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.

Words Matter When Treating Mental & Physical Health

Words Matter When Treating Mental & Physical Health

Many mental health clinicians and many people who have mental health issues agree that there is a big difference between how physical health and mental health are treated. In fact, most people agree there is a strong negative bias regarding mental health. The bias is so strong that many people who have mental health issues often do not seek treatment for their condition because they are afraid of the stigma attached to mental health issues. For example, people are afraid if people know they have a mental health issue that they may not be able to get a job or they may not be able to get health insurance. They are also afraid that people in general will not want to socialize with them if people knew they had a mental health issue.

If we look at history it makes sense, why people are concerned about these issues. In the 1800’s people determined to have a mental health issue were locked away in mental health asylums. These places were dirty and filled with numerous physical diseases and the patients were not really treated. Basically it was a place for families to hide a family member with a mental illness until they died. This way it was a secret and the family did not have to bear the negative stigma of having mental illness in their family. The mental illness was viewed as a weakness and wealthy families did not want to marry into families where there was a mental illness. They were afraid of a child being born with a mental illness and ruining their upper class family image.

Now many people may think of course it was the 1800s, but this didn’t happen during modern times. In fact it did and still continues today. Many patients who have mental health issues do not receive adequate treatment for their mental health issues or their physical health either. In the 1960’s the book and film One Flew Over the Kokos Nest was released as a book and movie. The book and movie looked at how patients in mental health hospitals were over medicated and were treated more like animals than people.

In fact some people were becoming aware of the treatment in State Mental Hospitals and states such as California started passing laws in 1950 to close these hospitals. In fact, in 1967, Ronald Regan, the governor of California, passed the Lanterman-Petris-Short (LPS) Act, which virtually made involuntary hospitalization impossible and also resulted in most of the State Mental Hospitals being closed. While the people passing these laws may have thought they were doing something positive, they neglected to establish plans for people with mental health issues once these hospitals were closed.

As a result of there being no planning to very poor planning, many people with mental health issues we’re having even more difficulties finding treatment for their mental and physical health issues along with have severe issues finding housing and food. Many of these people ended up living on the streets and turning to illegal drugs as a way to treat their physical and mental health issues. When people try to establish treatment facilities in their areas, many of the neighbors would protest and object to any mental health treatment being established in their neighborhoods. They were afraid that the patients at these facilities would steal from their homes and that these patients posed a danger to their children. They were still operating under the stigma of the 1800’s. Almost a hundred years had passed but the belief that a mental illness was associated with a diseased, unclean person persisted.

One reason it has persisted is due to the language we use when discussing mental health compared to physical health. We still use the same language today and some people may think how something is phrased is not important, but it is very important. The way we discuss physical and mental health today makes physical health sound legitimate and important and the way we discuss mental health makes it sound like a dangerous condition that should be avoided. Additionally, the way we discuss mental health issues make them sound like no one ever really improves from these issues. They just learn how to cope in society.

Let’s look at some examples. If a patient has cancer, diabetes or even hepatitis, the person is referred to as the patient with cancer, the patient with diabetes or the patient with hepatitis. Now compare this to mental health issues such as depression, anxiety or ADHD. The patients are referred to as the depressed person, the anxious person or the ADHD kid. The mental health diagnosis becomes their identities. With physical health the patient maintains their identity and there is some hope the person can be cured. With mental health issues, the diagnosis becomes the person’s identity. They are not a person struggling to overcome depression, no they are the depressed person. By making the diagnosis part of their identity many people including the patient assume they will always be depressed. The best they can do is to learn to cope with it.

If we make the mental health issue, the person’s identity we are treating them as less than human and giving up on a cure. I have seen this many times in my 25 years as a psychotherapist. Patients and their families assume they are the diagnosis and any thoughts or feelings they have are due to the diagnosis. This is very degrading and makes it very easy to place mental health at the bottom of the ladder. Therefore, less money is spent on research, patients and mental health clinicians are treated with less respect. Why pay attention to the patient or clinicians? They are not doing anything serious such as treating acne or allergies. If we continue to label patients with mental health issues as their diagnosis, how will we ever change the stigma. A patient dealing with depression is still a person, they are not their diagnosis. If a close family member dies and the person becomes sad, this is a normal human reaction. They are grieving the death just like other family members who do not deal with depression. Therefore, there sadness is not due to the depression, it is a normal emotional reaction.

Also if we look at research on depression, the antidepressants are designed to increase the amount of serotonin in the patient’s brain. The theory is the lack of serotonin creates the depression. We see the same thing in other medical conditions such as diabetes. In diabetes the patient’s body is not regulating the body’s insulin correctly. Therefore, if medical research is showing there is a similarity between how certain physical health issues and mental health issues occur and respond to medication in similar ways, why do we treat physical and mental health differently? More and more research is showing the bond between physical and mental health issues. Therefore, why do we continue to treat them differently? Mental health is equal to physical health and we should treat patients with physical and mental health issues the same. We also need to put the same amount of money into research and ensure insurance companies start treating physical and mental health issues the same. They can start by paying to treat both.

Bottom line the language we use regarding mental and physical health has a big impact how mental health and physical health issues are treated. We need to remember this fact and insist that everyone starts to treat mental and physical health issues equally.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children, teenagers, trauma victims and first responders. If you would like more information regarding Dr. Rubino’s work and 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.

Why Teenagers are Isolating and Ignoring Their Parents

Why Teenagers are Isolating and Ignoring Their Parents

“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. I ask this question on a daily basis. Cameron Crowe while discussing the movie with CNN for their special report on movies made his statement about teenagers. 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. It is so bad that I typically have difficulties scheduling appointments with teenagers because of tutoring sessions, meeting with college consultants and their homework. Many teenagers are so overbooked that they seldom have a free minute to relax.

Cameron Crowe was commenting on high school students in 1982. However, what he noticed occurring in high school in 1982, however it is now starting to occur in middle school not high school. 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. Many 6th graders do not think oral sex is being sexually active. They tell me they are jus “messing around, like kissing.” 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, vaping and 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 in 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 continue to live through the pandemic. Most kids had a year of remote learning which was a disaster. 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 , suicidal feelings and anxiety due to the Coronavirus. Who can blame them because they have lost a year of their childhood that they cannot get back.

Even though many teenagers are back in school, their school experience is not the same as it was prior to the pandemic. Their ability to socialize is still limited greatly and schools have changed many after school activities and have canceled events such as indoor dances. So teenagers are back in the classroom, but they still feel lonely and many see no end to the pandemic or school shootings in site.

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. In fact, in my office the number of middle and high school students seeking therapy has increased by a factor of 10. Besides parents calling, schools and insurance companies call daily regarding adolescents who need therapy. Many of these teens 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 2022 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 next, another school shooting or a return to remote learning due to this new variant. Many colleges returned to remote learning, so are middle schools and high schools next? This provokes anxiety and depression when you don’t know what to expect from the future. Especially when predictions are changing daily, teenagers are left having to wait and they see no end in site.

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. Teenagers know they are not going to get these years back which is depressing. Therefore, they are using computers, drugs and sex as a way to numb out the anger, disappointment and anxiety about what they are missing and not to worry about what their futures will be like.

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 over two years 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. Also as I stated above we have experienced a tidal wave of teenagers seeking psychotherapy. Furthermore, the longer the pandemic continues and the longer our society remains in chaos, the numbers continue to increase not decrease.

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.

Parents may notice that their teenagers are not taking to them or listening to them despite the fact that parents are trying to be supportive. The problem is that your teenagers are feeling so depressed and anxious that they are ignoring their parents. Many teenagers see how society is acting and they see no hope. They assume you are going to try to make them feel better, but you are just as powerless as they are so they ignore you. Be patient with them and continue to be there for them. By taking this approach when your teenager is ready to talk, you will be there and not miss the opportunity.

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, mass shootings and a 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 follow the 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 as often as they do. 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 800,000 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 24 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.

What Have We Learned Since Sandy Hook?

What Have We Learned Since Sandy Hook?

Today, December 14th, marks the nine year anniversary of the tragic shooting at the Sandy Hook Elementary school where many children and adults where senselessly killed. Since Sunny Hook more than 500,000 people in the United States have been killed by senseless gun violence. Additionally, there have been 350 school shootings since Sandy Hook Elementary and 28 of those shootings occurred this year (CDC). Also since the Columbine shooting in 1999, 278,000 students have been exposed to gun violence, 157 students have been killed and 357 students have been injured by school shootings (Gun Violence Archive).

In reviewing the subject of school shootings, I read an article by Cody Fenwick regarding children and gun violence. His article was very alarming. Since it is the nine year anniversary of the Sandy Hook shooting and it has been 3 years since the Parkland school shootings, Fenwick’s article about children and guns is very important. His article also outlines a strong connection to guns and the senseless shootings and to the alarming numbers of teenagers who commit suicide with a gun. The article by, Fenwick, confirmed what I am hearing from teenagers and children in psychotherapy. Additionally, other school shootings, such as the one in Nashville, or the shootings in the Synagogue in Pennsylvania or in the Texas Church, confirm the need for gun control. A point the statistics in Fenwick’s article support.

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

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

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

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

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

• 38 percent — suicides

• 6 percent — unintentional deaths

• 3 percent — law enforcement/undetermined cause

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

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

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

As a society, we need to look at these numbers and ask ourselves some questions. What are we going to do in order to improve gun safety? Most importantly, why are children as young as 6 years old thinking about suicide? Also what are we going to do so that children who are suicidal have access to mental health care? This is our problem because it does happen in Pleasant Hill, Walnut Creek and Lafayette.The students at Park Side High School and the Parents from Sunny Hook have marched and petitioned for sane gun control laws. However, nothing has happened so why should children believe us when we say we can keep them safe?

Also the recent school shooting in Oxford, Michigan shows how we are not protecting children from gun violence or providing mental health care when needed. Here is an adolescent teenage boy who one one day researching buying ammunition and the next day drawing a picture of people being killed and saying I can’t stop the thoughts and I need help. The teen should have been hospitalized immediately for being a danger to self or others. Instead the school and the parents have a meeting and they decide the boy needs psychotherapy within 48 hours. Instead of sending the boy home, he is allowed to return to the classroom because the parents decide he should stay at school. As I said he should have been hospitalized and the school should have demanded he leave the campus immediately. However, because the adults failed to follow their duties, students at the school were killed and injured senselessly. You think we would have learned after Columbine, Sandy Hook or Parkland, but we didn’t. How many kids have to die at school before we act? Why won’t we enact sane gun laws?

Dr. Rubino has 24 years experience as a psychotherapist working with children and teenagers, trauma victims and first responders. For more information about his work or private practice visit his website at www.RubinoCounseling.com or his Facebook page 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

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 about 9/11 that We Forgot

Lessons about 9/11 that We Forgot

Today is the 20th anniversary of the 9/11 attacks on New York City and the Pentagon. Our Country said it is a day we will never forget, however people in the early 20s were too young to remember and teenagers were not even born. They most likely have heard numerous stories about that day, but they did not experience the fear we all felt and the uncertainty we all were struggling with that day. 9/11 was the first time in history that the mainland of the United States had ever been attacked. It happened often in Europe but never here in the United States. On that day the safety we all were use to was destroyed. There will be a number of television documentaries this weekend about 9/11. Parents you may want to watch one of these documentaries with your children and discuss with them how they feel and answer any questions it may bring up.

There was something else that changed that day too. We witnessed how our first responders all pulled together in order to help victims and secure the Country. They did not come together for a day, they came together for months and exposed themselves to deadly dust and the possibility that building may further crash in on them killing them. They thought nothing about themselves. They were only thinking about helping survivors and families who lost loved ones. It was also amazing to see how first responders from all over the Country came to New York City and Washington D.C. to help. They also planned on being there for as long as needed which was several months. Regardless of the length of time our first responders were working 24 hours a day, seven days a week and no one complained.

We also witnessed citizens volunteer to help the first responders. We even witnessed a plane of citizens sacrifice their lives in order to protect a plane that was planning on hitting the White House. We all came together regardless of race, sexual preference, socioeconomic status and worked together. We were all Americans and we were going to work together to prove to the terrorist and the world that no one could stop the United States of America. Besides the citizens who volunteered at the sites that were attacked, people from all over the Country donated money, clothes and supplies for homes. Many people had lost their homes, survivors had medical bills and the first responders needed food, clothes and places to sleep. The main point is we all came together as Americans so we could help protect and save Americans impacted by this attack.

We owe a great debt to our first responders and we still do. Our first responders are responding the same way to the pandemic. They are working 24/7 to help victims of the pandemic and to help families who have lost loved ones. Many physicians and nurses have not had a day off since the pandemic started. The first responders continue helping victims of the pandemic while having to also help victims of hurricanes, floods and fires all over the Country. They do not think about themselves, they only think about the jobs and the people they need to save.

While our first responders continue to selflessly respond to the needs of our country, the citizens of our Country do not. Instead we are fighting with each other about who is right. The part that is really disgraceful is we are fighting with first responders and essential workers. When they have asked people to follow guidelines which have been established many of them have been beaten and some even have been shot and killed. We have a pandemic that has killed over 650,000 Americans. The tragedy on 9/11 killed over 3000 Americans. What would have happened after the planes hit the Twin Towers in New York City on 9/11 if we argued with first responders and if we shot at the first responders? I am afraid to think what would have happened.

Parents if you compare what is happening in our Country today with how people responded on 9/11, it is very disappointing. It seems like we have forgotten. We are not acting together as one Country, we are fighting with each other and we are emphasizing our differences. Parents try thinking back 20 years ago and explain to your children what it was like when we all acted together as one and we were all proud of our Country and that we were all working together. Maybe if we can explain this to our children and teenagers maybe they can start to work together and once again be proud about all of us being Americans.

Dr. Michael Rubino is a psychotherapist who has over 24 years experience treating children and teenagers and trauma victims including first responders. For more information about his work visit his website at www.RubinoCounseling.com or his Facebook page www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple

Examining the Issue of Teenage Suicide

Examining the Issue of Teenage Suicide

September is suicide awareness month. Many parents of teenagers ask me, if their child could be suicidal and what to do if their child is suicidal? I have been getting this question even more now that the pandemic has lasted so long. As a result of teenagers and children having to stay in the house for so long and not being able to see friends and now just starting to return to school, many teenagers are feeling isolated and lonely. Suicidal feeling have been increasing for teenagers for several years. As a result, the CDC has increased suicide from the the third leading cause of death to the second leading cause of death for kids 10 to 18 years old. As I stated, since the quarantine and pandemic has occurred, there has been an increase in suicides and deaths from drug overdoses. A recent study by the CDC has found that during the pandemic, the idea of suicide for teenagers has increased. Currently, 1 out of 4 teenagers have been having suicidal thoughts (CDC). Also for adults, suicidal ideations have increased by 11%. As a result, parents are worrying more about if their teenager may be feeling suicidal. Additionally, before the quarantine and pandemic, parents were had already started worrying about their teenager being suicidal because a study by the CDC indicated that survivors of mass shootings were more likely to attempt suicide. The issue of suicide is very scary especially because we do not discuss mental health issues in our society. As a result, parents are not sure what signs they should be looking for or what to do if they think their teen is suicidal. This creates a great deal of anxiety for parents because we were discussing there is an epidemic rate of teenage suicide, and since the pandemic has lasted so long, the number of teenagers thinking about suicide has increased significantly (CDC). Parents have been isolated due to the pandemic so besides the fact they are dealing with their own feelings of isolation and fatigue, they are faced with trying to decide what is the best thing to do for their teenager.

A successful suicide attempt is definitely a tragedy for the entire family. However, an unsuccessful attempt can be a major tragedy for the teen and the family too. Depending on the method used, a child who has an unsuccessful attempt may have to live their entire life with major medical complications. They can cause brain damage which may cause them to lose the ability to speak or the ability to breath on their own. Therefore, they may spend the rest of their life on a ventilator. Guns are one of the top three ways teenagers attempt suicide. However, teenagers are not aware that guns jump when fired. Many teens who use a gun do not kill themselves, but they do shoot off their face. The result is they have to have numerous surgeries to reconstruct their face, but their face and life are never the same. Some teenagers may need a face transplant which is a new technique surgeons have as an option.

I read this very good article describing what to do if you think your child is suicidal. It provides the steps you need to take in a non-threatening manner. It also addresses issues parents often may not think about, if they are concerned about their child being suicidal. The most important step is don’t be afraid to ask your child if they are feeling suicidal. It is a myth that if you ask someone if they are suicidal that you will cause them to become suicidal. In fact, you may save their life by asking them if they are suicidal. By asking you let them know it’s ok to talk about their feelings. Also by asking you reassure them there is nothing wrong with them and that you are emotionally strong enough to cope with the situation. Therefore, you may save their life by asking, if they are feeling suicidal.

Another reason many parents do not ask their teenager about suicide is the negative stigma associated with suicide. Often when someone dies of suicide the family will give another reason. Many families also request suicide not be listed as the cause of death. The Lighthouse Project conducted at Columbia University is attempting to remove this stigma. The Project has also developed questions that family members, friends and first responders can ask a person who they think might be suicidal. The questions have shown to be very effective at identifying someone who is suicidal and having the person to get help. I am including the link to the Lighthouse Project so you can learn more about it and download the questions that are most appreciated for you, if you feel someone in your life maybe suicidal. http://cssrs.columbia.edu/. It is a very good list of questions and the research shows that the questions are very effective at identifying someone who is suicidal. I have looked at the study and questions and I highly recommend the Lighthouse Project.

I have included the link to this article and I encourage parents to read it and to save it. What to Do if You’re Worried About Suicide |. https://childmind.org/article/youre-worried-suicide/#.W9PRyfwKel8.twitter. It provides you with symptoms and signs to watch for in teenagers. It also helps you talk to your teen about their feelings and opinions you can use for help. The bottom line, if you feel your teenager is suicidal do not be embarrassed. Remember today’s teenagers have had to deal with a lot over the past couple of years. They had to worry about being shot at school by a mass shooter, bullying has significantly increased so has the pressure to succeed and now they have had to cope with 4 months of being quarantined, their school was abruptly closed and now many are having to return to school remotely. They are all saying the same thing to me, when do I get to see me friends and when will life return to normal. Since many are now feeling life will never be normal, they are feeling suicidal. We need to be there for them and help them through these very confusing times. These times are confusing for adults imagine how they are for teenagers and children. So if you teen or child seem depressed or are talking an suicide make an appointment to have your teen evaluated by a psychotherapist who specializes in suicidal teenagers. If you walk in on a teenager attempting suicide, call 911 immediately.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating suicidal children and teenagers. For more information on his work or private practice visit his website www.RubinoCounseling.com or Facebook page www.facebook.com/drrubino3 or his podcast Understanding Today’s Teenagers on Spotify or Apple.

Teenagers Need Psychotherapy, but Insurance Denies Claim

Teenagers Need Psychotherapy, but Insurance Denies Claim

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. Additionally, we are coming up on the 20th anniversary of the 9/11 attack in New York. 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 600,000 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 over 150,000 people being diagnosed with the Coronavirus daily and the number of people dying is increasing and hospitals don’t have enough beds to treat everyone. Additionally, this time the virus is effecting teenagers and children. Since schools have started 450 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 have this spike and need to adjust our lives again. As a result, many things have to be closed down again, there are definite rules regarding wearing masks and they are 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.

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 are running out of beds and physicians are becoming exhausted, but we are also running out of psychotherapists. Also psychotherapists are exhausted because they are dealing with depression, suicide and anxiety daily. 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.

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 20 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.

Issues and Symptoms Associated with Teenage Depression

Issues and Symptoms Associated with Teenage Depression

Because we do not deal well with mental health issues in our society, there are a lot of myths about mental health. There are a lot of misconceptions about depression in particular. Over the last two years depression and anxiety have reached epidemic rates in teenagers (CDC). In fact, suicide in now the second leading cause of death for children 10 years old to 18 years old (CDC). The increase has been attributed to the numerous mass shootings and the mass shooter drills give have had to do in school. Additionally, we are now seeing children as young as eight years old committing suicide (CDC). Teenagers today have also been dealing with the Coronavirus and having to shelter in place and school remotely for the past 18 months. Research has shown that having to quarantine and attend school remotely has exacerbated depression for some teenagers and has caused some teenagers to become depressed and anxious (CDC). Since many parents have been consulting me about how to tell if their teenager is depressed, I was reading an article by Dr. Jerome Yelder, Sr., which outlines many symptoms of depression. He explained them so they are easy to understand and covered all symptoms parents need to be aware of regarding depression. This is important because typically children and teenagers do not act like adults do when they feel depressed. Additionally a study in the American Journal of Psychiatry shows that 75% of teenagers who experience depression without psychotherapy will experience issues with depression and mood disorders as adults. Therefore, it is very important that teenagers who are dealing with depression do receive psychotherapy. I have outlined the list of depression symptoms below for you to review and decide if you feel your teenager needs to see a mental health clinician for depression.

Sleep Problems

Depression can affect your body as well as your mind. Trouble falling or staying asleep is common in people who are depressed. But some may find that they get too much shut-eye.

Chest Pain

It can be a sign of heart, lung, or stomach problems, so see your doctor to rule out those causes. Sometimes, though, it’s a symptom of depression.

Depression can also raise your risk of heart disease. Plus, people who’ve had heart attacks are more likely to be depressed.

Fatigue and Exhaustion

If you feel so tired that you don’t have energy for everyday tasks — even when you sleep or rest a lot — it may be a sign that you’re depressed. Depression and fatigue together tend to make both conditions seem worse.

Aching Muscles and Joints

When you live with ongoing pain it can raise your risk of depression.

Depression may also lead to pain because the two conditions share chemical messengers in the brain. People who are depressed are three times as likely to get regular pain.

Digestive Problems

Our brains and digestive systems are strongly connected, which is why many of us get stomachaches or nausea when we’re stressed or worried. Depression can get you in your gut too — causing nausea, indigestion, diarrhea, or constipation.

Headaches

One study shows that people with major depression are three times more likely to have migraines, and people with migraines are five times more likely to get depressed.

Changes in Appetite or Weight

Some people feel less hungry when they get depressed. Others can’t stop eating. The result can be weight gain or loss, along with lack of energy. Depression has been linked to eating disorders like bulimia, anorexia, or binge eating.

Back Pain

When it hurts you there on a regular basis, it may contribute to depression. And people who are depressed may be four times more likely to get intense, disabling neck or back pain.

Agitated and Restless

Sleep problems or other depression symptoms can make you feel this way. Men are more likely than women to be irritable when they’re depressed.

Sexual Problems

Hopefully your teenager is not sexually active. While they may not have the sexual problems adults do, when they are depressed, they may show a lack of interest in dating or relationships and tend to isolate. They also may feel they are sexually unattractive.

If you’re depressed, you might lose your interest in sex. Some prescription drugs that treat depression can also take away your drive and affect performance. Talk to your doctor about your medicine options.

Exercise

Research suggests that if you do it regularly, it releases chemicals in your brain that make you feel good, improve your mood, and reduce your sensitivity to pain. Although physical activity alone won’t cure depression, it can help ease it over the long term. If you’re depressed, it can sometimes be hard to get the energy to exercise. But try to remember that it can ease fatigue and help you sleep better.

If you feel you child or teenager are experiencing the above symptoms and may be depressed, have them evaluated by a mental health clinician who specializes in treating children and teenagers. Remember, children and teenagers often display different symptoms when they are depressed so it is often misdiagnosed. Also do not be embarrassed or ashamed. The pressure children and teenagers are facing in the world today can be very overwhelming and can easily cause a depressive episode. The Coronavirus was the straw that broke the camels back for many teenagers. The most important thing is if your child or teenager is experiencing depression, get then the treatment they need.

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