Mental Health Care for Men and Teenage Boys

Mental Health Care for Men and Teenage Boys

We need to follow Heads Together and develop programs for men and male teens to help them address their mental health and their emotions. This would help eliminate the out dated male stereotype about how men should act https://www.headstogether.org.uk/duke-of-cambridge-visits-male-mental-health-organisations/

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Gifted Children May Have Learning Disabilities too

Gifted Children May Have Learning Disabilities too

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. These children often become very frustrated and start to act out at home and at school. They are trying to tell the adults in their lives that everything is not okay and they need help. 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. If your child needs accommodations at school do not pay for any psychological testing for your child. According to California law, the school district has the right to test the child first. They do not have to accept outside testing, if the district has not tested the child. If you disagree with the school district’s testing, say so and request a second evaluation. This evaluation is completed by a professional not associated with the school district and the school district pays for the testing not you.

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 websites http://www.RubinoCounseling.com, http://www.LucasCenter.org or his Facebook page http://www.Facebook.com\drrubino3.

A Year After Parkside, What Have We Learned?

A Year After Parkside, What Have We Learned?

This week will mark the one year anniversary of the Parkside High School shooting in Florida. Additionally, this year it will be the seven year anniversary of the tragic shooting at the Sandy Hook Elementary school where many children and adults where senselessly killed. Since Sunny Hook more than 500,000 people in the United States have been killed by senseless gun violence.

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 one year anniversary of the Park Side shooting and the seven 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. Many teenagers are permanently disabled from these injuries.

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. This study confirms that statistic and indicates 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 Park Side High School and the Parents from Sunny Hook have marched and petitioned for sane gun control laws. However, nothing has happened so why should children believe us when we say we can 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 http://www.RubinoCounseling.com or his Facebook page http://www.facebook.com/drrubino3.

Preparing for College, If you have an IEP in High School or Elementary School

Preparing for College, If you have an IEP in High School or Elementary School

Working with children and adolescents I have had many parents ask about 504 plans and Individual Educational Plans (IEP). Parents tend to focus on the assistance their child may need in elementary or high school due to a learning disability or mental health issues. Over 20 years as a psychotherapist, what I have observed is that children who need assistance in elementary and high school typically need assistance in college. Since we are coming to the end of the school year and as seniors in high school prepare for graduation and decide on plans for college, IEPs need to be addressed with colleges that students will be attending.

From my experience, most families assume there is no assistance in college. However, typically if a child has an IEP, they are also entitled to assistance in college. Most colleges in their Counseling departments have programs designed to help disabled students. A student with a physical or learning disability or mental health issue such as ADHD or depression would qualify for assistance by the Disabled Students Program at a college. I have recently been receiving many questions from Parents about what happens to their child’s IEP when the go to college and questions from parents who have college freshmen asking about their child’s IEP. Therefore, I thought it would be beneficial to provide information about how IEPs are handled by colleges. In addition to an IEP, any student with a learning disability or mental health issue is entitled to accommodations because they are covered by the Americans with Disabilities Act of 1991.

Additionally, if you live in California and you have a physical or learning disability or a mental health issue and if you had or did not have an IEP while in school, you may qualify to be a client of the California Department of Rehabilitation. This Department is responsible for assisting people in California, with a disability, find a job and get the education they may need to find a job. The Department may assist their clients by providing tuition assistance for community or state colleges and provide financial assistance to buy text books and school supplies. What they are able to do depends on the State budget.

This is another reason for parents to insist when their child does need an IEP that the school district places the child on an IEP. The lies schools tell parents that an IEP will prevent their child from getting into a college, the military or getting a job is not true. Another reason to insist on the IEP, if your child qualifies for an IEP, as a result of having an IEP, your child can be granted accommodations on the SAT or ACT. These are tests seniors typically need to take when they are applying to four year universities. The common accommodation most students require is additional time to complete the tests. I have had many teens with ADHD come to me seeking accommodations on the SAT or ACT. A common requirement that the testing boards require is that a student needs to have had an IEP if they are seeking accommodations on these tests.

Therefore, many students who have disabilities or mental health issues can receive assistance in college. While many people may be surprised, it is true. However, for many college students finding the assistance can be confusing and overwhelming. For a Freshman in college dealing with heath or mental health issues the confusion and embarrassment people deal with because of society stereotypes can cause students to give up. However, I was contacted by bettercollege.com with a resource guide they developed for college students with mental health issues. While their guide was created for students with mental health issues, it can also be used as a guide for students with physical or learning disabilities.

Since I feel this is a valuable guide to Freshman students and their families, I am including a link to this resource guide below:

Guide to College Planning for Psychiatrically Impaired Students – https://www.bestcolleges.com/resources/college-planning-with-psychiatric-disabilities/

Dr. Michael Rubino is a psychotherapist with over 20 years experience working with children, teenagers and college students. For more information about Dr. Rubino’s work and private practice visit one of his web sites http://www.RubinoCounseling.com or http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/drrubino3.

Why Teenager’s Need Sleep

Why Teenager’s Need Sleep

This week is dedicated to children’s mental health. A new study was just published again showing how important sleep is for children and teenagers. Here is the link to the study ChildrensMentalHealthWeek.org.uk/Research. Sleep is very important for children and teenagers. In fact, as you see research shows that sleep has a big impact on our mental health and physical health. Research continues to show 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 received some very good information regarding sleep and mental health. It was provided by Jenny Thompson who is associated with http://www.bettermattressreviews.com. Given it is children’s mental health week, 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 http://www.rcs-ca.com or http://www.RubinoCounseling.com or visit his Facebook page http://www.Facebook.com/drrubino3.