Reasons Why Teenage Boys Dislike Psychotherapy

Reasons Why Teenage Boys Dislike Psychotherapy

Many people have noticed that teenage boys and men hate to go to therapy. Therefore, let’s address this issue. Here is a link for a movie, “The Mask You Live In” https://youtu.be/hc45-ptHMxo. The above trailer contains explicit language, but it is language your third grader hears every day at school, from friends and television. Men and teenage boys are very resistant to taking care of their physical and mental health. The question then becomes, why? If you watched the trailer, you will have a very good idea why.

In our society there is a stereotype of what it takes to be a “man.” A man is strong, healthy, and can take care of himself, knows everything about sex and is sexually active, has a lot of money and never afraid to fight and never cries. These are a just a few parts of the stereotype. Many parents may be saying, “but I don’t bring up my son like that.” You don’t have to because it is part of our society. If a little 5 year old boy falls down at school, the school staff picks him up and tells him to shake it off, don’t cry, take it like a man. If a boy playing soccer or baseball gets hurt during the game, the coach says shake it off, take it like a man. You have even seen examples of this attitude on ABCs show “Dancing with The Stars”. A couple of times some of the men have started to get teary eyed and the asked for the camera to be moved because they did not want anyone seeing them cry.

Boys continue to be exposed to the stereotype in high school. There is a major focus on losing their virginity as fast as possible and sleeping with as many girls as possible. They can’t be a man if they are a virgin. Another popular activity with boys as a way to demonstrate their manhood is for boys to get into a fight and have a friend record it and post it on YouTube. They want everyone to see how tough they are and it makes them feel like a man. They also check their posts and compare who’s post has the most number of view. All of this to prove they are a “man.”

Also in High School boys stop accepting and asking for help, they are a man and they can handle life on their own. Also look at the movies and video games boys play. They have to do with fighting, killing and sex. Emotions are never mentioned and if a boy does cry he is called a “sissy, or a fag” just to list a few.

If men and boys are living with this stereotype going to a physician or a therapist is a very dangerous thing to do. They might have to confront the fact that they are not able to do everything by themselves and they might need help. This would mean they are not the tough guy they pretend to be. Also they know physicians and therapists treat other men and they are afraid how they might be compared to other males. They are afraid that the physician or therapist doesn’t see them as tall or as strong as other guys and the physician or therapist may think that they are not as tough as other guys. Now physicians and therapists are not making these judgments but the guys being treated still feel like a failure.

Going to a therapist is extremely dangerous for boys and men. Therapists ask you to deal with your feelings. What if they cry or admit they feel overwhelmed by life or inadequate to other men? If they do, they worry about their identity as a man. I have men and teenagers who cry in my office all the time. They all get really embarrassed and beg me not to tell their family and want to know if other guys cry have ever cried in my office. They need reassurance that they are still a man. The truth is it takes more strength to cry than not to cry, but most guys don’t believe this due to the male stereotype.

We need teenage boys to focus on their emotions. The best way for us to help boys and men is to eliminate this stereotype. Parents contact your son’s school and ask them to invite groups to the campus that are trying to eliminate this stereotype. Challenge Day is an excellent organization which tries to help teenage males face their feelings. Also monitor what they watch and how they talk with friends. Fathers don’t be afraid to cry and go to the doctor regularly and ask for help. Look for movies that show males as men even though they don’t follow the stereotype. This stereotype has a tendency to lead men and teenagers to crime, killings and needless deaths from heart attacks, strokes and suicide. It is going to take all of us to solve the problem.

If we take a moment and examine teenage boys more closely, the CDC statistics indicate that one in five boys would benefit from therapy. Additionally, anxiety and depression are at epidemic rates for teenagers especially boys. Furthermore, suicide is now the second leading cause of death for teenage boys and the preferred method for suicide are guns. Finally, the research indicates that teenage boys who try to conform to the stereotype are more likely to report feeling lonely and isolated. Given the situation with the pandemic, this is not a good time for teen boys to feel lonely or isolated. Therapy could be a tremendous help to teenage boys.

While teenage boys resist therapy for the above stated reasons, you need to remember you are the parent. If you notice your teenage boy is depressed and talking about suicide, therapy is not a choice. Additionally, if they appear depressed and you suspect they are abusing alcohol or drugs, therapy is not a choice. Yes you want to give choices about their lives, but remember they still are kids and cognitively not able to reason as an adult. Therefore, at times you must say there is no choice. Would you give them a choice of having surgery, if they had appendicitis?

Dr. Michael Rubino is a psychotherapist with over 24 years experience who specializes in treating children, teenagers and victims of trauma. To find out more about Dr. Rubino and his practice or to contact him visit his website at www.RubinoCounseling.com or Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Is Your College Freshman Depressed?

Is Your College Freshman Depressed?

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

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

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

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

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

Negative Emotions

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

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

What to say:

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

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

Irregular Sleeping And Eating Habits

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

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

What to say:

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

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

Disinterest In Extracurricular Activities

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

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

What to say:

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

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

Unexplainable Guilt

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

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

What to say:

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

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

Persistent Pain

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

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

What to say:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Teenage Boys Using Pornography to Cope with Their Emotions

Teenage Boys Using Pornography to Cope with Their Emotions

Most boys and teenage boys have grown up hearing a stereotype about what it takes “to be a man.” While many teenage boys may not agree with the stereotype, they are afraid to deviate from it because they don’t want to be labeled as “gay.” According to the research, this stereotype typically leads boys to becoming sexually active in middle school. Again this is based on current research data. Additionally it shows that boys also tend to feel a sense of isolation due to the stereotype. The stereotype makes teenage boys believe they should be prepared to handle life like a grown man. However, they are not fully mature nor are they prepared to handle everything on the own. However, due to the stereotype they feel they cannot ask for help or share their concerns with their friends. Hence they feel isolated, alone and like failures at the age of 16 years old.

This article is going to discuss the epidemic of addiction to porn that many teenage boys and men are dealing with today. In our society sex is a tabooed subject. It is unusual if anyone sits down with a teenage boy and discusses sex. They typically learn about sex by talking to friends, having sex or the most common way watching pornography. However, no one discusses how to treat a sexual partner, diseases you can catch and the importance of mutual consent. Most importantly no one discusses with boys to think about are they emotionally and financially ready to be a father. Any time a boy has sex, he can get a girl pregnant. Even if they were using birth control. There is no method that is 100% safe.

Many parents may feel this issue doesn’t apply to their son. However, with the internet being available on laptops, game centers and phones most people stumble on to pornography by accident and very easily. Look online for yourself. It is very easy to access pornography in today’s world. Most research studies indicate that most boys have been exposed to pornography between the ages of 8 years old and 10 years old. Their young minds are not prepared to process what they are seeing nor are they prepared for the feeling they experience and how their bodies respond to what they are seeing. They continue to watch and to go back to the sites over and over and many become addicted. Even though pornography addiction is not a formal psychiatric diagnosis yet, most research studies have concluded that the number of teenage boys visiting porn sites at least once a day has reached epidemic rates. Some teenage boys have self reported going to porn sites five to 10 times a day. Therefore, while the DSM V does not list porn addiction as a formal diagnosis, many researchers and clinicians believe that people especially teenage boys can become addicted to pornography.

This is an issue parents do need to pay attention to during the pandemic. Teenagers are having to spend more time at home and cannot see their friends like they are use to. Therefore, many teen boys are reporting being bored and some report being slightly depressed. Since they are spending more time in their bedrooms and have easy access to pornography via their phones or laptop, there is a temptation to look at pornography to help with being bored. This simple distraction can easily turn into an addiction during the pandemic. They are isolated and have no idea when the pandemic will end. Pornography therefore becomes an easy escape and habit before they know it.

Additionally, with the current confusion regarding the Delta variant and the number of people being diagnosed with the Coronavirus increasing significantly and hospitals running out of beds for adults and teenagers, the stress teenagers are feeling regarding the Coronavirus is increasing. Before teenagers were being told the virus mainly effects older adults. Now they are hearing the delta variant is impacting teenagers. In addition to the Coronavirus, we have been dealing with hurricanes and fires through out the the Country. As a result teenage boys are feeling stressed and they have learned that pornography can decrease their stress. Therefore, they are using pornography to help them cope with their current stressors.

Lisa Ling did an episode about porn addiction in her series This is Life. I have included the YouTube link here to the episode. YouTube does charge $1.99 to watch the episode but if you have teenage boys it is well worth the cost. She was able to talk to men in their thirties, homosexual men and an 18 year old high school senior who openly discussed their struggles with pornography and masturbation. They all explain how easy it was to become addicted but how difficult it is to stop. Some men had been trying for years to stop using pornography and still can’t succeed. Here is the link https://youtu.be/UqoCg9Srs18.

Additionally, these men and teenager discussed how pornography has negatively impacted their lives. Besides the guilt and shame they felt about their addiction, they reported difficulties with obtaining and maintaining an erection. Many also reported a decreased interest in having sex. They no longer felt interested in women sexually. They stated they were sexually interested in pornography only. One man stated the only way he could have sex with a woman was to fantasy about porn. Many of you may think these issues primarily pertained to the men in their thirties or 40s. Well these issues impacted the entire group even the 18 year old high school senior. The 18 year old high school senior reported he was only able to get an erection if he was watching pornography. He also stated he no longer was finding girls his age sexually attractive. He stated he found he was more attracted to pornography and despite his desire to stop he was not able to stop watching pornography. I have heard many teenagers and men make the same statements in sessions so it is reality.

Overall most of the men reported feeling isolated and lonely due to pornography. They felt embarrassed to tell their families or to seek help. Even if they wanted help, they did not know where to go to get help. The man who arranged this group that Lisa interviewed started a website NoFab. It is an online support group helping men over come their addiction to pornography and masturbation. When I say men, most guys on the site are between 18 and 24 years old. This site found that teens between the ages of 13 and 16 are at the greatest risk for becoming addicted to pornography. Most likely because at that age a boys hormones are out of control and they have little to no sexual experience. So unfortunately what they learn about sex comes from pornography a fantasy world.

This subject also pertains to teenage boys during the quarantine. How many teenage boys are spending more time in their bedrooms on their laptops and smartphones. How many were bored of being in the house and looking for something new. Well pornography is new and can eliminate being bored. We have no idea how many teenage boys may be starting their pornography addiction during the quarantine.

Father’s if you noticed changes in your teenage son in the past and you think it may be related to pornography or if he is spending a lot more time in his room since the quarantine then talk to him about pornography. However, do so calmly and gently. Remember how you felt at his age and if the subject of sex came up. You don’t want to embarrass him or make him feel his sexual feeling are wrong or perverted. Explain that pornography is a fantasy and not reality. It is adult entertainment not entertainment for teenagers. Also explain how it can give a boy the wrong idea about how to treat a woman or what she really wants. Basically, do not be afraid to have an open, frank discussion about sex and pornography. Also don’t be afraid to ask if they feel they are having problems with pornography. Reassure them if they are, you will not get mad and you will help them find help for the issue. Remember don’t shame them. Be there as their father to eliminate the lonely, isolated feeling and help them on the road to recovery. Also tell them how proud you are that they were brave enough to speak up and ask for help.

If your teenager needs help look for a psychotherapist who specializes in teenagers, addiction issues and sexual issues. Pornography addiction is not like being an alcoholic. A person can stop drinking alcohol, however, they cannot stop having sexual feelings. Sexual feelings are part of being human so they have to learn a new way to relate to their sexual feelings.

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

Teenagers Need Psychotherapy, but Insurance Denies Claim

Teenagers Need Psychotherapy, but Insurance Denies Claim

Over the years children and teenagers have been exposed to stressful life events especially the last two years. The teens today have grown up with daily school shootings and mass shooting drills. Imagine being a second grader having to rehearse a man with a gun is on campus and you don’t know if you are going to live or die. Additionally, we are coming up on the 20th anniversary of the 9/11 attack in New York. Teenagers today have also grown up with terrorist alerts and having to be searched anytime they went to a concert or places such as Disneyland. Finally they have had to cope with COVID. Over 600,000 Americans have died from this virus (CDC). Many children and teenagers have lost grandparents, siblings and parents to this virus. We thought we had turned a corner regarding the Coronavirus and we find out we are back at the beginning. There are over 150,000 people being diagnosed with the Coronavirus daily and the number of people dying is increasing and hospitals don’t have enough beds to treat everyone. Additionally, this time the virus is effecting teenagers and children. Since schools have started 450 children have died due to the Coronavirus virus (CDC).

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

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

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

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

As a result, many parents have asked me how to determine if their child is coping with anxiety and what to do if they are coping with anxiety. I can understand why parents are concerned especially because many children tend to try to hide their anxiety because they don’t want to worry their parents.

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

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

• Withdrawal from things the child usually enjoys

• Trouble falling or staying asleep

• Unexpected abdominal pain or headaches

• Extreme mood swings

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

Parents can actively help kids and adolescents manage stress by:

Being available

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

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

Listening actively

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

• Let kids complete their point before you respond.

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

Responding thoughtfully

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

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

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

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

• Word swap.

o   Say ‘and’ instead of ‘but’

o   Say ‘could’ instead of ‘should’

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

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

Consider

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

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

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

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

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

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

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

Starting High School During the Delta Variant Outbreak

Starting High School During the Delta Variant Outbreak

All over the Country teenagers will be starting their first year in high school or returning to high school. Typically I would recommend that parents think back to their first day of high school and how they felt and what they were expecting. I did this to help parents relate to some of the feelings their teenager maybe having as a way for parents to help their teenagers starting high school. This may help parents with some of the issues facing their teenagers, but teenagers starting high school or resuming high school in 2021 do so in the middle of a deadly pandemic. Therefore, high school students are facing additional issues besides the typical first day of school issues.

High school students, in fact all students, are starting school when there is a significant increase in the Coronavirus due to the Delta variant. As a result, many people including teenagers are contracting the virus and having to be hospitalized (CDC). The number of people contracting the virus is similar to the numbers we were seeing a year ago (CDC).

Therefore, high school students are starting high school not knowing if they will or will not contact the deadly virus. Yes there are vaccinations they can get and they can wear masks, all of which decreases their chances of getting the virus, but some governors, school boards and parents are refusing these options. People are objecting because they say the precautions are not necessary and do not work. However, teens are hearing that in Alabama the State has run out of ICU beds for teenagers and 99.7% of people contracting the virus and currently dying from the virus have not been vaccinated (CDC). Additionally, they have heard about schools not using masks and having to shut down because the Delta variant had already infected too many teachers and students (CDC).

Besides worrying about contracting the virus, students have missed an entire year of high school. Therefore, students who are sophomores never had a freshman year and have no idea what to expect. Teenagers who were enjoying their high school experience have missed out on an entire year. Therefore, students starting high school and returning to high school in 2021 are doing so facing many issues that students usually never face. For example, the main issue is adjusting from remote learning to being back in the class. Their school days are longer, they have more homework and they are around more people. This is not a simple adjustment. As a result of all the issues we have seen a significant increase in depression and anxiety in high school students (CDC).

Parents hopefully you can remember everything teenagers and you are facing as your teenagers start high school. You may need to contact your teenager’s school and ask for assistance from the school. You may need to seek out a psychotherapist who specializes in treating teenagers and have your teenager participate in psychotherapy. There is no shame in doing this because teenagers are facing tremendous mental health issues and many need help. Since the pandemic and school resuming, there has been a significant increase in the number of teenagers needing psychotherapy (CDC). In fact we are running out of psychotherapist who are able to treat these teenagers. No one planned on how to adequately handle the number of teenagers needing psychotherapy due to the pandemic.

Parents all you can do is to be patient and listen to your teenagers and seek the help you feel is appropriate. Also do not forget yourselves. Parents are under a great deal of stress too and you may need psychotherapy too. If you try to work together and are patient with each other, you should be able to handle the stress teenagers are facing due to the pandemic.

In addition to the pandemic, students starting high school still deal with common anxieties most teenagers have faced over the years. One common stressor for many teenagers are the stories they have heard about how seniors picking on and teasing the freshman students. Another common fear for freshman is that they are going to get lost on the campus and not be able to find their classrooms. Your teenagers are at a point in their life where they want to make a good impression on the other students. At their age image is very important. Therefore the idea of being teased by the seniors or getting lost on the campus can be very stressful and also create a great deal of anxiety for a student starting high school.

As parents, you can talk to your teenagers about your first days days at high school and reassure them that the stories they hear about Freshmen being targets for the seniors are greatly exaggerated. Also you can try to go with them over to the school before it starts and walk around the campus so they can get use to where everything is at their new school. Another thing you can do is remind them that everyone makes mistakes so if they do get lost the first day it is not a big deal. Remind them there will be a lot of other kids starting their first day of school too and there will be other kids getting lost. This is also another opportunity to continue to establish an open relationship with your teenager. The more you talk with each other, you increase the likelihood that they will feel comfortable coming and talking to you about issues they will have while in high school.

Another issue facing some students is starting all over. In middle school may be everyone knew them and they were in the “popular group.” Now no one knows them and they need to start all over. This may be frightening to them, but remind them there will be many times in life when they will need to start as the new person. Also remind them, if they were able to do it in middle school, they can do it in high school too. Be sure to encourage them to have faith in themselves because it won’t happen over night. Now for many students middle school was a nightmare. They may be looking forward to starting over. Again remind them if they have the desire to try they can do it. All the Freshmen are starting all over just like them, but also to be patient because it may not happen as quickly as they like.

Also before school actually starts is a very good time to establish what your expectations are regarding grades and after school activities and hanging out with friends. At this time is a good time to establish what your expectations are homework, after school jobs and weekend curfews. If you establish an understanding between yourself and your teenager before these situations arise you can save yourself a lot of time arguing with your teenager. However as you establish these guidelines you want to have a conversation with your teenager about these issues. Remember your teenager is starting to enter the adult world, if you simply just tell them these are the rules, they will feel that you are being unfair and they will try to find a way around your rules. If you have a discussion with them about the rules they will feel that their opinions were respected, they are more likely to feel that the rules are fair and are more likely to follow the rules. It is also a good idea to write a contract with all the things you agreed to. If you write the agreements down and there is a misunderstanding you simply need to refer back to the contract. Also this is another opportunity for you to establish a relationship with your teenager where they feel comfortable enough to come to you and discuss any problems they may be having. You are also role modeling to them how to have an adult discussion and how to negotiate fairly and respectfully with other their people.

Of course you also want to take this opportunity to discuss with your teenager the fact that they are going to be faced with making decisions about alcohol, drugs and sex. This is a good time to provide them with the education they will need in order to cope with these situations. It is even more important today because technology has changed a number of rules. For example, if a girl texts a nude photo to a boy, he is guilty of having child pornography. Yes it was mutually agreed to but they are still under 18 years old so it is a crime. Texting is another area where they can get into trouble. If someone takes a text as a threat they can get into trouble for bullying or assault. As I said, technology has changed the rules and many of us have not been able to keep it. Therefore, remind them that information they may receive from their friends may not always be accurate. Furthermore, encourage them that at any time if they have any questions or concerns regarding these matters or any other matters you are always there to listen and to talk with them.

One thing to remember is acronym HALT. I teach this often with anger management, but it helps with communication too.

H – hunger

A – anger

L – lonely

T – tired

If either one of you are having these feelings, it is generally not a good time to have a discussion. Also if either one of you is feeling like this and you may not be listening to each other. Therefore, if either one of you are having these feelings or don’t feel like talking, then it’s better to postpone the conversation until you are both ready to talk.

Lastly, remind them that they are starting a brand-new phase in their life and it is normal to feel anxious and stress. Also remind them that these feelings are normal in the beginning but they usually quickly disappear after they have started school.

Besides having to face the pandemic, high school students today also have to face the issue of school shootings. Sadly, this is another stressful subject you may want to discuss with your teenager. Develop a plan with your teenager about what they would do if there was a shooting at their school. Also discuss with them what to do if they hear rumors or have concerns about how another student is acting. Finally, discuss how you can help if they are feeling worried or not safe at school. It is sad, but this is the world we live in today. Talking to you teen can help decrease anxiety and help you to maintain open communication with your teenager.

A few things you can do on the first day of classes to help with any anxiety are you can get up in the morning with them and have breakfast with them before they go to school. You can also put a note of encouragement in their backpack that they will find when they are at school and this can help reassure them and remind them how much support they have at home. Finally, you can arrange to be at home when when they get home from their first day of high school so you can talk about it with them. Also plan to have a family dinner to discuss everyone’s first day of school and offer encouragement where needed. These are just a few ideas to help with the transition process.

Dr. Michael Rubino is a psychotherapist who specializes in treating children and teenagers. He has over 20 years experience working with teenagers. To learn more about his private practice in Pleasant or the work he has done over 20 years visit his web site at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple.

Lessons Simone Biles Taught Us About Mental Health

Lessons Simone Biles Taught Us About Mental Health

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Issues and Symptoms Associated with Teenage Depression

Issues and Symptoms Associated with Teenage Depression

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

Sleep Problems

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

Chest Pain

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

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

Fatigue and Exhaustion

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

Aching Muscles and Joints

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

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

Digestive Problems

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

Headaches

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

Changes in Appetite or Weight

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

Back Pain

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

Agitated and Restless

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

Sexual Problems

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

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

Exercise

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

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

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