The Epidemic of Anxiety in Teenagers, but The Lack of Treatment Available to Teens

The Epidemic of Anxiety in Teenagers, but The Lack of Treatment Available to Teens

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

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

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

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

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

In addition to children and teenagers needing to wait months to get into a psychotherapist or psychiatrist and this is not an exaggeration. If a child or teenager needs to be hospitalized because their symptoms are so severe, they often have to wait a day or two in the emergency room because the psychiatric department has no room. What does this do to a teenager who has raising thoughts or wants to kill themselves, to have to wait in the Emergency Department because there are no beds for them in the psychiatric department? I have had this happen to several patients that I tried to hospitalize.

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

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

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

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

• Withdrawal from things the child usually enjoys

• Trouble falling or staying asleep

• Unexpected abdominal pain or headaches

• Extreme mood swings

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

Parents can actively help kids and adolescents manage stress by:

Being available

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

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

Listening actively

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

• Let kids complete their point before you respond.

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

Responding thoughtfully

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

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

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

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

• Word swap.

o   Say ‘and’ instead of ‘but’

o   Say ‘could’ instead of ‘should’

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

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

Consider

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

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

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

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

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

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

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

The Benadryl Challenge

The Benadryl Challenge

Teenagers will find ways to get high because they believe that it is fun. However, many teenagers are not aware that the ways they are choosing to get high can cause serious health risks even death. Teenagers were using the cough medicine, Robitussin, because it contains DMX an provides an easy high. Well teenagers are now using another allergy medication. Teenagers are now using the medication Benadryl made by Johnson and Johnson.

Many parents are familiar with Benadryl. It is a common medication pediatricians prescribe to parents when their children have allergies. This medication is considered safe for young children and parents can purchase it over the counter. Additionally, many pediatricians suggest that parents use this medication when children are having difficulties sleeping. Besides being a safe allergy medication for young children, it also has a tendency to make children and adults drowsy. Most people fall asleep after taking Benadryl.

Now the app TikTok has found away to abuse this medication. People who use TikTok have issued a challenge to other TikTok users. The challenge is to take as many Benadryl pills as they can so they start hallucinating and experience a high. Therefore, we have teenagers across the country taking dozens of Benadryl pills. Teenagers are able to get Benadryl easy because it is sold over the counter and is considered a safe allergy medication by most people. Therefore, most parents won’t suspect anything if their teenager tells them they are taking Benadryl for their allergies.

However this challenge posted on TikTok is dangerous and deadly. Johnson and Johnson has stated that Benadryl was not designed with the intention of taking dozens of Benadryl pills at a time. At this point a 15 year old girl has died from taking too many Benadryl pills. Additionally, three 15 year old teenage girls in Fort Worth, Texas are in the hospital because they took too many Benadryl pills. Johnson and Johnson has stated that if you take to much Benadryl it can cause seizures and serious heart problems. The company has the guidelines on the bottle regarding what is an appropriate dosage of Benadryl for different ages and weights. Johnson and Johnson is warning parents about this TikTok challenge so parents can address it with their teenagers.

Parents TikTok is very popular with teenagers, despite the fact that the government is banning its use on their cellphones. Teenagers are not thinking about how dangerous this challenge can be and that people can die. If your teenager uses TikTok discuss this challenge with them and watch to see if your teenager has any Benadryl. If they use TikTok and have Benadryl take the medication away from them. You may be saving their lives.

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

What to do When Children Do Not Like Their Grandparents Gifts

What to do When Children Do Not Like Their Grandparents Gifts

At this time of year most people are worried about finishing Christmas shopping before Christmas and making sure they get gifts for everyone they need to. This year due to the Coronavirus and inflation, the Holidays continue to be different including shopping. Many families are spending money freely because they are happy to be out and able to be around people. Other families are being very careful with spending because they are having a difficult time just affording food and gas due to inflation.

Furthermore, as I stated above, many people are short on money. Besides gifts they are worried about having enough money for the Holidays. Besides buying gifts, people still need to pay the rent and buy food for the family. Therefore, some people will need to cut back on how much they spend on gifts and some people may not be able to afford to give gifts at all this year.

A common situation many parents worry about during the Holidays is what to do when your child receives a gift they don’t like or want. They are worried about their child saying something in front of their grandparents or their great aunt that they don’t like the gift and tossing it to the side. The parents feel embarrassed and are concerned that their child hurt their grandparents or great aunt’s feelings especially since many people are having difficulties affording gifts. This definitely applies to grandparents who are living on limited incomes.

All of these worries regarding gifts can ruin Christmas for people. We should be more concerned about the spirit of the Holidays. The Holidays are about spending time with the people who are important to us not gifts. Granted due to the Coronavirus, we may not be able to celebrate with everyone in person, but it’s acknowledging those people in our lives that are important to us which is the most important part of the Holidays.

If you child says something inappropriate about a gift, remember you cannot control what children will say all the time. Also the adults should understand that children do not think the same way as adults and will try not to take it personally.

All you can do is talk to you children about what to do if they receive a gift they don’t like so they will not hurt someone’s feelings. Additionally, you hope that Great Aunt Sally is mature enough to understand how children act. However, once again the focus should be on celebrating life and love not gifts.

As a helpful resource and gift I have included a link to a guide to your questions about giving & receiving Christmas gifts & how to handle gift situations http://www.designsponge.com/20… via designsponge

Dr Michael Rubino is a psychotherapist who has over 25 years experience working with children and adolescents. In addition to working with trauma victims and first responders. For more information about his work and services offered at his private practice visit his websites at www.rcs-ca.com or www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Teaching Teenagers about Thank You Notes

Teaching Teenagers about Thank You Notes

Teenagers like receiving gifts and they like when people are nice to them and help them. While teenagers enjoy receiving gifts and having people be kind to them, they do not always know how to say thank you. Many adults, such as grandparents are use to thank you notes. However, due to the computer teenagers, in fact many adults too, do not know how to or when to write a thank you note.

Many parents try to get their teenagers to write thank you notes, but as I stated most teenagers do not know how to write thank you notes because they are use to texting everyone. This can be frustrating because many grandparents, great aunts and uncles are family friends expect thank you notes. They expect thank you notes because often grandparents and other family members live on the other side of the country. Therefore, thank you notes let the person sending the gift that the teen received the gift and if they liked or not.

Since teenagers are use to texting so parents try to teach their teenagers how to write thank you notes and other notes appropriately. Again since many of us are use to texting, many of us may not be sure how to write thank you notes appropriately either.

Given the fact that we rely on texting a great deal, I did some research into writing thank you notes. Hallmark has some very straight forward guidelines about how to write thank you notes. I have included the guidelines below so parents can refer to them and help their teenagers write thank you notes for Holiday gifts they receive during the Holiday Season. Here are Hallmark’s guidelines regarding writing thank you notes:

1. Use an appropriate greeting: Dear Aunt Sally … Dear Nana and Grampy …

2. Express your thanks: Thank you for the … I loved the … I so appreciated the way you remembered my …

3. Add detail: I plan to use the money to help pay for my trip to California next month … Here’s a picture of me wearing the sweater I bought with the money you gave me …

4. Mention the gift-giver: I look forward to seeing you at Thanksgiving … I can’t wait to celebrate my graduation with you …

5. Say thank you again: Again, thanks so much for the …

Thank you notes may seem old fashioned to some people, but many still think they are appropriate. When you think about it, thank you notes are a good way to help teach teenagers how to express appreciation and gratitude to people who have been kind and caring to them. We tend to focus on receiving in our culture, but it’s very important to be able to express gratitude too. Especially in our world today. We are divided and a lot of people are being hurt due to their religion, ethnicity and sexuality. Expressing gratitude for people and what they do for us is away to try to overcome these divisions and try to work together for the common good.

Therefore, you may think thank you notes are old fashioned, but gratitude is not. Educating your teenagers about saying thank you to people and writing thank you notes is a big step towards teaching teenagers about gratitude and why it’s important for each of us to be grateful for what we have and that it’s important to be grateful to the people who help us have the things we have and be able to live our lives with advantages that many people do not have in their lives.

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

How to Cope with Holiday Stress

How to Cope with Holiday Stress

Halloween signals the beginning of the Holiday season. Many people will be worrying about how they will survive the Holidays with certain relatives and since prices have increased this year many people are worrying about how they will be able to afford the Holiday Season. Additionally, there is the Coronavirus pandemic. Many people have been vaccinated, but others for some reason have decided not to get vaccinated. Therefore, some families are faced with decisions about do they celebrate with relatives who have not been vaccinated. This can be very difficult and a very stressful situation. In addition, the Holidays can be stressful because they may bring up family issues that have not been resolved yet or you have some family members trying so hard to make the day prefect that it becomes a stressful day not a happy one. Also parents are concerned how their children will act around the entire family? Finally this year prices on everything have increased significantly and many families are struggling with being able to afford the rent, in addition to Thanksgiving and the Holiday Season.

Thanksgiving is next and then there is Christmas and Chanukah depending on your family’s tradition. Since Thanksgiving is next, you can evaluate how Thanksgiving went for everyone and decide if you want to make changes for the remaining holidays.

After you have assessed how you would like Thanksgiving and the Holidays to go, the next step is to sit down with your children and ask for their opinions. Also ask about what their expectations are for the Holidays . It is especially important to discuss this point with teenagers because they have been isolated from friends due to the pandemic. Are they expecting to spend Christmas Eve and Day with the family or are they expecting to spend time with friends and girlfriends or boyfriends. It is important to settle this issue before the Holidays. By discussing expectations and trying to accommodate everyone’s wishes, you can avoid arguments. However, many times you cannot accommodate everyone’s wishes and as the parents you may need to make the judgement call. If this occurs explain to your teenager you know they may be mad, but you hope they can understand and you would appreciate their cooperation. May be you make arrangements for them to spend time with their friends the day before or after certain Holidays.

The next discussion is gifts. Explain to your children the point of the Holidays is to appreciate and to be grateful for the people in your life and what you do have in your life. Therefore, if your grandparents give you something you do not like, be grateful that they thought about you and say thank you. Try not to make faces or act disappointed and hurt your grandparents feelings. Again remind them the Holidays are a time to be grateful for what you have in your life.

Reminding your children about being grateful leads us into the next tip for decreasing Holiday Stress. Lori Lite who writes about stress uses the acronym G-R-A-T-E-F-U-L as her Holiday stress guide. It helps her and others get through the day in a peaceful manner. Each letter reminds you of something to do or a way to view the day so you do not get upset.

So here is how to use Gratitude as your Holiday Stress Reliever.

G- Gratitude is the opposite of stress. It is difficult to feel stressed out when we are feeling gratitude.

R- Relax your expectations and let the day unfold. You might be surprised by the outcome.

A- Acceptance is the opposite of judgment. If we accept our family member for who they are and what they are capable of we can relax and enjoy ourselves.

T- Teens can be a part of the Holidays. Ask them what they would like to contribute to the evening or day. Let them what they feel they can contribute.

E- Empower children and let them help with age appropriate assignments. Putting the nuts out or making the centerpiece. Let them do it their way…not your way.

F– Focus on family for this day. Put all work and worries on the shelf

U– Unplug the electronics for dinner so that everyone can be fully present.

L- Love is often overlooked when we are busy. Be present with love… Speak with love… Show your love and gratitude for your family during this Holiday time.

This might seem very simple and obvious, but at times the best solutions are rather simple. Also you may want to practice using this in your daily life. It may seem simple, but it may be harder to do than you think because you are accustomed to doing things and viewing life in a certain way. This idea may challenge you to reassess how you approach life in general.

Many of us are not use to looking at our lives in terms of what we have to be grateful for. Also many of us have a hard time relaxing and not worrying about work or other things we need to do. I have found that just being in the moment is difficult for most people. Most of us believe we always have to be doing something. This creates stress and disappointment. Finally, since we feel we must always be doing something, disconnecting from cellphones and other electronics can be very difficult for the children and for adults too. However, think about it? How can you have fun and enjoy the day with your family, if your mind is not fully present? You can’t. Furthermore, this can create tension for others because they feel ignored and for you because you feel they don’t respect how important what you are doing at the moment is to you. As a result, you have stress which can turn into an argument and everyone is upset. A day of happiness becomes a day of anger and disappointment.

If you notice you are getting angry or your teenager is getting angry use the acronym HALT:

H – hunger, do not try to discuss a difficult situation if you or your teen are hungry.

A – anger, if it is obvious someone is angry give them time to calm down before discussing an issue. Pushing a discussion when someone is angry will only result in making a bad situation worse.

Lonely – lonely, if someone is feeling down or alone again pushing them to talk can make it worse. Let them know when they are ready you are there to listen.

Tired – tired, trying to have a conversation with a tired teenager can turn into an argument fast. Wait until they are ready to talk. There is no need to make a bad situation worse.

Therefore, in order to avoid the possibility of an unpleasant Holiday for everyone try to

use the words GRATEFUL and HALT as guidelines for the day. What do you have to lose?

Dr. Michael Rubino specializes in working with children, teenagers and their families. He has over 25 years experience. For more information about his work or private practice visit his website at www.RubinoCounseling.com or visit his Facebook page at www.facebook.com/drrubino3 or his podcast on Spotify or Apple.

How to Have a Safe, Calm Halloween with Your Family

How to Have a Safe, Calm Halloween with Your Family

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Michael Rubino has over 25 years experience as a psychotherapist who teats teenagers and children. For more information regarding Dr. Rubino’s work or private practice visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino 3.

Coping with the Epidemic of Anxiety Disorders in Children and Teenagers

Coping with the Epidemic of Anxiety Disorders in Children and Teenagers

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

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

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

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

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

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

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

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

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

• Withdrawal from things the child usually enjoys

• Trouble falling or staying asleep

• Unexpected abdominal pain or headaches

• Extreme mood swings

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

Parents can actively help kids and adolescents manage stress by:

Being available

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

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

Listening actively

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

• Let kids complete their point before you respond.

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

Responding thoughtfully

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

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

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

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

• Word swap.

o   Say ‘and’ instead of ‘but’

o   Say ‘could’ instead of ‘should’

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

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

Consider

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

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

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

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

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

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

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

Why Teenagers Stop Listening to Their Parents

Why Teenagers  Stop Listening to Their Parents

Many teenagers report being frustrated with their parents because they feel that their parents do not listen to them. As a result, many teenagers decide not to listen to their parents. They feel their parents are disrespecting them by not listening, so why should they be respectful to their parents and listen to them. This does create a number of arguments at home because many parents get very upset when they feel their teenagers are not listening to them.

Honestly, the teenagers are probably right at times. Many parents may not really be listening to their teenagers, even though they feel that they are listening. Most people have poor listening skills. These are not skills we are taught in school or at home. Most people tend to be focusing on how they are going to respond to the person talking rather than completely listening to the other person.

Since this is a common issue, what happens when children and teenagers feel that their parents are not really listening to them? What teenagers have told me is that they feel angry and that their parent does not care about their feelings. When teenagers have these feelings they tend to stop talking to their parents and to act out. When they feel that their parents don’t care, they feel like they have permission to do whatever they want and at times they act out using drugs or not going to school as a way to get their parents attention.

Teenagers may act like they know everything and that they are not afraid of anything or confused about what to do, but this is only an act. They do not know how to handle everything and often feel overwhelmed by life choices. As a result they turn to their parents. However, if their parents are not fully listening they feel hurt and rejected. As teenagers their communication skills and reasoning skills are not fully developed. Therefore, they don’t know how to let their parents know they feel hurt and rejected. They also do not know how to let you know that they feel you are not listening and they need your help. Most teenagers feel saying they need their parents as a sign of weakness. This is because they are not fully mature and they are still children and they need their parents.

For many parents this may come as a shock. It comes as a shock because of how teenagers tend to react to their parents. Again, because teenagers are not fully mature they tend to act like they know everything and don’t need their parents. However, as I stated above teenagers do need and want their parents support. However, due to their immaturity, teenagers act like they don’t need their parents. However, parents need to understand that teenagers are not fully mature yet and their actions do not always match how they are feeling.

With this being said, it is very important that parents listen to their teenagers. However, since communication skills are a problem for most people especially listening skills, I have provided a list of listening skills that parents may want to try. Remember these skills don’t come naturally to most people so it will take a while for you to improve your skills. Also since teenagers can be confusing at times it makes listening even harder at times. In addition to these skills, if you are listening to your teenager, but you are still confused try asking a clarification question. Repeat back what you thought you heard and ask your teenager if you heard them correctly. This shows you are listening, you care and you want to focus on their concerns. This is exactly what teenagers are wanting from you. Here are the skills you may want to try:

1)  Purposefully strive to focus on listening with an open mind, refrain from jumping to conclusions or forming an opinion while your child is talking.

2)  Do not hurry them, listening requires patience.  Wait for your child’s thoughts to take shape  and give time for the words to form and find expression.

3)  Always show respect and courtesy in listening to what your child has to say, no matter how much you may disagree with them.

4)  Your own body language is important, make eye contact and always provide your attentive and undivided attention.

5)  Don’t be thinking about how you will respond as this will take your concentration away from what they are really saying.

6)  Exercise awareness of your child’s nonverbal cues, facial expression, tone of voice, body stance, general mood and attitude.

7)  Don’t interrupt, hear them out and wait for the appropriate opportunity to ask questions.

8)  Always remain calm when listening and never show your personal feelings of anger or disappointment.

9)  Think of listening as personal growth as your children will always have something to say which will help you to grow.

10) Practice active listening with your heart to genuinely empathize with your child. Put yourself in their shoes to genuinely understand their feelings and emotions.

Remember this will take time and effort. However, by trying you are improving your relationship with your teenager and this is a tremendous benefit to you and your teenager if you can improve your relationship. Teenagers are facing a great deal of confusing and dangerous situations in today’s world and they need their parents now more than ever.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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