“I want food for Christmas “

The Holiday Season is here again, however, this year it still will not be our typical Holiday Season because we are still dealing with the effects of the Coronavirus and inflation. Over 1,000,000 Americans have died due to the Coronavirus and people are still dying daily due to the virus (CDC). So we have numerous people who are grieving for spouses, grandparents, siblings, parents, friends and children. Furthermore, due to inflation and a significant increase in the cost of food, many parents are having difficulties affording food, rent and their other monthly bills.

Millions of families cannot afford to pay the rent or buy food. Food Banks are reporting a significant increase in the number of people seeking food. Parents are getting in line at 5 am when the Food Bank opens at 9am. There are doing this because they are desperate for food so they can feed their children. Many of these people have well paying jobs prior to the pandemic and they never dreamed that they would be going to food banks or churches looking for food. However due to the pandemic, the war in Ukraine and inflation, they are finding it difficult to pay all their monthly bills.

A teacher asked her first grade class to write letters for Christmas. She asked each student to write one thing they want and something they need. One of the children wrote this heartbreaking letter asking for food and shoes. However, she was not the only one. Many children were asking for food, clothes and a place to live.

This video details the need that many families are facing and how many children are focusing on food and clothes for Christmas not toys. https://youtu.be/j_05ZuhqCZM

This video is the tip of the iceberg. Currently in the United States one out of five children are going to bed without food and are homeless (CDC). This is the United States, how are we allowing this to occur? While families are having to beg for food and a place to live, the former President Trump continues to lie about how he did not lose the election and spreading lies about the pandemic and inflation which only serve to make these children’s lives worse. Many have asked him to stop the lying and misinformation, but he ignores the pleas.

Many people assume that hunger is not a problem in the United States. However the current statistics of one in five children living below the poverty level and not having enough to eat and many living on the streets tells us that we have a severe problem in the United States. It’s not because they have drug addicted parents either. Many of their parents work 2 or 3 jobs, but they still cannot afford the prices for food and gas due to inflation. I have children who tell me they are happy to be going back to school because public schools now provide free breakfast and lunch. Therefore, by going to school they get to eat and not have to starve.

I do see children in this situation for psychotherapy. These children are often depressed and see no hope for the future. They feel that they will be homeless for their entire life. In therapy I am trying to help them to not give up. The suicide rate has increased due to the Coronavirus pandemic and if a child sees no hope for their future they do think about suicide. Many children I see I need to see pro bono or for a very low fee because their families don’t have insurance or their parents cannot afford the copayments the insurance companies require.

The other sad fact is that the United States government continues not to act. Additionally, the few programs that are helping these families will expire soon. However, the Senate refuses to cooperate with President Biden who is proposing programs to help these families and to give them their dignity back. Many of these programs are their only source of food and shelter for children. The children are the future of our country. Why would the United States, considered the richest country in the world, cut programs that will decrease the number of children living in poverty? Should a child in the United States, need to be asking Santa Claus for food and a blanket? Where are our priorities?

Dr. Michael Rubino has 25 years experience as a psychotherapist working with children, teenagers, trauma victims including first responders . For more information about his work with children visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple or Audible.

Loneliness Increases during the Holidays not Suicides

Loneliness Increases during the Holidays not Suicides

The Holiday Season is here and many people assume the Holidays and depression go together. In addition to assuming the Holidays and depression go together, people assume that suicide rates increase during this time of year. Well according to the statistics from the CDC, suicide rates actually drop during the Holiday Season. The study by the CDC is not sure why they drop but they do. May be they drop because during this time of year we pay more attention to depression and suicide. There are a number of ads and social media posts where people can call if they feel suicidal. We finally have a national suicide crisis line, 988, that people can call if they feel suicidal. In addition, now social media sites are offering assistance to teenagers and people who are feeling suicidal. Therefore, there definitely is more focus on people feeling suicidal than other times of the year. For example, we tend to forget about suicide during the summer and focus on the sun and swimming.

What the CDC did find is that loneliness increases during this time of year. During the Holidays there are songs and plenty of television shows regarding getting together with family and friends. You also have people talking about all the Holiday parties that they have to go to. Furthermore, you hear people talking about how well their lives are going. However, this is not the case for everyone. Especially with inflation, many people are struggling to afford food and a home for their families. Buying Holiday gifts is the least of their worries.

If you are a military family, a loved one may be stationed overseas and won’t be home for the Holidays. Also during the year some close friends or loved ones may have died and you are grieving their death. We are still dealing with the pandemic and we still have many people dying daily due to the Coronavirus. Since the pandemic started in 2019, over 1,000,000 Americans have died. Therefore, there are a lot of people in our Country grieving and feeling lonely due to a loved one dying from the Coronavirus. Additionally during the Holidays is a time when many people are talking about family and friends that have died and they remember the people they have lost over the years. The first Holiday Season without a close loved one or friend can be very difficult. You may not feeling like celebrating or you may have to change Holiday traditions which can make some one feel sad and lonely. However, it may be necessary so you can tolerate the Holidays.

Another common difficulty during this time of year is money. Especially this year with inflation and the costs for most things increasing significantly. Many people feel like they need to spend a great deal of money to show love. They may just be able to pay their monthly bills and cannot afford Holiday gifts. Why do we need to spend money to show that we care? What if you write a letter to someone telling them how important they are to you and how much you appreciate them. Isn’t that the real purpose of the Holiday Season? Isn’t this the time of year we take to tell people in our lives how much we appreciate them. Also it’s an opportunity to tell people we tend to ignore, people sleeping on the street or who are dealing with mental illness that they are important too? Everyone is important and should be included. Also instead of spending a lot of money, you can donate your time so someone who is struggling financially or emotionally has an easier time.

As a psychotherapist, I have seen that people dealing with mental illness feel lonely and out of place during this time of year. They don’t often feel the joy of the season. Sometimes they struggle just to make it through the day. Also mental illness is something we don’t discuss as a society. We tend to act like it doesn’t exist so we ignore the issue. Also since it is an uncomfortable issue for many people because they often feeling ashamed and embarrassment about family members who are mentally ill. As a result, they tend to ignore their family members and friends who struggle with mental illness because it makes them feel awkward. This makes it less likely for people dealing with family members or friends who have a mental illness to talk about it with others or seek help professional about how to cope with the holidays. This can make people feel lonely and isolated especially during this time of year.

We seldom acknowledge the daily struggle that people and families dealing with mental illness go through on a daily basis. It is important to acknowledge that mental illness is not a weakness it is a medical condition. There is no reason to look down on someone with mental illness. We offer encouragement and support to people with cancer, diabetes and chronic health conditions, why can’t we do the same for people with mental illness?

Additionally with so many teenagers experiencing depression and anxiety disorders due to the pandemic, many individuals are having a very difficult time finding therapist who are accepting new patients. Besides finding a therapist who is accepting new patients, people are having difficulties finding therapists who are accepting their insurance. Many insurance companies are denying claims for psychotherapy. Therefore, even if someone wants to go to therapy they may not be able to find a therapist or be able to afford it.

I have included a link to a video where a teenager discusses dealing with depression https://youtu.be/dAzqGcOLXBs. Listen to what he has to say and answer the question, does he deserve to be looked down upon because he is depressed?

Also remember the Holidays can be a lonely time for people. So if you see someone who looks like they are having a hard time or know someone who is struggling during this season, try to help. Do something kind for them. Another thing to remember, being kind to people should be a year round activity for all of us. We should not just be kind during the Holidays. If we try to be kind all year, we may be able to decrease how many people feel lonely and depressed. Also if we are kind and offering support year round may be we can eliminate the negative stereotype associated with mental health.

Dr. Michael Rubino is a psychotherapist with over 25 years experience. He specializes in treating depression and suicide especially depressed and suicidal children, teenagers, trauma victims and first responders. For more information about Dr. Rubino visit his websites at www.RubinoCounseling.com, www.rcs-ca.com or his Facebook page www.Facebook.com/drrubino3

How to Have a Safe, Calm Halloween with Your Family

How to Have a Safe, Calm Halloween with Your Family

Halloween is tomorrow and many children are anxiously counting the hours until Halloween. For children this is a great holiday. They get to wear a costume they like and they get free candy. What more could a child ask for? Many children plan all year about the costume they are going to wear. Many children have very elaborate costumes and they are very proud of their costume and they have a lot of fun being someone else for the day. Additionally, since many of the Covid restrictions have been removed, this is the first Halloween in two years where they can just have fun.

Since most children have been planning for Halloween for months and at school they often have Halloween activities and sometimes Halloween parties, it should not be a surprise that they are full of energy and usually hyper on Halloween. For some parents, this can create a problem especially when you have more than one hyper child to contend with on Halloween. Additionally, since children are so hyper on Halloween and expecting a lot, it is not surprising that children can have melt downs very easily in addition to being very excited. This can set up a situation where Halloween can easily fall a part. If parents have had a hard day or week at work, the last thing they are looking forward to is a house full of children bouncing off the walls who can’t understand why their parents are not excited too.

In order to avoid a chaotic Halloween it is helpful to establish a family plan for the day. A plan that you have also discussed with the children and everyone agrees to follow. By having a family plan you can help avoid melt downs and if one does occur you are in a better position to deal with it.

The first thing to do is to have a family meeting regarding costumes. Discuss what your children want to be and make sure it’s appropriate for their age and for the weather you typically have for Halloween. Additionally, you may need to look at how much your child wants to spend on their costumes. Once you and your child have agreed upon an appropriate costume that they like, you are ready for the next step.

The next thing you need to look at is what day of the week is Halloween. For example, this year Halloween is on Monday. Therefore, children have school the next day and this needs to be part of the family’s plans for Halloween. Additionally, parents need to decide if they are comfortable with their children trick or treating in their neighborhood or just at houses with people the family has as friends. Maybe you are not comfortable with trick or treating and your city, church or friends may be hosting a Halloween party and you are planning on attending a party. Some families also plan to have a special Halloween dinner and watching Halloween movies at home. Once parents have decided what they feel is the best option for their family, the parents can explain their decision to their children. During this time, parents can address any objections children may have and discuss the issues and feelings until you have an agreement.

The finally step is to have a plan in place for melt downs. The day before Halloween and the day of Halloween make sure your children were able to get a good nights sleep and have had breakfast, lunch and dinner and not too much candy. This will help your children to be able to control their emotions easier and make it easier for them to pay attention. If there is a melt down, a time out usually is the best option. If you are at a party, try to find a quiet place you can sit with your child while they get themselves together. If they are unable to get themselves together or the melt downs keep happening then it’s time to call it a night and let them go to bed. Try to frame it as they are going to bed because they need more sleep and not as a punishment. This may make it easier if you have to call it a night. Also before Halloween go over your expectations and what you consider a meltdown and any other behavior that may trigger a time out. It’s very important that everyone has the same understanding about the rules. This increases the odds that everyone will follow the rules and if they don’t, everyone will understand what is going to happen.

Putting together a plan increases your chances of everyone has a fun Halloween. However, most children are very excited about Halloween and are more hyper than usual. Therefore, take these factors into account when you are dealing with your children. Their behavior may not be what you expected, but if it’s not causing problems it’s best to overlook it. Remember, children have been attending school remotely for over a year with very little contact with their friends. Therefore, they are more likely to be a little more excited this year. Happy Halloween.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children, teenagers and trauma victims including first responders. For more information about his work visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple.

What Do I Do about My Teen’s Filthy Bedroom?

What Do I Do about My Teen’s Filthy Bedroom?

Due to computers, many teenagers spend a lot of time in their rooms gaming with their friends especially since the pandemic. However, many parents worry about what else their teenager may be doing in their room, such as vaping or drinking alcohol. As a result, many parents ask me, if is it appropriate if they search their teenager’s bedroom. Besides parents worrying about what their teenager maybe doing in their rooms, parents are frustrated that their teenagers bed rooms are a complete mess. The question about searching a teenager’s bedroom has been occurring long before the pandemic. However, since the pandemic and the quarantine, I have been hearing the question more often. While I understand parents concerns, we need to remember that teenagers do need their privacy. Their ability to have privacy has been significantly reduced due to the pandemic and quarantine. So parents feel in order to be a responsible parent they need to look at their teenager’s bedroom, however, developmentally teenagers need privacy. This is not an easy issue so let’s deal with this issue.

Parents it is very important to remember to pick and choose your battles. There are a lot of issues you will need to discuss with your teenager. Therefore, it is important to ask yourself, is it worth an argument? Teenagers are at a point in their lives where they do need their privacy. They are also at a point where they are trying to find their own identity. Their bedroom is a place they use for part of this process. Additionally, many teenagers, especially with the Coronavirus, feel they have no control over anything. For many teenagers they feel a sense of control in their bedrooms. They find this sense calming and reassuring. Therefore, it’s important to remember these issues and allow teenagers some additional time in their bedrooms. Also you want your teenager to learn responsibility.

My recommendation is not to make an issue of their bedroom. During this pandemic you and your teenager will become stressed over numerous issues. Also in the long run you will have more important issues such as school, how late your teen wants to stay out, where they want to go and the common issues of alcohol, drugs and sexual activity. Therefore, their bedroom really is a minor issue. In my opinion it is not worth the fight. Arguing about their bedroom, which they view as their private space, can lead to bigger problems with some of the other issues I listed above. During this pandemic period, teenagers need a private space so they can take mental breaks. Also remember these are only some of the issues you will need to set guidelines and expectations about your teenager’s behavior after the quarantine. This is why I strongly recommend leaving the bedroom alone.

Many parents ask me, “then I should just let them live in a junk yard?” The answer is yes. However, there are some guidelines I do set with teenagers. I tell them that Mom and Dad are not going to clean their room as long as they comply with the following guidelines:

1. The bedroom door must be able to be closed so no one else has to look at the mess.

2. People can walk by the room without smelling anything such as rotting food.

3. There are no ants or bugs going into or coming out of the room.

4. They do not keep dishes in their room so Mom has dishes when she needs them.

5. They are responsible for getting their clothes out of the room and cleaned. They are also responsible for putting away their laundry.

If they do not follow these guidelines, then they are giving Mom and Dad permission to go in and clean the room as they see fit. I ask the teenager and parents to both agree to these guidelines. I also recommend writing down the guidelines. Therefore, two months from now if someone remembers the agreement differently, you have a document you can refer back to which states what everyone agreed to.

Therefore, I recommend to parents if their teenager can agree to these guidelines, let them live in a junkyard. If they forget to get their clothes to the washer then they will be the one wearing dirty clothes. This is helping them to learn responsibility. It also gives them a sense of independence which they need.

I remind teenagers, if you do not want Mom and Dad cleaning their room then they need to abide by the guidelines. I also remind them it is their responsibility to get their clothes to the washer. If they don’t then they will be wearing dirty clothes to school. I also remind them that they cannot stay home from school because they do not have any clean clothes. I am basically telling the teenager that their parents and I feel they are responsible enough to take care of their room. This again helps the teen feel more mature and understand that they have to start assuming more responsibility for theirselves.

Now for the next issue, searching your teenager’s room. I do not think it is something parents should do on a regular basis just because their child is a teenager. As parents you have a responsibility to make sure you are raising a responsible young adult and if they need help, you have an obligation to provide them with the help they need. Therefore, if you have valid reasons to believe your teenager is using drugs or alcohol on a regular basis, then yes search the room. A valid reason would be noticing the smell of marijuana on their clothes or coming from their room. Finding marijuana or alcohol bottles in their backpack or car that they use. Other signs could be changes in their behavior and grades that are associated with drug use. However, before searching the room, I would recommend when your child enters middle school that you discuss with your child about the conditions which would make you search their room. If you feel it is necessary, tell your teen that you will be searching their room. Obviously, you do not tell them a week a head of time so they can hide things. I suggest you calmly inform them when they are home that you will be starting to search their room in a few minutes. It is important you explain the reasons why you are searching their room.

Parents may be concerned about an argument. This may start an argument, but this argument is worth it. Remind your teen about the agreement the two of you had made about searching their room. If you feel your teenager is not mature enough to abide by the agreement and is likely to start a physical fight, then you do not tell them and search it when they are out of the house. Remember you are only searching the room if you feel your teen is having a serious problem and need professional help. As a parent, it is your responsibility to get them help when they need it. You will want to remember this fact because your teenager may be very angry with you. However, it is better to have an angry teenager than a dead teenager. Many of the drugs teens are using today can kill someone very quickly and teenagers are not usually aware of all the risks.

Therefore, in general respect the privacy of your teenager’s bedroom, however, if you notice signs that indicate your teen is having difficulties then search the room.

As for the last issue that become more apparent during the pandemic is parents feel teenagers spend too much time in their bedroom. They hear them staying up late, sleeping until noon and the rest of the time playing games on their laptops and talking with friends using the games. Yes this can be an issue. The best approach is to discuss this issue prior to summer. However, if you did not, it is not too late. Let your teen know you need to talk to them about their room. Do not attack telling them they are spending too much time in their room. They will simply stop listening and the discussion is over. Before talking to them think about what and why you are concerned about the time in their room. One major reason hopefully is you want the opportunity to spend some time with them. Explain your concerns and some possible solutions you have developed. At this point ask your teen how they feel and do they have any solutions. If you have a calm, caring conversation and you are willing to consider all options, you should be able to resolve the issue. Most teens want to hear that their parents care and want to spend time with them. They tend not to admit to these feeling but they are their. Also teens do better when they feel you have listened to their ideas and are not just telling them what to do.

Remember the pandemic is stressful and scary for everyone. This is not a time you want to be arguing daily with your teenagers. If we all remember we are all in the same situation and decide to work together, we can get through this quarantine together.

Dr. Michael Rubino has over 25 years experience as a psychotherapist who teats teenagers and children. 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/drrubino 3.

Body Image Issues in Boy & Girl Teenagers

Body Image Issues in Boy & Girl Teenagers

Many adults and teenagers are currently concerned about their weight and how their bodies look due to the Coronavirus Pandemic. For almost two years adults and teenagers were confined to their homes. Furthermore, as things started to open up, gyms were the last places authorized to open. This resulted in many adults and teenagers not being able to go to the gym and workout and exercise. This was a major loss in many people’s daily routines. Additionally, many teenagers were not able to participate in their normal sport activities like they are use to doing. As a result, many people felt like they were sitting around a lot gaining weight. This is a common concern for many teenagers too. It is now even more of a concern because now teenagers are back in school. This means people are looking at them and school dances such as Homecoming. If you wear sweats you can compensate for any weight you might have gained. It’s impossible to cover up any weight you might have gained and are trying to lose in jeans. As a result, many teenagers are very concerned about how their bodies look and are looking for quick ways to lose the weight they may have gained during the pandemic. This may lead to eating disorders in teenagers.

Here are important facts about eating disorders everyone needs to know. Eating disorders and body image issues are a major problems for teenagers. Despite what most people may think, these issues impact girls and boys. Most people assume eating disorders only impact girls, but they impact boys too. Boys worry about their abdominal muscles and having the “six pack” look and how strong they are compared to other boys. Also for some sports such as wrestling they must make a certain weight to compete. Therefore, they worry about their weight. Many boys may not eat or over eat before a wrestling match so they can make it into their weight class. So eating disorders impact boys too.

Looking at the prevalence of eating disorders in teens can be very difficult. Some people break the statistics down by diagnoses such as anorexia. While some focus on teenagers who under eating and those who over eat. Both patterns do create eating disorders. Another classification is unhealthy eating that many teens engage in. Some may skip meals or some may consume to many calories to make weight for their sport and then go days without eating. Therefore, eating disorders can take many shapes and forms. Overall, it is estimated that eating disorders impact 5% of female teenagers and 1% of male teens (NIMH). However, the number for males is considered to be under reported. This assumption exists due to the belief many people have that eating disorders only impact girls. Therefore, there is an assumption that the 1% for boys is an underestimate due to under reporting. Working with adolescents I am sure the 1% is incorrect. I hear many teenage boys complain about their bodies or needing to make weight for their sport. I also hear things they do such as only drinking water a week before a weigh in or loading up on protein drinking before working out. What they report may not fit the picture of anorexia we have, but it definitely is not healthy and is involved with body image. This is a major factor in all eating disorders whether it be anorexia or over eating. Furthermore, since many teenagers have been at home during the Pandemic with nothing to do, many have been eating because they are bored or as a way to cope with depression or anxiety. Many teenagers have complained about eating too much or eating unhealthy foods, but they also say they are very bored due to the Pandemic and there is nothing else to do. We also know there has been a significant increase in teenage depression and anxiety during the pandemic. We also know food is often used by someone to deal with depression or anxiety. Therefore, if depression and anxiety increased for teenagers during the pandemic, it makes sense that eating disorders and body image issues have increased too.

One reason I’m addressing this subject is as I stated above most people assume that eating disorders do not impact boys. Eating disorders impact boys and teens from every economic level, ethnicity and religion. Additionally, we have all had to deal with the boredom caused by the Pandemic and many people have been eating because they are bored. Therefore, eating disorders are equal opportunity disorders. Another reason I’m addressing this issue is suicide is the number one mental health issue killing teenagers in our country. Eating disorders are the second leading mental health issue killing teenagers (CDC). It is estimated that every 62 minutes someone dies from an eating disorders (NIMH). The death may occur after someone has received treatment and is considered in recovery. Eating disorders take such a toll on teenage bodies they may die even though they are considered to be recovered. The singer Karen Carpenter is a prime example. She struggled with an eating disorder for years and struggled with treatment too. However, she finally reached a point where she was considered recovered from her eating disorder and started to resume her life. Unfortunately, she died suddenly one day from a heart attack. The toll the eating disorder put on her body weakened her heart severely. So severely that it caused her to have a heart attack even though she was in recovery.

This is a very sad story and fact. We can avoid these issues by early diagnosis and treatment. We also must realize that eating disorders impact boys too. If we are not aware of this fact, we are not addressing the entire problem. We need to address how our society look at men’s bodies and women’s bodies and the expectations we place on both genders. No one can live up to the female and male stereotypes we have created. In order to change these stereotypes we need to start with teenagers and provide them with enough self-esteem to reject the stereotypes.

As I stated early treatment is necessary. To have early treatment we must have an early diagnosis. I have included a link to a video by Dr. Pooky Knightsmith which discusses the ten common warning signs of an eating disorder in teens and children, please watch this video https://youtu.be/nKwbE8mP_PA.

If your teen or child displays any of these warning signs, if they are discussing gaining too much weight due to the Pandemic or, if you feel your teen maybe struggling with an eating issue, make an appointment with an adolescent psychotherapist who specializes in adolescents and eating disorders. Do not feel ashamed or embarrassed. A mental health issue is no different than a physical health issue. We only believe their is a difference due to the stigma we have created. However, keeping this stigma is endangering the lives of many teens so help your teen and ignore the stigma. Help them deal with their health issues, physical and mental.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating teenagers and children, trauma victims and first responders. He also treats teens including boys with eating disorders. For more information about his 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.

Coping with the Epidemic of Anxiety Disorders in Children and Teenagers

Coping with the Epidemic of Anxiety Disorders in Children and Teenagers

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

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

The fact that we thought we were on the right track with the Coronavirus and we continue to have spikes is confusing and irritating to teenagers. Just as we think we are returning to our normal lives, we see that we need to still take precautions and maybe we will never return to our pre-Covid lives. Again we are not able to give children and teenagers any definite answers regarding when life will return to something normal. Now we have changed the rules again and they are expected to adjust.

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

This is occurring when children and teenagers desperately need psychotherapy. Prior to the pandemic, anxiety disorders in children and teenagers were at epidemic rates (CDC). Since the pandemic there has been a 25% increase in children and teenagers being diagnosed with anxiety disorders. At this point anxiety disorders are the most common psychiatric diagnosis for children and teenagers (CDC). Yes depression, suicide, grief and trauma diagnoses have increased since the pandemic, but we have seen the largest increase in anxiety disorders (CDC). As a result, many children and teenagers have severe anxiety regarding school and many are stating they cannot go to school due to anxiety disorders.

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

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

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

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

• Withdrawal from things the child usually enjoys

• Trouble falling or staying asleep

• Unexpected abdominal pain or headaches

• Extreme mood swings

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

Parents can actively help kids and adolescents manage stress by:

Being available

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

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

Listening actively

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

• Let kids complete their point before you respond.

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

Responding thoughtfully

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

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

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

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

• Word swap.

o   Say ‘and’ instead of ‘but’

o   Say ‘could’ instead of ‘should’

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

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

Consider

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

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

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

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

Call a psychotherapist who specializes in treating children and teenagers, if stress begins to interfere with your child’s daily activities for several days in a row. It is very important that you contact a mental health clinician so you get an accurate diagnosis and an appropriate treatment plan for your child.

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

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

Middle School in the Year 2022

Middle School in the Year 2022

The school year is beginning and many parents are focused on their children’s transition into High School, College or Kindergarten. However, there is another important transition for children, Middle School. This is a major transition for pre-adolescents. As a psychotherapist who works with adolescents, I am very familiar with what is happening on High School and Middle School campuses and how big the transition is into Middle School these days. When kids transition to middle school they have to adjust to changing classes, having more than one teacher, increased homework and they are starting puberty and unsure of themselves. They are also not sure about all the academic changes. In addition to academic changes, physical changes with their own bodies, there are all the new social issues. Friends become more important and some students are talking about girlfriends, boyfriends and sex. This is a lot to adjust to at age 11. This is why we are seeing a significant increase in the number of middle school students being diagnosed with depression and anxiety disorders (CDC) In addition to all of these changes, there are all the stories they have heard about middle school. This only increases the stress and anxiety that middle school students in 2022 are feeling.

Many parents assume middle school in 2022 is similar to when they attended middle school, however the middle school in 2022 is very different than the middle school most parents attended. One example, when I ask parents, who have a child going into middle school or a child in middle school, if they have spoken to their child about drugs, alcohol and sex, I am told no and parents are surprised I asked this question about middle school students. I hear parents say every day that they don’t need to worry about drugs, alcohol or sex with their child in middle school because their child is too young for that right now. Well the reality is that Middle School Students in 2022 are drinking, using drugs and having sex. Many parents are unaware of what is happening in Middle Schools these days. Drugs and alcohol are just the tip of the iceberg. Children that are in the age group of middle school are now involved numerous dangerous activities such as selling drugs.

To begin with, most middle school campuses are better pharmacies than your pharmacy. I have had middle school kids say they can get Vicodin, Concerta, Ecstasy and of course weed and alcohol on their school campus. Some kids use at school and some use after school and on the weekends. More and more middle school kids are deciding to experiment with drugs and alcohol due to the pressure to feel successful as a teenager and so they fit in with friends. They also feel overwhelmed by the school shootings and the pandemic and they are looking for an escape. They see other kids at school using and they want to be part of the popular group so they think about and often try drinking or vaping.

Also many middle school kids are sexually active, but they don’t think they are sexually active. They think because they are not engaging in intercourse that they are not sexual active. Most 6th graders tell me oral sex doesn’t count as being sexually active. The kids say they are just “messing around” with each other and do not consider this sex. They also have no idea about sexually transmitted diseases or how to protect themselves from contracting STDs or getting pregnant. However, the number of middle school kids engaging in oral sex and intercourse has increased significantly over the last few years. The rate is now high enough that some middle schools, such as the San Francisco School District, are disrupting condoms to middle school kids. Yes, Middle Schools are giving condoms to children in the sixth grade. These kids are only 11 years old.

Another common issue in middle school is bullying. However, we are not just talking about one kid teasing another kid at school anymore. Today there is for a group of kids teasing one kid and it is not just at school. Now kids are using Facebook, Twitter, Instagram, Snapchat and texting by cellphone to tease and harass other kids. As many of you may recall there have been a number of kids who have committed suicide due to the teasing occurring at school. I wrote an article about a middle school girl who committed suicide and in her obituary she left a note to the other students just asking them to be nice to each other.

Another issue with teasing and dating is that students are not aware of the laws. As a result, many middle school students find themselves in trouble with the school district and often the police too. Harassment in middle school and dating often involves students texting or emailing pictures. Students are not aware that if they text a nude photo of another student or themselves that they have violated child pornography laws. Something many parents and students are not aware of is that a child can be charged with violating child pornography laws. When a child texts a nude photo of a middle school student, who is under 18 years old, it violates child pornography laws and the child who texts it and received it can both be arrested. The law is violated because the child in the photo is under 18 years old.

Also many kids in middle school, especially boys, don’t feel safe and are afraid of someone trying to beat them up before or after school. They say they have to fight because other kids are recording it and posting it on YouTube. Boys are bragging about their fights on YouTube and comparing how many people have watched their fight with their friend’s fight. Therefore, boys feel they must fight, otherwise if they don’t fight the other kids will think they are a “whimp.” Due to this fear many middle school students carry knives, metal pipes, guns or anything they can think of to protect themselves. This is very sad that kids have to live in fear for their lives and for safety reasons many middle schools have metal detectors. The number of mass shootings at schools and the mass shooting drills they do at school exacerbate this fear. It’s sad that a place they should feel safe in that students now are afraid for their lives. Also parents and students don’t realize, if a student is caught with any of these items on campus, they can be removed from their entire school district and required to go to continuation school. In addition, the school can have the student arrested. Due to mass shootings, schools take anyone possessing items that can severely hurt someone very seriously.

These are just a few of the issues that are occurring at all middle schools and they are very serious. Your child is not going to come to you to ask about these issues or tell you about them because they feel embarrassed and they are afraid of getting in to trouble. So parents even though you may feel embarrassed or awkward discussing these issues with your 11 year-old child, please do so. If you notice anything about your child’s behavior that seems different to you and you feel a sense of concern, ask your child about what is happening at school and with friends. Mention they are getting older and as a result the issues in their lives are becoming more difficult. Therefore, when you talk to your pre-teen mention drinking, sex or being teased and ask if they need to talk about it and they can talk about it anytime they need to. You may be saving their lives because they are dealing with things they know nothing about and these things can kill or have life long effects.

Here is a YouTube video that might help:

Life Talk | PSA: This could be your child (Teen drinking, alcohol,partying,peer pressure)

Dr Michael Rubino is an expert dealing with adolescents and adolescent issues. He has over 25 years experience treating children, adolescents, trauma victims and first responders. For more information about Dr. Michael Rubino’s work visit his website www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/Drrubino3.

Could My Child Have ADHD? If so, What Do I Do?

Could My Child Have ADHD? If so, What Do I Do?

Schools are starting to resume, however, many children are still experiencing issues due to the pandemic and remote learning. Children and teenagers reporting anxiety and depression have increased significantly since remote learning. Additionally, many students are still experiencing difficulties adjusting to their school schedules now that they are going to the school site versus logging on from home. These are issues parents need to keep in mind if their child or teenager is having difficulties with school.

Now that schools have resumed so has the fighting parents and teenagers have over getting homework completed and turned in on time. This means parents are once again getting notices from their children’s schools that their child is not doing homework and not paying attention in class. When kids were attending school remotely, many teachers and parents were not as concerned because they knew doing school remotely was very difficult. However, now that students are back in the classroom, teachers and parents are no longer ignoring attention issues or difficulties with homework.

As a result, some schools and family members may be suggesting to parents that their child has ADHD and needs medication. Many parents are not sure about the diagnosis and they are concerned about their child taking ADHD medication. I hear this very often from parents and do many assessments on children to determine if a child has ADHD. Yes ADHD is a really disorder, but too many teachers and schools rush to the conclusion that a child has ADHD and needs medication. Additionally given everything children have been through with the pandemic and remote learning, we need to be very careful about labeling a child with ADHD. There are a number of other options such as depression, anxiety and boredom.

According to statistics by the American Psychological Association, five percent of children in the United States have ADHD. It is also more common in males, however it does also occur in families. According to the CDC 15.9% of boys and 5.6% of girls have ADHD. However, not every child who has ADHD requires medication. Many children can be treated with psychotherapy and behavior modification. Therefore, if your child is diagnosed with ADHD do not rush to medicate your child. There are different subtypes of ADHD and different severities of the diagnosis.

If you child does have ADHD, they are entitled to accommodations such as extra time taking a test. It’s important to get them the accommodations they need. Children who have ADHD, but do not receive accommodations tend to show signs of low self-esteem around the fifth grade. Accommodations for ADHD can be covered by a 504 plan. However, if your child has severe ADHD and needs resource assistance too, they are entitled to an Individual Educational Plan (IEP). Many schools may tell parents ADHD does not qualify for an IEP. This is not true. The severity of the ADHD determines if a child needs an IEP. They would qualify under the categories of Emotional Disturbance or Other Health Impairments.

If you feel your child may have ADHD or their school suggests the idea, make sure you have your child appropriately assessed by a professional who specializes in ADHD. In the past schools would often diagnosis children with ADHD. Schools are no longer supposed to make this diagnosis. If they feel a child might have ADHD, they are supposed to have your child evaluated. Many parents take their child to their pediatrician, however, many pediatricians are not trained in diagnosing ADHD. I would suggest having your child evaluated by a mental health clinician trained in working with children and in assessing for ADHD.

As I stated above, if you are going to have your child evaluated for ADHD, make sure you take your child to a mental health clinician who specializes in children and in doing assessments. The assessment for ADHD is not very difficult and an appropriate evaluation by an appropriate mental health clinician should cost around $250 depending on where you live. I have seen some parents who have spent thousands of dollars getting CT scans, MRIs and PET scans. You do not need an expensive scan of your child’s brian to diagnosis ADHD.

The DSM V, the diagnostic manual that mental health clinicians use, list the criteria needed for the diagnosis. I am including a link to the Center for Disease Control which list the criteria for the diagnosis and other information about ADHD, http://www.cdc.gov/ncbddd/adhd/diagnosis.html. Typically the diagnosis can be made by a clinician interviewing the parents, having a play session or two with the child and observing the child at school or consulting with the teachers. However, remember if you are going to have your child evaluated for ADHD, you want a mental health clinician who specializes in treating children and assessing children for ADHD. Your child’s pedestrian should be able to refer you to someone or if you call your insurance they will probably have referrals.

Before you rush to have your child assessed, remember some basic facts. Most children between the ages of two to five are very active. They also have very short attention spans. Sometimes you need to give a child some time to mature especially if you have a boy. Remember boys mature slower than girls and tend to be more active than girls. It is important to keep these facts in mind when you are wondering if your child has ADHD.

Now if you child is more hyperactive than other kids his age or his attention span is shorter than most kids his age, there might be an issue. Also if there is a strong family history of ADHD in the family such as his father had ADHD as a child and paternal and maternal uncles all had ADHD as children, there might be an issue. Also if your child was born premature or there were complications during the pregnancy or child birth, there might be an issue. Premature babies or babies with a difficult pregnancy or birth are more likely to have ADHD and learning disabilities.

Bottom line, if someone suggests that your child has ADHD don’t rush to the pedestrian seeking medication. Compare your child’s behavior to other children and consider the risk factors. If your child doesn’t have many risk factors for ADHD maybe wait six months and reassess the situation. Also remember many children are experiencing anxiety due to the pandemic. Anxiety can easily look like ADHD. Therefore, instead of medication, maybe your child needs therapy for anxiety.

The most important thing to remember is if you decide to have your child assessed for ADHD, make sure you go to a mental health clinician who specializes in children and ADHD. You want a mental health clinician who specializes in treating children with ADHD and assessing children for ADHD. Also remember you do not need any expensive scans like a CT scan. There are other treatment options besides medication, so do not rush to medicate your child either. Consider all the treatment options.

Dr. Michael Rubino specializes in treating children and assessing children. He has over 25 years experience treating and assessing children and teenagers. For more information about Dr. Michael Rubino’s work visit his websites at www.rcs-ca.com, http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple.

Examine the Issue of Teenage Suicide

Examine the Issue of Teenage Suicide

September is dedicated to suicide prevention. Therefore, I decided to write this article. As a psychotherapist who treats teenagers, I work with many parents who are worried that their teenager is depressed and may be suicidal. Many parents worry because suicide is a mental health issue for children and teenagers that often is ignored. In fact, suicide is no longer the third leading cause of death for children 10 to 18 years old, it is now the second leading cause of death for this age group (CDC). Also suicide is becoming more common in our society. If we look at the past few years Kate Spade, a designer, and Anthony Bourdain, the chef from CNN, both a profile people have committed suicide. Suicide is also common in soldiers who have been deployed over seas. Additionally, suicide is occurring more often in teenagers who have survived school mass shootings and for first responders for mass shootings and those dealing with Covid patients (CDC). Therefore, it is becoming common in our society, however, there are few resources available to people. Also the negative stigma associated with suicide prevents people and families from taking about the issue. I hope the information in this article helps you understand the issue of suicide. To start off with, I have included an article where six people describe their suicidal feelings and the help they need http://linkis.com/huffingtonpost.co.uk/AlJc2

http://linkis.com/huffingtonpost.co.uk/AlJc2.

In today’s society there has been a significant increase in depression, anxiety and suicide among teenagers and children. Depression and anxiety disorders are now at epidemic rates for children and teenagers (CDC). Additionally, as I stated above, suicide is now the second leading cause of death in children 10 to 18 years old. Yes 10 year old children are committing suicide daily. The increase is significant enough that Netflix was running a series about teenagers feeling suicidal. The show was called 13 Reasons Why. The suicide rate for teenagers has been increasing yearly for several years. It is increasing faster in teenage girls and is considered an epidemic. It is estimated 800,000 people a year commit suicide and approximately 25 times that attempt suicide (CDC). Again, suicide remains the second leading cause of death for kids 10 to 18 years old and it rises every year and we are not providing resources (CDC).

In my practice I am seeing more and more children and teens reporting they feel depressed, anxious and overwhelmed. One of the main reasons I hear for these feelings is that children feel a great deal of pressure to succeed in school. I have kids in 5th grade and 6th grade worrying about grades. They are worried not because their parents will get mad because if they don’t get As, they are worried that they will not get into a good college and won’t get a good job and won’t be able to afford a house. They only feel like a success if they can make a lot of money. They don’t even consider how compassionate and caring many of them are and the good they offer our world. In their eyes, compassion is nothing if you are not driving a Mercedes.

This is a great deal for a 5th grader or 6th grader to worry about at their age. It is also a terrible way for them to value theirselves. This is how we create Bullies because compassion is looked at as a weakness. Also because money and possessions are becoming more important than people.

I also see middle school students and high school students involved in several sports and other activities such as Boy Scouts. The kids are feeling pressured to do extracurricular activities not for fun but for their resume. They are again concerned about getting into a good college and being a success. This pressure is not coming from parents either. It is pressure kids are now placing on themselves. Again they believe they need to grow up and make a lot of money to be happy and successful.

Recent studies are showing a correlation between lack of fun and time to relax with the increase in depression in children and teenagers. A study in Psychology Today discusses this issue. I have included the link so parents can read this study and think about it. Also so you can look at your children and talk with them. See if they are enjoying life or feeling overwhelmed because they need to succeed. Money pays the bills but doesn’t guarantee happiness https://www.psychologytoday.co.

Many parents are not sure what to look for and do not want to over react. If you notice these signs they are indicators that your teen may be feeling suicidal and needs to be assessed by a mental health clinician. The major warning signs are:

• Aggressive behavior

• Verbal outbursts

• Withdrawal from friends

• Writing or talking about suicide

• Dramatic mood swings

• Reckless behavior

• Refusal to engage in daily responsibilities

• Giving way personal items of worth such as jewelry or furniture

If you notice any of these signs don’t be afraid to ask your

teenager if they are feeling suicidal or thinking about suicide.

Many people have the misconception that if you ask someone

about suicide that you will cause them to think about suicide.

This is not true. By asking someone if they are feeling suicidal,

you are letting them know that it is safe for them to talk about their feelings,

including suicidal feeling. If someone is feeling suicidal it

is essential that they feel safe to talk about their feelings and

thoughts. Therefore, asking your teen if they are feeling

suicidal will not hurt them, it can help them to talk and possibly

save their life.

I understand that the topic of suicide is scary and something our

society denies and views it as there is something wrong with

anyone feeling suicidal. But the truth is, it is a mental health

issue and it is nothing to be ashamed of. It is also an epidemic for

teenagers. If we want to prevent the number of suicides from

rising and help teenagers who are currently feeling suicidal,

we must talk openly about suicide and seek mental health care for

teenagers who are feeling suicidal.

Another factor related to this issue is family and friends. If someone commits suicide, family

and friends tend to feel guilty and ashamed. They blame themselves for the suicide and feel they

should have prevented it. However, if the person doesn’t express their feeling and there are few

resources, how do you prevent it? Also because of the huge negative stigma associated with

suicide, family and friends are embarrassed to talk about death. As a result, many families

and friends fail to get help after a suicide and their lives may be ruined for the rest of their lives.

We seldom consider the impact that suicide has on the family and friends. I have included a link

to an article which discusses the impact suicide has on family and friends

https://nypost.com/2018/06/06/after-kate-spades-death-think-of-the-survivors/. We need to

consider these issues and start to provide more resources for people feeling suicidal and family

and friends who survive a suicide.

Dr. Michael Rubino is psychotherapist who specializes working with children, teenagers, trauma survivors and first responders for over 25 years. For more information about Dr. Rubino and his work visit his website www.RubinoCounseling.com, www.rcs-ca.com or follow him on Twitter @RubinoTherapy.

I Think My Teenager is Suicidal, What do I do?

I Think My Teenager is Suicidal, What do I do?

Since September is dedicated to preventing suicide, I decided to write this article for parents. Many parents ask me, if their child could be suicidal and what to do if their child is suicidal? This concern has increased since the CDC no longer ranks suicide as the third leading cause of death and now rates it as the second leading cause of death for kids 10 to 18 years old. Furthermore, since the quarantine for the Coronavirus there has been a significant increase in suicides and deaths from drug overdoses. As a result, parents are worrying more about if their teenager may be feeling suicidal. Additionally, before the quarantine, parents were worrying more about suicidal teenagers as we learned more about suicides of survivors involved in mass shootings due to survivors dealing with survivor guilt. 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 feel their teen is suicidal. Parents are aware there is a teenage suicide epidemic, but have no idea what to do or how to get help.

A successful suicide attempt is definitely a tragedy for the entire family. However, an unsuccessful attempt can be a tragedy for the child 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.

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 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.

Bottom line, if you feel your teenager is suicidal do not be embarrassed. Make an appointment to have your teen evaluated by a psychotherapist who specializes in suicidal teenagers. If you walk in on an attempt, call 911 immediately.

Dr. Michael Rubino is a psychotherapist with over 25 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.