The New High School Drugs

The New High School Drugs

High school students are out of school for the next two weeks for Winter Break. They are looking forward to spending time with their friends at school and those returning from college. This usually means a lot of late nights and parties. Many parents are concerned about the challenges their children will experience in these environments. A common one is peer pressure and drugs. As a psychotherapist who treats teenagers, I hear about what is going on with teenagers and what they are doing. I have been hearing from many teens about new designer drugs they are taking. Many people assume teenagers are primarily using marijuana. However, teenagers are looking for new drugs and ways to modify how they use marijuana. These new drugs can be very dangerous, even deadly. However, many teenagers are not aware of the dangers and risks they are taking.

Winter break is only two weeks so many teens will want to get in as many parties as they can. During winter break for many teenagers this means partying with old and new friends. Drugs are often part of these parties. One major problem facing teens is the fact that many Emergency Room physicians cannot keep up with all the new drugs teenagers are using. Therefore, if a teenager ends up in the Emergency Room due to overdosing or having a bad reaction to one of these new drugs, a teenager may die before an Emergency Room physician determines what the teenager took and how to treat it. The show The Good Doctor had an episode which addressed this issue. The teen had used, Molly, not a new drug but because there were so many options, the teenager almost died before they could determine how to treat him.

Recently I read an article by Angela Chen. The article discusses these new dangerous drugs and how deadly these drugs can be. I have included her article below so parents can be aware of the dangers facing their teenagers. Hopefully, parents will also take this opportunity to discuss this issue with their teenagers.

On a July day a little over a year ago, over 30 people collapsed on a street in Brooklyn. They lay on the ground, vomiting down their shirts, twitching and blank-faced. Some, half-naked, made jerking movements with their arms, eyes rolled back. Others groaned and clutched onto fire hydrants to try to stay upright. Witnesses said the scene was like The Walking Dead. Headlines claimed that people had turned into “zombies,” while police said that the 33 affected were lucky to be alive.

All had smoked an “herbal incense” product called AK-47 24 Karat Gold. Eighteen people were sent to the hospital by ambulance. The situation had all the signs of a drug overdose, and so doctors ordered the usual tests: blood count, urine analysis, heart rate monitoring.

The first patient tested was a 28-year-old man who was slow to respond, but otherwise showed few clear signs of trauma. Heart sounds: normal. Blood count: normal. His lungs were clear and there were no major neurological problems, no excessive sweating or skin lesions. He tested negative for opiates, cocaine, amphetamines. Nothing came up.

The case went to the Department of Homeland Security and the Drug Enforcement Agency. They knew who to call to get a second opinion. They packed blood and urine samples on dry ice and shipped them to a small lab 3,000 miles away in San Francisco, run by toxicologist Roy Gerona. If anyone in the country could figure out what was in 24 Karat Gold, it would be him.

Forty years ago, drugs had easy names: cocaine, meth, heroin. Today, the names can read like an ingredients list for a chemistry class: 5F-AMB, PX-2, MDMB-CHMINACA. Today’s designer drugs are made by synthesizing chemicals and hoping they give you a high that’s strong enough to be worth it, but not strong enough to send you to the hospital.

Designer drugs are volatile. If you tweak just one molecule, you can get an entirely differently substance, one you hadn’t bargained for. They’re also easy to get. There’s no shortage of “research chemicals” vendors on the dark web are willing to sell. And they’re growing more popular. These so-called “novel psychoactive substances” entered the mainstream in 2009. That year, according to the United Nations Office on Drug and Crime, there were about 100 of these substances reported; six years later, there were nearly 500. Because designer drugs don’t show up on traditional drug tests, they’re hard to track and identify. It’s a public health problem that requires a special set of skills to handle.

One of the most prominent categories of designer drugs are those intended to mimic marijuana, called synthetic cannabinoids. Marijuana, or cannabis, is widely considered one of the safest drugs, but synthetic cannabinoids are some of the most dangerous synthetic drugs. The Global Drug Survey (GDS) found that last year, for the fourth year running, the risk of seeking emergency medical treatment was higher after using synthetic weed than for any other drug.

When you smoke a regular joint, a chemical called tetrahydrocannabinol (THC) travels through your blood. It binds with receptors called CB1 and CB2. Because of the structure, there’s “kind of a limit on how stoned you can get,” says Adam Winstock, a London-based psychiatrist who administers the GDS. If you’re smoking a popular cannabinoid like K2 Spice, a chemical travels through your blood, but this time, it’s not THC. It’s something else that also binds with CB1 and CB2 — but unlike with regular weed, we don’t know exactly how these chemicals bind, especially when they’re illicit drugs from the black market. This mystery makes synthetic marijuana likely to lead to “much more extreme responses,” like seizures and psychosis, according to Winstock.

Synthetic cannabinoids originated in a quest to create a better pain medication. A Clemson University chemist named John W. Huffman synthesized hundreds of compounds in an attempt to find a better painkiller, but often created incredibly psychoactive substances with no medicinal properties at all. When he published the results of these compounds — called JWH compounds, after his initials — he made the information available to be copied.

There are more than 300 JWH compounds alone, and around 2004, labs in China began studying old research papers, synthesizing the compounds and distributing them as “herbal incense” products. K2 Spice itself — often partly based off the JWH-018 compound — started in China, became popular in Germany around 2008, and entered the US around 2009.

Labs can also turn to the expired patents — patents that are rich fodder, even if (or perhaps because) there was a good reason said drugs never made it to market. It’s nearly impossible to figure out how to shut down the overseas labs producing these drugs. As soon as you ban one substance, the labs move on to another.

Gerona, a toxicologist with gray hair styled in an undercut, was the one who received the biological samples from the DEA. From a small lab in the Medical Sciences Building at the University of California, San Francisco, Gerona says he and his team are playing a “cat and mouse game” with illicit international drug manufacturers. When an overdose happens, Gerona’s team tries to identify the drug in question — often synthetic substances no one has seen before. But the lab goes one further: Gerona’s lab attempts to identify and classify these substances before the mass overdoses even happen.

Inside, the lab is meticulously neat: rows of spotless tables are covered in bottles with orange rubber caps, all labeled with orange duct tape, and small gray centrifuges. A window overlooking a courtyard has molecular structures scribbled over it in pink and green marker. Near the door sits an enormous freezer, filled with thousands of brightly colored, frost-covered boxes of drug samples kept at -112 degrees Fahrenheit.

Gerona launched his toxicology lab in 2010, in partnership with the San Francisco Poison Control Center. The date wasn’t a coincidence; he says that 2010 was the year that a designer drug called “bath salts” began flooding the market. “Bath salts” is a blanket term for a group of designer drugs made from stimulants; they create a euphoric high like MDMA, sometimes with hallucinations thrown in. The drugs usually come in powdered and capsule form, and can cause freak-outs that were well-documented on YouTube at the time. The most famous of these was a viral story of a 31-year-old Miami resident attacking and then eating a homeless man. (Scientists dispute the drugs’ role.)

For users and the DEA, the spike in bath salts use was a nightmare. For Gerona, the increased interest in designer drugs led to more work and more samples from around the country. Eventually, the lab caught the notice of both Michael Schwartz, a toxicologist at the Centers for Disease Control and Prevention, and DEA pharmacologist Jordan Trecki. A collaboration between Gerona’s lab and the DEA was formed. (Neither the DEA nor the CDC responded to repeated requests for comment.)

The first step in doing an analysis at Gerona’s lab is getting the sample — urine, blood or, rarely, a tiny bit of drug itself — shipped over on dry ice. In traditional drug testing, you check to see if the sample matches any of the known substances: marijuana, heroin, cocaine, and so on. They match, or they don’t. Designer drugs, almost by definition, are made of chemical combinations we haven’t seen before. They almost never match traditional databases, and the chemists often don’t know what they’re looking for. So Gerona’s lab gathers as much information about the substance as possible.

A tiny vial of the biological sample — usually plasma, the colorless part of blood — goes into a bulky, printer-like machine. That machine is called a liquid chromatography mass spectrometer, and very crudely put, it separates out all the different parts of the plasma by mass. (Think of it like an extremely sensitive centrifuge.) That process makes it easier to identify chemicals, and the mass spectrometer then spits out the different measurements in a computer chart with peaks and valleys called a chromatogram.

Then, says Axel Adams, a graduate student in Gerona’s lab, you turn to the so-called “prophetic library.”

“ RESEARCHES LOOK FOR POSTS ABOUT DRUGS ON SUBREDDITS LIKE R/RESEARCHCHEMICALS

Gerona’s “prophetic library,” about three years in the making, is a detailed catalog of already synthesized variants that his team believes is going to be the next big street drug. The library was made possible with the help of Samuel Banister, a synthetic chemist at Stanford University. Banister synthesizes variants of popular street drugs and takes down their chemical information to create “reference standards.” Synthesizing can take anywhere from a few days to a couple of weeks; the lab now has almost 150 variants on file. It’s a side job for Banister, but at one point, he says, “I was pumping out five to 10 a week.” The final products look like white crystalline solids and are kept in drawers in the lab, ready for when a case like AK-47 24 Karat Gold comes along.

In addition, lab members spend hours each week on drug forums, researching trends. It’s more of an art than a science. Researches look for posts about drugs on subreddits like r/researchchemicals. They reference surveys like the Global Drug Survey and survey “trip reports” from experiential documentation sites like Erowid and PsychonautWiki.

They look for terms like synthetic pot, K2, Spice, and sometimes, scientific terms like “cannabinoids,” or a specific popular class of cannabinoids, like “FUBINACA” or “JWH compounds.” Often, the posts themselves will include the name of the chemical. Gerona has ordered drugs off the dark web. In one case, the invoice billed him for “cosmetics,” and the package included lipstick, fake eyelashes, and tabs labeled “powder.” The “powder,” unsurprisingly, turned out to be drugs. But most of the time, the drugs in the powder were not the drug that was ordered.

“ THE INVOICE BILLED HIM FOR “COSMETICS,” AND THE PACKAGE INCLUDED LIPSTICK, FAKE EYELASHES, AND TABS LABELED “POWDER”

If there is a match because the compound is already in the library, finding the right variant is “only going to take 15 minutes,” says Gerona. “Otherwise, it could take a week, or it could not be solved.”

Adams checked the results of a blood sample tied to AK-47 24 Karat Gold against the prophetic library. The computer pulled up a chart that indicated a line — jagged, up and down — that shows the mass of the components of AK-47 24 Karat Gold, versus the same information for AMB-FUBINACA.

Drugs don’t pass through the body untouched. Once they’re ingested, the body processes the compounds. So by the time they’re in the blood or urine, it’s not exactly the same compound as the drug that was ingested. It’s hard enough to find a reference standard for the original compound; it’s even more difficult to find a reference standard for the possible variants. In the case of AMB-FUBINACA, the chemical in the biological sample from Brooklyn wasn’t the parent compound. It was a derivative. Luckily, Banister had already synthesized that variant, too.

The peaks and valleys of the two lines of AK-47 24 Karat Gold and AMB-FUBINACA matched up precisely. It took the team only seven days to identify the substance in the Brooklyn case — and most of that time was spent waiting for the sample to get there.

Gerona’s lab has worked on cases across the country, from New York City to Sacramento to Colorado. The number of cases varies. Sometimes, they’ll get 15 to 25 samples a month. One Mississippi case involving synthetic cannabinoids resulted in over 400 samples. The average turnaround on results is about six months, says Adams. That’s not good enough for Gerona.

And it’s not likely that the problem will go away. Marijuana legalization advocates claim that people will stop with the synthetic stuff once the real thing is okay. But that’s not true in the experience of Andrew Monte, a clinical toxicologist at the University of Colorado School of Medicine who collaborates with Gerona’s lab. Recreational marijuana is legal in Colorado, but he sees patients who are on these synthetic compounds anyway. Monte’s team has surveyed people who come into the ER and even set up at music festivals to ask attendees questions. Synthetic drug users are “taking it for a different reason, to get a different high,” Monte says. “They’re really looking for something different than what pot gives, the same way you might choose cocaine over pot or meth over pot.”

“ ONE MISSISSIPPI CASE INVOLVING SYNTHETIC CANNABINOIDS RESULTED IN OVER 400 SAMPLES

To help address this problem, in 2016 Gerona started a new research consortium called P SCAN, or the Psychoactive Surveillance Consortium and Analysis Network. (Yes, the double entendre is intended.) They’re working with about 10 poison control centers in places like Kansas and Colorado. They’ve had more than 100 cases referred to them and are writing up case reports and manuscripts. (The 24 Karat Gold case was published by the New England Journal of Medicine.)

P SCAN will continue to do the surveillance work Gerona has been doing for years, but also create a database of clinical data connected to the specific synthetic drugs they track and discover. Think of it like a medical version of Erowid. This way, the next time there’s an outbreak like the one in Brooklyn, investigators and researchers can look at specific physical indicators (heart rate, respiratory information, neurological information, and more) and say, “Ah, this matches the symptoms of AMB-FUBINACA” — all without shipping samples across the country.

But even with P SCAN and the prophetic library, the task is huge. “The identity of a lab needs to constantly expand and rework in order for it to stay relevant,” says Gerona.

Gerona is a biochemist by training. Before launching his lab, he didn’t know anything about Spice, or AK-47 Gold, or the dark net. But now, Gerona says, “I have no other choice but to really learn about it, so that I am relevant and retain my relevance in the field.” He’s hoping to work with people in technology to automate this “market research” to glean new insights and make the prediction process even faster. “It would be so great if we could predict the drugs coming in with more accuracy, instead of after people are hurt,” he says.

Weeding out designer drugs is a Sisyphean task, Gerona admits. It may be impossible to shut down the overseas labs, but he wants to have even better methods for predicting what’s going to get big and then, instantly identifying the substances. He compares the endless drug variations to nature: the cold virus is still around because it changes all the time. HIV has never been cured because it continues mutating. “In a sense, they’re reinventing themselves all the time, so reinvention is key to persistence. As long as you’re reinventing yourself, you can persist.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers. He treats teenagers with drug issues and has seen many end up in the Emergency Room because teenagers think they are the experts. For more information about Dr. Rubino’s work or his private practice visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/Drrubino3.

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Teenagers and Depression

Teenagers and Depression

Since this week is dedicated to Mental Health Awareness Week, I decided to run this article. It is the end of the school year and many teenagers are feeling stressed about finals, prom (who they are taking or if they did not go), college (did they get into a college, did they get into the college they wanted, leaving home) and believe it or not leaving their high school. They have spent four years there and it feels like home so many teens often feel sad about high school ending. This is a lot of stressors and many parents worry about if their teenager is experiencing depression. Since I am asked the question often, 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. I have outlined his list below for you to review and decide if you feel your teenager needs to see a mental health clinician for depression.

Sleep Problems

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

Chest Pain

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

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

Fatigue and Exhaustion

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

Aching Muscles and Joints

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

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

Digestive Problems

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

Headaches

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

Changes in Appetite or Weight

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

Back Pain

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

Agitated and Restless

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

Sexual Problems

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

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

Exercise

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

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 on Twitter @RubinoTherapy

Condom Snorting

Condom Snorting

“Condom Snorting” is a new dangerous trend in teenagers. They first snort the condom up their nose and then try to pull it out of their mouth. This can cause choking, allergic reactions to the latex and other health problems.

This trend is similar to the trend where teenagers are swallowing Tide Pods. While both trends may seem odd to adults, parents need to remember that the prefrontal cortex of a teenager’s brain is not fully developed. This part of the brain is responsible for reasoning and risk assessment. Since it is not fully developed yet in teenagers, they are prone to taking risks.

I have included a link to a story done by ABC 7 News in San Francisco which details this new teenage trend. http://abc7.com/3296850/ via @abc7.

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

The Price Boys Pay to Conform to the Male Stereotype

The Price Boys Pay to Conform to the Male Stereotype

In our society people do not discuss mental health and it is something people feel embarrassed about. They also feel shame if they have mental health issues or if they go to a psychotherapist.

While we have this negative stigma about mental health, it is worse for men. In our society men do not cry or have emotional problems. Emotions are a sign of weakness for men and boys. The documentary, “The Mask You Live In,” address this issue that men and boys face. I recently read an article by the basketball player, Kevin Love, which addresses this issue and explains how it impacts men and boys. I have included what he wrote so you can understand what men and boys face in our society.

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

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

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

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

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

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

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

PHOTO BY CHRISTIAN PETERSEN/GETTY IMAGES

Then came the panic attack.

It happened during a game.

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

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

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

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

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

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

PHOTO BY JED JACOBSOHN/THE PLAYERS’ TRIBUNE

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

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

Why was I so concerned with people finding out?

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

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

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

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

PHOTO BY JEFF HAYNES/NBAE/GETTY IMAGES

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

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

A message from Kevin Love’s Grandma

“HAPPY BIRTHDAY, KEVIN.”

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

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

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

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

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

PHOTO BY BRANDON DILL/AP IMAGES

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

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

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

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

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

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

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

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

KEVIN LOVE / CONTRIBUTOR

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

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Surviving Your Teenager’s High School Prom

Surviving Your Teenager’s High School Prom

Yes it is that time of year again — Prom Season. Along with the prom come the concerns of who will I go with? What will I wear? How much can I spend on a dress? And a number of other issues. Hopefully, you and your teen have already discussed the issues around dating and have agreements regarding dating. If not, Prom may be a harder issue because now you have to deal with issues regarding dating and Prom.

As a parent, the first thing to do is to contact your teen’s High School and see what rules and guidelines the school has already established. Many High Schools have rules regarding who can attend, such as only students of that high school can attend, a dress code and some high schools require you to inform them if you are going and your date’s name and the telephone numbers for both set of parents. They do this so if your teen fails to arrive by the designated time or if there are any problems at the Prom, they know who to call.

Another reason to contact the school is to find out where the Prom is being held. Due to the number of drunk driving deaths, deaths due to drugs and due to the costs being so high, a number of high schools have decide to have the entire Prom on the school campus. They serve dinner and have the dance at the school. Once you have the details then it is time to discuss with your teen what your expectations are regarding the Prom. This is also the time where you will set the rules for the Prom and make your agreements with your teen.

Assuming the Prom is not being held at the campus and instead being held at a Hotel, there are a few items to discuss. The first issue is price. Most teens want to go to an expensive dinner, hire a limo for the night and for the girls there is the Prom dress. I have seen teens spend over $2,000 on their Prom dresses. A limo for the night can cost $800 and dinner can cost $200. If you have this money and are willing to indulge your teen then there is no problem. Most parents don’t have this extra money so you need to agree on a budget. For example, a limo is not a necessity for the Prom. As a parent you may feel safer with a limo because your teen is not driving. Also there is a new law and limos cannot carry liquor when they are driving for Proms and they must card anyone consuming alcohol in the limo. You can bring the price down by having your teen split the cost of the car with 2 to 3 other couples. However, you will want to talk to the parents of your teen’s date and any friends they are going with to ensure all the parents agree.

Another option is letting your teenager pay for part of their prom. There is nothing wrong with expecting them to contribute to the limo, pay for the dinner and for girls, they can pay for part of their dress. This is a good way to start teaching your teen about saving money and how much things really cost.

If you have a daughter you need to negotiate the cost of the dress or consider renting a dress. In my opinion she does not need to spend $500 on a dress or more to look good. The same rule goes for her hair. She does not need to spend $300 on styling her hair for one night.

You also need to talk with your teen regarding your expectations about consuming alcohol, using drugs and sexual activity on Prom night. Many teens plan After Parties for their Proms. Quite often at the After Parties is where the drinking, drug use or sexual activity occurs. This is another reason why it is important to know who your teen will be going with to the Prom and their parents. You should never allow your teen to go to an After Party where there is not adult supervision. If the party is at a friend’s house with adult supervision and you have spoken with the adult, there should be no problem. If your teen wants to rent a hotel room so their date and their friends can have a party, this is a huge problem and should never be allowed. There are too many incidents where teens overdose, drink to the point of alcohol poisoning, get pregnant or trash the hotel room. Most hotels will not rent a room to someone under 18, but many teens find away around this rule and some parents will rent the room for their teen. Another reason to know you teenagers friends and parents.

Another issue to discuss is curfew. Yes it is their Prom and you want them to have a good time, but there is no reason why they need to stay out the entire night or for the entire weekend. If there is adult supervision the entire time it may work. If there is not adult supervision it is a recipe for disaster.

Finally, you need to have a discussion with your teen regarding acting responsibly and self-respect. The Prom is a major event and it is another step that your teen is taking into the adult world. They need to remember if they want to act like adults, they have to be willing to accept being treated like an adult. So if they violate the rules that their school has established for the Prom, they may be giving up their right to graduate with their class. The Prom should be a happy event that you and your teen both remember for a long time. If you discuss the issues before the Prom and come to agreements that you both accept then it should be a safe, happy event for all. Good luck!

Dr. Michael Rubino specializes in working with teenagers, their parents and high schools. For more information on his work visit his website www.rubinocounseling.com or follow him on Twitter @RubinoTherapy.

A Study About Teenagers and Sexting

A Study About Teenagers and Sexting

Many parents are worried about how much time their teenager spend texting. Many parents are also concerned that their teenager’s Texting has crossed the line to sexting.

Sexting is a text which refers to sexual behavior between the people Texting. A research study in JAMA Pediatrics which was just released indicates that sexting is more common than many parents expect. This study looks at numerous other studies investigating sexting and draws conclusion about teenage sexting.

Tara Haelle reviewed this research study and Forbes published her article. This review contains many important facts about teenagers and sexting. Facts many parents should be aware of and issues that parents need to discuss with their teenagers. I hear teens talking about sexting often and they are not aware of many of the issues in Tara Haelle’s article. These facts are issues that teenagers and parents need to be aware of. Therefore, I am providing parents with the link to the article so they can read it and discuss it with their teenagers, https://www.forbes.com/sites/tarahaelle/2018/02/27/that-teen-sexting-study-what-else-you-need-to-know-before-freaking-out/.

Dr. Michael Rubino is a psychotherapist who specializes in treating teenagers. He has over 20 years experience working with teenagers. For more information about Dr. Rubino’s work or his private practice visit his website http://www.RubinoCounseling.com or visit his Facebook page http://www.Facebook.com/drrubino3.

Family Connections are Important to Children

Family Connections are Important to Children

In our fast pace world and chaotic lives we sometimes forget the importance of passing on traditions from generation to generation. Another problem that impacts this is our society has become very mobile. We no longer live close to our relatives. It’s not uncommon for grandchildren to live in California and grandparents to live back east. And with jobs becoming more difficult to find and the cost of living increasing families are moving where ever they can find a job or to a place where the cost of living is affordable.

The problem is the close family provided support and help for the family. Children could establish close relationships with grandparents and aunts and uncles. These adults could serve as additional role models and inform parents if something seemed off with the child. They are also able to spend additional time with the children and reinforce what parents are teaching their children and reinforce the family traditions.

The other thing that the close connection to generations provided was a sense of security. If there was a problem a child knew they could turn to their parents, aunts or uncles or cousins. It also helped a child’s self-esteem. You had the adults who could reinforce that you were worthy and you had cousins who would defend you at school or in the neighborhood because you were worth it. Also your older cousins could help you learn what to expect as you went from grade to grade. There was a sense of support and security that most children don’t have today.

The advancement in computers and communication may provide a way to try to recreate this sense of family. With such things as Skype where you can talk and see the other person, it’s almost like being with the person, but it is not the same. Children can Skype with grandparents, aunts and uncles and cousins too. We just have to make time for it. For those families that live close to each other, you need to remember the value of family and make time for family. At times it may be difficult, but you will find that the time and effort are worth it. I have found that children with close family ties and connections to their cultures do better. They have a sense of pride and a sense of where the came from that other children don’t.

I have attached a link to an article with a link to an article about sharing traditions with family. Check out this article from First 5 LA: http://www.first5la.org/index.php?r=site/article&id=3615&utm_content=buffere936a&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer.

I think you will find it interesting.

Dr Michael Rubino has been working with children/teens and their families for over 20 years and is well respected. For more information at Dr Rubino’s work or his private practice visit his website at http://www.rcs-ca.com.