(561) 223-6568Our very own Dr. David Gross recently received the Lifetime Achievement award from Sierra Tucson! Watch the full video below.
As more states legalize the possession and use of marijuana, we are beginning to get a clearer picture of the effects it can have on mental health. While more research is needed, we know there has been an upswing in suicides and mental health disorders in the states that have legalized the drug. So, what are the mental health risks of marijuana use?
The short term effects of marijuana use have been known for years. They include:
However, with long term use or with heavy use of cannabinoids, people are developing more serious mental side effects. This is particularly if the drug was initially used early in adolescence.
A 2016 study by Volkow, et al, found:
This is especially concerning because the study also reported that, “Currently, marijuana is the most commonly used “illicit” drug in the United States, with about 12% of people 12 years of age or older reporting use in the past year and particularly high rates of use among young people.”
Today’s marijuana is not the same strength as what people were familiar with in the past – cannabis is now much stronger. A review of the negative health effects of pot in the Western Journal of Emergency Medicine reported that, “Current commercialized cannabis is near 20% tetrahydrocannabinol (THC), the primary psychoactive constituent of cannabis, while in the 1980s concentration was <2%. This 10-fold increase in potency does not include other formulations such as oils, waxes, and dabs, which can reach 80–90% THC.” And, as the potency of marijuana increases, so do the rates of mental health disorders and psychosis.
Age at first use of the drug also makes a big difference in developing mental health issues. A 5-year study by Di Forti, et al, that was published in The Lancet in 2019 compiled data from across 11 sites in Europe and in Brazil and discovered that the occurrence of first-episode psychosis increased exponentially in those who used marijuana daily or in high potency form.
Although the study authors reported that “Use of high-potency cannabis (THC ≥10%) modestly increased the odds of a psychotic disorder compared with never use… those who had started using high-potency cannabis by age 15 years showed a doubling of risk.” And, they said that, “daily use of high-potency cannabis carried more than a four-times increase in the risk of psychotic disorder.”
USAToday recently published an article highlighting the debate over cannabinoid induced psychosis. In it, they detailed the downward spiral of a young man who had once been a star high school athlete. After months of vaping a highly potent form of THC, he showed up at work on his day off, disoriented and speaking incoherently. Upon hospitalization, doctors diagnosed him with “cannabis use disorder” and “psychotic disorder, unspecified.”
If the young man stays off pot for a year and has no further psychotic symptoms or episodes during that time, he will join the growing number of pot smokers who have been identified as suffering from cannabinoid induced psychosis. The diagnosis takes a year to confirm in order to ensure the psychotic episode did not stem from another reason.
This person is not alone. For their story, USAToday also “interviewed a dozen parents whose children suffered psychotic episodes – some of which led to schizophrenia – related to their marijuana use. Several of the children died by suicide. “
The USAToday article went on to say that, “In May, more than 40 Massachusetts doctors, psychiatrists, pediatricians and other public health professionals urged the state to add psychiatric risk warnings to marijuana packaging and to prohibit most advertising.”
In addition to concerns about marijuana use and the associated mental health risks are the recent vaping illnesses and deaths that dominated the news this summer. THC-containing vaping products and e-cigarettes have been implicated in almost all the cases. The Centers for Disease Control and Prevention (CDC) is recommending that people “should not use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online sellers.”
At this point, it is obvious that more research and time are needed to understand how marijuana affects the brain. Clearly, though, the drug isn’t as innocent as some people believe.
Talk with a compassionate child psychologist at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us today for more information at (561) 223-6568.
Sadly, bullying is more common than we like to think. Kids belittle and pick on each other for many reasons. In the past, adults often wrote off bullying as “kids being kids”, but we have learned that being subjected to this type of abuse can be devastating for the targeted child. And, now that computers and social media are commonplace, a bully’s harassment doesn’t have to be done in person – kids can be besieged by cyberbullying, too. So, how does online bullying affect a child’s mental health?
Cyberbullying can cause a child to have more physical problems (sleep disturbances, headaches, stomachaches) and issues with self-esteem. A child who is bullied is less able to learn and adjust in school and more likely to have “depression, anxiety, sleep difficulties, lower academic achievement, and dropping out of school” as reported by the Centers for Disease Control and Prevention (CDC). In extreme cases of online bullying, children have even been so traumatized that they have taken their own lives.
In addition, bullying also affects the child who is carrying out the harassment, resulting in a higher risk of substance abuse, problems in school, and violence in their teen years and in adulthood.
According to the U. S. government website, StopBullying.gov, “Cyberbullying is bullying that takes place over digital devices like cell phones, computers, and tablets. Cyberbullying can occur through SMS, Text, and apps, or online in social media, forums, or gaming where people can view, participate in, or share content. Cyberbullying includes sending, posting, or sharing negative, harmful, false, or mean content about someone else. It can include sharing personal or private information about someone else causing embarrassment or humiliation. Some cyberbullying crosses the line into unlawful or criminal behavior.”
An article on VeryWellMind about cyberbullying and depression in kids notes that, “Victims of cyberbullying can experience symptoms of depression including sadness, loneliness, insecurity, poor self-esteem, academic decline, feelings of not belonging, and suicidal thoughts and behavior.”
Because online bullying can be done 24/7, kids cannot escape it in the same way they might be able to avoid harassment in person. This can add to the victim’s depression and feelings of helplessness.
A 2012 study by Low and Espelage, the authors noted that there are “…relations between bullying behavior and more conflictual and harsh parenting styles…as well as low parental monitoring.” They report that, “it can be hypothesized that family conflict and ineffective monitoring would heighten bullying perpetration indirectly via (a) risk behaviors such as alcohol and drug use (AOD) and (b) impairments in social competency and self-regulation, manifested in hostility, depressive symptoms, and reduced empathy.”
In cyber space, people feel anonymous, so they often say or do things they might not ordinarily. Kids can post something about someone or put up demeaning photos of another person without feeling much responsibility for their actions. Plus, because the trauma is done online, they don’t actually see how their attacks hurt the targeted child, so they don’t feel the same guilt that they might if they bullied in person.
StopBullying.gov lists the following warning signs that could indicate that your child is either being cyberbullied or is bullying someone else:
For Parents
To prevent or stop online bullying, if you notice changes in your child’s behavior, try to:
For Teens And Adolescents
Cyberbullying can cause depression, anxiety, PTSD and other concerns for the child who is targeted. We can help your teen or adolescent handle their emotions and the way they manage online bullies. Talk with a compassionate child psychologist at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us today for more information at (561) 223-6568.
When you are a parent, you always want what’s best for your child. This leads to seemingly millions of dilemmas over the course of the child’s life and one of the biggest is trying to figure out what type of school is best for them.
Nowadays, parents have many different choices in education for their children. One child may do well in a traditional public school, while another might excel if they are in a gifted program or in one that offers academics geared more towards the child’s interests, such as a STEM school. But, how do you know which is the right environment for your child’s specific needs?
There are several types of schools, each featuring a certain learning structure. Parents must decide between public schools and private, as well as charter, choice, gifted, cluster, magnet, lab schools, and homeschooling. So, obviously, the first step in choosing a school is to understand what each type of school setting will offer children.
Public schools are located within a community and district. They generally must admit all students who live within the district. These schools get their operating money from local, state, and federal funding.
Most public schools are within or near neighborhoods. Sending your child to a public school makes it easy for them to get there and they usually will attend classes alongside friends from their area.
Some public schools are more specialized. For example, they might focus on certain subjects or be designed to help struggling students stay in school. An example is an alternative high school, which typically offers classes in a trade, such as hair styling or electrical work, to encourage teens to finish their education while getting early training in a career.
Charter schools are public schools with more autonomy than a traditional public school. They are run independently from the restrictions of a public school, so they can provide an intensive focus on a particular curriculum. One charter school might be geared toward college prep while another incorporates STEM components (science, technology, engineering and math) into each class.
Charter schools are held accountable to and operate under a contract (the “charter”) they have entered into with a charter school authorizer. These authorizers might be a university or college, a nonprofit organization, or may be part of a government agency.
Magnet schools (cluster schools) are also public schools. As with charter schools, magnet schools give students an education in a particular subject concentration (a cluster) of STEM subjects, languages, or the arts. Students who excel in science might want to go to a charter school that emphasizes science, for example.
Some magnet schools will accept any student who wishes to attend there, others may require the student pass a test or show they excel in a particular skill before they can be admitted.
Private schools
Private schools are not funded by state or federal tax dollars – instead, students must pay a tuition fee in order to attend. These schools typically provide religious-based educations, but some are secular. Private schools either offer focused programs or they educate children according to a specific teaching philosophy (example: a Montessori school).
Choice schools
School choice is found in public schools and has two forms:
If you wish to move your child through school choice, the U. S. Department of Education says, “Districts must pay for students’ transportation costs, giving priority to low-income, low-achieving students if there are not enough funds available to pay for all students.”
Gifted schools
All states offer some type of gifted-specific education. Some offer advanced classes, others provide for acceleration of the student’s grade or curriculum. Some states also have gifted high schools.
Lab schools
Generally operated by universities or colleges, lab schools provide a curriculum taught by teachers in training, under the guidance of the college’s education department. These schools offer a way for the educators to try out their methods and theories and give the student teachers a way to learn how to teach, firsthand.
There are many things to consider when choosing a school for your child. Obvious factors are your child’s needs and interests (i.e.: gifted, special education, or a particular focus, such as music or math), along with the school’s ability to provide the type of education you would like your child to have.
You also will want to think about:
It can help your decision to visit the school and take a tour. Is the school well maintained? Speak with some of the teachers to gauge their enthusiasm for working with the kids. Check out classrooms and watch how the students behave between classes or in the classroom.
Changing schools can be stressful for kids. Usually kids bounce back after a period of adjustment, but sometimes a big change can have a long lasting effect on a child. If your child is struggling in school, is anxious or sad, or has developed behavior that is concerning, they may have an undiagnosed learning disorder, depression, or other mood disorder.
Don’t ignore a problem – talk with a compassionate child psychologist at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us today for more information at (561) 223-6568.
It is October – a time for pumpkins, Halloween…and breast cancer awareness. The numerous pink ribbons we’ll see this month focus attention on the many women (and men) who are facing a breast cancer diagnosis and treatment. But what about the kids who have a parent or primary caretaker with cancer? For a child, coping with a loved one’s diagnosis can be particularly traumatic.
In this article, we’ll answer your questions about the best ways to discuss a parent’s cancer diagnosis and give you some ideas for supporting a child whose parent has cancer.
Absolutely – and this applies even to young children. Although your first instinct is to shield your child from a harsh reality, kids need to have open, honest conversations with their parents – no matter the prognosis. Imagine how much more upsetting it could be to know there is something wrong, but not knowing what it is.
When you first talk to your child about a cancer diagnosis, do it privately and be sure to set aside enough time to answer their questions. If you don’t know the answers, let them know that you will do some research and get back to them.
“The most important thing is to communicate openly, honestly and frequently,” say social workers, Wendy Griffith and April Greene, with the M. D. Anderson Cancer Center. “Children tend to think in very concrete terms and like to know what’s going on and what to expect.”
Keep in mind, too, that many people’s first reaction to a cancer diagnosis is the fear that the person will die. Children who are old enough to understand the concept of death will understandably be concerned about that possibility as well, even if they don’t ask.
Ms. Griffith and Ms. Greene recommend using “the 5 C’s” when you discuss a cancer diagnosis with your kids:
When talking to children about cancer, consider the age of the child and keep it simple, but informative. Just lay out the facts:
When discussing cancer treatments with a child, gear your explanation to the child’s age level. Young children need to know the basics, while teens and tweens will likely want a more in-depth explanation:
The National Cancer Institute has a free, comprehensive guide for teens whose parent or loved one is facing cancer. It is available in a PDF, a Kindle version, and ePub form and the information can be scaled down to help younger kids.
Children will worry about their parent’s health and will also likely feel some resentment that life has upended for everyone. They may also feel guilty, sad, and angry.
To help your child cope:
If your child is struggling with the cancer diagnosis of a loved one, talk with a compassionate child psychologist at Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us for more information at (561) 223-6568.
This summer’s hurricane season was fairly quiet until Hurricane Dorian blew through offshore earlier this month. Then, Humberto threatened the South Florida area last week, putting everyone on high alert for the second time in less than a month. For some children, hearing about the devastation in the Bahamas, watching parents make storm preparations and evacuation plans, or knowing that there are other menacing storms out there can bring up hurricane anxiety.
While you are listening to updates and getting ready for an impending tropical storm or hurricane, don’t forget to talk with your child about their fears. If a storm is coming, they will likely be worried about their friends, their home and school, their pets, and all the disruption that a major storm can bring.
In addition, if they have ever been through a hurricane, they will remember the fear they felt while sitting in the dark, listening to the wind howl and feeling the house shake. After a terrifying experience like that, even hearing the pounding rain of a normal storm could bring up some post-traumatic stress for the child. This can be magnified by the act of going through preparations for another hurricane.
Children who have hurricane anxiety might show their fears in the form of physical or emotional symptoms, or both.
Physical symptoms include thing like:
Emotional symptoms can show up in the form of:
If your child shows a heightened level of concern or fear about storms, our child psychologist recommends that you:
Even though you talk to your child about the steps you are taking to keep them protected, their hurricane anxiety may still continue. If their stress level seems too high for the current situation, it is best to seek the help of a child psychologist.
These experts can help your child identify and change their anxious thoughts. Through role-play and modeling of positive behaviors, your child will learn coping strategies to lessen their fearful response to an approaching hurricane or other storm.
If your child seems unduly worried about storms or overly fearful when there is talk of a possible hurricane, it may be time to speak with a child psychologist. For more information, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.
For many kids, the end of summer and the beginning of school is something to look forward to, but for some, it can trigger a case of school anxiety. Children may be unwilling to get on the bus for the first day of classes or might cry when they talk about starting school.
There can be many reasons for this separation anxiety and the resulting back to school fears: a move to a new house, an attachment figure’s illness, or a friend who has moved away. Kids may also worry over how they will do in school or if they will make new friends.
One of the most common triggers for back to school anxiety is starting school for the first time. First of all, any separation from a parent can be scary, especially if the child is used to being at home all day with them. In addition, school days are very organized – the child has to adhere to a schedule and do tasks and lessons at prescribed times, and these set routines can add stress.
For teens and older children who have been in school before, back to school anxiety is often directly related to their worries about how well they will do in the upcoming school year. They may be concerned about having to answer questions in class or might fear being asked to read aloud in front of their peers. In some cases, a child may have been made fun of at school or might have been the target of a bully the previous year, so they feel anxious about the possibility of this happening again in the new school year.
Even teens who are starting college may have some school anxiety, despite the fact they want you to think they are above something so “childish”. Leaving home for the first time, not having their parent around to fall back on, and having to adjust to a new world can all be nerve-wracking for a teen.
If your child is apprehensive the start of classes, they will show pretty obvious symptoms. Back to school anxiety is likely present if they have:
Some of the things you can do to help your child with school anxiety include:
We think of children as being the only ones who suffer from first day jitters, but many parents also have anxiety over the start of school. They’ve been their child’s protector, entertainer, and advocate all summer, so you would think these parents would be looking forward to getting a break.
Many parents actually dread seeing their kids head back to class, though, particularly those who have children starting kindergarten or whose teens are going off to college. Their worry over sending their “baby’ off to the unknown kicks in, leaving them with their own version of separation anxiety.
If this sounds like you, don’t feel alone. It is perfectly natural to be distressed over this milestone. Even so, here are some of the most common parental fears, along with ideas that can help reassure you that everything will be fine:
For most kids, the uncertainties surrounding the start of classes will fade away as they get used to the routine of a new school year. If these fears don’t go away within four weeks, however, or if your child has school anxiety that is inappropriate to their developmental level or age, they may really have school refusal.
School refusal is not an “actual” diagnosis, instead it is a result of the child or teen having a deeper issue, such as a separation anxiety disorder, panic disorder, post-traumatic stress disorder, or a social phobia.
If you think your child has developed a school phobia, it’s important to seek treatment as soon as possible. The longer their school refusal continues, the harder it can be to treat.
To get help for your child’s school anxiety or school refusal, talk with a compassionate child psychologist at Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us for more information at (561) 223-6568.
Our very own Dr. Ali Cunningham recently released a book, Counseling Adults with Autism. The cover art for the book was produced by a local man with autism, Michael Vidal (pictured here with Dr. Cunningham).
Counseling Adults with Autism is a practical guide for counselors, psychologists, and other mental health professionals looking to improve their confidence and competence in counseling adults diagnosed with mild to moderate autism spectrum disorder (ASD). Organized into 11 chapters based on key areas for guiding assessment and treatment planning for this population, this book highlights evidence-based practices and therapeutic interventions through case examples to demonstrate how assessment and treatment can be applied. Replete with insights from a variety of disciplinary approaches, this is a comprehensive and accessible resource for practitioners looking to support and empower clients struggling with social and behavioral challenges. Buy the book here.
Toddlerhood is defined as the age range from 12 to 36 months. During this period, a child’s emotional and cognitive development grows by leaps and bounds, as do their social skills. This also coincides with the time when children are likely to go into a daycare environment or head off to preschool. As they engage more often with other children and adults, it may also be the stage when a toddler’s social fears begin to emerge.
Just as with adults, some children are comfortable with social interactions while others may not be. Each group of kids will have the social butterfly as well as the “shy” child who quietly observes and doesn’t interact as much. It is one thing to be shy, however, and another to be intensely fearful and anxious in a social setting. Because we know it can show up early in life, a toddler who shows such strong reactions in a social environment is often regarded as having social anxiety.
We aren’t really sure what causes social anxiety in toddlers. Genetics likely plays a role, since it contributes to a child’s temperament and personality. We also know that some genetic traits can influence certain mental health conditions.
A toddler’s environment could also predispose them to social anxiety. For a young child who already has a higher genetic risk, living with trauma or a severe parenting style may be enough to initiate social anxiety.
Social anxiety may also be learned from a parent, according to a 2006 study by de Rosnay, et al. Their research focused on indirect expressions of a mother’s social anxiety on their infant. The results showed that, “compared to their responses following their mothers interacting normally with a stranger, following a socially anxious mother-stranger interaction, infants were significantly more fearful and avoidant with the stranger. Infant-stranger avoidance was further modified by infant temperament; high fear infants were more avoidant in the socially anxious condition than low-fear infants.”
Studies have shown that social anxiety is not a form of autism, although the two have overlapping indicators, such as separation anxiety and avoiding eye contact. In fact, not only are they two distinct disorders, but the symptoms and diagnostic criteria for each are vastly different.
As the name implies, social anxiety is driven by anxiety. A child who has social anxiety will function within the parameters of their level of unease. For instance, they may simply keep to themselves, avoid other children, or might talk too quietly. Some kids may not talk at all.
On the other hand, a child with autism spectrum disorder doesn’t behave based on their anxiety level. Instead, this child has trouble understanding social cues and the nuances of communication. They might speak too loudly, may push their way into a group of children, or might misinterpret facial expressions or gestures.
Children who have social anxiety may be branded as difficult kids because their anxiety can show up in forms other than just in social interactions.
Toddlers with social anxiety often show certain signs, such as:
Therapists who specialize in treating children’s mental health concerns can do an assessment, however a definitive diagnosis in a toddler with social anxiety may not be feasible due to their young age. The results should highlight challenging areas, though. It may also reveal the basis of the child’s social anxiety, which allows for early intervention.
At home, parents can demonstrate healthy social interactions when their child is with them, so the toddler learns not to be so fearful.
They can also rehearse a new situation with their child before it comes up. For example, a toddler who will be going to daycare for the first time might role-play some of the things they’ll do while they are there. Practicing certain aspects of the day or even dropping by the daycare a couple of times before officially attending can ease fears because the daycare will already be familiar. It would also be helpful to let the teachers or caregivers know about your child’s fears, so they can help build confidence.
Other supportive methods include:
Our warm and welcoming Children’s Center offers a wide range of clinical, therapeutic, educational and supportive services specifically for children ages two through twenty two. Additionally, our facility is the South Florida regional clinic for the National Social Anxiety Center (NSAC).
For more information about how our child psychologist can help your child with their social anxiety or other mental health needs, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.
References
Autism Spectrum Disorder (ASD) comes with a variety of challenges. For many children, it can mean issues with compulsiveness and repetitive behaviors, learning and social deficits, and a resistance to change. ASD also can manifest with various emotional difficulties – although not specifically linked, we know that ASD and anxiety frequently appear together in children.
Kids with ASD and anxiety can have physical symptoms (example: racing heart or a stomach ache) or their anxiety may also show up in the form of rituals that can help calm them (for instance: shredding paper). Because many autistic children are either non-verbal or have trouble communicating, an outward display of anxiety may be their only way of telling you that they are distressed.
“40% of young people with ASD have clinically elevated levels of anxiety or at least one anxiety disorder, including obsessive compulsive disorder”, according to an article by Dr. Elisabetta Burchi and Dr. Eric Hollander of the Autism and Obsessive Compulsive Spectrum Program at Montefiore Medical Center and the Albert Einstein College of Medicine.
They stress the importance of anxiety treatment for children with autism spectrum disorder. “While untreated comorbid anxiety has been associated with the development of depression, aggression, and self-injury in ASD, an early recognition and treatment may convey better prognosis for these patients“.
Some studies have shown that high-functioning children suffer from more anxiety disorders than do lower functioning children on the spectrum. Additionally, other research reports that adolescents and teens with ASD may be more challenged by anxiety than their younger peers.
It can be difficult to spot the signs of anxiety in a child who has ASD for a couple of reasons: kids who are verbal may not be able to recognize and express their emotions, while children who are nonverbal can’t tell you that they are afraid or worried.
Also, children with ASD often display common behaviors that can look similar to those found in anxiety disorders. For example, the compulsions that are carried out in obsessive compulsive disorder can look much like the repetitive behaviors that a child with ASD will use, however the autistic child may not actually be anxious.
Although there are no specifics to watch for, anxiety often presents in the form of physical or behavioral issues. The signs may not be apparent in a younger child, but may show up in later years as they mature and their world expands to include school and other settings.
Research has shown that behavioral interventions are helpful for many ASD children who have anxiety. One of the most effect therapies for treating autism and anxiety is cognitive behavioral therapy (CBT). This therapy is best for a child who has some verbal abilities.
CBT teaches kids how to uncover the fear beneath their anxiety so they can challenge their negative or inaccurate thoughts. For instance, if a child has anxiety about going to school, they may actually be afraid of getting lost and not being able to find their parents again.
Once the fear has been identified, the therapist can use small doses of exposure therapy to provide the child with evidence that they are safe. In the case of school anxiety and the resulting fears surrounding being separated from a parent, exposure therapy might involve having the child spend a minute or two in a room without their parent. When mom or dad come back in, the child feels safe. As the length of time apart from their parent increases with an end result of the parents returning, the child’s anxiety level can begin to decrease when they are away from the parent in other situations.
Depending on the child, an anxiety medication, such as a selective serotonin reuptake inhibitor (SSRI) like Prozac, may also be used in combination with behavioral therapy.
Our warm and welcoming Children’s Center offers a wide range of clinical, therapeutic, educational and supportive services specifically for children ages two through twenty two.
For more information about how our child psychologist can help your child with their ASD and anxiety, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.