Looking at the Issue of Teenagers Cutting

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

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.

Cyber bullying during the Coronavirus Pandemic

Cyber bullying during the Coronavirus Pandemic

Bullying is a big problem in our society. In fact, many consider it an epidemic. Also bullying often results in the victim committing suicide. Due to the Pandemic and many children attending school remotely, many people assume bullying is not a big issue at this time. However, bullying no longer just occurs at school. Today most bullying occurs online or via texting. Children who are being bullied are receiving emails, texts and having insults posted on Facebook, Instagram and Snap Chat. Most kids and teens don’t have the cognitive ability to cope with non-stop cyber bullying. Cyber bullying also can occur seven days a week 24 hours a day. As a result, the victims often feel suicide is the only way to stop the bullying.

Statistics by the CDC indicate that between 1 out of every 3 or 4 kids are bullied during their lives. The majority of bullying occurs during middle school. The kids most likely to be bullied are those that are considered different in some way. A boy may be emotional or a girl may not wear the right brand of clothes. These are common reasons many kids are bullied. If you think about it, these are no reasons to bully someone. In fact, there is no reason that justifies bullying.

Bullying has life long effects on those who are bullied, those who bully and those who stand by and watch the bullying happen. Let’s examine the impact of bullying on these different groups:

Kids who are bullied can experience negative physical, school, and mental health issues. Kids who are bullied are more likely to experience:

• Depression and anxiety, increased feelings of sadness and loneliness, changes in sleep and eating patterns, and loss of interest in activities they used to enjoy. These issues may persist into adulthood.

• Health complaints

• Decreased academic achievement—GPA and standardized test scores—and school participation. They are more likely to miss, skip, or drop out of school.

Kids who bully others can also engage in violent and other risky behaviors into adulthood. Kids who bully are more likely to:

• Abuse alcohol and other drugs in adolescence and as adults

• Get into fights, vandalize property, and drop out of school

• Engage in early sexual activity

• Have criminal convictions and traffic citations as adults 

• Be abusive toward their romantic partners, spouses, or children as adults

Kids who witness bullying are more likely to:

• Have increased use of tobacco, alcohol, or other drugs

• Have increased mental health problems, including depression and anxiety

• Miss or skip school

Because Donald Trump bullied many adults on Twitter, many adults failed to realize how cyber bullying impacts teenagers and children. However, as I just outlined above, it does have a serious impact.

The Harlem Globtrotters realized that bullying has a serious impact on children and have developed a program to help address and stop bullying. They call it the ABC program. It is not very difficult and makes a lot of sense. Here is the program:

Action – when you see bullying or are being bullied tell your parents or a teacher.

Bravery – don’t be afraid to walk away from someone who is bullying you. If you see someone bullying someone tell them to stop.

Compassion – if you know someone is being bullied or looks down go over and be nice to the person. Compliment them or encourage them to ignore the bully.

Here is a link to the ABC program so you can watch it and discuss it with your children https://youtu.be/O-TF7x3Q_sk.

If we don’t become active when bullying is occurring, it will never stop. This means teaching our children to speak out against it too. Look at the list above, bullying impacts everyone. It has life long effects on the bullied, the bullies and those who see it. Therefore, we must all act. Additionally, if we assume bullying is not occurring because of the Coronavirus Pandemic, we are wrong!

Dr. Michael Rubino is a psychotherapist who has over 20 yrs experience treating children and teenagers. He is a founding member of the National Street Soldier Advisory Board, an anti bullying program. For more information about his work and private practice visit his website www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Why Family History is Important

Why Family History is Important

Since technology has advanced so rapidly, many of our lives have become more complicated. One result I have observed is that we are having difficulties maintaining family connections and traditions. As a result of our fast pace world and chaotic lives we sometimes forget the importance of passing on these family traditions from generation to generation. Another problem that impacts this is our society has become very mobile. We no longer live close to our relatives. It’s not uncommon for grandchildren to live in California and grandparents to live back east. Also with jobs becoming more difficult to find and the cost of living increasing families are moving where ever they can find a job or to a place to live that is affordable.

The month of February is dedicated to Black History, however, it also addresses the importance of contact between generations. Black History month has many goals. It is a way to acknowledge what Black Americans have contributed to the United States and also a way to remember the struggles they faced due to discrimination. Therefore, it is also away to establish pride in younger Black Americans by helping them to become aware of their history and to remember their history and the struggles. By helping the younger generations remember their past, a bridge is being connected to their past generations which shows how the prior generations helped Black Americans achieve what they have achieved and are achieving today.

Now since many families are not living close to each other, family members cannot provide the support they could in the past, such as watching grandchildren after school. Additionally, children cannot as easily establish close relationships with grandparents and aunts and uncles, the same way as when they lived close by. These adults could serve as additional role models and inform parents if something seemed off with the child. They were also able to spend additional time with the children and reinforce what parents were teaching their children and reinforce the family traditions and values.

The other thing that the close connection to generations provided was a sense of security. If there was a problem a child knew they could turn to their parents, aunts or uncles or cousins. It also helped a child’s self-esteem. You had the adults who could reinforce that you were worthy and you had cousins who would defend you at school or in the neighborhood because you were worth it. Also your older cousins could help you learn what to expect as you went from grade to grade. There was a sense of support and security that most children don’t have today. Furthermore, children with support from extended family members are less likely to get involved with drugs and alcohol.

The advancement in computers and communication may provide a way to try to recreate this sense of family. With such things as Skype and Zoom, where you can talk and see the other person, it’s almost like being with the person, but it is not the same. Children can Skype with grandparents, aunts and uncles and cousins too. We just have to make time for it. For those families that live close to each other, you need to remember the value of family and make time for family. At times it may be difficult, but you will find that the time and effort are worth it. I have found that children with close family ties and connections to their cultures do better in school and life. They have a sense of pride and a sense of where the came from that other children don’t. Additionally, research has shown that families who eat dinner together have less mental health problems. Furthermore, research shows that children who are connected to their family generations have better self-esteem as adults.

I have attached a link to an article which is about sharing traditions with family. Check out this article from First 5 LA: http://www.first5la.org/index.php?r=site/article&id=3615&utm_content=buffere936a&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer.

I think you will find it interesting.

Finally, I think we can learn a lesson from Black History Month. Knowing where you came from and the issues your grandparents and great grandparents struggled with is important information for everyone and parents should take time to educate their children about family history. In addition to maintaining bonds between the generations. Another issue which points out that this is important for someone’s mental health is children who were adopted. Most adopted children around the age of 20 years old do seek out information regarding their biological families. They typically say they have a need to know about themselves. They love the families who adopted them, but it doesn’t answer the question who am I?

Dr Michael Rubino has been working with children/teens and their families for over 20 years and is well respected. For more information at Dr Rubino’s work or his private practice visit his websites at www.rcs-ca.com, www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3.

Three Years After the Park Side Shootings and What has Changed?

Three Years After the Park Side Shootings and What has Changed?

Today, February 14, 2021, will mark the three year anniversary of the at the high school in Parkside, Florida. On that day 17 people were killed and 17 people were injured. The lives of these students, teachers and staff and families were changed forever. Additionally, the lives of the first responders, paramedics and police, were also changed forever. A family never fully recovers from the death of a child. Furthermore, these statistics do not account for how many students at the school, teachers and family members are suffering from grief and Post Traumatic Disorder. Remember, this is Valentines Day and students and families were expecting a day of fun not a day of horror that has changed them for life.

Additionally, this year will be the nine year anniversary of the tragic shooting at the Sandy Hook Elementary school where many children and adults where senselessly killed. Again the students and families’ lives were changed forever on that day. Since the Sandy Hook shooting more than 500,000 people in the United States have been killed by senseless gun violence. This means over 500,000 families have been changed forever and we have no idea how many children and adults continue to suffer with PTSD. The research shows people associated with these shootings do suffer from PTSD afterwards and many survivors have committed suicide (CDC).

In reviewing the subject of school shootings, I read an article by Cody Fenwick regarding children and gun violence. His article was very alarming. Since it is the three year anniversary of the Park Side shooting and the nine year anniversary of the Sandy Hook shooting, Fenwick’s article about children and guns is very important. His article also outlines a strong connection to guns and the senseless shootings and to the alarming numbers of teenagers who commit suicide with a gun. The article by, Fenwick, confirmed what I am hearing from teenagers and children in psychotherapy. Additionally, other school shootings, such as the one in Nashville, or the shootings in the Synagogue in Pennsylvania or in the Texas Church, confirm the need for gun control. A point the statistics in Fenwick’s article support.

Many of us feel because we live in Pleasant Hill, Walnut Creek or Lafayette that our children and teenagers do not have to worry about gangs or gun violence. Unfortunately, this is not the truth. According to a new research study in the Journal of Pediatrics, guns continue to be the third-leading cause of death for Americans younger than 18 years old, killing around 1,300 children and teenagers a year in the United States. In addition, almost 6,000 children and teenagers are injured per year by guns. Many teenagers are permanently disabled from these gun injuries too.

The study examined data from the Centers for Disease Control and Prevention and the Consumer Product Safety Commission between 2002 and 2014. The study found that boys, especially older boys such as teenagers and minorities, were much more likely to be the victims of gun violence. The study did not say anything about where the boys lived. The facts are children who are male and teenagers, are at a higher risk for becoming a victim of gun violence. Therefore, teenagers in our area are at risk of becoming a victim of gun violence.

The study does indicate there has been a decrease in accidental deaths such as boys cleaning a gun. However, the rate as a method for suicide has increased. I have mentioned before in other articles that suicide is the third leading cause of death for 10 year old boys. However, since the article was published, the CDC states that suicide is the second leading case of death for children 10 to 18 years old. This study confirms that the preferred method of suicide for boys and teenagers are guns. According to Katherine Fowler, one of the lead researchers at the CDC, “Firearm injuries are an important public health problem, contributing substantially to premature death and disability of children.” Understanding their nature [guns] and impact is a first step toward prevention.”

When we look at these numbers, can anyone argue against taking steps to protect our children? Can you imagine a 10 year old boy using a gun to kill himself? Can you imagine a 10 year old boy feeling that his life is so bad at the age of ten that death seems like a better option than living?

The study indicates that in recent years guns were responsible for a large number of adolescent, males who were murdered. The study documented that deaths in the category of murder for boys under the age of 18 years old decreased to 53 percent. This is a decrease yet the rate is still 53%. The other causes of gun-related deaths include:

• 38 percent — suicides

• 6 percent — unintentional deaths

• 3 percent — law enforcement/undetermined cause

The study found 82% of those killed due to a gun were boys. This means 82% of gun deaths were boys who were children or teenagers. Putting it another way, this means these boys were not even 18 years old yet at the time of their deaths. The study also found that white and American Indian children have the highest rate of suicide using a gun.

We also like to think that the United States in one of the most advanced nations in the world. However, the statistics show that the United States has the highest rate in the world for children under 14 years old committing suicide. Again, the United States has the highest rate of children under 14 years old using a gun to commit suicide. That number scares me and is appalling to me. However, as an adolescent and child psychotherapist, I do not doubt it. I have heard 6 year old boys seriously discussing suicide.

Furthermore, I hear teenagers routinely talking about needing to carry a knife or gun with them for protection. They tell me you never know when you will be jumped and you need to be able to protect yourself. In fact, a few years ago a teenager was shot on his front door step in Danville over a marijuana deal. When I mention to teens the risks they are taking by caring knives or guns, the boys tell me there is no guarantee they will live until 30 years old. They would rather die protecting themselves than doing nothing. Violence in our society has become so severe that many teenagers do not expect to live to the age of 30. Think about that fact.

As a society, we need to look at these numbers and ask ourselves some questions. What are we going to do in order to improve gun safety? Most importantly, why are children as young as 6 years old thinking about suicide? Also what are we going to do so that children who are suicidal have access to mental health care? This is our problem because it does happen in Pleasant Hill, Walnut Creek and Lafayette.

The students at the high school in Park Side and the parents from Sunny Hook have marched and petitioned for sane gun control laws. Senators and former President Trump both promised to improve laws so children would be safe going to school. They are becoming angry and discouraged and how can you blame them? It is now 3 years after Park Side and 9 years after Sandy Hook, but there have been no changes. These students and families have been marching, holding rallies and speaking to Congressmen and Senators who have promised changes. However, nothing has happened so far. How long do these students and families need to wait for sane gun laws. Also, why should children and families believe us when we say we will keep them safe?

Dr. Rubino has 20 years experience as a psychotherapist working with children and teenagers. For more information about his work or private practice visit his website at www.RubinoCounseling.com or his Facebook page www.facebook.com/drrubino3 or his podcasts on Spotify or Apple.

The Toll the Pandemic is Taking on Teenagers’ Mental Health

The Toll the Pandemic is Taking on Teenagers’ Mental Health

The pandemic has reached a frightening point and a point where many teenagers feel the Coronavirus will never end. Over 475,000 Americans have died from the coronavirus and daily there are approximately 3,000 Americans dying from the Coronavirus. In addition we are discovering new stains of the Coronavirus and we race to get everyone vaccinated. We are starting to see a drop in the number of people being hospitalized, but all of this may be temporary according to the CDC. The CDC is warning if we do not wear masks on a regular basis and continue to social distance, the numbers will start to increase again.

Today’s teenagers have access to all this information via their smartphones. News updates pop up on their phones and once again their see that nothing in their lives is stable yet. It will be a while before we return to anything looking like normal life.

As a result, teenagers are losing hope and wondering what type of life they will be living. Teenagers have had their lives turned upside down and they are feeling overwhelmed and very stressed about how their lives have changed. Many college students and high school students are continuing to have to attend school remotely. Additionally, events such as sports, the prom and graduation ceremonies have already been cancelled for this school year. The high school experience they have heard about and have been waiting for no longer exists. Many teenagers are feeling depressed and angry about how their lives have changed. Furthermore, they have no control over the situation and have no idea what to expect from life.

Prior to the pandemic depression and anxiety rates were increasing for teenagers (CDC). Additionally, the suicide rate for teenagers had gone from the third leading cause of death to the second leading cause of death for teenagers. Since the Pandemic has started teenagers have had to shelter in place for months, attend school remotely and have not been able to hang out with their friends. This has caused depression and anxiety to reach epidemic levels for teenagers (CDC). The number of teenagers cutting (self-mutilating behavior) have increased significantly because they feel out of control and are having significant difficulties processing all the feelings they are experiencing. Also suicide rates and drug overdoses have increased in teenagers. Again because they feel helpless and are having significant difficulties processing their emotions. Suicide and drug overdoses have increased so much that there are now numbers in communities that teenagers can text for help if they are feeling suicidal or severely depressed.

Furthermore, besides their school experience changing significantly and not being able to hang out with friends, many are living in families who are worrying about paying the rent or having enough money for food. Unemployment is at a record high so many teenagers are living in a family where both parents have lost their jobs. This is a huge amount of stress for a child or teen to experience and have to cope with daily. Additionally, many of these teenagers are coming from families who never had to worry about money before. Having to stand in a line for food daily is something they thought only occurred in third world countries, they never thought it occurred in the United States or could ever happen to their family.

As a result, many teenagers are struggling with severe mental health issues due to the Coronavirus. As a result, the Mayo Clinic has been studying the impact that the virus and quarantine have on us and our mental health. Here is what they found and their recommendations:

Stress is a normal psychological and physical reaction to the demands of life. Everyone reacts differently to difficult situations, and it’s normal to feel stress and worry during a crisis. But multiple challenges daily, such as the effects of the COVID-19 pandemic, can push you beyond your ability to cope.

Many people may have mental health concerns, such as symptoms of anxiety and depression during this time. And feelings may change over time.

Despite your best efforts, you may find yourself feeling helpless, sad, angry, irritable, hopeless, anxious or afraid. You may have trouble concentrating on typical tasks, changes in appetite, body aches and pains, or difficulty sleeping or you may struggle to face routine chores.

When these signs and symptoms last for several days in a row, make you miserable and cause problems in your daily life so that you find it hard to carry out normal responsibilities, it’s time to ask for help.

Get help when you need it

Hoping mental health problems such as anxiety or depression will go away on their own can lead to worsening symptoms. If you have concerns or if you experience worsening of mental health symptoms, ask for help when you need it, and be upfront about how you’re doing. To get help you may want to:

• Call or use social media to contact a close friend or loved one — even though it may be hard to talk about your feelings.

• Contact a minister, spiritual leader or someone in your faith community.

• Contact your employee assistance program, if your employer has one, and get counseling or ask for a referral to a mental health professional.

• Call your primary care provider or mental health professional to ask about appointment options to talk about your anxiety or depression and get advice and guidance. Some may provide the option of phone, video or online appointments.

• Contact organizations such as the National Alliance on Mental Illness (NAMI) or the Substance Abuse and Mental Health Services Administration (SAMHSA) for help and guidance.

If you’re feeling suicidal or thinking of hurting yourself, seek help. Contact your primary care provider or a mental health professional. Or call a suicide hotline. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use its webchat at suicidepreventionlifeline.org/chat.

Continue your self-care strategies

You can expect your current strong feelings to fade when the pandemic is over, but stress won’t disappear from your life when the health crisis of COVID-19 ends. Continue these self-care practices to take care of your mental health and increase your ability to cope with life’s ongoing challenges.

In addition to the facts above, people who have had the virus have been reporting feeling anxious and depressed. They have also reported the virus has impaired their ability to make decisions. This is being referred to as “the long haul syndrome.”The bottom line is the virus is creating mental health issues for those dealing with the quarantine, first responders, medical personnel and people with the virus. We are focusing on getting the virus under control which we must do. However, as we struggle to get control of the virus, we also need to address the mental health issues created by this pandemic. At this point, we have no idea how many will need mental health care and for how long. Therefore, as we focus on finding a cure, we may want to start to prepare for the mental health issues which are occurring and will after the quarantine.

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

The Pressure Teenagers Face to be Sexually Active

The Pressure Teenagers Face to be Sexually Active

It’s Valentine’s Weekend and a major issue for many teenagers is if they have a boyfriend or girlfriend. Having a girlfriend or boyfriend is very important to many teenagers. Often teenagers feel defective if they do not have a girlfriend or boyfriend. Many people are familiar with this line, “you complete me,” from the movie, Jerry McGuire, starring Tom Cruise. A deaf couple signs this message to each other in an elevator and Tom Cruise’s character assumes they must really be in love. However, this may not be the reality. In reality it may be an unhealthy relationship.

As a psychotherapist with over 20 years experience treating couples and teenagers, I have observed a common mistake that many people make regarding relationships and love. Many people tell me they feel an emptiness inside themselves and describe it as a “big empty hole.” They assume that a relationship will fill this emptiness. In other words, they are relying on their partner to eliminate the empty feeling they are experiencing.

This is a mistake. The only person that can fill that emptiness you feel is you. When I work with couples or an individual who is experiencing this emptiness, they usually are upset with their partner. They are upset because their partner is not filling the emptiness. Also the other partner is frustrated because they are tired of having to constantly reassure their partner. They report they are tired of always having to worry about meeting their partner needs and that their needs are constantly being pushed aside.

This type of pattern is very common in relationships where there is domestic violence or a substance abuse problem. Also jealousy is a major issue in these relationships. The person who is experiencing the emptiness is very sensitive to feeling rejected or abandoned. This is usually a result from childhood issues that have never been addressed. However, as an adult, if they sense these feelings in their relationship they tend to over react to them. The person may drink excessively to reduce their fears and men often result to verbal or physical abuse. Anything that will keep their partner in the relationship and continue to fill the empty space.

This tends to occur because as we grow up there is a great deal of pressure for people to be in relationships. You see this in children in first grade or kindergarten when adults jokingly ask children if they have a boyfriend or girlfriend. If a child doesn’t they often feel there is something wrong with them.

I see this issue a lot with teenagers. I have teenagers who feel they are defective because they never had a girlfriend or boyfriend. This defective feeling increases significantly, if the teenager never has been on a date. They believe if they are going to be a “normal” teenager, they must at least be dating. Boys tend to believe they must be sexually active too in order to be normal. I have had teenagers tell me they felt suicidal or were using drugs because they did not have a girlfriend or boyfriend. They are willing to risk their lives using drugs or believe they are better off dead, if they don’t have a girlfriend or boyfriend. They are so tied up trying to live the stereotype, they can’t believe that many teenagers do not have a girlfriend or boyfriend and do not date in High School.

This pattern continues into adulthood. Many women feel defective if they are 30 years old and not married. Men feel as if they are not men if they do not have a girlfriend. Both men and women often settle for anyone as long as they can say they are in a relationship.

As children, we never learn how to love and care for ourselves. Ask someone if they would go out to dinner by themselves and most people look terrified by the idea. They have no idea what they would do and they are afraid about what other people with think. This is a sad state that we cannot love ourselves. If we always need someone to reinforce we are lovable, we turn our power over to strangers. If someone says something nice about us we feel good, if they say something hurtful, we feel unworthy as a person. But, why should someone else determine our value? We should be the one who judges if we are lovable or not. A relationship should add to our life like a bottle of wine adds to a meal. A relationship should not define us as a person.

As a result of this problem, many couples end up divorcing because a partner is tired of having to reassure their spouse daily. I have seen these divorces become very nasty and costly. So both parties are hurt even more and so are the children. They only people benefiting are the attorneys.

We also have this same issue with teenagers. However, when they break up it tends to be more dramatic. A teenager may start to use drugs, develop an eating disorder, start cutting, become depressed and may attempt suicide. The behaviors are not uncommon after teenagers break up.

We see this acting out behavior more in teenagers and children. Teenagers and children are desperate to feel that they are loved by their parents especially. If they don’t feel they are loved, there is a tendency to act out. Disney’s movie, Frozen, has a segment where the trolls explain that if someone doesn’t feel loved they may act out in pain or make poor decisions in an attempt to find love. Oprah, during her last show, had a very good way of expressing this need. She stated, “everyone wants to know: ‘Do you see me? Do you hear me? Does what I say mean anything to you.” The program Challenge Day, which Oprah recommends, states what teens are looking for this way: every teenager wants to feel safe, loved and celebrated. I see it every day, when teens don’t feel loved, they act out. Negative attention is better than no attention.

How do we handle this issue? We need to start to acknowledge as a society that a relationship doesn’t make you a complete person. Only you can make yourself feel complete as a person. Also we need to remove the stigma of seeking mental health care. We need to encourage adults who feel incomplete without a relationship to seek psychotherapy and deal with their issues. Parents, if you notice that your teenager is desperate to be in a relationship, help them get psychotherapy so they can deal with the pain they are feeling. Remember this emptiness feeling typically begins in childhood. Therefore, if we show children and teens that they are loved or get them help when they are acting out, we can prevent them from dealing with this emptiness for years.

Again, please remember a relationship should add to your life, it should not make you a person or define you as a person.

Dr. Michael Rubino has over 20 years experience working with families and teenagers. If you would like more information about his work or private practice visit his website at www.rubinocounseling.com or his Facebook page www.Facebook.com/drrubino3 or listen to his podcasts on Spotify or Apple.

Heroin and the Coronavirus

Heroin and the Coronavirus

Many teens die from suicide and drug abuse. Since the Pandemic started last year we have seen an increase in the number of teenage suicides and teens dying due to a drug overdose. In fact, suicide is now the second leading cause of deaths for children 10 to 24 years old (CDC). One thing that contributes to teenage suicide is drug use. Specifically, the use of pain killers and heroin. In this article I attempt to describe both issues for parents. It is important for parents to be aware of these issues if we are going to stop them.

ABC 20/20 did a very good show last year about the epidemic of heroin use in the United States. If you did not see it, you can probably find it on YouTube. Parents this is a show you need to see because many teenagers I work with are not afraid or concerned about how dangerous heroin can be. In fact in 2017, the CDC estimated 494,000 people 12 and older used heroin. The minimum age the CDC is citing is 12 years old. Think about that fact there are 12 year old kids using a highly addictive drug such as heroin.

According to ABC 20/20, 129 people die every year from a heroin overdose. A majority of these deaths are teens and people in their twenties. Heroin is used by people in the lower income level and by people who are the wealthiest in the country. It is used by whites, blacks, Hispanics basically every ethnic group. It is also used by males and females. Therefore, for the families in Lafayette, Walnut Creek and Danville who say we don’t have that problem here, yes you do. Also for parents and educators who think that if their child is in a private school, they are less likely to use, you are wrong too. Heroin crosses all ethnic and economic boundaries. The epidemic is so severe some schools have started teaching children in the 6th grade how to use Narcan at school. However, since most children are attending school remotely, the Narcan is not really effective at this time. This drug can reverse an overdose of heroin if administered in time.

Therefore, parents in the Bay Area, you need to pay attention to this issue and these facts. You might be saving the life of your child or someone else you love.

As stated Heroin use to to be a drug of the past but it is now very popular with teens. Heroin is a cheaper alternative to many other drugs. For $10 a teenager can buy a capsule of heroin. This is much cheaper than other drugs.

Heroin is still mainly snorted or injected. Because it is injected teens are exposing themselves to HIV and Hepatitis C. Both are life threatening conditions with no cure. Also many girls who use heroin get pregnant but don’t realize they are pregnant until the 4th or 5th month. The girls stop using but stoping when you are five months pregnant it is too late for the baby. The babies will be born drug addicted and if they live through withdrawals, these children will have on going health issues and learning disabilities. In addition to exposing themselves to diseases most teens use Heroin with other drugs such as alcohol. This makes the probability of overdosing on Heroin even higher. Heroin lowers a persons breathing rate and the drugs they are combining it with lower the breathing rate even more making an accidental over dose more likely. The person’s rate of breathing becomes so low and they die. If your body doesn’t have enough oxygen to keep your brain a live, your brain stops working and so does your heart and all your other organs. The rate of deaths due to a heroin overdose has increased by a factor of 5 from 2010 to 2017 (CDC). This is a shocking and alarming statistic. Remember 12 year old kids are using heroin so many of those deaths are 12 year old kids.

Why is Heroin coming back and very popular with teens? Heroin is very similar to the Opioid based pain killers that teens have been using for years. However, with the cost of pain killers rising on the streets and becoming harder to get due to new prescription laws, heroin is easier to get and cheaper. Also teens tend to like the high better. It is not uncommon for someone to get addicted after using heroin one time. Also with the Opioid epidemic in our country, teens are now more likely to try heroin because it is easier to get and cheaper.

In the last few years the number of teenagers using heroin has doubled. The boredom of the Pandemic has not helped the problem. It has exacerbated the problem. What teens are at the highest risk? Those who have been using Opioid pain killers, those abusing marijuana and males. Remember it is very common for teens to combine heroin with other drugs and they are unaware of the impact it has on their breathing. They may collapse and not know why and by the time their friends get them to an emergency room it’s too late. Also teens may go to sleep after using and their breathing rate is so shallow they never wake up.

This is a very dangerous drug. If it doesn’t kill when the teen uses it the drug, it can kill when the teen is an adult if the teen contracts HIV or Hepatitis C. The rate of teens using this drug has doubled and the amount of people dying from an overdose has increased by a factor of 5 since 2010. Again, parents you cannot ignore this issue. Heroin is being used by upper class children and poor children, athletes, and all races. So it is impacting all teens. Also teenagers are looking for ways to escape the Pandemic and heroin offers them an escape. If suicide and drug abuse have increased by a factor of five since 2010, imagine how it has increased since the Pandemic started.

The other major issue with this drug is stopping. Someone cannot just go off heroin. People can die from withdraw. However, finding a treatment center that is affordable or with an open space is very difficult. They may have to wait four months to get into a rehab center. This is very dangerous. When someone decides to stop heroin, they need to enter rehab immediately. If they have to wait even 2 days, they may not make it because they cannot stand the withdrawal symptoms.

If we get involved we can hopefully stop teens from using this highly addictive killer. I have attached a link to a handout by the CDC with facts, warning signs and suggestions to help your teen if you think they are using heroin. http://www.cdc.gov/vitalsigns/heroin/

http://www.cdc.gov/vitalsigns/heroin/

In addition to these issues, Heroin and drug abuse is linked to teenage suicide. These drugs besides creating a high, create depression. At times a depression so severe that a teenager decides they would be better off dead and they commit suicide. For the age group 10 to 24 years old, suicide has gone from the third leading cause of death to the second leading cause of death now (CDC). Therefore, we need to pay attention to the pain killers and other drugs kids are using. And yes 10 year old kids are using these drugs too.

Many times the teen has decided they want to get clean and stop using the drug. However, as I mentioned above, finding an affordable treatment program with an open bed can be very difficult. Some teenagers may need to wait 2 months. This can be two months two long. The teenager may be so depressed and tired of living the drug life that they decide to kill themselves rather than endure the emotional and physical pain of waiting two months.

Another point is for some teenagers they have to try four or five times in rehab before they are successful. Again most teenagers are usually dealing with severe depression at this point. For them the thought of trying again and not succeeding is to much to tolerate. Therefore, they chose the option of suicide to eliminate their pain.

Finally, I mentioned a number of teenagers can overdose by accident, however it may not be an accident. Many teens know these drugs very well so they know how to stage what will look like an accidental overdose. Therefore, we really don’t know how many teenagers are committing suicide due to being sick and tired of using drugs and living a drug life. Many of the accidental overdosages could really be suicides. There is no way to tell.

What we know is drug use and suicide are at an epidemic rate for teenagers and the Coronavirus is making the epidemic worse. It is at a point where we need to get aggressive and provide better access to rehabilitation programs and better access to psychotherapy so the depression can be treated. We need a multi-disciplinary approach to this issue and we need to make it easy for teenagers and parents to use it. We also need to remove the negative stigma and judgement, if someone admits they are addicted and need help. Admitting you need help is an essential first step and it is extremely difficult to do to. Therefore, we don’t need people shaming them for taking that step.

Dr. Michael Rubino is a psychotherapist who has been working with teens for over 20 years and he is considered an expert in this field. For more information about Dr. Michael Rubino and his private practice visit his website at www.rubinocounseling.com or his Facebook page at http://www.Facebook.com/DrRubino3.

Coping with Your Teenager during the Pandemic

Coping with Your Teenager during the Pandemic

Many parents worry because their teenager talks more to their friends than to them. Often many parents feel like a failure because their teenager is spending more time with friends than them. This is normal developmentally, but parents do want to be aware of who their teenager has as friends and what they do. However, with the Pandemic and the quarantine many teenagers have not been able to hang out with friends as usual. They have however maintained contact with friends by texting, FaceTime, Zoom and on line gaming where they can play and talk to each other. Some parents have seen the Pandemic as an opportunity to increase the amount of time they spend with their teenagers and as an opportunity to improve their relationship with their teenagers. This is an excellent idea. As a result some parents are trying to get their teen to spend more time with them than their friends. A parent may feel they are doing something positive during the Pandemic and their teenager may resent the parent for intruding into their private lives with their friends. Unfortunately, the idea the parent had of improving their relationship with their teenager during the Pandemic is ruined and instead of improving the relationship, they are ruining their relationship with their teenager.

Most parents want to improve their relationship with their teenager so if their teenager is having a problem, such as drugs or alcohol, they are hoping their teenager will feel safe enough to talk to them and ask for help. Unfortunately many parents tell me they have decided they way they can resolve this issue is“I am going to be my teenager’s best friend.” Unfortunately, many of these parents do not understand that it is normal developmentally for teens to spend more time with their friends.

The solution that you are going to be your teen’s best friend is wrong!! You do not want to be your teen’s friend. You need to be your teen’s parent. Your teen has enough friends. Your teen doesn’t need another friend, they need a parent. They need someone to educate them about life and how to make decisions.

Remember, as a parent it is your responsibility to help guide your teen to be successful as an adult and in life as a productive member of society. This means at times you will have to set firm boundaries, educate them about life and sometimes tell your teen no. It is important to remember being a parent is not a popularity contest. You must set appropriate limits for your teen which means at times they will be mad at you. It is okay if they are mad at you. This is part of the process a teenager experiences as they are maturing into an adult.

Despite what they say, most teens want and like boundaries. At times they can be very helpful to your teen. They may be faced with a great deal of peer pressure to do something that they do not want to do and they can use you as the excuse why they cannot do it. Some may say this is immature because the teen is using their parent as an excuse, but we put our teens in a very, very difficult world so I think they are allowed some extra help now and then.

Another reason why should you not be your teen’s friend because your word and rules will mean nothing to your teen, if you are their friend. A friend is defined as a close associate. In other words, teenagers see their friends as equals. Now think about what this implies, if you are equals, you are on the same level as your teen. Therefore, they think they know as much as you do and since you are equals they can choose to follow your rules or ignore them as they see fit.

I run into this problem daily in my office. A parent will say “we have always been best friends, I talk to my teen and their friends about everything and we have good times together hanging out. I don’t understand why they disregard my authority as their parent.”

The answer is simple: you eliminated your authority as the parent and made yourself an equal as a friend. If you want your teen to respect your authority as the parent, you must remain the parent and not be the friend.

Consider the decisions these teens have to make every day. They are faced with issues regarding alcohol, drugs, sex, gangs and decisions about careers in their future. Teens live in a very difficult and complex world today. They need parents to help set appropriate boundaries and guide them so they make the best choices for themselves and avoid a great deal of trouble. You can only do this as a parent. Remember, as a parent you are not in a popularity contest. You have a responsibility to help guide your teen. If you want to help them survive high school then be the parent and make the tough, unpopular decisions that are in your child’s best interest. This will help your teen to respect you and the rules you made earlier you can enforce. If you set yourself as friend and equal, your teen loses respect for you, your advice and your rules. You find yourself powerless and you leave your teen on their own to decide what is appropriate behavior.

This is a difficult time for you and your teenager, but if you maintain your role as parent and your teen maintains their role as child you both will survive high school easier. Of course there will be difficult moments, but nowhere near as difficult if you blur the relationship boundaries.

Dr Michael Rubino has over 20 years experience working with teenagers and their parents. He is well respected in the community. To learn more about his work or private practice, visit his website at www.rcs-ca.com or www.RubinoCounseling.com. You can also visit his Facebook page www.Facebook.com/drrubino3. You can also listen to his podcasts on Spotify and Apple.

Super Bowl Parties and the Coronavirus

Super Bowl Parties and the Coronavirus

This week is the Super Bowl. Usually it is a weekend when family and friends gather together for Super Bowl parties. This has been a tradition for people for many years. However, this year is different because of the Coronavirus. Yes in California, the shelter in place order was lifted and the number of people in the hospital for the Coronavirus has decreased. However, we still need to take precautions. In addition to the Coronavirus, Super Bowl Sunday in is also the day when the most domestic violence occurs in the United States. This statistic is for adults and teenagers. So, how do you have a safe, fun Super Bowl Sunday? You need to develop a plan that reduces stress and too much drinking.

First, this year you need to be careful about who you invite and keep the party small. Everyone needs to be wearing a mask and you need to try to keep appropriate social distance. In addition it would help if you keep the windows open for appropriate ventilation. Some people may think that because some people are now receiving the vaccine that these steps are not necessary. However, only one percent of the population has been vaccinated (CDC). Additionally, the virus has mutated and the new stains are more contagious and deadly. Therefore, in order to have a safe and fun party, precautions are necessary.

Next, remember that it is just a day and just a football game. Therefore, if everything is not perfect such as you don’t have all the food you wanted or things are not arranged how you wanted, do not stress over it. You can still enjoy the game without a lot food or alcohol. Also if everything is not arranged perfectly, you can still enjoy the game. In other words, do not stress and argue over minor details.

If you are going to have small children around, set up a separate room with food and activities for them. Many children under 10 years old will lose interest in the game and if there is nothing else for them to do, they will want attention and distract people from the game. Therefore, set up another room where they can watch other television shows and have games to play. This way they are not bored and they can enjoy themselves.

People drinking too much is a common problem during Super Bowl parties. Therefore, when your friends arrive, tell them you care about them and their safety. Therefore, you want everyone to put their car keys in the basket as they enter. This way if someone accidentally has too much to drink, you can give them a ride home. This way if someone has too much to drink, you don’t have to argue about them driving if they are not safe to drive. This can help avoid an argument and a possible physical fight.

Also watch how much alcohol you are serving. If you are serving alcohol, serve food too. The food helps to absorb the alcohol and decreases the likelihood that someone will drink too much. Also towards the end of the game stop serving alcohol and switch to sodas. If someone has had too much to drink, this gives them a chance for their body to process the alcohol they consumed so they can lower their blood alcohol level.

Another good idea is to set rules for your party. Announce to your guests that you want everyone to have a good time and no arguing or fighting. Therefore, cheering for their team or favorite player is fine, but you do not want any name calling nor is there to be any insulting other people at the party. Also good nature teasing is fine but no swearing and if someone asks you to stop the joking, respect their request. Bottom line, state that regardless of who wins or loses, you expect everyone to act like adults and to treat each other respectfully so it is a fun day for everyone.

It would also be helpful to remember the acronym HALT:

H – hungry

A – angry

L – lonely

T – tired, too much alcohol

If you notice someone expressing these emotions or drinking too much, this is a situation which could result in an argument or violence. Therefore, if you notice a potential violent situation, try talking to the person to see what is bothering them. If you notice a couple arguing try having one person step outside with you for a time out so they can calm down. You may want to let them know that they seem slightly upset and you are just checking-in to see if there is a problem and if you can help. Instead of ignoring the situation try to offer some help so people can calm down. This can help a great deal.

At the end of your party, if someone is not sober enough to drive, offer to drive them home. Remember all the car keys are in a basket so you do not have to argue to get the car keys. Remind them that you are only offering to drive because you care about them. You do not want to see them arrested for driving under the influence, you do not want to see them get into a car accident and you definitely do not want to see them kill someone else or themselves in a car accident.

If you notice a couple who appear to be arguing, offer to allow one person to stay for a while and you will drive them home later. Giving them a chance to calm down could help avoid a domestic violent incident. If after a little while the person at your house or the person who went home tells you they do not feel safe around the other person right now – listen to them! Offer to let the person stay at your house for the night. You do not want to assign blame to anyone. Simply state that they seem to be having a stressful day and instead of them both staying in the same house that night and arguing all night and arguing in front of the children is not a good idea. It is okay if they need to take a break for the night and talk about it tomorrow. You are providing them and the children with a safe environment and hopefully avoiding a domestic violent incident. Many people are afraid to step in and offer help when they see a potential domestic violent situation. However, if more people offered to help and did not shame the family, the incidence of domestic violence could decrease and more people may be willing to seek help.

If you are a couple who are having incidents with domestic violence, discuss the issue before the day. Hopefully, the two of you are in psychotherapy and can discuss the issue in a therapy session. Discussing a potential problem with a therapist or even a friend prior to the event can be very helpful. If you are not in therapy and afraid to talk to a friend and do not feel safe call the following number for help: The National Domestic Hotline 1-800-799-SAFE (7233). Someone will answer 24 hours a day, 356 days a year. Do not be embarrassed to call. If you need help, please reach out and ask for it before someone gets seriously injured or killed.

Hopefully these suggestions help and you can enjoy the game in a fun peaceful environment.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and he is certified to assess and treat domestic violence. If you want additional information regarding Dr. Rubino’s work or his private practice visit his websites www.rcs-ca.com, www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3 or his podcast on Spotify or Apple.