Who Are 2E Children?

Who Are 2E Children?

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

Wikipedia defines 2E children in the following way:

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

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

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

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

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

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


The Benefit of Natural Consequences

The Benefit of Natural Consequences

Working with children and teenagers, I am often asked about how to implement rules and what are appropriate consequences. While I am a strong advocate that every family should have a household contract which contains the rules for the family, I also strongly believe in natural consequences. Sometimes you need to allow nature to takes its course and children and teenagers often learn very fast. Mary Burns, M.ed., who also works with children advocates for natural consequences too. I have outlined the concept below and how Ms. Burns and I believe parents can use natural consequences.

Natural consequences can best be described as the logical outcome of a decision your child makes. These consequences can come from outside forces such as teachers or the police, but may also come from you setting limits on how much you will do for your child.

A benefit of natural consequences is that you don’t have to come up with them yourself. Instead, you’re allowing the “chips to fall where they may.” This can help your child to learn about what happens when he makes various choices on his own. It shows him that rules are here for a reason and going against them is unpleasant.

Natural consequences allow you to take this stance:

“This isn’t my problem. You’re the one who made the choice. What are you going to do differently next time?”

5 Natural Consequences You Should Let Your Child Face

1. Poor Decisions at School

I’ve worked with many parents whose kids get into trouble at school. But instead of letting their child be accountable, they try to bail their kid out. Remember that your child’s version of the story is not always the true version of what has happened. Your child will sometimes rearrange the facts to justify his poor choices—and omit information about his own behavior.

When your child makes a poor choice at school, such as a lewd comment in the cafeteria or pushing a peer in the hallway, the information you get about the situation is often incomplete. There is often much more going on that teachers see and hear that you don’t know about. Most of the time it’s harmless and there is no need to tell you and teachers know that all kids make mistakes.

When your child is given a consequence at school, there’s usually a very good reason for it. Let your child face these natural consequences such as missing recess, going to detention, or attending school on Saturday. If you try to bail your child out of trouble at school, you undermine the school’s authority. Your child gets the message that he doesn’t have to listen to his teachers and his behavior will likely worsen.

Finally, don’t punish your child further for actions that he is already facing consequences for at school. Let the school handle the school issues if they are doing so adequately.

2. Personal Belongings

In most cases, it’s effective to let your child be in control of her own space and her own belongings. If you tell your child to put her dirty clothes in the laundry and she doesn’t, then they don’t get washed. The natural consequence is that she has no clean clothes.

You aren’t doing anything extra here or going out of your way to do something your child can do herself. You are simply washing what there is to wash. You may even make your child responsible for her own laundry. If she doesn’t do it, she doesn’t have clean clothes.

The natural consequence of a dirty room is that your child won’t be able to find things. Not wearing a coat to school in the winter? He will get cold. If your child brings his favorite toy to school (when you told him not to) and it gets lost or stolen, then his toy is gone. Lose or carelessly break your phone and you will be without a phone for a while. The options are plentiful here.

3. Household Chores

The most common way for families to handle chores is to provide a small allowance. It works best to break the allowance down into a payment for each chore. When children don’t do the chores, they don’t get paid. It’s just like in the real world. If you don’t work, you don’t get paid and you can’t buy the things.

Another system I love that works well with kids who leaves their things all over the place is the “Saturday Box.” Every night after bed, you pick up whatever your child left lying around the house and put it in the Saturday Box. And, as the name implies, she won’t get it back until Saturday. If one of those items happens to be her handheld game device for example, then you have a bonus natural consequence: she won’t get to play until Saturday. And that’s on her, not you, as long as you told her about the Saturday Box ahead of time.

4. Homework

Your child needs to learn to take responsibility for homework and grades. The natural consequences are plentiful here. He may get lectured by the teacher or he may have to stay in from recess to finish the homework. In some instances, he may not get to participate in school-sponsored activities. And, if it’s very serious, he might even have to repeat the grade or go to summer school.

This consequence may sound harsh. But, you aren’t going to follow your child around to his job when he grows up to make sure he does everything his boss wants him to do, right? That’s why it’s best for your child to learn now what happens when you don’t meet your responsibilities.

This is not to say that you ignore homework and school altogether. It is appropriate to set up consequences to help ensure that your child does his homework, and I discuss this further below. But, natural consequences play an important role here as well.

5. Behavior in the Community

We say this all the time here at Empowering Parents: no matter how much you would like to, you can’t control your child’s behavior outside your home. If your child does something rude or obnoxious at a friend’s house, the natural consequence might be that he isn’t allowed over there for a while. If he speeds, he might get a ticket. Each of these actions has their own natural consequences.

When misbehavior outside your home poses a safety risk, you certainly do want to impose some consequences of your own at home, of course.

When Should You Give Your Child Consequences?

Natural consequences are important and you should not shield your child from them. But you still need to develop your own consequences for many behaviors. Does my child’s behavior present a serious safety concern? Is my child’s poor decision in this situation likely to have long-term negative or unhealthy consequences? Is my child being rude or verbally abusive towards me? In these cases, you do not want to wait for natural consequences to occur. Instead, you need to come up with effective consequences yourself to improve their behavior.

For example, if your child’s grades are failing, you can establish a daily structure where he has no access to electronics or favorite toys from after school until the work is done. You could also try to add additional incentives for your child to follow this structure at least 3 or 4 days in a row.

After you’ve set up effective consequences and rewards, the rest is up to your child. She will choose whether to risk the natural consequences again or not.

Additionally, you must step in if there is a safety is a concern. If your child has been smoking pot or experimenting with alcohol, the car can be off limits for a while. When your child refuses to wear a helmet, the bike is locked up. If your child has shoplifted, he might lose the privilege of walking to the store on his own for a while. These are just a few of many possible examples.

Coach Your Child

With every child, it’s helpful for you to talk with him or her about their decisions and the outcomes of those decisions. Younger children will need you to offer them choices, while mid-elementary aged kids and up can make choices more independently.

When you talk, you can discuss your child’s reason for making a decision, what the outcome was, and what he could do differently next time. This will help him maximize the learning that comes from mistakes and give him the skills to avoid unpleasant consequences in the future—natural or otherwise.

The Real World Experience Kids Gain by Facing Consequences

While it’s your responsibility to coach your child and point out the consequences of his choices, it’s up to your child to make the choices. And it’s up to your child to experience the outcome of those choices.

Even the best-behaved kids will make poor choices now and again. The hard truth is that decision-making is a skill your child needs to learn so he can function as an adult. Natural consequences are one of the best teachers a child can have.

How Sexual Assault Impacts Teenage Girls and Boys

How Sexual Assault Impacts Teenage Girls and Boys

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

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

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

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

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

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

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

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

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

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

The Relationship between Bullying and Suicide

The Relationship between Bullying and Suicide

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

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

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

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

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

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

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

Why Sleep is Important for Teenagers’ Mental Health

Why Sleep is Important for Teenagers’ Mental Health

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

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

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

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

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

Schizophrenia and sleep

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

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

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

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

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

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

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

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

Anxiety disorders and sleep

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

Source: The National Academies Press

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

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

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

Depression and sleep

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

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

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

Bipolar disorder and sleep

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

Insomnia, or difficulty falling or staying asleep

Hypersomnia, or oversleeping, especially during depressive episodes

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

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

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

REM sleep issues like vivid nightmares

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

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

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

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

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

Sleep tips for individuals with mental health disorders

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

1. Practice good sleep hygiene.

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

2. Be careful with napping.

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

3. Try sleep therapy.

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

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

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

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

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

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

4. Explore natural remedies.

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

5. Keep a sleep diary.

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

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

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

Facts about Teenagers and Suicide

Facts about Teenagers and Suicide

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


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

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

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

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

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

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

• Aggressive behavior

• Verbal outbursts

• Withdrawal from friends

• Writing or talking about suicide

• Dramatic mood swings

• Reckless behavior

• Refusal to engage in daily responsibilities

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

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

teenager if they are feeling suicidal or thinking about suicide.

Many people have the misconception that if you ask someone

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

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

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

including suicidal feeling. If someone is feeling suicidal it

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

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

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

save their life.

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

society denies and views it as there is something wrong with

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

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

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

rising and help teenagers who are currently feeling suicidal,

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

teenagers who are feeling suicidal.

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

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

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

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

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

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

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

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

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

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

and friends who survive a suicide.

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

The Deadly Drug Pink

The Deadly Drug Pink

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

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

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

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

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

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

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

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