My Teen is Extremely Anxious, What do I do?

My Teen is Extremely Anxious, What do I do?

Over the years children and teenagers have been exposed to stressful life events especially the last two years. The teens today have grown up with daily school shootings and mass shooting drills. Imagine being a second grader having to rehearse a man with a gun is on campus and you don’t know if you are going to live or die. Teenagers today have also grown up with terrorist alerts and having to be searched anytime they went to a concert or places such as Disneyland. Finally they have had to cope with COVID. Over 1,000,000 Americans have died from this virus (CDC). Many children and teenagers have lost grandparents, siblings and parents to this virus. We thought we had turned a corner regarding the Coronavirus and we find out we are back at the beginning. There are still people being diagnosed daily with the Coronavirus and a number of these people have been vaccinated. However, most are not fully vaccinated. Additionally, this time the virus is effecting teenagers and children. Since schools have resumed on site classes at least 1,000 children have died due to the Coronavirus virus (CDC).

This is a lot for a child or teenager to have to adjust to. Remember, their brains are not fully developed yet. Therefore they cannot understand things like adults do. Furthermore, they have very active imaginations which are fueled by misinformation on social media or from people such as Tucker Carlson on Fox. Having to cope with all of this together has resulted in a significant increase in depression, suicide, drug overdose and anxiety disorders. At my office we get at least 20 requests daily for teenagers seeking psychotherapy due to anxiety disorders.

The fact that we thought we were on the right track with the Coronavirus and now we have another spike which is similar to the numbers a year ago is confusing and irritating to teenagers. Just as somethings were opening up and returning somewhat to normal, we had another spike and needed to adjust our lives again. As a result, many things had to be closed down again, there were definite rules regarding wearing masks and teens were not able to freely socialize with their friends. Again we are not able to give children and teenagers any definite answers regarding when life will return to something normal. Now we have changed the rules again and masks are not required but recommended for events inside.

With everything teenagers have had to cope with growing up, terrorist attacks, war, the economy collapsing, mass shooting and now the Coronavirus, we failed to make plans for their mental health care. Yes hospitals were running out of beds and physicians have become exhausted, but we are also running out of psychotherapists. Also psychotherapists are exhausted because they are dealing with adults and teenagers daily who dealing with depression, suicide and anxiety. However, psychotherapist do need some breaks so they can keep going. Finally, more and more insurance companies are declining claims or raising copayments so high that families cannot afford their copayments.

This lack of mental health care is unacceptable in the United States. Parents call the Human Resource Department at your work. They negotiate your benefits with the insurance companies. Therefore, they can renegotiate your coverage so you receive the benefits your family needs. Also call your Senators and demand that insurance companies need to provide mental health care.

As a result, many parents have asked me how to determine if their child is coping with anxiety and what to do if they are coping with anxiety. I can understand why parents are concerned especially because many children tend to try to hide their anxiety because they don’t want to worry their parents. Additionally, parents are trying to find psychotherapist who can treat children and teenagers are parents are trying to figure out how they can afford therapy with the cost of living increasing and insurance companies restricting coverage.

Therefore, the APA (American Psychological Association) developed guidelines that parents can use to determine if their child is dealing with anxiety and what to do if they are dealing with anxiety. You can also use the guidelines for depression too. I have provided an outline to the APA guidelines below:

The American Psychological Association (APA) offers the following tips to recognize if children may be experiencing stress or anxiety:

• Withdrawal from things the child usually enjoys

• Trouble falling or staying asleep

• Unexpected abdominal pain or headaches

• Extreme mood swings

• Development of a nervous habit, such as nail-biting

Parents can actively help kids and adolescents manage stress by:

Being available

• Start the conversation to let kids know you care about what’s happening in their lives.

• Notice times when kids are most likely to talk – for example, in the car or before bed.

Listening actively

• Stop what you’re doing and listen carefully when a child begins to open up about their feelings or thoughts.

• Let kids complete their point before you respond.

• Listen to their point of view even if it’s difficult to hear.

Responding thoughtfully

• Resist arguing about who is right. Instead say “I know you disagree with me, but this is what I think.”

• Express your opinion without minimizing theirs – acknowledge that it’s healthy to disagree sometimes.

• Focus on kids’ feelings rather than your own during conversation.

• Soften strong reactions, as kids will tune you out if you appear angry, defensive or judgmental.

• Word swap.

o   Say ‘and’ instead of ‘but’

o   Say ‘could’ instead of ‘should’

o   Say ‘aren’t going to’ instead of ‘can’t’

o   Say ‘sometimes’ instead of ‘never’ or ‘always’

Consider

• Model the behavior you want children to follow in how they manage anger, solve problems and work through difficult feelings. Kids learn by watching their parents.

• Don’t feel you have to step in each time kids make what you may consider a bad decision, unless the consequences may be dangerous. Kids learn from making their own choices.

• Pay attention to how children play, the words they use or the activities they engage in. Young children may express their feelings of stress during play time when they feel free to be themselves.

• It is important to explain difficult topics in sentences and even individual words kids will understand. For little kids it might mean saying simple things like, “We love you and we are here to keep you safe.” For adolescents, it’s important to be honest and up front about difficult topics and then give them a little space to process the information and ask questions when they’re ready.

Call your child’s or adolescent’s health care provider or a psychotherapist who specializes in treating children and teenagers, if stress begins to interfere with his or her daily activities for several days in a row.

You can find additional helpful information about kids and stress by visiting the Centers for Disease Control and Prevention’s Helping Children Cope webpage at https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/for-parents.html.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children and teenagers. For more information about Dr. Rubino’s work visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple or on Audible.

There is No Reason to be Ashamed of Mental Health

There is No Reason to be Ashamed of Mental Health

Mental health is a topic we tend to avoid in our society. We avoid it so much that the month of May is dedicated to Mental Health Awareness. Many people are afraid that if other people know they are feeling down or anxious that people will think they are crazy. Many people think of someone living in the streets when you mention mental health. This is not reality. This negative stigma makes it difficult for adults to seek help for mental health issues. This negative stigma also makes it very difficult for children to ask for help when they feel depressed or anxious. They are afraid their friends won’t understand and won’t want to be friends with them. They are also afraid their parents will think they are crazy and be disappointed with them. These ideas are incorrect, but if mental health is overwhelming for an adult, imagine how it can be for a child.

It is very important that children and teenagers do ask for help when they are experiencing mental health issues. The CDC estimates 1in 5 children need psychotherapy for a mental health issue. Furthermore, the CDC has stated that Suicide is an epidemic for children between the ages of 10 and 18 years old and is the second leading cause of death for kids 10 to 18 years old. Cutting, self-harming behaviors, are also now at an epidemic rate in children. Most teenagers I work with, as a psychotherapist, have had suicidal thoughts and have cut before starting therapy with me. They also tell me about many of their friends who are feeling suicidal and cutting. According to the CDC, the Suicide rate and the number of teenagers engaging in self-harming behaviors has been increasing every year for the past twenty years.

While the need for teenagers needing psychotherapy is increasing, the reluctance to attend psychotherapy is increasing. Most teenagers I see for psychotherapy are afraid that their friends would stop being their friends if they knew they were going to therapy. They are afraid it makes them crazy and nothing will help because they are weak. They blame themselves for the feelings they are having. They are shocked when I explain that they are not weak and it is not their fault.

We need to change this stigma associated with mental health. Mental health should be treated the same way a physical health because they are the same. Clinical depression is caused by a chemical imbalance in the brain. If some one is diabetic, do we call them crazy or weak because their pancreas is not producing the correct level of insulin? No we do not. Therefore, when we have numerous research studies which show a link between physical health and mental health, why do we continue to view mental health so negatively? By doing so we are causing a number of teenage deaths. Suicide use to be the third leading cause of death for teenagers, however now according to the CDC it is the second most common cause, as I stated above. Many teens also die every year from eating disorders. Eating disorders occur in both girls and boys despite the belief girls only have eating disorders. Bullying is a severe problem and many teenagers are opting to commit suicide rather than discuss the pain and torture they are experiencing due to being bullied. This does not make sense that teenagers should be dying because the teen or their family are embarrassed to seek treatment.

I was researching this subject and found a video by the Anna Freud Institute. It is called, “We all have mental health.” It is a short video directed at teenagers and middle school students. It discusses the issue in a very relaxed manner and provides teenagers with options for how they can talk about their own feelings. I encourage parents, teachers and anyone who deals with children to watch this video. You may want to watch it with your teen and begin a discussion about feelings. The link to the video is https://youtu.be/DxIDKZHW3-E.

We need to start to change the negative stigma associated with mental health. Besides causing the deaths of teenagers, this stigma effects an entire family. A death impacts everyone in a family. Not being able to talk openly about a death because it was related to a mental health issue, creates more problems for the survivors. Nothing will change until we start to approach mental health differently. I also encourage you to look at the foundation started by Prince William and Henry, Heads Together. It provides a number of ways we can start to change the negative stigma associated with mental health and save lives.

Furthermore, at this time in our world, when we are in the middle of a pandemic which besides killing thousands of people daily, it is creating mental health issues for those in quarantine, those with the virus and our first responders. These issues will not disappear quickly just like the virus will not disappear quickly. As a result, we will have even more people needing mental health care. How will they receive it if they feel ashamed for needing treatment or if we continue to treat mental health as a disease? Mental health and physical health go hand in hand, when will we treat them equally?

Dr. Michael Rubino is a psychotherapist with over 20 years experience working with teenagers and children. For more information about his work or private practice visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.

Mother’s Day when Mom is not Here

Mother’s Day when Mom is not Here

Many people assume Mother’s Day is a happy day for people because they can honor their mother. However, due to the pandemic and deaths due to the pandemic, Mothers Day this year maybe a very difficult day. We have many adults and children who are grieving the death of their mother or grandmother due to the coronavirus. Therefore, making it a sad day for them. Remember over 1,000,000 Americans have died due to the Coronavirus. Many people who died were mothers and grandmothers so there will be a lot of grieving families this Mother’s Day.

In addition to the Coronavirus, there are other reasons that Mothers Day maybe difficult for people and children. For some people their mother may have died when they were children. For some people their mother may have left them when they were children and they had to live in foster care. For others, their parents separated and their father raised them and they rarely or maybe never saw their mother. Finally, many people have lost their mothers, grandmothers and aunts over the year due to cancer, heart attacks and other diseases. Therefore, Mother’s Day may not be a happy day. Also for children who were raised in foster care all their lives, today typically is a very difficult day.

While this may not be a happy day for adults, it also can be a very difficult day for children too. Some children may be dealing with the recent death of their mother. As I stated above, some children may have a mother who died from the Coronavirus or cancer. Other mothers may have left the family due to a drug problem and are not involved with the family any longer. Seeing television commercials or having other family members tell them that it still can be a good day can be difficult for them. Also if their school is making Mother’s Day gifts it can be difficult for children whose mothers have died or left the family.

I work with many of these children, I described above, in psychotherapy. Many don’t express their feeling, but they tend to deal with the emotional pain by acting out. They may be very oppositional during the week and on Mother’s Day as away to express their feelings. Other children may isolate themselves and not want to be involved with anyone or anything having to do with Mother’s Day.

I have had parents ask me how they should handle Mother’s Day when a parent has passed away or left the family. They understand that it is a difficult day, but they do not know what to do in order to help their children.

My recommendation is let the child cope with the day in the way they need to. Try not to make an issue about the day. The other thing I recommend to a parent is to talk to their child. Acknowledge that Mother’s Day may be difficult but it is just one day. They may have a rough day today but tomorrow is another day. It is important that you understand that Mother’s Day is difficult for them and you understand if they are upset or don’t want to do anything. I also recommend to a parent, when a parent has passed away, to ask the child if there is anything they may want to do to remember their mother. A child may want to release a ballon with a note, they may want to visit the cemetery or they may want to do something for an aunt or another female role model in their life. If they do have an idea, go with what they want to do. If they don’t have an idea, let them know that is okay. If they come up with an idea then you can do it. If they do not have an idea, then remind them it’s just one day that you all need to get through and tomorrow will be better.

This approach can help children whose mother has left the family too. Many children may believe their mother will return one day. Confronting this belief around Mother’s Day is not the time to confront it. However, if they have an idea regarding how they want to honor their mother, allow them to do it.

Hopefully this will help parents understand the issues their children may be dealing with on Mother’s Day and make it easier for everyone.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children and teenagers. For more information about Dr. Rubino’s work or private practice visit his website www.RubinoCounseling.com or on Facebook at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Teenagers are Crying Out for Help

Teenagers are Crying Out for Help

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.

Let’s look at the pressure teenagers are facing today. One major stressor is social media. They look at the accounts of other teens who post everything is going great in their lives and they have a lot of friends. This is not the reality, but most teenagers are not aware of this fact and they start to wonder what is wrong with them. Why don’t they have the same wonderful lives full of friends and good grades?

Another stressor for teenagers is the Coronavirus. Over 700,000 Americans have died from Covid and 1200 Americans are still dying daily (CDC). Therefore, many teenagers are grieving the loss of family members and friends and the grief is especially difficult during the Holidays. Additionally, we do not have a firm grip on the Coronavirus and information is changing daily. Therefore, teenagers are still dealing with restrictions at school and are not able to see their friends on a regular basis. Furthermore, they don’t know if their lives are ever going to return to pre-pandemic routines or have their lives and childhood been permanently changed.

Finally, teenagers today are dealing with school shootings which continue on a regular basis. The school shootings impact more teenagers than we think are impacted by them. When there is a school shooting every student at that school, in that community and in our Country is effected. They are traumatized again and again begin to worry, will I be killed today at school. This is why the shooter in Oxford was charged with terrorism. Every student, teacher, parent and first responders were terrified about would they be killed, would someone they know be killed, how are they going to cope with what they find at the school and students, parents are teachers all over the Country worried about could this happen at our school? As a result, many teenagers do not want to go to school because they don’t feel safe and parents worry when their child leaves that day for school, could it be the last time they see their child alive. All of these factors are a lot to expect a 13 year old to cope with on a daily basis, year after year.

Ten years ago as part of my initial evaluation of a teenager I would ask, 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. They say they have used cutting to cope with the stress of life or they have thought about it. 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. They apologize for trying it or thinking about it, but they explain life was so stressful they didn’t know how to cope with the emotions they were feeling. Again these teenagers are facing stress because they are admitting that life has become too stressful. They are afraid that I will be upset with them or that their parents may be upset that they cannot handle everything that is going on in their lives.

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, as I stated above. 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.

A teenager’s blog about cutting. 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.

This is how one teenager tries to explain cutting to adults and how it makes them feel years after they have stopped cutting. Really read and think about what this teenager is saying. Should any teenager have to feel this way because they are feeling overwhelmed by life? Overwhelmed by circumstances which are not their fault and they cannot control? Is it fair they should suffer this way, when they are asking for help, but insurance companies deny to help them? What responsibility do we have to help these teenagers who are begging for help?

Dr. Michael Rubino is a psychotherapist with over 24 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.

Ways to Have A Happy Holiday Season with Your Family

Ways to Have A Happy Holiday Season with Your Family

Halloween signals the beginning of the Holiday season. Many people will be worrying about how they will survive the Holidays with certain relatives and since prices have increased this year many people are worrying about how they will be able to afford the Holiday Season. Additionally, there is the Coronavirus pandemic. Many people have been vaccinated, but others for some reason have decided not to get vaccinated. Therefore, some families are faced with decisions about do they celebrate with relatives who have not been vaccinated. This can be very difficult and a very stressful situation. In addition, the Holidays can be stressful because they may bring up family issues that have not been resolved yet or you have some family members trying so hard to make the day prefect that it becomes a stressful day not a happy one. Also parents are concerned how their children will act around the entire family?

Thanksgiving is next and then there is Christmas and Chanukah depending on your family’s tradition. Since Thanksgiving is next, you can evaluate how Thanksgiving went for everyone and decide if you want to make changes for the remaining holidays.

After you have assessed how you would like Thanksgiving and the Holidays to go, the next step is to sit down with your children and ask for their opinions. Also ask about what their expectations are for the Holidays . It is especially important to discuss this point with teenagers because they have been isolated from friends due to the pandemic. Are they expecting to spend Christmas Eve and Day with the family or are they expecting to spend time with friends and girlfriends or boyfriends. It is important to settle this issue before the Holidays. By discussing expectations and trying to accommodate everyone’s wishes, you can avoid arguments. However, many times you cannot accommodate everyone’s wishes and as the parents you may need to make the judgement call. If this occurs explain to your teenager you know they may be mad, but you hope they can understand and you would appreciate their cooperation. May be you make arrangements for them to spend time with their friends the day before or after certain Holidays.

The next discussion is gifts. Explain to your children the point of the Holidays is to appreciate and to be grateful for the people in your life and what you do have in your life. Therefore, if your grandparents give you something you do not like, be grateful that they thought about you and say thank you. Try not to make faces or act disappointed and hurt your grandparents feelings. Again remind them the Holidays are a time to be grateful for what you have in your life.

Reminding your children about being grateful leads us into the next tip for decreasing Holiday Stress. Lori Lite who writes about stress uses the acronym G-R-A-T-E-F-U-L as her Holiday stress guide. It helps her and others get through the day in a peaceful manner. Each letter reminds you of something to do or a way to view the day so you do not get upset.

So here is how to use Gratitude as your Holiday Stress Reliever.

G- Gratitude is the opposite of stress. It is difficult to feel stressed out when we are feeling gratitude.

R- Relax your expectations and let the day unfold. You might be surprised by the outcome.

A- Acceptance is the opposite of judgment. If we accept our family member for who they are and what they are capable of we can relax and enjoy ourselves.

T- Teens can be a part of the Holidays. Ask them what they would like to contribute to the evening or day. Let them what they feel they can contribute.

E- Empower children and let them help with age appropriate assignments. Putting the nuts out or making the centerpiece. Let them do it their way…not your way.

F– Focus on family for this day. Put all work and worries on the shelf

U– Unplug the electronics for dinner so that everyone can be fully present.

L- Love is often overlooked when we are busy. Be present with love… Speak with love… Show your love and gratitude for your family during this Holiday time.

This might seem very simple and obvious, but at times the best solutions are rather simple. Also you may want to practice using this in your daily life. It may seem simple, but it may be harder to do than you think because you are accustomed to doing things and viewing life in a certain way. This idea may challenge you to reassess how you approach life in general.

Many of us are not use to looking at our lives in terms of what we have to be grateful for. Also many of us have a hard time relaxing and not worrying about work or other things we need to do. I have found that just being in the moment is difficult for most people. Most of us believe we always have to be doing something. This creates stress and disappointment. Finally, since we feel we must always be doing something, disconnecting from cellphones and other electronics can be very difficult for the children and for adults too. However, think about it? How can you have fun and enjoy the day with your family, if your mind is not fully present? You can’t. Furthermore, this can create tension for others because they feel ignored and for you because you feel they don’t respect how important what you are doing at the moment is to you. As a result, you have stress which can turn into an argument and everyone is upset. A day of happiness becomes a day of anger and disappointment.

If you notice you are getting angry or your teenager is getting angry use the acronym HALT:

H – hunger, do not try to discuss a difficult situation if you or your teen are hungry.

A – anger, if it is obvious someone is angry give them time to calm down before discussing an issue. Pushing a discussion when someone is angry will only result in making a bad situation worse.

Lonely – lonely, if someone is feeling down or alone again pushing them to talk can make it worse. Let them know when they are ready you are there to listen.

Tired – tired, trying to have a conversation with a tired teenager can turn into an argument fast. Wait until they are ready to talk. There is no need to make a bad situation worse.

Therefore, in order to avoid the possibility of an unpleasant Holiday for everyone try to

use the words GRATEFUL and HALT as guidelines for the day. What do you have to lose?

Dr. Michael Rubino specializes in working with children, teenagers and their families. He has over 24 years experience. For more information about his work or private practice visit his website at www.RubinoCounseling.com or visit his Facebook page at www.facebook.com/drrubino3 or his podcast on Spotify or Apple.

How Many Teenagers Die because of the Shame associated with Mental Health

How Many Teenagers Die because of the Shame associated with Mental Health

In our society there is a huge negative stereotype about mental illness and treatment for mental illness. You would think with all the advancements in the world and society, that our attitude towards mental health would have changed by now. However, it has not and that is why the month of September is dedicated to Suicide awareness. Many people are surprised that in the United States in the 21st century, statistics show that 1 in 5 people could benefit from psychotherapy (CDC). Also suicide is the second leading cause of death for children 10 years old to 18 years old (CDC).

Most people when they think about psychotherapy or mental illness, think of someone sleeping in the street or some one with severe schizophrenia. Because of this stereotype many people feel ashamed or embarrassed if they are told they need therapy. Family members also feel ashamed and embarrassed and never mention it to other people if someone in their family needs psychotherapy. People are afraid that other people will think they are “crazy” too, if someone in their family is going to therapy. However, most people who need treatment for a mental illness need treatment for depression or anxiety not schizophrenia. Diane Swayer, who use to anchor ABC news, started a non-profit because her sister has Bipolar Disorder. She was not ashamed to announce this publicly. Also we all witnessed how the world responded when, Simone Biles, decided not to participate in the Tokyo Olympics due to mental health issues. We need more examples like Diane and Simone.

Research studies show that most depression is due to a chemical imbalance in brain. Similarly, Diabetes is due to the pancreas not being able to coordinate glucose levels in the body. We don’t make a person with diabetes feel embarrassed or ashamed so why do we make someone dealing with depression feel embarrassed or ashamed? Both issues are due to chemical imbalances in our bodies.

What is the cost of this stereotype? People who have depression are at risk for suicide. The Center for Disease Control statistics show that suicide is the second leading cause of death for people aged10 to 24. Yes ten year old children are suffering from depression and are killing themselves. One of the most common methods is a gun. People assume this is a guarantee. Wrong, a gun is not a guarantee. Quite often the gun jumps and the person lives. However, they have to undergo multiple surgeries to try to rebuild their face. However, no matter how good the surgeon, the person is left with multiple permanent scars. Psychotherapy and medication might have prevented the suicide attempt.

However, because of our negative stereotype, depression and suicide have never been taken seriously. As a result, the Golden Gate Bridge is the most common place in the world for people to attempt suicide by trying to jump off the Bridge. It wasn’t until just recently that the Bridge District voted on what type of anti-suicide barrier they are going to build. However, even though they have voted for an anti-suicide net, they are still debating the details. The Golden Gate Bridge is over 78 years old. It has taken over 78 years to do something about a life or death issue and they are still debating over minor details. As they do, over 200 people a year try killing them selves by jumping off the Bridge. According to the Bridge District, there have been 1700 recorded deaths. The longer we wait, more people can die. BART has been around for decades and people had been jumping in front of trains for years. However, BART understands the issue and that it must be addressed despite the stigma. BART has an anti-suicide campaign showing we can address the issue of mental health without shame.

Often we assume it is a money issue. Only poor people commit suicide because they cannot afford treatment. The suicide of Robin Williams destroyed that myth. He had plenty of financial resources for treatment and had been in and out of treatment centers for years. In an interview with Dyane Swayer he described how overwhelming depression is, he said, “no matter what there is always that little voice in the back of my mind saying jump.” If that voice is always there but society is saying there is something wrong with you for having depression in the first place or because you have not over come it, are you going to ask for help or keep seeking help? No.

Yes society often blames the patient. Why don’t they try harder? Why didn’t they think of their family? After Robin Williams’ suicide a number of comedians and actors talked about their silent struggle with depression. Rosie O’Donnell stated it best, “when you are that deep down in that black hole with intense emotional pain, the only think you can think about is how to stop the pain. You don’t think about your family or anything else.”

I ask you to think about your opinion or thoughts about mental illness. Think about a 10 year old boy feeling that suicide is the only way out of his pain. Think about the fact that he is dealing with a medical diagnosis similar to diabetes or high blood pressure. If this is right, why is there this negative stigma about mental illness? If a child has diabetes he receives medical treatment, there are summer camps and there is no shame put on the child or the family. Think about the fact that the bill President Trump try to make Depression and anxiety pre-existing conditions so insurance companies could deny people health care.

We need to make a change in how we view or react to mental illness. We live in the United States of America and we are supposed to be the super power in the world. You wouldn’t think that in the most powerful nation in the world that the second leading cause of death for our children is suicide. We must change this ridiculous stereotype we have about mental illness and start providing people and children with appropriate treatment for their mental illness. The life you save might be your’s child’s life or the life of a family member or friend.

We may want to look at England. The Duke and Duchesses of Cambridge have formed a program called, Heads Together. The goal of the program is to eliminate the negative stereotype about mental health and to make sure people who need psychotherapy receive it. In fact, the Duchess of Cambridge said publicly that if her children ever need psychotherapy that they will receive it. We might want to follow their example.

Also consider these facts and points Chris Cuomo made about how we stigmatize mental health on his CNN show https://youtu.be/9nSN9eDnhmk. It’s worth listening to.

Dr. Michael Rubino is a psychotherapist who specializes in treating children and teenagers. Dr. Rubino has over 20 years experience as a psychotherapist. He is very active in eliminating the stereotype about mental health. He is an active member in Heads Together in London, a non-profit founded by Prince Willam and Princess Kate to help people understand that people need mental health care. For more information about Dr. Rubino’s practice or his work visit his website at www.rubinocounseling.com or his Facebook page www.Facebook.com/drrubino3.

Lessons Simone Biles Taught Us About Mental Health

Lessons Simone Biles Taught Us About Mental Health

Mental health is a topic we tend to avoid in our society. It’s the “dirty little secret” people whisper about and will talk about behind someone’s back. Many people are afraid that if other people know they are feeling down or anxious that people will think they are crazy. Especially if a teenager is going to psychotherapy. They assume many people will think of them like the person living in the streets and talking to themselves. This is not reality. This negative stigma makes it difficult for adults to seek help for mental health issues. This negative stigma also makes it very difficult for children and teenagers to ask for help when they feel depressed or anxious. They are afraid their friends won’t understand and won’t want to be friends with them. They are also afraid their parents will think they are crazy and be disappointed with them. These ideas are incorrect, but if mental health is overwhelming for an adult, imagine how it can be for a child.

It is very important that children and teenagers do ask for help when they are experiencing mental health issues. The CDC estimates 1in 5 children need psychotherapy for a mental health issue. Furthermore, the CDC has stated that Suicide is an epidemic for children between the ages of 10 and 18 years old and is the second leading cause of death for kids 10 to 18 years old. Cutting, self-harming behaviors, are also now at an epidemic rate in children. Furthermore, since the pandemic has started we have seen a significant increase in the number of teenagers seeking therapy for depression, anxiety and suicidal thoughts. Additionally, since the pandemic we have seen a significant increase in teenagers overdosing on drugs. Before the pandemic anxiety, depression, suicidal ideations and overdosing on drugs were at alarming rates in teenagers too (CDC). Teenagers have been dealing with mental health issues for years and the number of teenagers needing therapy has been increasing every year (CDC).

This year at the Tokyo Olympics, Simone Biles, took a huge step forward in removing the stigma from mental health issues. Simone came into the Tokyo Olympics with everyone expecting her to win gold in every event. In addition to this pressure, during the pandemic she came forward to say she too had been sexually abused by the team doctor for years. This was a huge thing to do especially since the entire world would learn about it. She stated she did not retire and continued with the Tokyo Olympics to ensure that the Olympic committee takes steps to protect the younger girls in the program.

Simone was dealing with a lot and we do not know what else is occurring in her private life. She had posted some posts on social media stating she was feeling slightly overwhelmed but that was the extent of what she said publicly. To everyone’s surprise on the first night of the Women’s team competition, Simone suddenly drop out of the competition. She confirmed she was dealing with some emotional issues but that she was okay and would decide about the rest of the competition later. She finally decided to remove herself from competition completely.

After she removed herself from competition, she commented about the overwhelming support she received. It sounded like she was expecting criticism not support. Additionally, she commented it was the first time in her life that she realized there was more to her as a person than just gymnastics. Making this realization made her feel very good about herself in the statement she released.

Many parents are wondering what is the lesson to learn from what Simone did this week. As a psychotherapist, who works with teenagers and young adults, there are several lessons we can learn from Simone.

The first and in my opinion the most important lesson is that everyone deals with mental health issues daily and at times we may need to take a break or seek treatment. Simone handled her situation no differently than if she was having a medical issue such as tearing a ligament. She did not act ashamed not did people treat her like she was crazy. In fact, other competitors complimented her. They all have had struggles with mental health issues and they were happy and proud that Simone was taking care of herself and not acting embarrassed or ashamed that she had a mental health issue she needed help with. Therefore, the lesson is mental health is part of life and when you need help it’s okay to ask for help.

The next lesson is how people responded to her request. No one acted like she was crazy and the team coaches and her team mates were giving her the time and support she needed. Therefore, the second lesson is when a teenager asks for mental health help, we need to support them in getting the help they need without judging the person.

Another important lesson is that asking for help did not destroy how people reacted to her or her accomplishments. She is still a world class gymnastics star and she won a silver team medal at the Tokyo Olympics. Therefore, asking for help did not ruin her life. If you have a teenager who needs mental health help, reassure them that it will not ruin their life. Asking for mental health care is no different than asking for physical health care. Our mental health and physical health go hand in hand. This is another lesson Simone taught us. Mentally she needed help and therefore she was not physically capable of competing.

Providing support to someone is another lesson Simone taught us this week. Her teammates, coaches, family and friends offered support abs would check-in with her. No one walked away which many teenagers fear if they say they need mental health care. Her support system was there for her. They did not smother her, but if she needed their help they were there.

Also commentators had been wondering if something was wrong because she was not acting like herself. Therefore, if your teenager or friend is acting somewhat differently and you are concerned, don’t be afraid to ask if they are having a problem. Sometimes asking for help can be difficult especially when you are a teenager. Therefore, if your teenager or friend is acting differently, do not be afraid to ask if they need help.

Finally we often assume people who look like they have everything they want, cannot have problems in their lives. Simone Biles is one of the most decorated Olympians in gymnastics history and she is having problems. Kevin Love, a pro basketball player, suffered from panic attacks. Here are two athletes at the top of their games, but they still have mental health issues. Therefore, we all have mental health issues and need therapy at times and there is no reason to be embarrassed or ashamed. It is simply part of life.

I was researching this subject and the lessons Simone opened up this week and found a video by the Anna Freud Institute. It is called, “We all have mental health.” It is a short video directed at teenagers and middle school students. It discusses the issue in a very relaxed manner and provides teenagers with options for how they can talk about their own feelings. I encourage parents, teachers and anyone who deals with children to watch this video. You may want to watch it with your teen and begin a discussion about feelings. The link to the video is https://youtu.be/DxIDKZHW3-E.

Dr. Michael Rubino is a psychotherapist with over 20 years experience working with teenagers and children. For more information about his work or private practice visit his website www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3.

Teenagers No Longer Feel they have A Future

Teenagers No Longer Feel they have A Future

Many people may think I am crazy making this statement, but do people realize we are in the middle of a deadly pandemic. Furthermore, the Coronavirus, which is creating the pandemic, has muted and created a new strain. The Delta form of the Coronavirus is even more contagious and far more deadly than the original strain of the Coronavirus. If we have a doubt, look at how the Delta strain in ravaging India. In India they have run out of space for the dead and people are dying in the streets because the hospitals are full. However, for some reason people in the United States are ignoring what is happening in other countries and ignoring the warnings our public health doctors are giving us.

The Fourth of July was supposed to be the reopening of the United States. However, our Country was not sufficiently vaccinated. The public health physicians warned us if more people were not vaccinated, the Delta strain would take over and we would be facing a desperate situation again. The public health physicians and Biden’s administration were not wrong when they were urging everyone to get vaccinated.

Prior to the Fourth the number of infections were decreasing significantly. Now after the Fourth, we have seen a significant increase in the number of people being diagnosed with the Coronavirus and needing to be hospitalized. We are now in a situation again where it is recommended to wear a mask again in public. This is very discouraging especially when we have vaccinations which have proven they can help control the Coronavirus.

Over the last month, 98% of people who have been hospitalized or died from the Coronavirus were not vaccinated. Additionally, the people being infected the most are between 20 to 50 (CDC). People in their 60’s and 70’s are vaccinated and are basically immune to the Coronavirus. However, the former President who has been pushing lies that the vaccines are not safe and healthy people in their 20s and 40s do not need to worry about getting the virus is wrong. The vaccines are safe and anyone can become infected with the Coronavirus virus and die at any age.

This brings me to a very scary situation which has now been created. Children under 12 years old cannot be vaccinated yet. We are having significant outbreaks again in every state and we want children to return to school onsite. Many states such as Texas, Florida and Tennessee are saying children do not need to wear masks and schools do not have to practice social distancing. Viruses mute all the time to find new hosts. This leaves children under 12 years old as prime targets for the Coronavirus.

Do not believe the lies from Trump and Fox News that children rarely get the Coronavirus. The truth is children do get infected with the Coronavirus. Children are also at risk for a very rare side effect from the Coronavirus. Children can develop a condition where their immune system attacks their own body and their internal organs and blood vessels swell. This is a deadly side effect. Since this new spike with the Delta strain has started, children make up 21% of people being diagnosed with the Coronavirus. In one week, 88,500 children and teenagers were diagnosed with the Coronavirus. Additionally, since the pandemic started in the United States, children and teenagers make up 13.6% of those diagnosed with the Coronavirus (AAP, Childrens Hospital Association). Therefore, do not believe the lie that children cannot contract and die from the Coronavirus.

Many people say they are exercising their First amendment right by not getting vaccinated. However, you cannot affect me in the course of exercising your rights. This is why you cannot scream “fire” in a movie theater. We are in the middle of a health crisis. A crisis which has taken over 600,000 American lives. If you want to refuse the vaccines which have proven to work and to be safe, then you need to accept the consequences. If employers require proof of vaccination or your health insurance increases your premium, do not complain. Why should employers suffer if you spread the Coronavirus and why should the rest of us who were responsible and were vaccinated pay for your health bills when you get sick. It’s not fair.

Also what are we doing to teenagers and children. UCLA released a study earlier this year showing people between 40 and 18 had a unhappy outlook on life due to the Coronavirus. Since the pandemic started we have seen a significant increase in depression, anxiety, drug abuse and suicide in teenagers and children as young as 10 years old. They don’t think their lives will ever return to normal again.

When the Country started to open up on the Fourth of July, they had some hope. Now that they are hearing the news regarding the new spike, States such as California requiring masks again and hearing that states such as Texas, Tennessee and Louisiana not following through with the vaccines, they are losing hope.

The teenagers in this generation are intelligent and can access all kind of information via their cellphones. They know if people are going to continue to lie about the vaccines and refuse the vaccines that our Country will never recover. They are also very angry. If teenagers were causing these problems, adults would say they have no rights and tell them what they were going to do. However, when adults, such as Trump and Ted Cruz, want to play political games with the lives of teenagers, people act like their is nothing they can do.

There is something parents can do. Contact your children’s school and demand that they take all necessary precautions needed so your child is not exposed to the Coronavirus. You can contact your employer and demand safety precautions. Listen to the public health physicians and follow their recommendations. Finally, call your State and Federal representatives and Senators and demand they enact laws to keep you and your family safe. Remember children under 12 cannot be vaccinated so they are at the highest risk. Do you want to have to plan their funeral? Are we going to prove them right that there is no hope left. Think about being 11 years old and feeling like your life is over. I am hearing this from many intelligent children.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children, teenagers and trauma victims including first responders. For more information regarding his work visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/Drrubino3 or his podcasts on Spotify and Apple

Today’s Kids are Missing Out on Being Kids and Paying a Big Price

Today’s Kids are Missing Out on Being Kids and Paying a Big Price

What are we doing to our kids?” is a quote from Cameron Crowe, who wrote the movie Fast Times at Ridgemont High a movie from 1982. Cameron Crowe was discussing the movie with CNN for their special report on movies. He explained he went undercover in a high school as a high school senior to write the movie. He stated he was shocked at how sexually active these kids were in high school. He stated between the focus on sex and working, the kids were being denied their adolescence. They were going from kids to adults very quickly. Sadly what Cameron Crowne noticed in 1982 has continued and has only become worse.

Cameron Crowe was commenting on high school students in 1982. However, what he noticed occurring in high school in 1982 is now occurring in middle school today. In middle school today it is not uncommon for kids to be sexually active. In fact, many middle schools now provide condoms to sixth graders. In addition to sex, kids in middle school are using drugs. They are not just using marijuana. Many middle school students are using concerta, ecstasy and other designer drugs.

In addition to being sexually active and using drugs many middle school students are worrying about how much money they will make at their jobs. Kids are looking at different careers and thinking about how much they will get paid and what they will be able to afford. They wonder about, how big of a house or what type of car will they be able to afford as adults? Mr. Crowe’s observation was correct in 1982. However in 2021, kids are losing their childhood too early and they are losing their childhood earlier and earlier. In 1982 it was high school in 2019 it is occurring in middle school. When will it start occurring in fifth grade?

In addition to these factors, teens in middle school and high school have had to live through the pandemic and over a year of remote learning. Therefore, teenagers were forced to spend over a year at home by themselves and their main interaction with friends was by texting or gaming. As a result, many teenagers feel like they have lost a year of their lives that they will never get back and a year of exploring life with their friends. Many teenagers are reporting depression and anxiety due to the Coronavirus. Who can blame them because they have lost a year of their childhood that they cannot get back. How are kids going to react when they return to school full time?

Since I specialize in treating children and teenagers, I have had more children and teenagers reporting depression, anxiety and a sense of loneliness over this past year. Additionally, they are wondering how they should act when they return to school. Many of them are feeling disconnected and out of touch with their friends and other teenagers their age. In 2000, I was noticing this in a few teenagers now in 2021 a majority or teens and middle school students report feeling lonely and isolated and anxious. I am also beginning to hear this from fifth grade boys too. Besides loneliness increasing in middle school and high school, the number of kids feeling depressed is increasing significantly. It makes sense. Teenagers have lost a year of “normal” teenage life and no one knows what to expect when they return to school.

You may ask with their focus on friends and sex, how are they feeling lonely or isolated? With this focus on friends, sex, drugs and the future comes a great deal of competition. Everyone wants to look like they know exactly what they are doing. Therefore, they may be talking and texting each other, but they focus more on shallow issues. No one really opens up about their true fears and worries. As a result, they feel lonely and isolated. They also have missed a year of “normal, typical” experiences which help them mature.

A very good example of this are teenage boys. Most teenage boys are trying to live up to the outdated stereotype about what it takes to be a man. According to the stereotypes men don’t cry, don’t focus on emotions because they are weak and must be sexually active to be a man. There is a documentary, The Mask You Live In, which focuses on boys conforming to this outdated stereotype. Overwhelming the boys in the documentary reported feeling lonely and isolated. They shared they had no one who they could talk to when they felt overwhelmed or confused by life. They always had to have the right answer and they did not always what was the right answer. As a result, they made mistakes and they felt lonely not being able to ask for help. They felt like they had to hide their true feelings which makes them feel lonely.

Having a year with little to no personal contact with their friends only increases this feeling of isolation and loneliness. Since teenagers try not to act like they need help, they are experiencing more feelings of anxiety and depression. The CDC has documented a significant increase in the number of teenagers coping with depression and anxiety since the beginning of the pandemic.

Texting and online gaming have increased as a way for teenagers to feel a connection with their friends. Many parents worry about their teenagers texting or gaming, but if it provides a sense of connection with their friends and the world, I have recommended to parents to adjust their rules regarding these behaviors during the pandemic. Teenagers need a way to feel connected to others. Without this sense of connection during the pandemic, we see an increase in the number of teenagers committing suicide or overdosing on drugs.

Another aspect to teenage boys and girls feeling lonely, isolated, depressed and anxious is that they tend to close themselves off emotionally. As a result, they do not know if anyone cares about them. They never know if someone loves them. This can create major issues for teens. In the Disney movie Frozen, they point out how people will act out in pain and make mistakes when they don’t feel loved or cared for by people. The movie also points out how opening yourself up so you can feel love will help people change and make better choices. The lead character, Elsa, when she felt lonely and afraid could not control her power and it only caused destruction. When she finally opened herself up and saw she could be loved she discovered the good her powers could do. When she was afraid she isolated and when she felt loved she opened up and interacted with others. I see this happen daily with teens. When they feel no one cares, they isolate themselves and say hurtful things to keep themselves isolated. When they discover people care, they allow themselves to open up and start to share their true feelings and interact with others. They are very happy and surprised when they make this discovery.

In 1982 the world was much easier. In today’s world things are moving fast and make it easy for people to isolate by texting or using social media to communicate. In addition, teenagers are living through a pandemic and political climate that has changed how we communicate and view the world and each other. As a result, teenage boys and girls feel pressure to outdated stereotypes about men and women. There are few people telling teens they don’t need to follow these stereotypes. We also need to set examples about communication. Adults need to not text so much and rely on social media enough. Parents need to take time talking with their children as soon as they are born. Technology can be a great thing but it is making many people feel lonely and isolated. Teens as well as adults. We need to study technology and look at how it is impacting our lives and the lives of our children. One thing for sure, I have seen technology increasing the amount of teens feeling lonely and depressed. We don’t want our kids to lose out on their childhood. Therefore, we need to study the impact technology has on us and teach our children how to use it responsibly. Also we need to teach teenage boys and girls that they don’t need to live up to the outdated stereotypes about men and women. We need to encourage our kids to be themselves and to accept themselves.

Additionally, teenagers today are the only teenagers in recent history who have had to cope with daily mass shootings and a pandemic which has killed over 600,000 Americans. We need to look at all these issues and help our children and teenagers cope with the world they have to live in. Hopefully this will help our children reclaim their childhood and be kids.

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