segment on Good Morning America about Camouflaging. In fact, here is the link to the GMA segment https://gma.yahoo.com/video/parents-worry-tween-teen-camouflaging-122935763.html?soc_src=copy. Also if parents look at the February issue of Teen Vogue, you will find an article about Camouflaging.

Dr Michael Rubino has over 20 years experience working with teenagers and their families. Dr Rubino is considered an expert psychotherapist in the treatment of teens. For more information about Dr Rubino and his private practice visit his website at www.rcs-ca.com, www.RubinoCounseling.com or www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Teenagers Respond Better to Discipline

As a psychotherapist who works with children and adolescents, I often hear how their parents are too strict and unfair. Many children and adolescents feel their parents punishments are not appropriate and their parents are out of touch with today’s world. I also hear parents tell me no matter what rules or punishments they impose that their children refuse to follow the rules. While this disagreement has been going on for many, many years, I would imagine with the Coronavirus and teenagers doing school remotely and not able to spend time with friends that the argument has become unbearable for some families by this time.

From my experience, one of the major issues in this situation is the difference between discipline and punishment. Many people may feel there is no difference between the two concepts. However, there is a major difference between the two terms. The difference can determine how many arguments you and your teenager have regarding the issue.

Discipline is used to teach a child or teenager about rules and life. Punishments are used to tell a child or teenager they did something wrong such as breaking a house rule. However, punishments often have no association to the broken rule and often make a child feel like they are bad and they often don’t know which rule they broke. Punishments do not teach they only make a child feel bad or angry. For example, if it was the child’s turn to take out the garbage and they forgot and played their video game online with friends. Discipline would be having them take out the garbage and clean the dinner table for a week and they could not play their online game. A punishment would be that they were grounded and had to stay in their room for two weeks without any electronics. What connection does the grounding have to forgetting to take out the garbage?

Research has shown that discipline is a more effective way to teach children\teenagers about rules and appropriate behavior. The discipline needs to have some association with the rule that was broken. A punishment which tends to make a child think they are bad and has no association to the rule they broke typically teaches a child nothing. What it typically does is make a child feel like they are a bad person and they often don’t understand why they are being punished. All punishment tends to teach some children and teenagers is that they are worthless and they feel unlovable.

I had a fourth grader ask to come to therapy because they were tired of getting in trouble at home. They felt like they were a bad person and he had no idea why he was doing bad things at home on a regular basis. Therefore, the punishments taught him nothing except it did lower his self-esteem. Research also has shown that children and teenagers who feel they are bad people are more likely not to graduate high school and to get involved with drugs and alcohol. They feel they are bad so they feel they should be doing things associated with “bad kids.” They give up trying because they don’t believe anyone will see them as a lovable person who is worth something.

As I stated discipline has been shown to be more effective with children and teenagers. However, before a parent imposes discipline there are important steps for the parent to take:

1. First, the parent needs to let the child\teenager know that they love them and that the child\teen is not bad, but they made a mistake.

2. The parent needs to explain to the child when they made a mistake and what was the mistake. Additionally, emphasizing to the child that they are not the mistake, their choice was a mistake.

3. Explain that they are imposing the discipline to help the child learn from their mistake and hopefully they won’t make the same mistake again.

4. Let the child know when the discipline starts and ends. Also do not make it too long or severe. It should be in proportion to the mistake. It should also needs to be age appropriate.

5. Finally, ask the child if they understand and if they have any questions.

One thing that makes disciplining a child or teenager easier is having a behavior contract. It is important that parents sit down with their child or teenager and develop a behavior contract regarding house rules and expectations a parent has for them and consequences if the child violates the contract. Therefore, if your child makes a mistake, the consequence is already known because it is in the contract. Therefore, it is less likely that the child will feel like a bad person or confused about the consequences because everyone in the family agreed to them. This also makes it easier the mistake was the choice they made not them.

I recommend contracts on a regular basis. The contracts help reinforce the discipline and that choices have consequences. Therefore, the parent is teaching a child to think before they act. Thereby, significantly decreasing the odds that they will make a bad choice. It can also help a child deal with peer pressure because you have already discussed what you feel is appropriate and inappropriate. A contract also help to reduce arguments at home. If everyone agrees to the contract and a teenager violates the contract they cannot blame Mom and Dad for the consequences. Mom and Dad are only enforcing the agreed upon contract. The teenager needs to take responsibility for their choice.

Dr. Michael Rubino is a psychotherapist with 20 years experience treating children and teenagers. For more information about Dr. Michael Rubino’s work visit his website at www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

When Do We Address the Issues Impacting Teens and our Nation?

As we start to re-open the Country issues we have not been paying attention to are reemerging. Those issues are mass shootings and hate crimes directed at people of certain races. This past week 6 South Korean women were killed in Atlanta by a mass shooter. Additionally people died in the hospital. The statistics we have from the Gun Violence Archive for 2019 through November of 2019 indicate there were 336 mass shootings that year.

The official statistics for 2019 indicate1347 people were killed in mass shooting and 1,684 people injured in 2019. Additionally, these statistics don’t account for how many families have been changed forever and how many first responders are dealing with traumatic reactions.

At the beginning of 2020, we started to focus on the Pandemic and were not focusing on mass shootings. We have over 500,000 Americans who have died due to the Coronavirus. Therefore, in addition to people grieving and dealing with traumatic reactions due to mass shootings, we have added over 500,000 American families who are grieving and dealing with traumatic reactions due to the Coronavirus. In addition to family members, again we have first responders who have been emotionally impacted by the Coronavirus virus.

Finally, the other issue we have had going on, but not paying attention to are hate crimes directed at Asian Americans. Donald Trump blamed China for the flu and assigned a racial slur to it. As a result, many Asian Americans have been yelled at, spit on and killed. There are numerous older Asian Americans who have been attacked walking on the streets and have died from their injuries. Again, we are adding to the Americans grieving. We have Americans involved with mass shootings, the Coronavirus and Asian Americans all grieving and dealing with traumatic reactions. We have a tremendous amount of people grieving and coping with trauma in the United States, but what are we doing about it?

In 2019, former President Trump said he would address the mass shootings in the United States. He said we would definitely be taking action and there would be universal background checks. He then made a public statement from the Oval Office that there would be no universal background checks. The President stated the background checks we currently have are enough to keep us safe. He also publicly stated that the people who helped him win the election would not be happy with universal background checks. He had been speaking to the chairman of the NRA that day. Therefore it appears, the money the NRA donated to his campaign was more important than the children of the United States.

The former President initially said he would support sane gun laws and the he decided that the issue was simply a mental health issue. By doing so he did not help the issue and he reinforced the negative stigma about mental health in our country. When he referred to a mental health issue, he called the people “sick” and stated they need to be locked up. The research clears shows that people with mental health issues pose a danger to themselves by cutting or committing suicide. The research clearly shows that people with mental health issues are rarely dangerous to society. The Director of the American Psychiatric Association issued a statement stating the same information (2019).

Mental health issues are not the primary reason for mass shootings, hate is the primary issue. In fact the FBI was able to arrest three men planing mass shootings. One of the men arrested issued a statement that he was planing the shooting because he hated anyone who was not white. He was also at the Charlottesville protest and stated to a reported he believed in only a nation for white people and was advocating killing anyone who was Jewish. This man is not being labeled as mental ill. He is being charged with charges related to a Hate crime. Again in order to be charged with a Hate crime you must be attacking someone because you hate them due to their ethnicity, religion, sexual orientation etc. The Klu Klux Klan has held rallies and have been accused of killing people for years, but no one in the group is labeled mentally ill. The KKK is labeled as a hate group.

As children start to resume going back to their schools and they come into my office saying they are afraid of returning to school due the mass shooter drills and the possibility of a mass shooting, what do I say to them? How can I say we are doing everything we can to protect them, when our government is not doing anything. We have not passed any sane gun laws. How can I say don’t worry when every day in 2019 there was a mass shooting and more students were killed at a school? Children today also hear the news easily and they will know that I am lying. Remember, most teenagers and middle school students have access to the news very easily because the news updates pop up on their phones. In order for therapy to work, the children and teenagers need to trust me. If I lie, they will not trust me. Again, with the issues I cited for this year alone, how can I tell a child there is nothing to worry about.

The other issue is how do parents get children and teenagers to come to a psychotherapist’s office. Former President Trump has been on national television stating all mass shooting is due to mental illness. He refers to the people as “sick puppies” and that they need to be “locked up in asylums.” Teenagers and children will be worried that their parents are taking them to my office to be locked up. Many teenagers need psychotherapy for mental health issues such as depression. According to the CDC, one out of five children need psychotherapy. Anxiety disorders and depression have increased significantly during the Pandemic. Cutting is also at epidemic rates in teenagers and children. I have children as young as 10 who self- mutilate. Also suicide was the third leading cause of death for kids 10 to 18 years old. In the last few months, the CDC changed suicide from the third leading cause of death to the second leading cause of death. There are many children who need psychotherapy, but will be afraid of being locked up or called a “sick puppy” by their friends and they will fight their parents about going to therapy.

Also what about the people who experienced a mass shooting or lost a loved one to the Coronavirus, their family and friends and the first responders, their lives have been changed for ever. They are going to need years of psychotherapy to cope with their PTSD. However, besides being labeled as a victim, they are not going to want to be looked at as a “sick puppy” because they need therapy. This is what they will think and feel because of how the former President and republican senators have responded to mass shootings and such things as masks. We already have survivors of mass shootings and the Coronavirus committing suicide because they cannot stand the pain associated with their grief. We have seen the same thing from veterans committing suicide because they did not have access or were embarrassed to seek psychotherapy. When will we learn? When will we stop demonizing mental health?

Since the former President refused to act, we need to learn from the high school students from Parkland, Florida shooting and take action ourselves. Remember by acting you may be saving the life of your child or a loved one. Call the Senators for your state and demand sane gun laws and if they are too afraid of the NRA, you will vote against them in the next election. Next, demand they make decisions about the Coronavirus based on the medical experts. Several states reopened for Spring Break even though public health experts said it was too soon. The result, Florida again is seeing a significant increase in the number of Coronavirus cases. Finally, demand that Congress take steps to protect Asian Americans.

There have already been 3,800 Asian Americans attacked this year and most victims were women (NBC news). These number is probably lower than reality because most Asian Americans tend not to report these attacks to the police because they fear for their safety. A majority of the victims are older and many of them were killed. Why have Asian Americans been attacked so often this year? The former President Trump has blamed China for the Coronavirus. Many of his followers have misinterpreted Trump’s racist remarks as a reason to blame Asian Americans for the Coronavirus Pandemic. This is absurd because there are strains that came from Europe in addition to China. The Asian Americans did not create or cause the Coronavirus and they are Americans just like the rest of us are Americans. Therefore, they are entitled to the same rights and protection. However, most Asian Americans are now worried about their grandparents leaving their houses. Again we have more Americans grieving and dealing with traumatic reactions. When are we going to learn that we are all in this together and need to work together to solve these issues?

No American should be afraid to go outside because they may be shot, catch a deadly virus or attacked because of their ethnicity. We have a number of Americans who are suffering emotionally and need professional mental health care. We need to focus on providing mental health care to those who are in need of it and also how we are going to work together to solve our issues in the United States.

Some people will say I have no right to be writing this article. However, I see and hear the kids crying daily because they are afraid of being killed or their parents being killed. I also am trained in Critical Indent Debriefing, certified as a first responder therapist and specialize in treating trauma victims. I am tired of hearing how the first responders lives are being changed and the night terrors they experience. I am not afraid of the NRA stopping sane gun laws. We have a huge problem with hate and race in our Nation that must be addressed. Also we also do not have adequate mental health services in our Nation. This is why the suicide rate went from the 3rd leading cause of death to the second leading cause of death for kids. Mental health issues are not causing the mass shootings! If it was we would have had the problem in the 1970s and 1980s, but we didn’t.

Dr. Michael Rubino is a psychotherapist with over twenty years experience treating children and teenagers. He is also trained to treat victims of trauma, he is certified as a first responder therapist and to do Critical Incident Debriefing. For more information regarding Dr. Rubino visit his website http://www.RubinoCounseling.com or Facebook page www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Teenagers are Using ADHD Medications to get High

Working with teenagers, I often have parents who are concerned about their teenager using marijuana or alcohol. Besides the concern that their teenager may be using drugs or alcohol, they are concerned about their teenager becoming addicted. Besides marijuana and alcohol, parents are concerned about methamphetamines and heroin. Currently there is an epidemic of teenagers addicted to methamphetamine, heroin and opioids in the United States (CDC). While parents worry about opioids, methamphetamines and heroin addiction in teenagers, there is another drug parents need to be concerned about. Parents need to be concerned about the drugs children and teenagers take for Attention Deficit Hyperactivity Disorder (ADHD).

Methamphetamine is a very popular drug because it is easy to get and there are a number of ways to use it. Also many teenagers like the effect that they receive from methamphetamine. They get an adrenal rush and can stay up for days at times. Therefore, it makes it easier for them to get all their work done. Many teenagers are involved with numerous school activities, trying to maintain a good grade point average and want to spend time with their friends. They often find out that they don’t have enough energy to keep up with their schedule. The boost they receive from the methamphetamine helps them keep up and get everything done. However, buying methamphetamines can be a dangerous thing to do and if they are caught with methamphetamines, they are in a lot of trouble.

Many teenagers do not want to run the risk of being caught with or buying methamphetamines. Therefore, teenagers have found away around the risk, medications for Attention Deficit Hyperactivity Disorder (ADHD). Most medications for ADHD such as Ritalin or Concerta are stimulant based. In other words, they contain a form of methamphetamine. Therefore, if a high school student who does not have ADHD takes Concerta, they experience the same effect as if they took methamphetamine such as cocaine. They get a burst of energy and can stay up all night so they can finish their work.

During finals, I hear many teenagers talk about taking Concerta or other ADHD drugs so they have the energy to study. Some teenagers will tell their parents they are having difficulties concentrating hoping their parents will take them to the physician so they can get a prescription for ADHD medication. On the other hand, teenagers who are suppose to be taking medication for ADHD often sell their medication. They can sell it very easily to friends at school and they can make good money too. Many of these teenagers feel they don’t need their medication so they are happy to sell it.

The buying and selling of ADHD medications on high school campuses is a daily occurrence. Most research studies indicate it starts in 8th grade and continues in high school. Many teenagers rely on ADHD medications to help them when they feel they are falling behind in school. Many teenagers see no problem using the ADHD medications because they were prescribed by a doctor. However, they were not prescribed to them. Therefore, the dosage they are taking may be too much for their body. Also I have seen teenagers combine these medications with energy drinks which have very large amounts of caffeine. I have had teenagers report they felt like their heart was going to come out of the chest because it was beating so fast. In addition, they also report not being able to sleep for days because they are wired.

This is a major danger when teenagers use ADHD medications to stay awake. They can become wired the same way as if they used cocaine or smoked methamphetamine. Also taking these ADHD medications opens the door to teenagers experimenting with such drugs as cocaine. They like the effect of the ADHD medication and wonder how other drugs may feel or may be they can no longer get the ADHD medication so they start experimenting. In fact, research indicates that teenagers who abuse ADHD medication are more likely to use methamphetamine or heroin.

In addition to opening the door to other drugs, they are risking their health and life. If they heart rate is racing and their blood pressure is rising they can induce a heart attack. Also parents may notice there is something wrong, but if they do not know their teenager has been taking ADHD medication, there is no way for a parent to tell a physician. Therefore, the teenager may not get the medical help they need. In addition to the physical symptoms, using too much methamphetamine can cause psychotic symptoms and the teenager may need to be hospitalized. The bottom line is just because the ADHD medication came from a pharmacy does not make it safe for everyone. I have included a link for parents which discusses the dangers and symptoms that parents need to be aware of regarding teenagers abusing ADHD medications https://drugabuse.com/library/adderall-abuse/#effects-of-adderall-abuse.

Hopefully, parents can take this information and discuss the situation with their teenagers. Encourage them that if they are feeling overwhelmed by school and life to talk to you not to turn to a drug. A drug will never solve the problem and more likely create more problems. Also let your teenager know all you expect is the best they can do naturally. You do not expect perfection.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and children. He is a founding member of the National Advisory board for the Alive and Free program. For more information regarding Dr. Rubino’s work or private practice visit his website www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3.

Teenage Body Issues Associated with the Coronavirus Pandemic

Many adults and teenagers are currently concerned about their weight due to the Coronavirus Pandemic. For a year most adults and teenagers have been confined to their homes. Teenagers have not been able to participate in their normal sports or go to the gym like they are use to doing. Now many of us are concerned due to the Coronavirus Pandemic, however, many teenagers worry about their weight all the time. In fact, the last week of February is National Eating Disorder Awareness week. It’s sad to say, but eating disorders have become so prevalent that we designate a week of the year to focus on the issue.

Here are important facts about eating disorders everyone needs to know. Eating disorders and body image issues are a major problems for teenagers. Despite what most people may think, these issues impact girls and boys. Most people assume eating disorders only impact girls, but they impact boys too. Boys worry about their abdominal muscles and having the “six pack” look and how strong they are compared to other boys. Also for some sports such as wrestling they must make a certain weight to compete. Therefore, they worry about their weight. Many boys may not eat or over eat before a wrestling match so they can make it into their weight class. So eating disorders impact boys too.

Looking at the prevalence of eating disorders in teens can be very difficult. Some people break the statistics down to diagnoses such as anorexia. While some focus on under eating, teenagers who over eat can also have an eating disorder. Another classification is unhealthy eating that many teens engage in. Some may skip meals or some may consume to many calories to make weight for their sport and then go days without eating. Therefore, eating disorders can take many shapes and forms. Overall, it is estimated that eating disorders impact 5% of female teenagers and 1% of male teens (NIMH). However, the number for males is considered to be under reported. This assumption exists due to the belief many people have that eating disorders only impact girls. Therefore, there is an assumption that the 1% for boys is an underestimate due to under reporting. Working with adolescents I am sure the 1% is incorrect. I hear many teenage boys complain about their bodies or needing to make weight for their sport. I also hear things they do such as only drinking water a week before a weigh in or loading up on protein drinking before working out. What they report may not fit the picture of anorexia we have, but it definitely is not healthy and is involved with body image. This is a major factor in all eating disorders whether it be anorexia or over eating. Furthermore, since many teenagers have been at home during the Pandemic with nothing to do, many have been eating because they are bored. Many teenagers have complained about eating too much or eating unhealthy foods, but they also say they are very bored due to the Pandemic and there is nothing else to do.

One reason I’m addressing this subject is as I stated above most people assume that eating disorders do not impact boys. Eating disorders impact boys and teens from every economic level, ethnicity and religion. Additionally, we have all had to deal with the boredom caused by the Pandemic and many people have been eating because they are bored. Therefore, eating disorders are equal opportunity disorders. Another reason I’m addressing this issue is suicide is the number one mental health issue killing teenagers in our country. Eating disorders are the second leading mental health issue killing teenagers. It is estimated that every 62 minutes someone dies from an eating disorders (NIMH). The death may occur after someone has received treatment and is considered in recovery. Eating disorders take such a toll on teenage bodies they may die even though they are considered to be recovered. The singer Karen Carpenter is a prime example. She struggled with an eating disorder for years and struggled with treatment too. However, she finally reached a point where she was considered recovered from her eating disorder and started to resume her life. Unfortunately, she died suddenly one day from a heart attack. The toll the eating disorder put on her body weakened her heart severely. So severely that it caused her to have a heart attack even though she was in recovery.

This is a very sad story and fact. We can avoid these issues by early diagnosis and treatment. We also must realize that eating disorders impact boys too. If we are not aware of this fact, we are not addressing the entire problem. We need to address how our society look at men’s bodies and women’s bodies and the expectations we place on both genders. No one can live up to the female and male stereotypes we have created. In order to change these stereotypes we need to start with teenagers and provide them with enough self-esteem to reject the stereotypes.

As I stated early treatment is necessary. To have early treatment we must have an early diagnosis. I have included a link to a video by Dr. Pooky Knightsmith which discusses the ten common warning signs of an eating disorder in teens and children, please watch this video https://youtu.be/nKwbE8mP_PA.

If your teen or child displays any of these warning signs, if they are discussing gaining too much weight due to the Pandemic or, if you feel your teen maybe struggling with an eating issue, make an appointment with an adolescent psychotherapist who specializes in adolescents and eating disorders. Do not feel ashamed or embarrassed. A mental health issue is no different than a physical health issue. We only believe their is a difference due to the stigma we have created. However, keeping this stigma is endangering the lives of many teens so help your teen and ignore the stigma. Help them deal with their health issue.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and children. He also treats teens including boys with eating disorders. For more information about his work and private practice visit his website www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Looking at the Issue of Teenagers Cutting

Today’s teenagers are under a great deal pressure. In fact, according to the CDC, 1 out of every teenager has a diagnosable mental health issue. In addition, depression, anxiety, drug overdoses and suicide are currently at epidemic rates for teenagers. In fact, suicide was the third leading cause of death for teenagers and now it is the second leading cause of death (CDC). Furthermore, cutting or self-harming behaviors are also at epidemic rates for teenagers (CDC). Self-harming behaviors include teenagers cutting themselves with knives or scissors in addition to scratching themselves severely and sometimes teenagers may even use erasers to erase their skin and cause sores. These are only a few examples.

Ten years ago if I asked a teenager if they were cutting or had ever cut, once in a while I would get an answer of yes. Today when you ask teenagers about cutting most teenagers answer yes. In fact, it’s no longer just teenagers. Children as young as 8 or 10 years old often respond yes to this question. This is alarming, but it is evidence of the amount of emotional pressure these kids have to deal with today.

When you ask a teenager about cutting behavior, they usually respond it was easier to deal with the physical pain than the emotional turmoil they were dealing with inside. Others will say the cutting takes their mind off of the emotional situation and others even say it makes them feel human. So as you can see there are numerous reasons, but teenagers are also very embarrassed and ashamed about the cutting behavior. If I am treating a teen who is engaging in cutting I must be very sensitive and non-judgmental about the behavior if I’m going to help. In addition, the family needs to be non-judgmental as well. Teenagers do not cut for the attention and as I stated above they are embarrassed about their behavior. If they sense that someone is viewing them in a negative way, they will not talk about it. Additionally, teenagers who are engaged in cutting hide their cuts so no one will know about their behavior.

Therefore, when treating or dealing with a teenager who is cutting you need to be patient and non-judgmental. Remember they are resorting to this behavior because it is the only way they are able to deal with the emotions they are feeling and the situations they are facing. Life today can be very overwhelming and often teenagers are not prepared for what they have to face in life and they are embarrassed to ask for help too. Often they are embarrassed because our society looks down on people dealing with mental health issues. I recently had a 13 year old ask me, why don’t we place more emphasis on mental health so people can get the help when they need it? A very good question to ask. Our society has a very strong negative stereotype regarding mental health and therapy. As a result, it is very difficult for teenagers to ask for and receive the mental health care they need.

After being treated for cutting, many teenagers are still embarrassed and feel awkward about their past behavior. Many times teenagers are left with scars on their bodies from cutting. Most families cannot afford plastic surgery and insurance will not cover it, even though it is a mental health need and in my opinion should be covered. The point is many teenagers continue to feel embarrassed and ashamed of the scars years after they have stopped cutting. Below is a blog from a teenager who discusses how they feel about their scars and people’s reactions. It also may help give you some insight to what teenagers are going through these days and how many of them are feeling overwhelmed by life. Instead of ignoring their cries for help we need to figure out how we can help them without making them feel embarrassed or crazy.

My self-harm scars are “hideous.” I’m covered in them. Head to toe. No amount of time, no amount of fading will make them unnoticeable. That doesn’t mean I hate them. It doesn’t mean I’m embarrassed by them. I am aware that they make other people uncomfortable and there are times, when out of respect for others, I will cover them. There are other times when I won’t cover them. Whether I choose to cover them or not, I don’t feel that I should have to explain my choice. If I choose to cover them, it doesn’t mean I’m ashamed or feel forced to cover them. If I choose not to cover them, it doesn’t mean I want attention.

I regularly see people comment on social media saying, “If you make a public post people have the right to say whatever they want.” Apparently this entitles people to be nasty and judgmental. It excuses them from filtering what they say and think. It exempts them from extending basic decency and courtesy to others.

I’ve heard the same said about people who walk around with self-harm scars exposed. No. Just because you can see my scars doesn’t give you a free pass to say what you want. You don’t get to say, “You’re too pretty for that.” You don’t get to say, “You’re too smart for that.” It doesn’t matter whether you know me or not. They are my scars from my battles. Even if you know me, I can guarantee you won’t know all about my battles. You won’t know my darkest moments or thoughts. If you’re a stranger? What could you possibly think you know about my life? You don’t get a say on what my scars look like. You don’t get a say on whether or not I’m too pretty, too smart or too strong for that. You don’t get a say on whether or not I cover them.

Yes, you can see them. Yes, they are “hideous.” Look away. Walk away. Think about it by all means. Talk to someone else about it. If you’re game, educate yourself on it. Take responsibility for what you are doing. Take responsibility for what you are saying. Yes, you can see my scars but that doesn’t make me responsible for your reaction.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers. In addition, he specializes in treating victims of trauma and first responders. For more information about his work or private practice visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

The Pandemic can Cause Children to act like they have ADHD

Many schools are starting to reopen. Also there are still schools operating remotely still. Either way many parents are tired about fighting over homework or telephone calls from school that about the fact that their child is not doing their homework again. As a result, some schools and family members may be suggesting to parents that their child has ADHD and needs medication. Many parents are not sure about the diagnosis and they are concerned about their child taking ADHD medication. I hear this very often from parents and do many assessments on children to determine if a child has ADHD. Yes ADHD is a really disorder, but too many teachers and schools rush to the conclusion that a child has ADHD and needs medication. Additionally given everything children have been through with the pandemic and remote learning, we need to be very careful about labeling a child with ADHD. There are a number of other options such as depression, anxiety and boredom.

According to statistics by the American Psychological Association, five percent of children in the United States have ADHD. It is also more common in males and it does tend to run in families. According to the CDC 15.9% of boys and 5.6% of girls have ADHD. However, not every child who has ADHD requires medication. Many children can be treated with psychotherapy and behavior modification. Therefore, if your child is diagnosed with ADHD do not rush to medicate your child. There are different subtypes of ADHD and different severities of the diagnosis.

If you child does have ADHD, they are entitled to accommodations such as extra time taking a test. It’s important to get them the accommodations they need. Children who have ADHD, but do not receive accommodations tend to show signs of low self-esteem around the fifth grade. These would be covered by a 504 plan. However, if your child has severe ADHD and needs resource assistance too, they are entitled to an Individual Educational Plan (IEP). Many schools may tell parents ADHD does not qualify for an IEP. This is not true. The severity of the ADHD determines if a child needs an IEP. They would qualify under the categories of Emotional Disturbance or Other Health Impairments.

If you feel your child may have ADHD or their school suggests the idea, make sure you have your child appropriately assessed by a professional who specializes in ADHD. In the past schools would often diagnosis children with ADHD. Schools are no longer supposed to make this diagnosis. If they feel a child might have ADHD, they are supposed to have your child evaluated. Many parents take their child to their pediatrician, however, many pediatricians are not trained in diagnosing ADHD. I would suggest having your child evaluated by a mental health clinician trained in working with children and in assessing for ADHD.

As I stated above, if you are going to have your child evaluated for ADHD, make sure you take your child to a mental health clinician who specializes in children and in doing assessments. The assessment for ADHD is not very difficult and an appropriate evaluation by an appropriate mental health clinician should cost around $250 depending on where you live. I have seen some parents who have spent thousands of dollars getting CT scans, MRIs and PET scans. You do not need an expensive scan of your child’s brian to diagnosis ADHD.

The DSM V, the diagnostic manual that mental health clinicians use, list the criteria needed for the diagnosis. I am including a link to the Center for Disease Control which list the criteria for the diagnosis and other information about ADHD, http://www.cdc.gov/ncbddd/adhd/diagnosis.html. Typically the diagnosis can be made by a clinician interviewing the parents, having a play session or two with the child and observing the child at school or consulting with the teachers. However, remember if you are going to have your child evaluated for ADHD, you want a mental health clinician who specializes in treating children and assessing children for ADHD. Your child’s pedestrian should be able to refer you to someone or if you call your insurance they will probably have referrals.

Before you rush to have your child assessed, remember some basic facts. Most children between the ages of two to five are very active. They also have very short attention spans. Sometimes you need to give a child some time to mature especially if you have a boy. Remember boys mature slower than girls and tend to be more active than girls. It is important to keep these facts in mind when you are wondering if your child has ADHD.

Now if you child is more hyperactive than other kids his age or his attention span is shorter than most kids his age, there might be an issue. Also if there is a strong family history of ADHD in the family such as his father had ADHD as a child and paternal and maternal uncles all had ADHD as children, there might be an issue. Also if your child was born premature or there were complications during the pregnancy or child birth, there might be an issue. Premature babies or babies with a difficult pregnancy or birth are more likely to have ADHD and learning disabilities.

Bottom line, if someone suggests that your child has ADHD don’t rush to the pedestrian seeking medication. Compare your child’s behavior to other children and consider the risk factors. If your child doesn’t have many risk factors for ADHD maybe wait six months and reassess the situation. The most important thing to remember is if you decide to have your child assessed for ADHD, make sure you go to a mental health clinician who specializes in children and ADHD. You want a mental health clinician who specializes in treating children with ADHD and assessing children for ADHD. Also remember you do not need any expensive scans like a CT scan. There are other treatment options besides medication, so do not rush to medicate your child either. Consider all the treatment options.

Dr. Michael Rubino specializes in treating children and assessing children. He has over 20 years experience treating and assessing children and teenagers. For more information about Dr. Michael Rubino’s work visit his websites at www.rcs-ca.com, http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple.

Dr Michael Rubinio

Understanding Your Teenager

Month: March 2021