New Information About Head Injuries and Teenagers

New Information About Head Injuries and Teenagers

Many parents of high school athletes are aware of the dangers of concussions. Research now shows that even one concussion can cause permanent damage according to recent research studies. However, there is another condition that parents need to be aware of when their child plays sports. This disorder is CTE. CTE is Chronic Traumatic Encephalopathy (CTE) it is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head.

Our brain sits in our skull surrounded by fluid. Therefore, any time anyone hits their head or their head is jarred around, the brain moves in this fluid hitting the front and back of your skull or the sides of the skull depending on what direction the force came from. When the brain hits the skull it can cause bruising and microscopic tears of very fine nerve fibers. Nerve fibers that are too small to be seen on an MRI or a CT scan.

Physicians have known that CTE effects boxers for many years, however, it was just a few years ago that evidence showed that football players are at risk too. This was the main focus of the movie, Concussion, starring Will Smith. The NFL did everything they could to stop the filming of this movie. The movie shows how CTE results in the patient becoming severely depressed and psychotic. Many of the patients with CTE commit suicide. Also many CTE patients were professional football players who started playing in High School.

Why is this important for parents to know? It is important because CTE is caused by chronic head injuries. Head injuries that date back to when a teenager was playing high school sports. Therefore, it is important for parents to ensure that their teenager’s school is using the latest safety gear, especially for the head, and to take any head injuries seriously. There is no way to tell what will happen when these teenagers become adults.

For many years, football and schools have reported that they are developing helmets that protect the head better. However, these safer helmets are not being used in high schools or professional football. Schools and professional football are monitoring players closer after a head injury, but still little to nothing is being done to protect the brain prior to an injury. Furthermore, this week evidence was uncovered showing that professional football players may not receive an adequate evaluation for a concussion if they are hit during a game. In fact, it is believed that even with all the information we have regarding concussions that many professional football players continue in games even though they have a concussion.

This issue game up during the week when a player for the Miami Dolphins suffered a hit and was assessed not to have a concussion. He resumed play and four days later sustained another hit and was diagnosed with a concussion. He was believed to be suffering from second impact syndrome. “What we currently believe second impact syndrome to be is a second blow to the head or second concussion prior to the resolution of a first one. And that can result in uncontrolled swelling of the brain,” explained Steven Broglio, director of the University of Michigan’s Concussion Center. Broglio is a certified athletic trainer and is a lead author on the National Athletic Trainers’ Association position statement on management of sport concussion (CNN). It is estimated that it takes approximately 14 days for the brain and the brain chemistry to return to normal after the brain sustains a hit causing a jarring motion of the brain. Often these injuries have no symptoms (CDC).

If professional football players are being allowed to play with concussions and are developing second impact syndrome, what are happening to high school athletes? Researchers such as, Neuroscientist Julie Stamm, a clinical assistant professor in the Department of Kinesiology at the University of Wisconsin-Madison, are questioning the protocol being used to assess athletes for concussions (CDC). If professional athletes are not being adequately assessed and now developing a new condition, second impact syndrome, what is occurring with high school athletes?

As an adolescent psychotherapist who has been practicing for 25 years, I am seeing more evidence of student athletes sustaining head injuries every year. Every year I am seeing more teens with Post Concussion Syndrome. This may occur after a concussion and can be associated with headaches, mood swings and memory difficulties. The teenagers who experiences this Syndrome become very frustrated because they are aware of the changes and because no one can say how long the symptoms will continue. In fact, no one can guarantee that the symptoms will disappear.

This becomes very frustrating to the teenager and their parents. Some teenagers are so overwhelmed that they start self-medicating with drugs and alcohol. Anything that they think might help. Others become so depressed because they fear that the symptoms are permanent that they become suicidal and may attempt suicide.

For many years these head injuries in teenagers were down played because there was not enough evidence to indicate that teenagers could be impacted by head injuries. Well the research clearly indicates that teenagers can suffer long term results from a single concussion. Additionally, this can create symptoms that are overwhelming for the teenager and their family. Imagine being a parent and you see your child suffering with Post Concussion Syndrome and there is nothing you can do to stop it. Parents also become depressed and nervous that their child may never recover.

Another issue to consider, athletes can develop second impact syndrome which can lead to CTE, causing patients to have mood swings and feel like they are going crazy. They do not understand what is happening inside their head. Many teenagers who act out often report the same feelings and the fear that they are going crazy. Many of these teenagers have had head injuries. It is possible that teenagers may also suffer from second impact syndrome, post concussion syndrome or developing CTE?

Everyone’s brain is different and so is the recovery process. This means we have no way of knowing how many Concussions or head traumas it takes before CTE is started in someone. It also means we have no way to determine how long it will take for someone to recover from a concussion or if they will have permanent impairments. If we are unable to adequately assess concussions, how many players are developing second impact syndrome? We only can tell after it occurs not before.

We do know that patients recovering from Post Concussion Syndrome or dealing with CTE can benefit from psychotherapy. Often this option is not given to teenagers because again many people believe teenagers are very unlikely to suffer with these issues. However, if you look at the research it indicates that teenagers can and do suffer from Post Concussion Syndrome and teenage head injuries can cause CTE.

As a psychotherapist who treats teenagers with head injuries, I strongly encourage every parent to watch the movie, Concussion. Also before your child starts playing any competitive sports, such as football or soccer, go online and research head injuries and signs and symptoms of concussions. Also if you teenager does sustain a head injury while playing sports or just playing have them evaluated. You never know how severe a head injury is by just looking at someone. A few years ago an actress fell in the snow and her friends said to go to the doctor she said she was fine. Two hours later she was dead. When she fell she caused her brain to bleed and she died.

Above all, use your best judgement as a parent. Do not be afraid to ask for a CT scan or an MRI if your child suffers any type of head injury. If your teenager does sustain a concussion and you notice a personality change or memory issues do not hesitate to seek psychotherapy for your child and for yourselves. Also don’t hesitate to talk to your teenagers high school. If the teenager is having problems concentrating after a head injury, the school may need to provide them with accommodations until the child recovers.

This can be an overwhelming and frightening topic to consider but the more you educate yourself, the easier it will be to manage. If you have additional questions regarding the personality changes or neuropsychological changes with head injuries, please feel free to contact me.

Dr. Michael Rubino has been treating children and teenagers for over 25 years. Dr. Rubino specializes in treating children, teenagers, trauma victims including first responders. He also has training in neuropsychology. For more information about Dr. Rubino’s work or private practice visit his website at www.RubinoCounseling.com or his website that deals with accommodations at school www.LucasCenter.org.

Why Men and Boys Avoid Seeking Help for Their Stress

Why Men and Boys Avoid Seeking Help for Their Stress

In our society people do not discuss mental health and it is something people feel embarrassed about. They also feel shame if they have mental health issues or if they go to a psychotherapist. However, our lives have become very complex and difficult, especially for children and teenagers. Besides coping with everyday life issues, we now face mass shootings and killings on a regular basis. Technology is advancing very quickly and the way we do things is changing very quickly too. As soon as we learn one thing, there is a new way to do the task that we need to learn. This makes our lives stressful and creates anxiety.

While we have this negative stigma about mental health, teenagers worry about it a great deal. Especially since 1 out of 5 teenagers deal with mental health issue. As a psychotherapist who treats teenagers, I see a large number of teens for panic attacks especially boys. I believe teenage boys are more prone to anxiety attacks because of the stereotype that boys don’t cry and they see emotions as weak. However, in our society men do cry and have emotional problems. Emotions are not a sign of weakness for men and boys. The documentary, “The Mask You Live In,” address this issue that men and boys face. I recently read an article by the basketball player, Kevin Love, which addresses this issue and explains how it impacts men and boys. I have included what he wrote so you can understand what men and boys face in our society.

On November 5th, right after halftime against the Hawks, I had a panic attack.

It came out of nowhere. I’d never had one before. I didn’t even know if they were real. But it was real — as real as a broken hand or a sprained ankle. Since that day, almost everything about the way I think about my mental health has changed.

“I DID ONE SEEMINGLY LITTLE THING THAT TURNED OUT TO BE A BIG THING.”

Kevin Love discusses his decision to seek help after suffering from a panic attack. (0:54)

I’ve never been comfortable sharing much about myself. I turned 29 in September and for pretty much 29 years of my life I have been protective about anything and everything in my inner life. I was comfortable talking about basketball — but that came natural. It was much harder to share personal stuff, and looking back now I know I could have really benefited from having someone to talk to over the years. But I didn’t share — not to my family, not to my best friends, not in public. Today, I’ve realized I need to change that. I want to share some of my thoughts about my panic attack and what’s happened since. If you’re suffering silently like I was, then you know how it can feel like nobody really gets it. Partly, I want to do it for me, but mostly, I want to do it because people don’t talk about mental health enough. And men and boys are probably the farthest behind.

I know it from experience. Growing up, you figure out really quickly how a boy is supposed to act. You learn what it takes to “be a man.” It’s like a playbook: Be strong. Don’t talk about your feelings. Get through it on your own. So for 29 years of my life, I followed that playbook. And look, I’m probably not telling you anything new here. These values about men and toughness are so ordinary that they’re everywhere … and invisible at the same time, surrounding us like air or water. They’re a lot like depression or anxiety in that way.

So for 29 years, I thought about mental health as someone else’s problem. Sure, I knew on some level that some people benefited from asking for help or opening up. I just never thought it was for me. To me, it was form of weakness that could derail my success in sports or make me seem weird or different.

Then came the panic attack.

It happened during a game.

It was November 5th, two months and three days after I turned 29. We were at home against the Hawks — 10th game of the season. A perfect storm of things was about to collide. I was stressed about issues I’d been having with my family. I wasn’t sleeping well. On the court, I think the expectations for the season, combined with our 4–5 start, were weighing on me.

I knew something was wrong almost right after tip-off.

I was winded within the first few possessions. That was strange. And my game was just off. I played 15 minutes of the first half and made one basket and two free throws.

After halftime, it all hit the fan. Coach Lue called a timeout in the third quarter. When I got to the bench, I felt my heart racing faster than usual. Then I was having trouble catching my breath. It’s hard to describe, but everything was spinning, like my brain was trying to climb out of my head. The air felt thick and heavy. My mouth was like chalk. I remember our assistant coach yelling something about a defensive set. I nodded, but I didn’t hear much of what he said. By that point, I was freaking out. When I got up to walk out of the huddle, I knew I couldn’t reenter the game — like, literally couldn’t do it physically.

Coach Lue came up to me. I think he could sense something was wrong. I blurted something like, “I’ll be right back,” and I ran back to the locker room. I was running from room to room, like I was looking for something I couldn’t find. Really I was just hoping my heart would stop racing. It was like my body was trying to say to me, You’re about to die. I ended up on the floor in the training room, lying on my back, trying to get enough air to breathe.

The next part was a blur. Someone from the Cavs accompanied me to the Cleveland Clinic. They ran a bunch of tests. Everything seemed to check out, which was a relief. But I remember leaving the hospital thinking, Wait … then what the hell …

I was back for our next game against the Bucks two days later. We won, and I had 32. I remember how relieved I was to be back on the court and feeling more like myself. But I distinctly remember being more relieved than anything that nobody had found out why I had left the game against Atlanta. A few people in the organization knew, sure, but most people didn’t and no one had written about it.

A few more days passed. Things were going great on the court, but something was weighing on me.

Why was I so concerned with people finding out?

It was a wake-up call, that moment. I’d thought the hardest part was over after I had the panic attack. It was the opposite. Now I was left wondering why it happened — and why I didn’t want to talk about it.

Call it a stigma or call it fear or insecurity — you can call it a number of things — but what I was worried about wasn’t just my own inner struggles but how difficult it was to talk about them. I didn’t want people to perceive me as somehow less reliable as a teammate, and it all went back to the playbook I’d learned growing up.

This was new territory for me, and it was pretty confusing. But I was certain about one thing: I couldn’t bury what had happened and try to move forward. As much as part of me wanted to, I couldn’t allow myself to dismiss the panic attack and everything underneath it. I didn’t want to have to deal with everything sometime in the future, when it might be worse. I knew that much.

So I did one seemingly little thing that turned out to be a big thing. The Cavs helped me find a therapist, and I set up an appointment. I gotta stop right here and just say: I’m the last person who’d have thought I’d be seeing a therapist. I remember when I was two or three years into the league, a friend asked me why NBA players didn’t see therapists. I scoffed at the idea. No way any of us is gonna talk to someone. I was 20 or 21 years old, and I’d grown up around basketball. And on basketball teams? Nobody talked about what they were struggling with on the inside. I remember thinking, What are my problems? I’m healthy. I play basketball for a living. What do I have to worry about? I’d never heard of any pro athlete talking about mental health, and I didn’t want to be the only one. I didn’t want to look weak. Honestly, I just didn’t think I needed it. It’s like the playbook said — figure it out on your own, like everyone else around me always had.

But it’s kind of strange when you think about it. In the NBA, you have trained professionals to fine-tune your life in so many areas. Coaches, trainers and nutritionists have had a presence in my life for years. But none of those people could help me in the way I needed when I was lying on the floor struggling to breathe.

Still, I went to my first appointment with the therapist with some skepticism. I had one foot out the door. But he surprised me. For one thing, basketball wasn’t the main focus. He had a sense that the NBA wasn’t the main reason I was there that day, which turned out to be refreshing. Instead, we talked about a range of non-basketball things, and I realized how many issues come from places that you may not realize until you really look into them. I think it’s easy to assume we know ourselves, but once you peel back the layers it’s amazing how much there is to still discover.

A message from Kevin Love’s Grandma

“HAPPY BIRTHDAY, KEVIN.”

Kevin’s grandmother records a greeting for his 25th birthday in 2013. (0:33)

Since then, we’ve met up whenever I was back in town, probably a few times each month. One of the biggest breakthroughs happened one day in December when we got to talking about my Grandma Carol. She was the pillar of our family. Growing up, she lived with us, and in a lot of ways she was like another parent to me and my brother and sister. She was the woman who had a shrine to each of her grandkids in her room — pictures, awards, letters pinned up on the wall. And she was someone with simple values that I admired. It was funny, I once gave her a random pair of new Nikes, and she was so blown away that she called me to say thank you a handful of times over the year that followed.

When I made the NBA, she was getting older, and I didn’t see her as often as I used to. During my sixth year with the T-Wolves, Grandma Carol made plans to visit me in Minnesota for Thanksgiving. Then right before the trip, she was hospitalized for an issue with her arteries. She had to cancel her trip. Then her condition got worse quickly, and she fell into a coma. A few days later, she was gone.

I was devastated for a long time. But I hadn’t really ever talked about it. Telling a stranger about my grandma made me see how much pain it was still causing me. Digging into it, I realized that what hurt most was not being able to say a proper goodbye. I’d never had a chance to really grieve, and I felt terrible that I hadn’t been in better touch with her in her last years. But I had buried those emotions since her passing and said to myself, I have to focus on basketball. I’ll deal with it later. Be a man.

The reason I’m telling you about my grandma isn’t really even about her. I still miss her a ton and I’m probably still grieving in a way, but I wanted to share that story because of how eye-opening it was to talk about it. In the short time I’ve been meeting with the therapist, I’ve seen the power of saying things out loud in a setting like that. And it’s not some magical process. It’s terrifying and awkward and hard, at least in my experience so far. I know you don’t just get rid of problems by talking about them, but I’ve learned that over time maybe you can better understand them and make them more manageable. Look, I’m not saying, Everyone go see a therapist. The biggest lesson for me since November wasn’t about a therapist — it was about confronting the fact that I needed help.

One of the reasons I wanted to write this comes from reading DeMar’s comments last week about depression. I’ve played against DeMar for years, but I never could’ve guessed that he was struggling with anything. It really makes you think about how we are all walking around with experiences and struggles — all kinds of things — and we sometimes think we’re the only ones going through them. The reality is that we probably have a lot in common with what our friends and colleagues and neighbors are dealing with. So I’m not saying everyone should share all their deepest secrets — not everything should be public and it’s every person’s choice. But creating a better environment for talking about mental health … that’s where we need to get to.

Because just by sharing what he shared, DeMar probably helped some people — and maybe a lot more people than we know — feel like they aren’t crazy or weird to be struggling with depression. His comments helped take some power away from that stigma, and I think that’s where the hope is.

I want to make it clear that I don’t have things figured out about all of this. I’m just starting to do the hard work of getting to know myself. For 29 years, I avoided that. Now, I’m trying to be truthful with myself. I’m trying to be good to the people in my life. I’m trying to face the uncomfortable stuff in life while also enjoying, and being grateful for, the good stuff. I’m trying to embrace it all, the good, bad and ugly.

I want to end with something I’m trying to remind myself about these days: Everyone is going through something that we can’t see.

I want to write that again: Everyone is going through something that we can’t see.

The thing is, because we can’t see it, we don’t know who’s going through what and we don’t know when and we don’t always know why. Mental health is an invisible thing, but it touches all of us at some point or another. It’s part of life. Like DeMar said, “You never know what that person is going through.”

Mental health isn’t just an athlete thing. What you do for a living doesn’t have to define who you are. This is an everyone thing. No matter what our circumstances, we’re all carrying around things that hurt — and they can hurt us if we keep them buried inside. Not talking about our inner lives robs us of really getting to know ourselves and robs us of the chance to reach out to others in need. So if you’re reading this and you’re having a hard time, no matter how big or small it seems to you, I want to remind you that you’re not weird or different for sharing what you’re going through.

Just the opposite. It could be the most important thing you do. It was for me.

Dr. Michael Rubino is a psychotherapist with over 20 years of experience treating teenagers and children. For more information about Dr. Rubino’s work or private practice visit his website http://www.RubinoCounseling.com or follow him on Twitter @RubinoTherapy.

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Texting is a Serious Issues Teens Seldom Consider

Texting is a Serious Issues Teens Seldom Consider

In today’s world texting has become a very common way for people to communicate with each other. If I go to a baseball game or the theater, I see adults texting the entire time. I have even seen people fired via text. We now have a President who makes major announcements via Twitter. His actions make teenagers feel Texting is normal. While it is becoming very common with adults, it is even more common with teenagers. The teenagers I see for psychotherapy text all the time. It appears that texting is now the preferred way that teenagers communicate with each other. If you remove their cellphones and they cannot text, many teens become very upset and I have seen many become violent.

While technology is advancing at a fast pace, our laws and ethics are having a difficult time keeping up with the latest advances. However, when laws are passed or ethical standards set, many teenagers and adults are not aware of the new laws. This is creating a tremendous problem for teenagers and their families. I have worked with many teenagers who are struggling with an issue due to texting and they had no idea they were doing anything inappropriate.

First, it is important to note that any time you post something, tweet or text, it is on the internet forever. This is why many celebrities have won very large monetary judgements against people who have posted false or embarrassing material. You can remove it from the site it was posted to, but it still can found on other sites. Therefore, if a teenager post something, they need to think about the fact that it will be out there forever and anyone can see it. This may lead to embarrassing situations.

Let’s consider the most common problems that teenagers encounter. The first one is texting sexually explicit photographs to their boyfriend/girlfriend. At the time they think it is no big deal. However, high school romances typically do not last. If one of the individuals feels hurt, they can post that sexually explicit picture all over the Internet. It can be sent to their families and friends. In fact, their entire school could see it. This would be extremely embarrassing. Even if the person who posted the picture is punished, the picture is still out there and the damage is done.

Additionally, teenagers fail to think about the fact that they are under 18 years old. Therefore, they could be violating child pornography laws by sending the picture or by receiving it and having a copy on their cellphone. In fact, Congress is trying to pass stricter laws regarding teenagers texting sexually explicit picture. Therefore, besides being very embarrassed, the teenagers involved might find themselves facing legal charges for violating child pornography laws.

The second major issue is harassment. Friends get mad at each other or often one teenager is singled out and they become the object of numerous texts telling them they are ugly, no one likes them etc. These texts can be sent so often and by some many other teenagers that the teen who is the target commits suicide. There are numerous examples of this and a common one is accusing a teenager of being gay. This is not harmless teenage game playing. This harassment can be vicious. They are also cases where the teenagers sending these texts have been charged with stalking or more serious charges if the teenager committed suicide.

When this occurs, the teenagers are shocked. They think they were just teasing another kid and it was harmless. They have no idea what this teenager is already dealing with in their life or what it can be like to have numerous classmates texting you every day all day long. It is not harmless teasing, but because technology has increased so quickly it is not the same teasing that use to occur at school. We have not had enough time to think about this point.

Another major issue is that texting is an excellent way for schools or police to arrest teenagers for dealing drugs, buying or using drugs. I have worked with many teenagers from numerous schools where the school catches someone using or selling marijuana on school grounds. The school then checks the student’s cellphone and looks at the text history. The school then starts calling in the student’s on the text history and asking about drug use or selling. One teenager getting caught at school can result in ten teenagers being expelled. The teenagers are usually in shock. First, they never thought they were doing anything wrong and they never thought a text could get them in trouble. However, it can and it does. I have seen many teenagers for psychotherapy because of a text found by the school.

Finally, new research is showing that texting is increasing the rate of depression in teenagers. Texting creates more access in some ways, however, it is isolating too. When you text you lose the personal interaction which is very important. People do need personal interaction for their mental health. When teenagers text they miss out on the personal interaction. This can and does at times lead to a lonely feeling. If a teenager is already having a hard time and then they experience of feeling isolated too, this can lead to depression. Research is showing an increase in teenage depression and I am seeing an increase in the number of teenagers I am seeing for depression. Therefore, we need to take a closer look at teenagers and texting.

Parents, we see adults getting into trouble due to texts they have sent, what makes us think that teenagers can’t get into trouble too? Remember they are not grown adults yet, so their ability to think logically as an adult is not fully developed. Even if it was, technology is moving so fast that adults are getting into trouble due to the rapid change in our lives due to technology. Therefore, we cannot expect teenagers to be able to sort all of this out on their own. Talk to your teen about texting, you may need to monitor their texting. There are apps that can help teenagers identify texts that may be inappropriate. Bottom line teenagers need to support and guidance from their parents regarding the ever evolving technology that we are facing. If we cannot keep up with the ethical issues, how can a teenager?

Dr. Michael Rubino is a psychotherapist with 20 years of experience working with children and teenagers. He also treats Internet addiction. For more information on Dr. Rubino’s work or his private practice visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/drrubino3.

Issues Associated with Texting that Teens Seldom Consider

Issues Associated with Texting that Teens Seldom Consider

In today’s world texting has become a very common way for people to communicate with each other. If I go to a baseball game or the theater, I see adults texting the entire time. I have even seen people fired via text. We now have a President who makes major announcements via Twitter. His actions make teenagers feel Texting is normal. While it is becoming very common with adults, it is even more common with teenagers. The teenagers I see for psychotherapy text all the time. It appears that texting is now the preferred way that teenagers communicate with each other. If you remove their cellphones and they cannot text, many teens become very upset and I have seen many become violent.

While technology is advancing at a fast pace, our laws and ethics are having a difficult time keeping up with the latest advances. However, when laws are passed or ethical standards set, many teenagers and adults are not aware of the new laws. This is creating a tremendous problem for teenagers and their families. I have worked with many teenagers who are struggling with an issue due to texting and they had no idea they were doing anything inappropriate.

First, it is important to note that any time you post something, tweet or text, it is on the internet forever. This is why many celebrities have won very large monetary judgements against people who have posted false or embarrassing material. You can remove it from the site it was posted to, but it still can found on other sites. Therefore, if a teenager post something, they need to think about the fact that it will be out there forever and anyone can see it. This may lead to embarrassing situations.

Let’s consider the most common problems that teenagers encounter. The first one is texting sexually explicit photographs to their boyfriend/girlfriend. At the time they think it is no big deal. However, high school romances typically do not last. If one of the individuals feels hurt, they can post that sexually explicit picture all over the Internet. It can be sent to their families and friends. In fact, their entire school could see it. This would be extremely embarrassing. Even if the person who posted the picture is punished, the picture is still out there and the damage is done.

Additionally, teenagers fail to think about the fact that they are under 18 years old. Therefore, they could be violating child pornography laws by sending the picture or by receiving it and having a copy on their cellphone. In fact, Congress is trying to pass stricter laws regarding teenagers texting sexually explicit picture. Therefore, besides being very embarrassed, the teenagers involved might find themselves facing legal charges for violating child pornography laws.

The second major issue is harassment. Friends get mad at each other or often one teenager is singled out and they become the object of numerous texts telling them they are ugly, no one likes them etc. These texts can be sent so often and by some many other teenagers that the teen who is the target commits suicide. There are numerous examples of this and a common one is accusing a teenager of being gay. This is not harmless teenage game playing. This harassment can be vicious. They are also cases where the teenagers sending these texts have been charged with stalking or more serious charges if the teenager committed suicide.

When this occurs, the teenagers are shocked. They think they were just teasing another kid and it was harmless. They have no idea what this teenager is already dealing with in their life or what it can be like to have numerous classmates texting you every day all day long. It is not harmless teasing, but because technology has increased so quickly it is not the same teasing that use to occur at school. We have not had enough time to think about this point.

Another major issue is that texting is an excellent way for schools or police to arrest teenagers for dealing drugs, buying or using drugs. I have worked with many teenagers from numerous schools where the school catches someone using or selling marijuana on school grounds. The school then checks the student’s cellphone and looks at the text history. The school then starts calling in the student’s on the text history and asking about drug use or selling. One teenager getting caught at school can result in ten teenagers being expelled. The teenagers are usually in shock. First, they never thought they were doing anything wrong and they never thought a text could get them in trouble. However, it can and it does. I have seen many teenagers for psychotherapy because of a text found by the school.

Finally, new research is showing that texting is increasing the rate of depression in teenagers. Texting creates more access in some ways, however, it is isolating too. When you text you lose the personal interaction which is very important. People do need personal interaction for their mental health. When teenagers text they miss out on the personal interaction. This can and does at times lead to a lonely feeling. If a teenager is already having a hard time and then they experience of feeling isolated too, this can lead to depression. Research is showing an increase in teenage depression and I am seeing an increase in the number of teenagers I am seeing for depression. Therefore, we need to take a closer look at teenagers and texting.

Parents, we see adults getting into trouble due to texts they have sent, what makes us think that teenagers can’t get into trouble too? Remember they are not grown adults yet, so their ability to think logically as an adult is not fully developed. Even if it was, technology is moving so fast that adults are getting into trouble due to the rapid change in our lives due to technology. Therefore, we cannot expect teenagers to be able to sort all of this out on their own. Talk to your teen about texting, you may need to monitor their texting. There are apps that can help teenagers identify texts that may be inappropriate. Bottom line teenagers need to support and guidance from their parents regarding the ever evolving technology that we are facing. If we cannot keep up with the ethical issues, how can a teenager?

Dr. Michael Rubino is a psychotherapist with 20 years of experience working with children and teenagers. He also treats Internet addiction. For more information on Dr. Rubino’s work or his private practice visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/drrubino3.

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.

Parents What Teenagers are Wanting from You

Parents What Teenagers are Wanting from You

Many parents ask me what their teenagers are looking for from them. Teenagers want to know that they are loved, you hear them and see them for who they really are as a person. These statements can help your teenagers. Try it and sees what happens.

Dr. Michael Rubino is a psychotherapist with over 24 years experience treating children, teenagers and trauma victims. For more information about his work visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/Drrubino3

Teenagers Need to Earn Their Parents Respect

Teenagers Need to Earn Their Parents Respect

As an adolescent psychotherapist one of the major issues I deal with is respect. Teenagers feel disrespected by their parents and parents feel dissected by their teenagers. At this time of year with high school beginning many teenagers believe they are entitled to more respect because they are now high school students. They feel they should be allowed to make more of their own decisions and that their parents do not need to know everything about their friends or activities.

This article is somewhat different from the ones I usually write. While it is helpful for parents, I am directing a great deal of it towards teenagers.

Yes it is true that as teenagers you are becoming young adults and that you should be able to handle more responsibility. The big word in that last sentence is SHOULD. Just because you have graduated from middle school or high school doesn’t mean you are in charge of or that you are ready to handle all aspects of your life. You are a YOUNG adult. Noticed I capitalized the word young. There are still a number of life experiences for you to learn from and until you do, your parents are responsible for and probably need to help you.

A number of you have heard your parents say when you are 18 years old you can do as you like. This is the case if you are in a situation where you can financially support yourself and provide for all your needs. If you are still financially dependent on your parents, even though you are 18, your parents do have a right to set certain rules that you need to follow.

Prior to you turning 18, any trouble you get into, your parents are legally responsible for the damage. If you damage property, your parents are legally responsible. If you get arrested and put in Juvenile Hall, your parents receive a bill from County for the length a time you were in Juvenile Hall. These are just a few examples that your parents have being your parent.

You may think that you do not need your parents, but you need their permission to drive and basically for anything you want to do in life. Even if they give you permission to drive and you get your license, they have the ability to have your driver’s license suspended at any time they want while you are under the age of 18.

As I started off as a teenager you SHOULD be able to handle more responsibility. This responsibility is not an automatic gift you receive when you turn 13. This respect you so desperately want is something you have to earn. How do you earn it? You earn it by respecting the rules that your parents have set and by taking care of your responsibilities – for a teen, your primary responsibility is school. This means going to school on a regular basis, doing your homework, earning decent grades and not making poor choices such as drinking alcohol or drugs. For teenagers who have graduated high school you may feel the above guidelines do not apply to you. However, if you parents are assisting to pay for college, your living expenses and such things as your health insurance, the guidelines apply to you too. You may say this is unfair, well welcome to the adult world.

Ask your parents how many times they have to do something at work they feel is unfair, but if they want their job they have to do it. Ask your parents how many days they get up tired or not feeling well and they would prefer to stay home from work, but they still go to work. They go to work because the have a family to support and bills to pay. Your parents want you to succeed in life. If you feel they really are not giving you enough freedom, then ask your parents if you can discuss this issue with them. However, ask in a mature, respectful manner do not demand a conversation. When you discuss the issue with your parents have some things you have been doing, e.g., your homework, respecting curfew, that demonstrate you can handle more responsibility. Do not just demand it because your friends have it.

Remember the respect and maturity that you want, you must earn. You earn it by respecting your parents, other adults and recognizing that you have responsibilities. You do not get it because you turned 13 or because you graduated high school. This can be a difficult time of life, but it can be a time when you learn a lot about the world and yourself. If you remember you need to earn your parents trust and you actively try to do so, your parents will work with you and start to trust you. The choice is yours, you can make your teen years difficult or make them easier by working with your parents – you decide.

Parents while your teenagers have a lot to learn and do need to demonstrate they can handle responsibility, you need to give them opportunities to earn your respect. You have to have faith in your teenager and say yes sometimes even when you have doubts. Obviously you start by saying yes to the little request and allow them to earn your respect. Also if you have doubts or concerns talk to your teenager about high school or college. If you have open minded conversations with your teenager, they will respect and trust you. This provides a situation where you and your teen can have open, honest conversations in the good and bad times. It can help you develop a closer relationship with your teen and you can assist your teenager in becoming a responsible young adult you can be proud of.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating adolescents and children. To learn more about his work or private practice visit his website www.RubinoCounseling.com or www.rcs-ca.com or his Facebook page www.Facebook.com/drrubino3.

Is Your College Freshman Depressed?

Is Your College Freshman Depressed?

Transitioning from high school is difficult. Many freshmen deal with depression or anxiety or both. This year maybe more difficult due to the Coronavirus and the chaos we are experiencing in our Country. Therefore, it’s helpful if family and friends are aware that someone starting college are at risk for depression and check-in with them. If you think they are depressed do your best to be supportive and maybe recommend therapy.

The National Association of the Mental Illness examined this issue. Here are some of the facts that NAMI discovered that maybe helpful to some college freshmen.

In 2018, more than 63% of college students reported experiencing overwhelming anxiety during their enrollment and nearly 42% reported feeling so depressed that they had trouble functioning at some point during the last 12 months. Some of these students may not have battled a mental health challenge before attending college and might not know how to deal with depression in this new environment.

Meanwhile, friends, roommates and classmates often have difficulty recognizing symptoms of depression in students. However, if these peers understand the warning signs to look for, they will be empowered to check in with the college students in their lives who may be struggling sooner and assist them in getting help. Better yet, a familiarity with the warning signs could help curb the thousands of preventable deaths by suicide each year.

So, if you want to be an attentive friend or support system for someone dealing with depression — and help your fellow students — keep an eye out for the following warning signs so you can begin a conversation with anyone you may be concerned about.

Negative Emotions

One of the first warning signs of depression is expressing or showing negative feelings or emotions. For instance, someone might reveal they’re feeling sad, anxious or numb, or perhaps they’ll share that they’re dealing with more stress than usual. Others may not express what they are feeling, but it may be obvious that they are feeling more anger, frustration or sadness than in the past. For example, they may have a short temper, exhibit less engagement in conversation and normal activities or experience sudden outbursts.

Often, people with depression can’t identify why they’re feeling sad or when they began to experience these emotions. It’s also possible that if you ask more questions about “why” or “when,” they may shut down and become avoidant or unresponsive.

What to say:

Let’s say you’re concerned about your roommate. It can be helpful to avoid asking too many questions, remind them they’re not alone, validate their feelings, and prepare to listen if they do open up.

  • You: “I noticed you’ve been quieter than usual lately. I’m not sure what you’re going through, but I’m here for you if you want to talk.”
  • Them: “Yeah. I’ve felt kind of numb these past few weeks and I’m not really sure why. But I don’t want to talk about it.”
  • You: “It’s okay to feel low sometimes. I’m your friend no matter what, and we can get through this together.”

Irregular Sleeping And Eating Habits

If you pay close attention, you might notice irregular eating habits in your friend or roommate. Do they skip meals regularly? Do they eat whenever they are stressed? Both undereating and overeating are warning signs of depression.

Depression also affects people’s sleep schedules. For instance, if your roommate is experiencing depressive symptoms, they may repeatedly sleep for more than 10 hours a night while someone else with depression might struggle with insomnia.

What to say:

It’s best not to comment on someone’s eating or sleeping habits, but rather inquire about the underlying reasons they might be engaging in that behavior.

  • You: “You look like you could use some caffeine. Have you been staying up late to catch up on your favorite show?”
  • Them: “Actually, I haven’t been able to fall asleep lately, so I turned on the TV hoping it’d knock me out.”
  • You: “Has anything been bothering you? I know I struggle to sleep when something’s on my mind. I hope you know I’m always here if you want to talk.”

Disinterest In Extracurricular Activities

Hobbies are a great way to explore your interests and relieve stress while you’re in college. However, students struggling with depression might not care to engage in activities they used to enjoy. They might also avoid social situations, including time with friends.

This general lack of interest is a telling sign of depression and can often perpetuate more feelings of loneliness, isolation and sadness.

What to say:

If your roommate rarely leaves the dorm, offer to do something — or nothing — together.

  • You: “Hey, do you want to go get ice cream with me?”
  • Them: “No thanks. I don’t really feel like going anywhere or doing anything.”
  • You: “Okay, well, I don’t have anything going on. We can just chill here and do nothing together.”

Unexplainable Guilt

Depression doesn’t always come from specific circumstances, and people from all backgrounds and situations can experience it. Unfortunately, this can cause guilty feelings in students who have “had it good” and still struggle with depression.

As a result, these feelings can cause students to spiral because they perceive themselves as a burden or as “incomplete,” which can make symptoms even worse. Therefore, it’s essential to watch out for negative self-talk and twinges of guilt.

What to say:

Discourage negative self-talk, validate your roommate’s feelings and remind them of their worth.

  • Them: “I shouldn’t complain so much. So many people have it worse than I do. Maybe I should just suck it up and move on.”
  • You: “No. You have every right to feel that way. Your experiences are real, and you can take as much time as you need to work through your past trauma. You deserve to feel whole again, too.”

Persistent Pain

Depression can cause unexplainable pain, chronic illness, and discomfort independent of any injury. Muscle aches and joint pain in the chest, back, neck and shoulders are all potential warning signs.

Of course, these symptoms are easy to spot if they’re severe and cause great discomfort. However, if your roommate is avoiding you — or is just really good at hiding their true feelings — you might go weeks without noticing their aches and pains.

What to say:

Ask about potential injuries or underlying conditions before jumping to conclusions. Then, work together to find ways to alleviate discomfort.

  • Them: “Ugh. My lower back is killing me lately.”
  • You: “Did you sleep funny or hurt it playing basketball the other day?”
  • Them: “No. I think it might have something to do with my sleep schedule, but I’ve also felt off lately.”
  • You: “Well, I’m not sure why you feel bad either, but some movement might help. Maybe we can do some stretches later or take a yoga class together. If that doesn’t help, would you consider talking to a doctor?”

If you notice any of these warning signs of depression in college students, it’s crucial that you reach out and encourage them to seek help. Your empathy and concern could save someone’s life, so the sooner you speak up, the better.

Dr. Rubino is a psychotherapist with over 24 years experience treating children and teenagers and trauma victims. If you are interested in his work, please visit his website at http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple.

Helping Teenagers Cope with Peer Pressure

Helping Teenagers Cope with Peer Pressure

Many parents worry about peer pressure and so do a lot of teenagers. Teenagers worry about the stories they have heard and don’t know what to do. Many parents see their teenagers worrying and don’t know what to do about it either.

Let’s face it peer pressure has been part of life for a long time and it does not appear that we will eliminate it any time soon. However, be sides the negative we associate with it, research shows pressure does play an important role in helping Teenagers develop into adults. Therefore, since it doesn’t appear we will be eliminating it soon, we should help our children learn how to cope with it in a positive manner.

Additionally, since the research indicates that it plays a role in the development of teenagers, parents need to understand it better. If parents understand it better, they will be better prepared to help their children deal with it. While researching this topic I found an article which explains these points easily and it is an article that is easy to read. Therefore, I have included the link so parents can read it and gain a better understanding about peer pressure it more.

Here is the link to the article https://yourteenmag.com/social-life/teenagers-friends/peer-pressure

Dr. Rubino is a psychotherapist with over 20 years experience treating children and teenagers and trauma victims. For more information regarding Dr. Rubino’s work, please visit his website at http://www.RubinoCounseling.com or his Facebook page at Facebook.com/Drrubino3

Helping Teenagers Get Enough Sleep

Helping Teenagers Get Enough Sleep

It’s getting close to the end of summer and for many teenagers will be returning to school soon. For most students they will be returning to their school sites. This means no more remote learning and students will need to be getting school on time in the mornings. In order to do so they need to get a good nights sleep. However, many parents have been reporting that with the remote schooling students were able to sleep in because school was starting later. As a result, many teenagers have developed poor sleep habits such as staying up later at night and taking naps during the day. Many parents are concerned how they are going to get their children and teenagers back to a health sleep pattern so they can function at school and get up on time for school.

I have had many parents asking me and emailing me regarding getting children and teenagers back on a healthy sleep pattern for school. Many parents are looking at this as an opportunity to get their children and teenagers on a healthy sleep pattern because their teenagers were never on a healthy sleep pattern to begin with. As a result I researched teenage sleep patterns and found some very good information from James Maas, PhD., who specializes in sleep patterns, and he wrote the book, Power Sleep for Success. According to Dr. Maas many teenagers are sleep deprived because beginning at puberty up until the age of 25 around midnight teenagers brains begin producing human growth hormones and reduces the amount of melatonin the brain produces. As a result, teenagers are not ready to sleep until 2am and their brains are ready to wake up at 11am. Dr. Maas refers to this as Chronic Delayed Phase Syndrome and states that every teenager suffers from it.

Since the amount of natural melatonin being produced in teenagers brains is reduced, many parents try providing their teenagers with melatonin supplements. The parents hope that by increasing the amount of melatonin in their teenagers brains with melatonin supplements that teenagers will be able to sleep easier. However, this may not be the case.

Dr. Maas has this to say about melatonin supplements. He states they are not the best way to get your sleep. First, 3 mg of melatonin is the maximum amount that an adult needs, and many over-the-counter formulations start at 5 mg. Some even go to as high as 10 or 12 mg. You are peeing away a lot of melatonin that your body doesn’t need and can’t process. It does work, but there are other options on the market that work just as well as melatonin or better: (1) lavender, either in tea or in a spray; and (2) valerian root. These two over-the-counter supplements actually have been clinically proven to have a sleep-inducing effect.

Dr. Maas has outlined several steps that teenagers can go through before trying to go to sleep. He believes that if children and teenagers follow these steps on a regular basis that it will help a teenager fall asleep. He also believes these steps will help teenagers get enough sleep so they are not sleep deprived and are ready for school the following day. Here are the steps Dr. Maas recommends that children and teenagers follow before their bedtime:

1. Take a warm bath or shower an hour before bed to relax and to signal to the brain that it’s time to begin to unwind.

2. Avoid eating food late at night that is likely to disturb your sleep: heavy, greasy, spicy, or difficult-to-digest foods like pizza, garlic, or anything really fatty. Instead try fruit (bananas or grapes) or lean protein such as tuna.

3. Get your homework done earlier in the afternoon or evening while you are still awake and alert. This will also reduce your stress if you don’t have so much homework to do in the evening close to bedtime.

4. Watch how you are spending your waking hours. Teenagers don’t typically have great time management skills. They can get caught up on social media or on their phones, which are a huge distraction and eat up that part of the day when you should be in study mode. Catch up on your social things after your homework is over.

We know that the amount of sleep that a child or teenager gets is related to how well they do in school, but it is associated with many more aspects of a teenager’s life. Dr. Maas noted that sleep is really the one thing that underlies all of good health. Good health refers to both physical and mental health. When you are getting enough sleep, stress goes down and immunity goes up. It’s linked to greater longevity and reduced risk of car accidents, cancers, and heart attacks. If teenagers could add just one more hour of sleep to their daily routine, they would find that they have a higher GPA, that their athletic skills are better, and that their social life and ability to manage stress and anxiety improve. Everything hinges on getting enough sleep. If I could tell teenagers one thing, it’s this: If you want to do well in school and on the athletic field, getting more sleep is the single best thing you can do. I have seen this in many teenagers that I see for psychotherapy. Additionally, most teenagers who are having difficulties with anxiety or suicidal thoughts are sleep deprived.

Therefore, parents it is important to make sleep an important issue with your children and and teenagers. If you explain to your children and teenagers why it should be a priority, you increase the probability that your children and teenagers will understand why sleep is important and will work with you to help them increase their amount of sleep especially as they try to adjust their schedules and lives to a post pandemic world.

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