Looking at Autism Realistically

Looking at Autism Realistically

Over the years I have had the opportunity to work with many children and teenagers who happen to be autistic. Often their parents are very worried. They worry about their child’s future and how people will treat their child. They have this concern because society tends to treat autism like some terrible disease. Many people assume that someone with Autism will never have a future or decent life. Additionally, many parents have difficulties with schools because many public schools find working with students on the autism spectrum difficult. At times it may be difficult, but my experience has been if the schools try slightly harder students on the Spectrum do fine. No one should decide that because someone is on the Spectrum that they cannot do well in school.

Unfortunately, many of these children on the Spectrum are teased at school. It appears that boys seem to be teased more than girls. In my experience this is because boys on the Spectrum tend not to comply with the typical outdated male stereotype. They tend to express their feelings more and they tend to be more accepting of others who are different. As a result, the other boys see them as easy targets to tease. This tends to really hurt their feelings and confuse the boys. They don’t understand why the other boys are being mean to them because they would never treat them the way the boys are treating them. Therefore, my experience has been overall boys only the Spectrum are more sensitive and caring. However, many parents are children will see them as inappropriate and they worry how they might treat their children. All of this is due to a stereotype regarding Autism.

However, this has not been my experience. The children and teens I have had the pleasure to work with who have autism are caring, smart, decent people. When they are given a chance, they can achieve a great deal. Many teenagers on the autistic spectrum are able to go to college, get a job, have a family and be productive members of society. However, for this to occur we need to eliminate the negative stigma associated with autism and mental health. We also need to provide them with the mental health services so they can succeed. They should be able to access these services without being judged. However, many children with Autism are teased at school and many insurance companies refuse to pay for psychotherapy. Autism is not a disease and you cannot catch it. Also people with Autism having feelings and being teased at school does a great deal of damage to their self-esteem. Children and teenagers need to be treated with respect meaning schools need to eliminate the teasing they endure at school. Insurance companies need to pay for psychotherapy so they can develop their abilities to express their emotions and so they can interpret social cues. If we do this, a child with Autism can achieve a lot in their life. The show the Good Doctor, shows an autistic young man who became a doctor. This is not a fantasy. There are several physicians with Autism who are perfectly capable of working as doctors and do.

I saw a video of a teenager talking to a judge. This teen with autism shows why we need to eliminate the negative stigma associated with mental health and provide access to services without judgement. Also he shows why we should not judge people or label people. Watch how impressed the judge is by this young man. He is very mature, acts appropriately, has a plan for himself and not ashamed about being autistic. People can surprise you when you don’t judge them https://www.linkedin.com/feed/update/urn:li:ugcPost:6507566653688160256.

If we provide other teens who are on the autistic spectrum or are depressed with the appropriate services, you would be amazed at what they can do. I have never met and worked with a child or teen on the autistic spectrum who has not impressed me with what they can do once they are given a chance.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers many have been on the autistic spectrum. For more information regarding his work or private practice practice visit his website www.RubinoCounseling.com, his Facebook page www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple or Audible.

Responding to Someone Grieving during the Holidays

Responding to Someone Grieving during the Holidays

The Holiday Season is just around the corner. For many people it is a very happy time, however, if someone you loved passed away this year the Holidays most likely will not be a happy time because you are missing your loved one. This is true every Holiday Season, however this year it is likely to very different. In previous years there have been a few families grieving the loss of a loved one. However, this year due to the Coronavirus, there are over 225,000 families grieving. Therefore there will be a lot of people grieving this year.

A common problem people face regarding grief is they do not know what to say or do at times when someone is grieving. The reason we have this problem is that we do not really talk about death and grief in our society. There is a tendency to think that after funeral services are completed that people quickly resume normal life. This is not true. The grieving process can take a long time and everyone has their own way of grieving. This makes knowing what to say or do very difficult especially during the Holidays.

I have had many patients ask me what should I say or do when they are talking about someone who is grieving. Therefore, I researched the literature on grieving and came up with these suggestions about how you can respond to someone who is grieving during the Holidays or anytime.

The 10 Best and 10 Worst Things to Say to Someone in Grief

Sheryl Sandberg’s post on Facebook gave us much insight into how those in grief feel about the responses of others to loss. Many of us have said “The Best” and “The Worst.” We meant no harm, in fact the opposite. We were trying to comfort. A grieving person may say one of the worst ones about themselves and it’s OK. It may make sense for a member of the clergy to say, “He is in a better place” when someone comes to them for guidance. Where as an acquaintance saying it may not feel good.

You would also not want to say to someone, you are in the stages of grief. In our work, On Grief and Grieving, Elisabeth Kubler-Ross and I share that the stages were never meant to tuck messy emotions into neat packages. While some of these things to say have been helpful to some people, the way in which they are often said has the exact opposite effect than what was originally intended.

The Best Things to Say to Someone in Grief

1. I am so sorry for your loss.

2. I wish I had the right words, just know I care.

3. I don’t know how you feel, but I am here to help in anyway I can.

4. You and your loved one will be in my thoughts and prayers.

5. My favorite memory of your loved one is…

6. I am always just a phone call away

7. Give a hug instead of saying something

8. We all need help at times like this, I am here for you

9. I am usually up early or late, if you need anything

10. Saying nothing, just be with the person

The Worst Things to Say to Someone in Grief

1. At least she lived a long life, many people die young

2. He is in a better place

3. She brought this on herself

4. There is a reason for everything

5. Aren’t you over him yet, he has been dead for awhile now

6. You can have another child still

7. She was such a good person God wanted her to be with him

8. I know how you feel

9. She did what she came here to do and it was her time to go

10. Be strong

Best & Worst Traits of people just trying to help

When in the position of wanting to help a friend or loved one in grief, often times our first desire is to try to “fix” the situation, when in all actuality our good intentions can lead to nothing but more grief. Knowing the right thing to say is only half of the responsibility of being a supportive emotional caregiver. We have comprised two lists which examine both the GOOD and the NOT SO GOOD traits of people just trying to help.

The Best Traits

Supportive, but not trying to fix it

About feelings

Non active, not telling anyone what to do

Admitting can’t make it better

Not asking for something or someone to change feelings

Recognize loss

Not time limited

The Worst Traits

They want to fix the loss

They are about our discomfort

They are directive in nature

They rationalize or try to explain loss/li>

They may be judgmental

May minimize the loss

Put a timeline on loss

The above information is meant to be used as a guideline. Everyone goes through the grieving process in their own way. It is very important to understand that point. It is also important to remember while the above is a guideline, the most important thing is your intent. So if you say a worse thing but you said it out of love the person will understand. The guideline will hopefully make you more comfortable to offer support to your grieving loved one or friend. Because someone who is grieving needs people to talk to without people feeling awkward. Also everyone is around immediately after the death and through the funeral services. Most people then go back to their normal lives. However, those who were really close to the person are still grieving and trying to figure out how to proceed with life. So don’t forget the person who is grieving can use emotional support for the first year especially. Therefore, do not forget to call, send a card or stop by occasionally. Especially around the holidays and birthdays.

Dr. Michael Rubino has over 20 years experience as a psychotherapist treating adolescents, children and their families. For more information regarding Dr. Rubino visit his website www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3 or follow him on Twitter @RubinoTherapy or his podcasts on Spotify or Apple or Audible.

Teenage Cutting Increases due to the Pandemic

Teenage Cutting Increases due to the Pandemic

Last year when I was guest co-hosting the Street Soldier radio show on 106.1 KMEL, the topic was how teenagers are impacted by social media. The topic of depression and cutting came up during the conversation. The adults were shocked to hear about cutting and the teens tended to feel the cutting was more of an issue for the girls. However, as a psychotherapist who works with teenagers, I have observed the increase in teenage cutting over the years. I have also observed that a behavior that once was believed to occur mainly in girls is also occurring in teenage boys too. From what I have seen it appears that just as many boys are cutting as girls. I mentioned when I was co-hosting last year before the Coronavirus. Since the Coronavirus pandemic and quarantine the number of teenagers cutting has significantly increased (CDC).

The first question I often receive when I mention cutting is, what is it? Cutting is any behavior that a person engages in with the goal of self-mutilating. Teenagers cut with razors, knifes, paper clips, staples, using erasers or even scratching themselves. These are just a few ways teenagers have found to self-mutilate themselves. Since this is an activity associated with a great deal of guilt and shame, I am sure there are more ways that we have not learned about yet.

Also because cutting is associated with a great deal of guilt and shame our statistics on how many teenagers cut are not entirely accurate. Most recent studies indicate that approximately a third of all teenagers have tried cutting or actively cutting (CDC). If you noticed the research shows a third of all teenagers, which means boys too. I am seeing cutting become more popular with teenagers especially with boys who say they are cutting, have cut or are thinking about it. Therefore, cutting not only occurs in girls but it is occurring in boys too. We need to be aware of the fact that cutting is becoming more popular with teenagers. It is important because cutting can lead to accidental suicide attempts if an artery is cut or permanent damage if nerves in the arm or legs are severely cut. These are things that teenagers and parents don’t think about.

Why do teenagers cut? The reasons I commonly hear is it is easier to deal with the physical pain than the emotional pain they are feeling. Teens who are severally depressed state that cutting reminds them they are alive. They are so depressed that they feel nothing, but when they cut they feel. Also teenagers cut as a way to punish themselves because they are ashamed about something they did or they feel they have let their parents down. Cutting is a way for teenagers to deal with the guilt and shame they are experiencing. It is also a way that they can feel in control of life when their life feels or the world feels out of control or overwhelming.

Since the Coronavirus pandemic many teenagers are feeling overwhelmed and powerless. They also see very little hope for things to improve. As a result, many more teenagers have started cutting since the beginning of the pandemic. It is a way teenagers can try to cope with feeling overwhelmed and powerless due to the pandemic. I have had more teenagers reporting incidents of cutting and more friends who are cutting since the beginning of the pandemic and as the pandemic continues.

If we look at how boys are raised, cutting is a good fit for boys. Most boys grow up learning that boys can’t cry and if you express feelings of sadness or disappointment you are weak. Teenage boys are always supposed to look like life is perfect and they can handle anything without help. Cutting allows them to express sadness, fear or embarrassment in private. No one knows they are cutting or how they are feeling. Unfortunately, this leads to a vicious circle where emotions can get out of control and a boy may end up doing something he never indented to do. The number of boys cutting has increased due to the pandemic because they feel overwhelmed and out of control. There is nothing they can do about the Coronavirus and how their lives have changed due to the Coronavirus.

At this point, most people working with teenagers consider cutting an epidemic. In fact, the CDC does consider teenage cutting to be an epidemic. Additionally, the little research we have about this behavior supports this idea, but we are unable to determine how severe the epidemic is in teenagers. When I mention cutting to a teenager now, they don’t look shocked. Instead they talk about it like we are talking about the weather. They often tell me about friends who are cutting too. Most teens who cut have friends that cut. Most teenage boys who have girlfriends tend to have girlfriends who cut too. As I stated above, the number of teenagers cutting has increased significantly since the Coronavirus pandemic because many teenagers are feeling helpless and overwhelmed by life. No one alive has ever dealt with a pandemic so teenagers feel helpless and hopeless about life. This has been my experience.

Cutting can be a very dangerous behavior and does need to be treated with psychotherapy. If you feel your teen may be cutting, talk to them in an understanding manner. Do not give them any reason to feel guilty or ashamed if they say yes. As I stated above, the teen already feels a great deal of shame and if they feel they will be looked at in a shameful manner or that you will be shocked they will never open up to you. You need to reassure them you love them and you only care about their safety.

I said it needs to be treated with psychotherapy. Find a psychotherapist who specializes in treating teenagers and in treating self-mutilating behavior. If you have to go to someone who is doing teletherapy due to the pandemic that is fine. This is very important because if the therapist acts negatively or shocked, the teenager will shut down and therapy may not work with any other therapist because the teenager now assumes everyone is judging them. I have had teens test me in various ways because of what a previous therapist said about their behavior or what the therapist said to their parents. They need to feel safe and accepted by their therapist if therapy is going to work.

I have included some risk factors and warning signs for you to be aware of in case you think your teen might be cutting:

Risk Factors

Knowledge that friends or acquaintances are cutting

Difficulty expressing feelings

Extreme emotional reactions to minor occurrences (anger or sorrow)

Stressful family events (divorce, death, conflict)

Loss of a friend, boyfriend/girlfriend, or social status

Negative body image

Lack of coping skills

Depression

Warning Signs

Wearing long sleeves during warm weather

Wearing thick wristbands that are never removed

Unexplained marks on body

Secretive or elusive behavior

Spending lengthy periods of time alone

Items that could be used for cutting (knives, scissors, safety pins, razors) are missing.

While this is a scary subject, I have worked with many teens who have overcome this issue. The important thing is as parents you are accepting and non judgmental. Also you need to be aware that this issue does exist. My last point is that boys cut too. Girls are not the only teenagers engaging in this behavior.

Dr. Michael Rubino has over 20 years experience treating children and teenagers. He has treated many teenagers who cut and is considered an expert in this area. For more information regarding Dr. Rubino visit his websites www.rcs-ca.com , www.RubinoCounseling.com , or his Facebook page, http://www.Facebook.com/Drrubino3

Teenagers Playing a Deadly Game with Benadryl

Teenagers Playing a Deadly Game with Benadryl

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 right now. 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 20 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.

Am I a Second Class Citizen because I’m Black?

Am I a Second Class Citizen because I’m Black?

As a psychotherapist who works with black adolescents and other minority adolescents, I am seeing these adolescents feel hopeless and angry. Many of these teenagers have dreams of going into the military so they can serve our Country. They are very proud of the United States, but they want to know why the President doesn’t care about them and makes them feel like second class citizens. Many may think these teenagers are overreacting, but if you just look at today’s events it appears they are not overreacting.

Today the President traveled to Wisconsin, even though the governor, the mayor and community felt it was inappropriate for him to visit. He disregarded their requests and made the visit. Now since he went to Kenosha, Wisconsin, you would think that he would mention Jacob Blake or visit Mr. Blake. However, he did not mention Mr. Blake nor did he visit him either. In fact, he has not even called the family yet. His excuse is the family has an attorney. However, he did mention, Kyle, the 17 year old white adolescent from Illinois who decided he had the right to go to Wisconsin because of the protestors in Wisconsin. While he was there he shot and killed two people and seriously injured a third person. The President has sympathy for Kyle and mentioned that case and Kyle has attorneys. However, Kyle is also white and is an outspoken supporter of the President. Additionally, while he was in Kenosha, Wisconsin, two reporters asked the President about systemic racism. He ignored the first reporter and told the second reporter he was asking the wrong question. The President denied systemic racism and did not want to discuss it. He would discuss the violence in Portland, Oregon. He also mentioned a plane full of “thugs” who were going to cause problems in the Country. However, he could not provide concrete details at the moment about the plane. Another scare tactic that he uses so often.

Not mentioning the real victim is not uncommon for the President especially when the victim is a minority. He is on Twitter all the time but never mentioned Jacob Blake. He stated he spoke to the family’s pastor. However, the pastor he spoke to was from Illinois and was not Mr. Blake’s pastor. When George Floyd was murdered by police several weeks ago, again he did not mention Mr. Floyd or Tweet about it. Here is another incident when a black man was killed but the President did little to nothing to get involved or to rectify the problem. However, how can you rectify a problem when you are denying the fact that systemic racism exist. How does this make black teenagers feel? The President address issues when White people are involved but if the victim is black or a minority, he ignores the situation. This makes black teenagers feel like they are not important.

Another fact black teenagers see is that the President wants to protect Confederate statues and military bases and schools named after Confederate soldiers. This is the same President who verbally attacked football and basketball players who did not stand or took a knee for the flag during the National Anthem. These players were protesting the systemic racism in our society. The President attacked these sport stars, but wants to honor Confederate soldiers. The Confederate soldiers destroyed the flag of the United States and they were trying to destroy the United States and they supported slavery. What does this tell a black teenager if the President supports people who advocated for slavery? In my opinion it would tell me, I’m not important to the President.

Why is this important? Currently depression and anxiety are at epidemic rates for teenagers (CDC). Also suicide has moved from the third leading cause of death for teenagers to the second leading cause of death for teenagers (CDC). The terrifying fact is that the suicide rate for black teenagers is five times the rate for white teenagers (CDC). If that is the case, how many black teenagers are we losing to suicide? The teenagers I am working with are telling me based on everything I outlined above, they do not see a future for themselves. They feel hopeless and don’t see any point in trying due to systemic racism. They are even more confused because many of them are wanting to serve the United States. They don’t understand how a Country they want to serve and protect is willing to allow systemic racism to exist. They do know their are many Americans who support them, but when you hear this support for systemic racism coming from the President daily, it gives black teenagers little hope that anything will change.

Because there is a belief that nothing will change, this is why groups such as Black Lives Matter are important to teenagers. Black Lives Matter is focused on changing the systemic racism in our Country despite what other people may think about the group. The group is not racist, it is designed to eliminate systemic racism. This gives black teenagers some hope for their future. Another group, Alive and Free in San Francisco which was founded by Dr. Joseph Marshall also provides black teenagers with hope for their futures and the teenagers need this hope. For this reason I am proud to be one of the founding members of the National Alive and Free Board which connects professionals across our Country to provide teenagers with hope and to work on eliminating systemic racism. Dr. Marshall has helped over 200 black teenagers get into and graduate college. This is what can happen when we remove racism.

Mr. President is urge you to take a deep look into your attitudes and educate yourself about racism. It is necessary if we are going to eliminate systemic racism and also so black teenagers don’t feel like second class citizens in the United States.

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

Teenagers May Need more Access to Electronics during the Pandemic

Teenagers May Need more Access to Electronics during the Pandemic

Most middle school and high school students have grown up with smart phones and computers for gaming and texting their friends. This brings up the common argument about how much time teens are spending on line. Many parents have concerns that their teenager is addicted to their smart phones and gaming. Teenagers feel that their parents are over reacting and they can’t become addicted to their devices.

However, due to the pandemic gaming is now one of the few safe activities teenagers can do. Most places such as movie theaters and malls are closed so gamine provides a safe way to hang out with friends. This is very important to their social development at their age. Additionally, research is showing that teenagers who have little access to normal social activities are becoming depressed during the pandemic (CDC). Therefore, we need to re-evaluate the issue of gaming during the pandemic.

While the truth is teenagers can become addicted to their computer devices and gaming. The World Health Organization (WHO) took a step this year and classified “Gaming Disorder” as a formal diagnosis. As I stated, many parents have been concerned about this for years. Also it does not just impact teenagers, as many may think. I have had couples come in for marriage counseling because Gaming was destroying a marriage. For several years the American Psychological Association has said it would be adding Gaming addiction as a formal diagnosis to the Diagnostic and Statistical Manual, however, so far the APA has not been able to decide on the specific criteria for this diagnosis. What the WHO has done is they have acknowledged what many parents have been reporting for years and helping us to take a step so it is acknowledged as a diagnosis. While it is a diagnosis according to the WHO, gaming again is one of the safe activities teenagers can engage in during the pandemic. This does create a difficult situation.

The United States appears to be behind other countries in identifying that video game addiction does exist and does create problems for individuals and families. Seoul, South Korea and Tokyo, Japan have inpatient treatment centers for gaming addiction. These rehabilitation centers have been open for years and have treated thousands of people over the years. Therefore, other countries have acknowledged Gaming addiction that United States parents have been reporting for years.

As a psychotherapist who treats teenagers, I would have to agree with the parents and I say Gaming addiction is real. I have seen teenagers become violent, punching holes in walls or physically threatening their parents, if there video games or cellphones are taken away as a punishment. Teenagers have told me they cannot function without their video games or cellphones and will do anything to get them back. This sounds like and look like a problem to me. A cellphone or PlayStation should not be a teenager’s life line.

However, as I stated above, the pandemic does create a different situation regarding teenagers gaming online with friends. Since this is a safe way for teenagers to maintain social contacts, I think we need to create new guidelines for the pandemic. Parents are aware that teenagers can become addicted, but they can monitor how their teenagers are acting before and after using electronics. Also maybe have a day without electronics, while allowing some extra time on other days. So try to balance out how much time they are on electronics along with doing other things such as going outside for walks to get exercise.

The statement from the WHO states that the Gaming must be interfering with activities of daily life, such as homework, and be present for at least a year. These guidelines seem sensible to me. Also the WHO cautions that issues such as depression and anxiety need to be ruled out before assigning the diagnosis of Gaming Addiction. Many teenagers who are depressed or dealing with severe anxiety do self-medicate with video games. Finally, the WHO states your child needs to be evaluated by a mental health clinician who specializes in treating and assessing children and teenagers. This is very important because typically children and teenagers do not always have the typical symptoms we associate with depression or anxiety. A clinician experienced in assessing children and teenagers can make the appropriate diagnosis. Given these guidelines it appears to me that parents can allow teenagers to use their electronics more during this time of the pandemic. Parents can make sure to balance electronic time with other activities such as exercise. Furthermore, parents need to be observing their teenagers mood on a daily basis. If the teen is looking depressed or acting anxious then the parents need to schedule a time to have their teenager evaluated by a mental health professional who specializes in treating children and teenagers.

I have included a link to a segment on Good Morning America which discusses the diagnosis and other issues I have discussed to assist you in understanding what the WHO is referring to with Gaming Addiction, https://youtu.be/axG1tLdutmY.

The World Health Organization has taken an important step in helping us understand and define a problem many parents have been reporting for years. This is not a bad thing. I view it as a positive step. Technology is moving very fast. In fact, it is moving so fast we cannot keep up with all the new issues we need to deal with as a result of new technology. The more we understand this technology the more we all can benefit and avoid potential serious problems.

With that be stated, the Coronavirus pandemic does present parents and teenagers with a entirely new set of issues. If we stay calm and flexible, we should be able to address these new issues without a great deal of stress for parents or teenagers. Remember this is a new situation for everyone and no one has experienced this type of health situation before. Therefore, if we all work together, we should be able to find solutions to the new issues we continue to face on a daily basis.

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

Is my Teenager Depressed due to the Coronavirus?

Is my Teenager Depressed due to the Coronavirus?

Because we do not deal well with mental health issues in our society, there are a lot of myths about mental health. There are a lot of misconceptions about depression in particular. Over the last two years depression and anxiety have reached epidemic rates in teenagers (CDC). In fact, suicide in now the second leading cause of death for children 10 years old to 18 years old (CDC). The increase has been attributed to the numerous mass shootings and the mass shooter drills give have had to do in school. Now teenagers are having to deal with the Coronavirus and having to shelter in place for over thee months. Research has shown that having to shelter in place has exacerbated depression for some teenagers and has caused some teenagers to become depressed and anxious (CDC). Since many parents have been consulting me about how to tell if their teenager is depressed, I was reading an article by Dr. Jerome Yelder, Sr., which outlines many symptoms of depression. He explained them so they are easy to understand and covered all symptoms parents need to be aware of regarding depression. This is important because typically children and teenagers do not act like adults do when they feel depressed. I have outlined his list below for you to review and decide if you feel your teenager needs to see a mental health clinician for depression.

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

Chest Pain
It can be a sign of heart, lung, or stomach problems, so see your doctor to rule out those causes. Sometimes, though, it’s a symptom of depression.
Depression can also raise your risk of heart disease. Plus, people who’ve had heart attacks are more likely to be depressed.

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

Aching Muscles and Joints
When you live with ongoing pain it can raise your risk of depression.

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

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

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

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

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

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

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

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

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

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

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and children. For more information about Dr. Rubino’s work and private practice visit his website http://www.RubinoCounseling.com or his Facebook page http://www.facebook.com/drrubino3 or follow him on Twitter @RubinoTherapy.

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

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

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

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

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

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

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

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

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

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

Gay Pride and Teenagers

Gay Pride and Teenagers

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

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

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

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

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

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

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

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

Teenagers Need Appropriate Role Models

Teenagers Need Appropriate Role Models

As a psychotherapist who specializes in treating teenagers, I often hear how they are disrespectful, oppositional and have little to no respect for authority figures and rules. I also hear how many people feel that their teenagers do not feel the rules apply to them and that teenagers feel they can pick and choose the rules they are going to follow. Because I work with teenagers daily, I would agree many teenagers due act like this at times. However, when I watch the news this week, it makes sense why teenagers are acting the way they do. We have a President who is making fun of a pandemic and refuses to comply with the laws. He wants everyone else to comply with the laws, but he doesn’t want to. Therefore, he refuses and we are supposed to say that his behavior is acceptable.

Look at what has occurred in Tulsa, Oklahoma and Phoenix, Arizona. Both states are experiencing a significant increase in the number of people being hospitalized with the Coronavirus virus. Dr. Fauci, the leading expert in the world regarding the virus, has stated that the virus is out of control and we need to practice social distancing and wear masks to try to manage the virus. In fact, other countries such as South Korea and New Zealand have been able to control the Coronavirus by using testing, social distancing and requiring people to wear masks. Everyone in these countries had to follow these guidelines even their leaders. These are also the recommendations of the CDC. They are recommending testing, social distancing and face masks as a way to control the virus.

Now the President is aware of these guidelines and he should be setting the example as the President, however he is doing the opposite. He had a rally in Tulsa, Oklahoma ignoring all the guidelines and 10 of his staff people contracted the Coronavirus. Today he is holding a rally in Phoenix, Arizona where wearing face masks is an order by the mayor, but the President is not using a mask. He is blatantly ignoring the rules which everyone else in Phoenix, Arizona must follow. Additionally, his refusal regarding anyone wearing masks has intimidated the mayor and governor of Arizona. They are allowing the rally to take place with no social distancing being used and no one being required to wear a face mask. Arizona has already used 80% of their ICU beds for patients with the Coronavirus and they recorded another recorded breaking number of hospitalizations today (CDC). Is holding the rally today under the conditions the President wanted, responsible behavior for the President? Why is the President allowed to ignore the laws of Phoenix, Arizona? The mayor was afraid to enforce the law on the President’s rally and said so in an interview she gave regarding the rally and the President and face masks (CNN). She did not want to argue with the President or upset him.

Now you have teenagers seeing these events and hearing the requirements for social distancing and wearing face masks. You also have teenagers seeing the President disregarding all the rules and nothing happening to him. Additionally, they hear about the President lying about the virus. At the rally in Tulsa he stated the virus was not a big deal and prior to the rally he said the numbers for the virus were very low and it was just going to disappear. All these statements are lies. The number are going up and the virus is not disappearing. Florida, Texas, Arizona, Oklahoma and California are all reporting record number of new Coronavirus cases and record number of hospitalizations since the pandemic started (CDC). However, nothing happens to the President when he lies and misleads the public about the pandemic which endangers lives. In fact, his staff claims he was just joking so we can ignore his remarks. However, the President proudly contradicted his staff and said he doesn’t joke around. If the President can lie about something as serious as the pandemic and no one holds him accountable, what are we teaching teenagers?

As for respect, he continues to use Twitter to call people names, threaten people exercising their right to freedom of speech and complaining that the media and Supreme Court don’t like him and are being unfair to him. This is exactly the type of behavior we expect and see from teenagers using social media. However, how do we expect them to follow the rules, when the President ignores the rules. In fact, when teenagers are getting in trouble for their posts they feel it’s unfair because the President is never held accountable for his posts. Society is expecting them to comply with the laws, but the President, the most powerful man in the world, doesn’t have to follow the laws. We are being hypocrites and teenagers have a right to complain.

I wrote a prior article on this subject, but I am writing this one today because the situation is very serious. We have a President who demeans people daily and who is misleading people regarding the status of the pandemic. We are supposed to be the strongest and be the smartest nation in the world, however we have the largest number of people with the Coronavirus virus and the most deaths than any other nation in the world. His disregard for the medical experts recommendations are putting people’s lives in danger and causing the death of thousands of people. In addition to this serious issue, he is teaching the teenagers of our Country that it is acceptable to demean people, to be disrespectful, to lie and to just think about what is best for you ignoring everyone else. If we do not act, the Coronavirus will kill thousands of additional people, maybe one of your children, and some teenagers will see his behavior as acceptable and act like him. We will have a very difficult time changing how these teenagers act and some of them we won’t be able to change their attitudes. Therefore, we will have a generation of lying, narcissistic, racist adults. This is a sad outlook for our Country. Parents this leaves you with a very tough job. Explaining to your teenagers why it’s important for them to act as respectful, caring people regardless of how the President acts and to vote for role models you want your teenagers to follow.

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