Issues related to Teenage Concussions

Issues related to Teenage Concussions

Many high school students look forward to participating in high school sports and other physical activities as part of their high school experience. While school may be ending for the year, many athletes will be practicing over the summer for next years games. Football is one example of a sport where the players practice the entire summer in order to be ready for the next school year’s season. Typically most people look at the fun and the positive experience these activities provide for students. However, high school athletes do get hurt, sometimes seriously. High school athletes do suffer broken arms and legs, but they also suffer concussions, traumatic brain injuries and spinal cord injuries. Parents are now learning that “basic” concussions in teenagers are more common than people think and can create more problems that people think. A concussion can cause physical impairment such as not being able to walk or emotional issues such as a teenager suddenly having anger problems or depression. Unfortunately, this year we had example of these issues, when a wrestler from College Park High School suffered a spinal cord injury and was paralyzed.

As a result of these head injuries, many teenagers develop Post Concussion Syndrome after a concussion. Teenagers can have violent mood swings, difficulties concentrating and with memory. This can cause problems at school and with family and friends. I have seen teenagers who get so depressed by these changes that they become suicidal. Post Concussion Syndrome can last a year and often physicians do not warn parents or teenagers about this syndrome. This makes matters worse because they feel like they are crazy because they don’t understand why they have the symptoms. Also these symptoms can create problems at school that the student may need accommodations for in order for the student to understand the classes.

We have been hearing more and more about concussion in professional sports in recent years. We have also seen professional athletes walk away from their careers because they are not willing to risk the after effects of multiple concussions. A fact that some in professional sports do not want to be publicized. Will Smith stared in a movie regarding a professional football player and how his life significantly changed after several concussions. The National Football League tried to stop this movie from being made and shown, but they lost.

However, we do have examples. Mohammad Ali is the most notable example of how multiple concussions can change a person and leave them disabled. Also a news anchor for ABC News documented how his life changed after receiving a traumatic brain injury while covering the war in Afghanistan.

Concussions, Traumatic Brain Injuries and Spinal Cord Injuries also occur in teenagers. Teen athletes such as football players routinely suffer concussions, traumatic brain injuries or spinal cord injuries. Many of these athletes suffer permanent brain damage such as difficulty remembering things or emotional issues such as mood swings. Also a number of high school athletes do die from concussions every year.

A research study from Boston University released shows that boys who play football before the age of 12 years old are more likely to have memory problems and problems making decisions as adults. This study also shows that boys who play football before age 12 are three times more likely to develop clinical depression as an adult. The study suggests the reason this occurs is because around the age of 12, a child’s brain is undergoing a great deal of development at this age. Robert Stern, one of the authors of the study, explained that “the brain is going through this incredible time of growth between the years of 10 and 12, and if you subject that developing brain to repetitive head impacts, it may cause problems later in life.”

Another MRI study, by the Wakes Forest School of Medicine, showed that boys between the ages of 8 years old to 13 years old who played even just one season of football showed signs of diminished brain function.

High school athletes are not the only teenagers at risk for concussions or other serious injuries. Teens in general are at risk because teens are willing to engage in risky behavior such as jumping off something or racing cars. Many teens feel they are safe. They hear about these issues but think it would never happen to them. However we never know who it will happen to. Therefore, parents you need to educate and monitor your teenager’s behavior. If you have a teen athlete, you may need to make the decision to stop them from playing a sport if they have suffered a couple concussions. This is not easy but you must think of their lives after high school.

Also boys are not the only ones at risk for concussions. Girls are at risk for concussions and other serious injuries. In fact, some studies show that cheerleaders are at a higher risk of getting a concussion than football players. Cheerleaders do not use helmets and have no head protection. Also many people assume a child needs to be knocked out in order to sustain a concussion. This is not true. You can sustain a concussion without losing consciousness. So football players are not the only one at risks. Any high school athlete is at risk – boy or girl. Anything that causes a jarring of the head can cause a concussion. Our brain sits in fluid in our skull. Therefore any jarring force can cause the brain to hit the side of the skull and cause a concussion. This is why all high school athletes are at risk for concussions.

I have included a link to a YouTube video where a physician describes the basic information about what happens to a brain during a concussion and the process of recovery from a concussion. This is a must see for any parent https://youtu.be/zCCD52Pty4A.

In addition to this video I have included a fact sheet from the CDC regarding information about concussions for you to review http://www.cdc.gov/headsup/pdfs/schools/tbi_factsheets_parents-508-a.pdf.

I have also included this link from the CDC which helps parents, coaches and schools https://www.cdc.gov/headsup/.

Parents need to talk to their teenagers’ school and coaches regarding making sure that they use the latest safety equipment for their sport. Parents may even want to research what the latest safety equipment so if your teen’s school is not using the latest safety equipment, you can inform the school. The ultimate goal is we want high school sports to be fun and safe for high school students.

Dr. Michael Rubino has over 20 years experience working with teenagers and their families. For more information on Dr. Rubino’s work or private practice, where he treats Post Concussion Syndrome, please visit his website at http://www.RubinoCounseling.com or follow him on Twitter @RubinoTherapy.

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20 years After the Columbine Shootings

20 years After the Columbine Shootings

This week marks the 20th anniversary of the Columbine High School shooting. Unfortunately, we have not changed many gun laws and the mass shootings continue. On the 17th anniversary ABC interviewed the mother of one of the shooters about the warning signs she missed. If it was only that easy, but it is not. A great deal was missed by many and there is plenty of blame to go around. The parents did not create the Columbine shootings, but they must live the rest of their lives with what their sons did that day.

First in our society, there is a huge negative stigma regarding mental illness and psychotherapy. I see many teens who would benefit from psychotherapy, but the teenager resists because only “crazy” people go to therapy and they are not crazy. The parents often don’t force the teen to go to therapy because, “he is too big for me to force him to come”, or “if he is going to go I want him to want to go. I think forcing him may cause more damage.” So parents are allowing teens to make the decision about psychotherapy because people believe it is not that important unless you are crazy. If their son’s pedestrian said their son needed surgery, the parents would not allow their son to decide about having or not having surgery.

Another issue facing parents is that belief that only crazy people go to therapy. They don’t want their child or family to be seen as the “crazy one or the weird one.” In these situations, I often hear well we will think about it and try changing things at home and if we feel we really need help we will call. Typically, I receive the call when their son is in juvenile hall for a number of crimes. They are calling too late.

The other problem is the school systems. I work with parents who are reporting symptoms of depression and their son feeling overwhelmed by school or being bullied at school. They ask the school for help, but the school acts like the parents are over protective. When I become involved and let the school know the student needs help and will need an IEP (Individualized Educational Plan), the school down plays the behavior or blames the parents. They don’t want to do an IEP because it will cost the school money. I have seen schools tell parents all kind of lies to avoid giving a student an IEP and what the school is forgetting is the help the student desperately needs.

Finally, our health care system is to blame also. One Thanksgiving Day, I was paged by a parent I never met. She had been given my number by the County Hospital. She brought her son there because he was suicidal. The hospital told her they had no more beds for suicidal teens and could not help. She had my service page me begging for help. Her son definitely need to be hospitalized. There was nothing I could do on an out-patient basis. I gave her several numbers to hospitals in the areas and told her if all else fails go to an ER room because they cannot refuse to treat.

I have seen this with other teenagers that I have treated. Parents are begging and pleading for help. Their insurance company won’t pay for in-patient treatment or only pay for two weeks when it is a 60 day program. The cost for the treatment programs is often $10,000 a month. A price most families cannot afford. At times when they do receive the insurance authorization, they cannot find an in-patient program with an opening because there are not many of these programs. These parents are doing everything they should but because of society’s view point that mental illness is not real, they find it very difficult to get their children the help they need.

A good example is the shooting at UC Santa Barbara. The parents knew their son had emotional issues and had been trying to get him help. When he went to school in Santa Barbara and his mother found a file on his computer, they knew people were in danger. They called everyone they could think of but were dismissed as over reacting.

An act such as Columbine doesn’t happen because one parent ignored symptoms. An act such as that occurs because parents, friends, family, teachers, school and our mental health system missed warning signs and failed to make the teenager get help. Mental health does deal with life and death situations not just someone crying. Mental health issues are just as serious as what occurs any Friday night in ER rooms in hospitals all over the country.

ABC asked the mother to look at herself, I am asking you to look at yourself and our approach to mental health. Columbine happened 20 years ago and every year since we have had more school shootings and more deaths. When ABC News interviewed the mother of the shooter in 2016, according to the CDC, we already had more students deaths by school shootings in 2016, than in the preceding 17 years. In one year more deaths than when you add up the preceding 17 years. This is a very scary, and sad statistic. We need to look at ourselves and ask, what are we going to do to help prevent these senseless killings, not the mother of the Columbine shooter. We as a society must change. The life you save may be your own or your own child’s life. New Zealand showed us that change can occur. Within three weeks of the shooting, all assault weapons had been banned in New Zealand. It’s 20 years later and the United States has done very little to implement safer gun laws. However, we do terrorize school children by undergoing routine mass shooter drills. What are our priorities?

Dr. Michael Rubino specializes in treating high risk teenagers, and teenagers and children who have survived traumatic events and their families. For more information on his work or private practice visit his websites at http://www.RubinoCounseling.com, http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/drrubino3.

How Much Time Should A Teen Spend Online?

How Much Time Should A Teen Spend Online?

A common argument I hear daily in my office is how much time should an adolescent be spending on their laptop or their smart phone. Parents typically believe that their adolescents are spending too much time on their cellphones and laptops. Of course adolescents feel that their parents are being unfair and not allowing them enough time on their cellphones or laptops. Adolescents typically say they need their laptops and cellphones for homework and to communicate with their friends. They feel that their parents don’t understand how the world works today.

In fact 20/20 the ABC News Show, just did a story about how the internet is affecting teenager’s brains. We now have MRI evidence which demonstrates too much screen time has a negative effect on teenage brains and adult brains. They also discussed the issue of Internet addiction. While the American Psychological Association feels more research is needed before it can be labeled a formal diagnosis, think about it? If you can be addicted to porn, gambling or exercise, why not the Internet? I have included a link to a video discussing how the internet is impacting teenagers’ brains https://youtu.be/6Ggz9h7S4b4.

The major problem is that today’s adolescents have grown up with the internet, laptops and smart phones their entire lives. Texting is a very common method of communication for teenagers too. I have teens telling texting is their primary way of communicating with friends. However, most parents grew up when laptops could not do as much and cellphones were typically only used for making a telephone calls not texting. Therefore, there is a difference of opinion regarding how teenagers should use technology and how their parents have used technology over the years. Especially, because when most parents were teenagers themselves technology was not so prevalent.

Besides parents and teens having different views about technology. Parents are worried that their teenager is becoming addicted to the Internet and their cellphones. Having seen how some teens react to having their cellphones or the Internet taken away, I can understand why some parents feel their teenager is addicted to the Internet.

However, parents have additional concerns too. Parents are concerned that with all the texting teens do and all the time they spend on the Internet that their teens are becoming anti-social. Other concerns are the amount of bullying that occurs online, the sexual perpetrators that are online and how easy it is for teens to obtain drugs online. Another concern is that their teen may be involved in sexting or sending naked photos of themselves while on line. Sexting is a relatively new phenomenon so we don’t have a great deal of information regarding it.

However, we do have evidence to support parents’ concerns. There are numerous examples of cyberbullying and examples of teens commuting suicide due to cyberbullying. There is evidence of child predators using the internet to prey on teenagers. There is also evidence of teenagers being able to access drugs easier and engaging in sexting and sending sexually explicit photographs of themselves via the Internet and texting.

Therefore, there are reasons for parents to be concerned. While there are research studies which indicate that there are reasons to be concerned about how much teenagers use cellphones and go online, there is also research showing there is reason to be concerned about what teenagers are exposed to online and can access online. Some studies do conclude that teenagers spend to much time daily online and on their cellphones. Some studies indicate that teenagers should be limited to one to two hours per day online. As I stated above, the American Psychological Association is considering including a diagnosis of internet addiction in the Diagnosis and Statistical Manual. However, because the amount of people using cellphones and the internet in numerous ways, there is no agreement about what defines an addiction and what is normal usage. Therefore, parents are encouraged to monitor their teens and use their own judgement regarding rules involving cellphones and the internet.

While, there is research indicating that the internet can pose a danger to teenagers, there is also research showing that there are benefits to the internet and cellphones. The research has shown that teenagers who are depressed, anxious or questioning their sexuality that they can find cites online where they can talk with other teens feeling the same way. Texting has been shown as a way friends have of identifying friends who are suicidal. Because of the Internet, they were able to get their friend help. In fact, just this week, Facebook has added additional ways that people can get help for someone especially if they feel their friend might be suicidal. Many teens I work with find it easier to open up to friends or parents via texting or emailing at times. Therefore, while research shows there are reasons to be concerned, there are also studies indicating that cellphones and the internet can provide positive benefits to teenagers.

So, what do parents do? At this point there are no firm answers because this technology is so new. Therefore, parents need to pay attention to the news and research studies that are being reported. Furthermore, parents need to have conversations with their teenagers and educate their teens about the risk associated with texting and the internet. Also parents need to use their judgement and set rules regarding cellphones, texting and using the internet that they feel are appropriate. Currently, the accepted amount of time for a teen to be online recreationally so for fun and this doesn’t include homework is one to two hours a day.

Another issue is that Internet addiction may also affect adults. Therefore parents, you need to monitor your internet use and set an example for your teenagers. Such as no cellphones during dinner or no cellphones or Internet use after 9pm during the week. These are a couple of examples.

As for treatment of Internet addiction. The Utah Wilderness Camps they showed on 20/20, I do not recommend. These camps typically costs thousands of dollars and are not covered by insurance. Also so far, I have not seen a teenager benefit from attending one. In my opinion, individual psychotherapy is appropriate. Because just like any other addictions/compulsion, there are always underlying emotional issues that need to be addressed. A camp seldom addresses the underlying emotional issues.

Dr. Michael Rubino is a psychotherapist who specializes in treating children and teenagers. Dr. Rubino does treat teens and adults who feel they are addicted to texting or the internet. For more information about Dr. Michael Rubino’s work or his private practice visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/drrubino3.

Children Are Not Mail Boxes

Children Are Not Mail Boxes

As a child psychotherapist, I hear from many parents about their concerns for their child when there is a divorce. A divorce is a stressful event on the entire family including the children. However, there are ways parents can reduce the stress, but they do not. The most common mistake I see is using the child as a messenger.

Many divorces are hostile and neither parent wants to speak to the other one. However, when you have children, you must speak to each other. You need to co-parent which means communicating with the other parent. You do not have to talk about your lives or even be friends. However, you must communicate with the other parent about issues involving your children. You need to provide each other with information about school, your child’s health, if they have an activity coming up, etc. Basically, anything that involves your child.

However, I see many parents choose to use the child as the message carrier. They tell the child do not forget to tell your father to look at your homework or tell your mother to look at the note regarding your school conference. Many of these children are 10 years old so they forget or get the message wrong and then there is a big fight. The child blames themselves because if they did not forget, there would be no fight.

This is a great deal of responsibility to put on any child at any age. When parents use their child as a messenger, at times children feel they have to take sides or protect a parent. They know mom and dad do not get along and they will do anything to decrease the fighting. So if they have a message that might upset dad, they will worry about it and try to solve the issue so they do not have to give dad the message. The children I see in this situation are very anxious and resentful. They are mad that mom and dad got a divorce and now they feel they have to keep the peace between their parents.

When children are older such as 12 or 13 years old, they may start to act out. They may start using marijuana or alcohol as a way to escape. They also may start to make parenting decisions on their own. They feel if I have to carry the information back and forth, I might as well decide for myself. This can really hurt the relationship that a child has with one parent or both.

What is the solution? Parents, you need to communicate with each other directly and not use your child. The two of you divorced not your child. No one asked them and they should not have to take responsibility for any divorce issues. Also you really cannot get mad at the child for make parenting decisions, if you are putting them in the middle. You can go to co-parenting classes or co-parenting therapy to help the two of you with communication issues. You can also use email. Many Court systems have an email service you can subscribe to so you know messages are delivered. In Contra Costa County they call it the family wizard.

The main point is you can stop being married but you cannot stop being parents. It is important to remember this fact and set up a co-parenting plan during the divorce process not after. Trust me your children will thank you for it.

Dr. Michael Rubino specializes in treating children and teenagers and in high conflict divorces. He has over 20 years experience. For more information about Dr. Rubino’s work or private practice visit his website at http://www.RubinoCounseling.com or his Facebook page http://www.Facebook/drrubino3.

Helping Parents Cope with Cyber Bullying

Helping Parents Cope with Cyber Bullying

‪Cyber bullying is a major problem. However, research indicates parents do not know how to cope with cyber bullying. We need more programs to educate parents about this deadly issue. Digital Age Parenting: Dealing with Cyberbullying | Psychology Today https://www.psychologytoday.com/us/blog/shame-nation/201904/digital-age-parenting-dealing-cyberbullying‬

Allowing Teenagers to Learn from their Mistakes

Allowing Teenagers to Learn from their Mistakes

Working with teenagers, I hear very often from parents that they feel their teenager is not responsible and they have concerns about trusting their teenagers. I also hear from teenagers how they are upset with their parents for not trusting them and not allowing them to make decisions. I understand the parents’ concerns, but at times they are being unfair and unrealistic about their ability to control their teenagers’ decisions.

We routinely tell teenagers that they need to be responsible for their choices and actions. However, we seldom allow teenagers the ability to make their own decisions. It is not uncommon that parents have set rules and curfews for their teenagers. Also with the advancement in technology many parents have software installed on their teenagers’ cellphones so they can read their teenagers’ emails or texts. Also they have GPS programs so they can determine where there teenager is and try to figure out what they are doing.

Teenagers are aware that their parents have software programs on their cellphones so they can read their emails or texts or use a GPS program to determine where they are and what they are doing. This usually makes teenagers upset that their parents do not trust them. Teenagers’ tell me if they want me to be responsible how can I be responsible if they do not give me a chance? Also most teenagers have found ways to bypass these programs or they have developed a Texting code so parents will not know what they are texting about to their friends.

Teens there are some facts you need to be realistic about too. You cannot demand that your parents treat you like adults, but if you get into trouble, you want mom and dad to fix it. If you want people to respect your choices and opinions, then you must be prepared to accept the consequences and reactions from other people regarding your choices and opinions. You cannot have it both ways.

The other fact that parents need to accept is you cannot control everything your teenager is doing. You can monitor your teen all you want, but if a teenager wants to do something they will figure out away to do it. Also if you want your teen to be responsible you have to learn to accept their decisions and the consequences that may result from their choices. Additionally, your teenager needs to learn their decisions have consequences and teenagers need to learn to accept the consequences for their actions.

What parents need to do is have a calm conversation with their teenager. During this conversation you discuss issues that your teenager will be facing such as alcohol, drugs, sex and their futures. Explain what you expect and what you are willing to do or not to do. Therefore, they may begin to understand what consequences they will face depending on the decisions they make. They also may start to understand that you will not always be able to solve their problems. If they want to be treated as adults, they need to be able to deal with the consequences of their actions.

This is an important lesson for teenagers to learn. They need to understand that their actions have consequences and they are responsible for dealing with these consequences. One consequence may be that as parents you may be upset with their decision. This is a consequence that they need to be able to accept. Not everyone is going to always accept or approve of your choices. Teenagers need to learn this fact. It is important that they understand that their choices have consequences and they are responsible for their choices.

It is important that parents learn to accept the fact that they cannot control their teenager’s choices. Allowing them to learn from their choices is the best way for them to learn responsibility. It is also away for parents to learn to allow their teenagers to grow up and be responsible adults. Yes at times this may be difficult, but parents need to be realistic that they cannot control their teenager. Also it is better if they make mistakes before they are 18 years old. Typically these mistakes can be resolved easier if they are under 18 years old. When they are over 18 years old, they face the same consequences as a grown adult. Parents it is important to remember that part of your teenager becoming an adult is allowing them to make choices and to learn from those choices. Also the time to start educating them about choices and right and wrong is when your child is in elementary school. If you wait until they are teenagers, they think they know more than they do and they are less likely to listen to you.

Dr. Michael Rubino has over 20 years experience working with teenagers and their families. He is considered an expert working with teenagers. For more information regarding Dr. Rubino’s work and private practice visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/drubino3.