Celebrating Halloween during the Pandemic

Celebrating Halloween during the Pandemic

In about a month it will be Halloween. This is a holiday that many children look forward to every year. However, this year most children will be missing Halloween due to the Coronavirus pandemic. Many states are reporting an increase in Coronavirus cases and the flu season is beginning too. Therefore, it is not medically safe for children to be trick or treating this year. The major problem is most of these children have missed their birthdays, playing with their friends, summer vacation and now they are having to go to school remotely. As a result, main children are feeling depressed and do not want to participate in school.

With everything these children have been through, hopefully we can find some safe, fun ways for them to celebrate Halloween. One possible option is, as a family, you can let your children pick out their costumes and since Halloween is on a Saturday this year, let them wear these costumes all day. Additionally as a family you can pick out scary movies to watch all day and night and treats they can have for the day. You can also carve pumpkins and prepare a special Halloween dinner. If you google Halloween recipes, you will find a number of dishes that have a Halloween theme. This may not be the same as trick or treating but it can be a fun time for the entire family.

Another possibility is to arrange trick or treating with your family and family friends. You can arrange that with family members and friends that are taking appropriate precautions such as wearing masks and social distancing so they are not likely to have the Coronavirus that you can stop by their homes and trick or treat. This way your children do get to trick or treat but at least you are trying to do it in the safest manner possible. Obviously, your children would need to wear masks and being feeling well. If they had a runny nose or a slight fever, you would need to keep them home. However, this occurs every year, if at the last minute a child is looking or acting ill, you need to keep them home. Obviously, your family and friends would be wearing masks when you went to their houses and if they were feeling sick they would let you know before you left your house so you would know to skip their house.

Another option would be if your city or church has a community center. You can have people who volunteer to pass out candy on Halloween at the hall. All the volunteers would wear masks and their temperatures would have been taken to keep it as safe as possible. You could schedule 10 children at a time to go through the hall and trick or treat. Again, the children will need to be wearing masks and have had their temperatures taken. This way you are making it safe for the children and volunteers. You would need a schedule so you would not have too many children in the same space at the same time. Yes this will take a fair amount of work. However, it will allow children to celebrate a holiday specifically for children and they have a chance to act like children and forget the pandemic for a night. This would be a tremendous gift to children who have missed a lot of their childhood due to the Coronavirus pandemic.

Some people may be tempted to say just forget the pandemic and let the children celebrate Halloween like they usually do. However, the research does document that children can and do contract the Coronavirus. The research also shows that children do need to be hospitalized due to the Coronavirus. The research shows that 1out of 3 children who are hospitalized will end up in the ICU. Finally the research numbers show children will and have died due to the Coronavirus. However, an additional complication during this time of the year is it is flu season too. It is possible for a child to have the flu and Coronavirus at the same time. Therefore, we cannot treat this like any other year and we need to brainstorm how children can celebrate Halloween safety.

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

Children’s Right to Psychotherapy is at Serious Risk

Children’s Right to Psychotherapy is at Serious Risk

Parents our elections are coming up and it is very important that you vote and call your Senators regarding health care. Currently President Trump has several suits in the Courts to eliminate the Affordable Care Act and pre-existing conditions. Yes he signed an Executive Order, but insurance companies do not have to comply with the Order. The Executive Order are only recommendations so insurance companies can and will ignore it. I have been a psychotherapist for over 20 years and I have seen how the Affordable Care Act has benefited thousands of people. Before we had it, many people were denied or could not afford psychotherapy.

Before the ACA, if you had ever taken antidepressants, your insurance could deny to cover psychotherapy for you or require you to pay a very high copayment. I saw this happen many times to patients I was treating prior to the ACA. Depression and anxiety are considered pre-existing conditions. Also in your insurance contact there is a standard clause that if the insurance company wants to see all your medical records you cannot stop them. I had insurance companies make these requests and I checked with numerous attorneys and the answer always was the same. The way the insurance writes their contract, you cannot stop them from getting all your records from the day you were born. If you refuse, they can terminate your insurance coverage. Insurance companies typically will ask for all your records because if you had psychotherapy as a teenager that is a pre-existing condition. Therefore, they can deny to cover your psychotherapy. They could even terminate your health insurance all together.

What if you have children? If you have a child with Autism, ADHD or if they were ever suicidal, your child will not be able to get insurance coverage or the psychotherapy they desperately need. Before the ACA I had many families in this exact situation. Many would automatically terminate therapy. Research now shows if children with these issues receive therapy when they are very young we can improve the outcome for them as adults. However, without the ACA, insurance companies specify these issues as pre-existing conditions and therefore the child is not entitled to psychotherapy. I often provided psychotherapy to these families at a fee they could afford. However, not every therapist can afford to lower their fees and I can only do it for a certain number of families because it cost money to run a business.

This election and these cases before the Courts could have disastrous effects on you and your children if the pre-existing clause is eliminated. The President has stated he will protect the clause, but his actions indicate he will eliminate it if he can. If this clause is eliminated anyone who has dealt with depression or ADHD will not be able to get insurance or if they can the rate will be very high. Remember if the clause is eliminated it will not just stop you or your child from receiving therapy it will also stop you from receiving medical care. So if you develop long haul syndrome after having the Coronavirus, you will not be able to get insurance coverage. The Coronavirus is a pre-existing condition. Another fact is that 1 out of 5 children meet the criteria for a diagnosable mental health issue (CDC). This means 1 out of 5 children have a pre-existing condition. So parents please vote and call Senators and save the pre-existing condition clause. Please do not trust President Trump to do it.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers for more information about Dr. Rubino visit his website at http://www.RubinoCounseling.com

An Important Role Model for All Teenagers

An Important Role Model for All Teenagers

On Friday, September 18, 2020, we lost an American legend and a person who taught all of us some very important lessons. The person we lost was Supreme Court Justice Ruth Bader Ginsberg at the age of 87. While the politicians are arguing about who and how her place on the Supreme Court will be filled, let us take sometime to look at her legacy and honor what she has done for the United States. She fought for the rights for many people and groups who were discriminated against due to the law. She truly worked and devoted her life to make our Country “a more perfect Union.” Additionally, she is and excellent role model for teenagers. Yes she is a role model for teenage girls, but she is also an excellent role model for teenage boys too. Let’s take a moment to look at the lessons she taught teenagers and how teenagers can use the lessons she provided.

Justice Bader Ginsberg personally faced discrimination and negative stereotypes and she learned first hand how they were unfair to the person but also how the stereotypes and discrimination hurt our nation too. Justice Bader Ginsberg had three strikes against her. She was a woman, she was Jewish and she was a mother. Here are two examples of the discrimination and negative stereotypes she faced during her life. She lived in Nebraska with her husband and she was working for the United States Social Security office in Nebraska. When she had her first child she was demoted and received a pay cut because women with children should not be working. Another example is after she was accepted to Harvard University. A professor called her aside and asked her to justify why she should be at Harvard and deny a man from attending Harvard. She did not allow these acts of discrimination to stop her. She understood why she was facing the discrimination and she would not let the discrimination stop her from moving forward with her life and the discrimination did not stop her from fighting against it and other inequalities many people faced.

After Justice Bader Ginsberg finished her law education and she graduated tied for first place at Cornell University, she was unable to get a job at a law firm because she was a woman, Jewish and a mother. Married Jewish women were not supposed to be attorneys. They were suppose to stay at home and raise a family. Again the discrimination would not stop her from fulfilling her life’s dream and her potential. She became an attorney for the ACLU and started to challenge discrimination and prejudice legally. She also had a husband, Marty Ginsberg, who supported her. He was an attorney too, but he believed that his wife had the right to be an attorney too and encouraged her to continue.

She did continue and people started to notice her talent and she started to change barriers. She took on discrimination against women, discrimination against voting rights for minorities and discrimination against people with disabilities. Her talent was recognized by President Carter who appointed her to be a Federal Judge and then President Obama appointed her to the Supreme Court. She over came the fact that she was a woman, Jewish and a mother. She made the world better for herself and for thousands of American citizens.

In addition to all the discrimination she faced, she also faced numerous bouts of being diagnosed with cancer. Many people may have retired after their first diagnosis, but not Justice Bader Ginsberg. She continued to work through chemotherapy, radiation and surgeries. She did not allow cancer to stop her from fighting for people’s rights. If she was not able to make it to the Court, she participated via conference calls from her home and even from her hospital bed. This is a person with a strong drive and who was not going to let anything get in her way of making our Country “a more perfect Union” for everyone regardless of their gender, race, religion or sexual orientation.

Now that we of an understanding of what she faced and her work, let’s look at the important lessons she taught teenagers. First, she showed that one person can make significant changes in our world. Also her friendship with Justice Scalia (a strong republican) taught us that you can respect and be kind to people with different opinions from you. In fact, you can even be friends with someone who has different opinions or different background from you. This is very important for teenagers to remember that you can be kind and respect people who are different from you or has different beliefs.

Another very important lesson she taught teenagers is not to let someone else’s prejudice or negative stereotype about you to stop you from fulfilling your dreams or to cause you to doubt yourself. If I had listened to people when I graduated from U.C. Berkely, I would have never earned my doctorate degree. I was told when I graduated from U.C. Berkeley that people with physical and neurological disabilities don’t go on to get advanced degrees. I should just be happy getting a job. I ignored the comments and discrimination I faced a long the way and I earned a Master’s degree and my Doctorate degree. I followed Justice Bander Ginsberg example and followed the faith I had in myself and ignored the stereotypes and discrimination. Girls and other teenagers who are belong to a minority, also need to believe in themselves and follow their dreams. Do not let someone else tell you what you can achieve in your life based on their prejudices or stereotypes they hold. Follow the belief you have in yourself and pursue your dreams.

Another lesson Justice Bader Ginsberg taught teenagers is you have an obligation to speak out against injustices and to help other people by helping to eliminate discrimination and negative stereotypes. As our Constitution states, “all men are created equally.” If that statement is going to mean anything then everyone regardless of ethnicity, financial class, gender or religious beliefs need to have the same opportunities as white Americans. Therefore, supporting groups such as Black Lives Matter and other groups addressing the systemic discrimination in our Country is our responsibility. Justice Bader Ginsberg’s life was dedicated to eliminating systemic discrimination and racism. This is why her last request was her successor be named by the winner of the Presidential Election on November 3rd. We can help ensure that the intent of her last wish will be carried out if teenagers speak up and demand that any systemic discrimination or racism they observe is changed.

Justice Bader Ginsberg lived her life showing us that no one has the right to define us as a person and in the United States we are all equal and deserve to be treated equally with kindness and respect. I hear many teenagers telling me they feel the same way when I see them for therapy. Therefore, we can honor this amazing lady by encouraging our teenagers not to allow stereotypes and racism to define them as people. Furthermore, we can honor this amazing lady by encouraging our teenagers to speak up and fight against racism and discrimination they see in our society. Remember Justice Bader Ginsberg’s belief that everyone in the United States deserves to be treated with dignity, respect and kindness regardless of ethnicity, gender, sexual orientation, financial class or disability status.

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

I Have A Dream but I Am Afraid

I Have A Dream but I Am Afraid

Today was the 57th year anniversary of Dr. Martin Luther King, Jr’s, “I have a dream” speech. In Washington D.C. protestors had a protest today to honor the anniversary and to look at how close we have come to meeting the goals that Dr. Martin Luther King set 57 years ago. Unfortunately, it appears we have not made a great deal of progress when it comes time to racial equality. Statistics show this fact and I hear it every day in my office from the teenagers that I work with who come from minority backgrounds. Many of these teens and children are telling me that they do not feel safe in the United States.

One thing that many people ignore is that this generation of teenagers are actively involved in politics and very aware of what is occurring politically in our Country. Teenagers today have smartphones which give them access to everything that is going on in the world and our Country and they are paying attention. They are also very concerned about the possibility that Trump could be re-elected President. They feel if he is re-elected the progress which has been made regarding racism will be erased by Trump. They have a right to feel this way. Trump criticizes sport stars for not standing during the national anthem. He claims they are disrespectful to the United States. However, Trump wants to protect statues of Confederate soldiers. These soldiers did away with the United States Flag and were committing treason against the United States and wanted to keep slavery. Trump wants to honor these soldiers. If I was a black teenager, I would be worried about what Trump might do to my rights if he is elected for a second term. Teenagers are telling me about these fears.

Looking back after Trump was elected it became apparent to me how Trump was making teens and kids anxious and afraid. I had many children who were Hispanic and from other minority backgrounds asking me if they were safe in the U.S. They had heard what the President had been saying about deporting people, they were very afraid that their families would be deported. However, all the kids and their families were American citizens so they could not be deported. However, due to what they were hearing and seeing the President do, they were very afraid for their safety.

This past week provides another example to children and teenagers to worry about their safety. A few weeks ago we witnessed George Floyd, a black man, being murdered by the police. Many of us hoped that this incident would be the trigger for all of us to look at the institutional racism in our Country. However, we were wrong about this being the trigger to make changes in our Country. This last week Jacob Blake was shot seven times in his back and the police officer had the gun in Jacob’s back as he shot. The President never addressed the shooting and we have heard little from the police. However, a white, 17 year old male from Illinois felt it was his duty to go to Wisconsin to protect people. He shot and killed two people and walked down the middle of the street with his gun and the police did nothing. In fact, we are hearing he may have done nothing wrong because he was acting in self defense. However, he doesn’t live in the city and had no reason to take a gun, a gun he had no legal right to own, and go to Wisconsin to protect people. I may be wrong, but I thought that was the job of the police not a 17 year old Caucasian boy. It seems like the two men were treated differently due to their color.

The black adolescent boys all tell me they need to be careful when they are out so they don’t get arrested. Looking at the above example and the statistic that black teenagers are 15 times more likely to be arrested than Caucasian teenagers (DOJ, 2018) helps me to understand why they are so concerned. Also from my own experience working with teenagers on probation, I see the discrimination. I have had white teenage boys violate their probation numerous times and nothing is done. However, a black teen I was working with who was on home arrest had to go back to Juvenile Hall for a month for a probation violation. The reason was there was a power outage on the way home from his appointment with me. Because there was no power the monitor turned off and he was unable to call in because the phones were down. Probation decided he violated probation because the monitor went off and he did not call probation. The probation officer knew the power was off, but charged him with a violation anyway. Why? I also had some black teenagers tell me that at there high school students were using the “N” word and someone left and hanging noose on campus. The black students were assured that the incident would be addressed, but it never was addressed.

I have mentioned before that suicide is now at an epidemic rate and has been increasing every year for the past 20 years now so now it is the second leading cause of death for teenagers (CDC). However, Black teenagers are five times more likely than Caucasian teenagers to commit or attempt suicide. The reasons why the rate is higher for black teenagers seem to be racism and feeling like no matter how hard they try they feel they cannot succeed due to institutional racism (CDC). When I hear how many of the black teenagers I work with are being followed when they go to stores or if they say they want to be a physician or get their doctorate degree that their high school counselors discuss being plumbers or electricians with them instead. These teens are very bright and this must be very discouraging. I was told the same thing in college because I have a neurological disability. I share my story with these teenagers and encourage them to go for their dreams.

57 years ago today Dr. Martin Luther King, Jr disgust a dream where racism was not an issue and we were all treated equally. However, if we look at our society, we are very far from Dr. King’s dream. The teenagers who are speaking out and protesting are telling the truth and we need to listen to them. Many people criticize them for protesting during a pandemic, however no one says anything to President Trump about not wearing a mask and holding campaign rallies that violate all the safety guidelines regarding the pandemic. Again a white man is getting a way with exposing thousands of us to the pandemic, yet the protestors who wear masks and try to social distance are criticize. Stop and think about that point.

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

Managing Screen Time, Bedtime and Online Schooling

Managing Screen Time, Bedtime and Online Schooling

Due to the Coronavirus and having to shelter in place, many kids have been using computers, IPads and smartphones to entertain themselves. Also many teenagers state this is how they can still communicate with friends by texting, FaceTime or Zoom. Since it’s summer many parents are allowing their teenagers to use electronics more because there is not much to do as a result of the coronavirus. Additionally, many families have had to cancel or drastically change vacation plans due to the pandemic. This all makes sense and is appropriate given the situation we are living in and the limited number of options children and teenagers have to enjoy the summer.

While most parents are fine with the increase use of electronics over the summer, they are worrying about what happens when school resumes. Many families are still waiting for final decisions to be made by school districts. However, it appears based on medical advice and the recent increase in the spread of the Coronavirus that most children are teenagers will not be returning to their schools and instead they will resume online schooling like they were doing at the end of school last year. Whether they are returning to the physical school structure or doing school online, they still need the appropriate amount of sleep. Many parents are concerned with relaxing some of the rules around electronics, how will their children respond to less electronic time when school resumes and if there are difficulties, how will it impact their children’s sleep if they are using electronics prior to bedtime.

Research studies have shown the electronics, and especially screens, can be stimulating to children and teenagers brains. While that might be a good thing during the day, it’s not at night when it’s time for kids to sleep.
Part of the stimulation from electronic screen time is from the blue wave light that comes from screens. During the day, many things stimulate our brains, and blue wave light is one of them. But at night, blue wave light exposure sends a signal to the brain that it’s daytime. When exposed to blue wave light, children may struggle to wind down and begin the process of falling asleep.

Besides the effects of blue wave light, screen time affects sleep if children become stimulated having conversations over the phone or text, playing games, or engaging in social media. Video games or movies might include disturbing themes or images that will affect sleep and emotional health.

How to Manage Screen Time for Better Sleep:
Your pediatrician may have their thoughts about how screen time affects sleep and you may want to consult your pediatrician about the appropriate amount of screen time before bedtime. Limiting screen time mostly to daytime hours is best. Blue wave light exposure during the day isn’t as problematic as nighttime exposure. And stimulation from screens during the day is normal.

As parents, it’s essential to set clear rules on screen time use. A good rule of thumb is to avoid screen time at least 2 hours before bedtime. Encourage kids to engage in other relaxing evening activities during that time as part of a healthy bedtime routine. They can read a book, work on a puzzle while listening to relaxation music, and get ready for the next day. The other rule parents should enforce is to avoid screen use in your child’s bedroom. Their bedroom should be an environment devoted to sleep and relaxation, and when you bring screens into it they may be tempted to engage rather than sleep. Additionally, when you bring your electronics into their bedrooms, you are sending a mixed message about not using electronics before beds. This may result in teenagers trying to use electronics in their bedrooms, when you think they are asleep. It is not uncommon for some teenagers to stay up until 2am texting or watching movies on their smartphones.

Another factor to consider is how screen time has replaced play time in some households. Kids who are using screens for many hours a day may be sedentary while they do so. Activity and exercise are a part of a healthy lifestyle, as they reinforce a circadian rhythm that’s in sync with the environment and allow kids to be tired when it’s time for bed.

Screens have become a part of everyday life and are an important tool for kids and adults. It’s imperative for parents to show their children the proper way to use screens without negatively affecting their lives. Take the lead to demonstrate responsible use so children can enjoy screen time as well as a good night’s sleep. Therefore, try to develop a nightly routine for yourself where you stop using electronics before you go to bed. By modeling appropriate behavior regarding electronics before bed, you increase the probability that your children and teenagers will follow your example and you also decrease the likelihood of arguments because you are not asking your children to do anything that you are not willing to do yourself.

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

A Dangerous New Teenage Activity

A Dangerous New Teenage Activity

There is a disturbing new dangerous trend occurring in teenagers that parents need to know about so they can talk to their teenager. We know that many teenagers feel a sense of being invulnerable and nothing bad will happen to them and their friends. It appears that teenagers in Alabama are putting this belief to the ultimate test (CDC, CNN). As a result, they are risking their lives, their friends lives and the lives of their families for a few hundred dollars.

The starting point of this risky behavior is in Alabama and city mayors and paramedics have heard about the risky behavior and they are very concerned. Teenagers are having Coronavirus parties. They invite people who are infected with the virus to a party and then they sell tickets to the party to their friends and other teenagers. The first person who can provide proof from a physician that they have contracted the virus after attending the party wins all the money that was collected. Teens are using social media and word of mouth to advertise these Coronavirus parties. They do not consider how dangerous these parties are and that they are playing Russian Roulette with their lives and with the lives of any one they come in contact with after the party.

We know that teenagers brains are not fully developed until they are 25 years old and the last part of the brain developing is the prefrontal cortex. This part of the brain is responsible for more advanced functions such as reasoning and dealing with abstract concepts. Therefore, when the White House and President Trump are saying 99% of Coronavirus infections are not serious, some teenagers will listen to President Trump. Also when President Trump states we have the virus under control, again some teenagers will listen. They have difficulties reconciling statements from Dr. Fauci and the University of Washington which indicate the virus is not under control and reaching very dangerous levels in our Country. They are not sure who to believe. Also most teenagers don’t listen to a lot of news so they are not aware that United State citizens cannot fly to Europe because the virus is so much out of control in the United States that other countries don’t want to expose their citizens to the virus again. Even if you want to go to New York, the state of New York is requiring people to go into a 14 day quarantine. New York finally has the virus under control in their state and Governor Cuomo is doing what he needs to so New York keeps the virus under control. Therefore, since teenagers are hearing the virus is not a big threat and the President refuses to wear a mask, they are not aware how the virus is really impacting people or how dangerous it can be.

As a result, these Coronavirus parties don’t seem very dangerous to them and they could win $200. They are unaware that they can die from the Coronavirus. An 11 year old boy died in Florida from the Coronavirus so children do die from the Coronavirus (CDC). They also are unaware of the risk they are taking with their families lives. These parties seem like fun to them. It is summer and they are looking for ways to have fun especially having been in quarantine for the past 2 months. Additionally, no one can give them definite answers about school yet. Maybe they will be going to school on line or maybe they are going back to school part time. How they resume school also has an impact on their ability to see their friends and have fun hanging out with their friends. Therefore, they are dealing with a lot of uncertainty that no one can answer right now. However, these parties mean fun with their friends now, they can win some money and the President is saying they don’t need to worry about the virus. As a result, it is easy for their brains to decide to go to the party and have fun with their friends. Currently, it’s the only answer that makes sense to them when they look at how the President and the government are responding to the pandemic.

We are in the middle of a global pandemic. As of today, 136,000 people in the United States have died from the Coronavirus (CDC). Today another 792 people in the United States died (CDC). When we have hundreds of people dying everyday from the Coronavirus, we should not be making this a political issue. All this accomplishes are more people getting infected and more people dying. It also increases the amount of stress and anxiety that our children and teenagers are experiencing. This anxiety results in more teenagers needing psychotherapy for anxiety disorders and more teenagers turning to alcohol, drugs (CDC) and now Coronavirus parties as a way to cope.

Parents what your teenagers need from you is for you to discuss the current situation with them and what are the current recommendations from the CDC. For example, when they go outside they need to wear a face mask and to keep 6 feet in between them and other people. Also to wash their hands regularly and to avoid touching their faces when they are out. Also have an age appropriate conversation about how dangerous the virus can be. Therefore, explain to teenagers how these Coronavirus parties are very dangerous. They can also transmit the virus to other family members or friends who have other health conditions resulting in that person’s death. Furthermore, if they do catch the virus some studies are showing people can have life long after effects such as depression or neurological issues. Overall the message should be since we do not know what this virus can do, it’s not something to ignore and needs to be taken seriously.

Discuss that you understand there are conflicting reports at times and this can be confusing. Therefore, if they hear things that are confusing or friends saying things that do not make sense, they should ask you. Together you can discuss the confusing information and look up the latest information on the CDC website or your county’s Coronavirus website. Bottom line explain that yes this is a very confusing time but if you work together as a family you can help each other to understand what is happening and to stay safe. Let the politicians play games with their careers and lives, but not your children’s or family’s lives.

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

Is my Teenager Depressed due to the Coronavirus?

Is my Teenager Depressed due to the Coronavirus?

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. Now teenagers are having to deal with the Coronavirus and having to shelter in place for over thee months. Research has shown that having to shelter in place 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. I have outlined his list 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 http://www.RubinoCounseling.com or his Facebook page http://www.facebook.com/drrubino3 or follow him on Twitter @RubinoTherapy.

Dealing with Anxiety When the Coronavirus is Out of Control

Dealing with Anxiety When the Coronavirus is Out of Control

Anxiety is a common issue for children especially when we were all on quarantine and kids having to attend school from home. Remember children’s imaginations are very active. During the last few months we have had conflicting information from the White House and the medical doctors, such as Dr. Fauci who is the expert, about the Coronavirus and what we need to do. Therefore, there has not been a lot to explain to children and they have heard a lot on the news. Many parents tell me they have limited the access to news but with their IPads, phones and friends, they hear more than we are aware of. Also don’t forget, prior to the pandemic the children were dealing with mass shootings on a daily basis. Therefore, children and teenagers already were dealing with a lot of anxiety before the beginning of the pandemic.

The White House had told us they had the virus under control and it was time to start reopening the economy. However, we now find out that this was not the truth. In fact, today our Country had its highest numbers for new cases, hospitalizations and deaths, since the beginning of the pandemic. Many states such as Florida, Texas and Arizona are reporting numbers indicating the virus is out of control in their states. The doctors are clearly stating we opened too soon and we will need to at least pause reopening and in many cases possible go back to shelter in place. California is re-evaluating their numbers and most countries will be issuing new health orders that will take effect immediately. This will definitely increase anxiety for children, teenagers and parents. In other words, it will increase anxiety for everyone.

According to the CDC and what I have seen in my patients, anxiety has been at epidemic levels for children for awhile. The most common reason children are coming into therapy right now is anxiety or depression associated with the state of our Country (mass shooting, riots and the pandemic). Many parents want to know what they can do in between therapy sessions to help their child with their anxiety, especially now since, many people are experiencing an increase in anxiety as the pandemic spins out of control. I ran across an acronym by Lori Lite that is designed to help children who are anxious. The acronym is ASSURE. I will explain what is stand for and how to use it below.

A – Align with your child
 with their body language
 with their tone and volume of speech
 validate their feelings
S – Share your experience
your feelings in stressful moments
mistakes you’ve made and how you emerged from them
how you cope with stress in day-to-day situation
perspective you’ve gained from seeing “this too shall pass”
S – Skills-training
give them words for feelings and worries
get them involved in appropriate exercise and activities to release stress
teach and model coping strategies like visualization, deep breathing, positive imagery
U – Uncover stress-related signs and symptoms
body aches – head, stomach
irritability and mood change
appetite change
sleep changes
R – Reassure them
that they’ll come through
that you’re there for them
that you’re proud of the effort they’re investing in calming and coping
things will normalize – recall examples
E – Engage the topic when they’re calm
listen to what they say and don’t say
respect their process in overcoming stress and worry
brainstorm options while they’re calm, since that’s when the “thinking” part of the brain is turned on.
This may not eliminate their anxiety all together, but it should help reduce their anxiety. Also remember if their anxiety is severe also seek psychotherapy for your child with a therapist who specializes in treating children. Psychotherapy can now be done via telemedicine so there is no risk of exposing them to the virus. Between the mass shootings and the pandemic caused by the Coronavirus, our children are living through historic times. We have never experienced events like we currently are experiencing so there should be no surprise that children may need psychotherapy at this time.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers. His practice does offer telemedicine. For more information regarding his work or private practice visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/drrubino3.

Teenagers are Trying to be Their Friend’s Therapist during the Pandemic

Teenagers are Trying to be Their Friend’s Therapist during the Pandemic

There is an issue I have encountered many times working with teenagers in psychotherapy that is seldom talked about. The issue is teenager’s trying to act as a therapist to the friends or girl/boy friend. This issue is increasing due to the pandemic and quarantine. Many teenagers are experiencing more anxiety (CDC) and boredom due to being at home more and no school. There have been many times that a teen will tell me their girlfriend is suicidal and ask me what they should do to help her? Often a teen will ask could they just bring their girlfriend into one of their sessions. They argue since I am helping them, I can help their girlfriend. At this point we need to have a conversation about how therapy works and the situation that they are in at that point.

In terms of me just seeing the girlfriend, I explain I need parental consent because she is under 18 years old. I also explain if she is suicidal the parents should be involved. Sometimes the teen explains their girlfriend is living in an abusive household and the parents would never agree to psychotherapy. In these situations, I provide the suicide crises number and tell the teen to have the girlfriend call the crises line and they will get her help. Some teens will exaggerate a situation just so I will see the girlfriend. Therefore, it may be a normal argument between a teenager and parent that I may be entering. Therefore, I provide the crises line and 911 so the situation can be assessed. If the girl does need help, I don’t want to ruin the chances of her getting psychotherapy by acting too fast. I also need to be careful how I handle the situation with my patient. If he is wanting me to see his girlfriend, I have established a therapeutic relationship and trust with him and I do not want to spoil that bond.

The other part of this situation and the more important part is the teen trying to act like their friend’s psychotherapist. Many teens feel since they have been coming to therapy and making progress, if I give them some advice they can help their friend. I explain that they do not having the training needed to be a therapist. I also point out they are not emotionally ready to be a psychotherapist. Many teens feel a very close bond to their friends and girlfriends because they have shared a lot of very personal information and have been open emotionally. While this may be true, it is not the same as psychotherapy.

Why is it important to discuss this issue? What if a teen tries to be their friend’s therapist and the friend commits suicide. They teen will be emotionally devastated and blame themselves. The parent of the teen who committed suicide may blame the teen too. Maybe they were not handling the situation correctly and the teen might have been saved if they had been hospitalized. However, the teen was never hospitalized because their friend was acting as the therapist. The teen could be in a lot of trouble. I have seen this happen. I have had parents come in for grief therapy because their child committed suicide and their child’s friend was acting as therapist and keeping everything a secret. This is a very sad and tragic situation for all involved.

Any time I have a teen asking me about a friend I explore the situation to determine if they are acting as therapist. If they are I explain to the teen why this is inappropriate. I acknowledge how close they are to their friend and how much they care about their friend. I then point out because they care so much they want to do what is best for their friend. I ask them how they would feel if their friend committed suicide? I point out that they are in a very difficult situation that they are not emotionally prepared for or professionally trained for. We discuss that this doesn’t mean anything negative about them. We discuss how they are expecting too much of themselves. I explain if they really want to help their friend, they will encourage their friend to seek help or they may need to tell someone such as the school counselor or their friend’s parents. Sometimes they say, “but I promised to keep it a secret.” I explain sometimes you may need to break a promise to help someone. I also point out their friend may initially be mad but if they truly care they need to do what is best for their friend.

Teenage suicide is an epidemic. The CDC just moved suicide from the third leading cause of death to the second leading cause of death for teenagers. Also the CDC has noted there has been an increase in anxiety, depression and suicides since the beginning of the pandemic. Additionally, teenagers are turning to cutting more often to deal with their feelings about life and the pandemic. Therefore, at this time in our history, this issue has become a bigger issue and needs to be addressed. The situation where friends try to act like the therapist happens more often than people realize. I had a situation occur this week. After explaining the situation to the teen, they spoke to their friend and their friend is now in therapy. This was a good ending. I would estimate 1 out of 3 teens ask me about their friends and are trying to be the therapist to their friend. Besides teens feeling they can handle this situation because they feel so close to their friend, I believe this occurs due to our views on mental health.

Because of the mental health stigma many teens are reluctant to go to therapy. They don’t want to be labeled as “crazy” or “weird.” Furthermore, it is not easy for teens to get therapy. Many psychotherapist prefer not to work with this age group for various reasons. Also many families cannot afford psychotherapy and many insurance companies do not cover psychotherapy. As a result, teenagers tend to turn to each other when they are encountering emotional issues. Research indicates that teens turn to their friend first when they encounter emotional issues. If we want to stop teenagers from acting like psychotherapist and if we want teenagers to get appropriate mental health care, we need to talk to teenagers about why they can’t act as a friend’s therapist and we need to increase access for teenagers to mental health care and remove the mental health stigma.

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

Gay Pride and Teenagers

Gay Pride and Teenagers

This month we celebrate Pride month. We celebrate that people have a right to be homosexual, transsexual and transgender. We also celebrate a recent Supreme Court ruling guaranteeing gay and transgender people are entitled to the same protection on their jobs as everyone else. In a number of ways, this is correct. Homosexual marriage has been legal in our country for a few years and there are many laws now.Therefore, the laws are acknowledging that regardless of sexual orientation, we are all human beings entitled to the same rights.

While there has been progress is it enough? As a psychotherapist who treats adolescents, I would say no. I still have parents who bring their teenager who identifies as homosexual or transgender into therapy. They do not bring the teen in for therapy to help them deal with the social pressures they are encountering at school and other places. No they bring their teen into me so I can fix them. Many parents still consider these feelings to be a teenage phase or that someone convinced their child to think and feel this way. When I explain to parents there is nothing to fix, many parents do not believe me. They tell me they will take their teen to someone who will fix them.

It is true that at times during adolescence or young adulthood, college age, that some people may have doubts about their sexuality and may even experiment. Just because some teens do question doesn’t mean every teenager questions. Think back to when you were a teenager, sexual feelings were very confusing. Therefore, some teens do question. However, I also have seen many teens who are not questioning. I have worked with many teens who know their sexuality for sure. They are not questioning and many of these teens tell me they have known their sexuality since they were little children.

When parents are still brining teens in for me to fix them and they are still being harassed and bullied at school, I do not think we have made a lot of progress. Yes some progress has been made, but we still need to make more progress.

One example that indicates we still need to make progress is suicide. The suicide rate for teenagers in general has increased from the third leading cause of death to the second leading cause of death. However, the rate is much different for homosexual or transgender teenagers. It is estimated that the suicide rate for teens who identify as homosexual, transgender, transsexual or questioning is five times the rate of the “average” teenager (The Trevor Project)). Think about this, for the general population of teens suicide is the second leading cause of death and those who identify as LGBT are five times more likely than the average teen to commit suicide. This means there are millions of teens killing themselves due to their sexual feelings and stereotypes that are outdated. Also the five times is an estimate. Many teens who attempt or commit suicide may have told no one about their sexual feelings. Also sexuality is not part of an autopsy. Therefore, the number is probably higher.

Another fact which indicates we still have work to do is that teenagers who identify as homosexual or transgender have few places to go to for help. Many are afraid to seek therapy from a private therapist because they are afraid the therapist will tell their parents. Legally a psychotherapist cannot tell parents if their teen is questioning their sexuality, but many teens are not willing to take that chance. There are very few non-profit groups dedicated to the topic because stereotypes still exist. I practice in the East Bay Area of San Francisco and I only know of one non-profit, the Rainbow Center, which provides services to teenagers who are questioning their sexuality.

Fifty years later, after people were killed in a nightclub for being gay, teenagers should not have to be dealing with these stereotypes at home and at school and there should be support services available. We need to eliminate the stigma associated with sexuality and mental health, we need to educate parents and schools about teenagers sexuality and we need more mental health services for teens. As psychotherapist we need to do a better job of educating the public that if a teenager tells us they are homosexual or transsexual or transgender, we cannot break confidentiality. Meaning we can tell no one not even there parents. We also need to educate parents this is not a disease that we cure. Sexuality is a normal part of being a human being and there are various forms of sexuality and they are all normal. Again, think about those suicide rates and how many teens we lose every year because of a stereotype. This is ridiculous!!

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