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The Connection Between Diet And Mental Health

Food And Mental Health – Is There A Connection?

If your child is hungry, be wary of letting them reach for the chips or soda – junk foods could affect their mood. In fact, recent studies are showing that food and mental health are more closely linked than we realize.

Felice Jacka, president of the International Society for Nutritional Psychiatry Research reports that, “a very large body of evidence now exists that suggests diet is as important to mental health as it is to physical health. A healthy diet is protective and an unhealthy diet is a risk factor for depression and anxiety.”

Nutrition Psychiatry

In the U. S., mental health conditions are more common than you might think.The Centers for Disease Control and Prevention (CDC) estimates that around 50 percent of Americans will be diagnosed with a mental health condition some time during their lives. They report that, as of 2018, “mental illnesses, such as depression, are the third most common cause of hospitalization in the United States for those aged 18-44 years old.”

These alarming statistics, coupled with the fact that the Western diet is often filled with junk food, made scientists wonder if there was a connection between the two. Could it be that nutrition affects the brain as much as it does the body? To find out, researchers began to look into the relationship between food and mental health about a decade ago.

Drew Ramsey, MD, an assistant clinical professor at Columbia University reports that the last ten years of study has shown that, “the risk of depression increases about 80% when you compare teens with the lowest-quality diet, or what we call the Western diet, to those who eat a higher-quality, whole-foods diet.” He also points out that, “the risk of attention-deficit disorder (ADD) doubles.”

Because they are seeing that nutrition can play a role in mental health, researchers are now even thinking that food allergies might affect bipolar disorder and schizophrenia.

Food and Mental Health

Most of the recent studies have revolved around the connection between a healthy diet and anxiety and depression. Although direct evidence linking food and mental health has not been found yet, there are trials in progress to prove it.

Meanwhile, we do know that a healthy diet affects brain health by:

  • Changing brain proteins and enzymes to increase neural transmitters, which are the connections between brain cells.
  • Boosting brain development.
  • Raising serotonin levels through various food enzymes, which improves mood.
  • Increasing good gut bacteria. This promotes a healthy gut biome, which decreases inflammation. Inflammation is known to affect both cognition and mood.

We now know that a nutrient-rich diet creates changes in brain proteins that improves the connections between brain cells. But diets that are high in refined sugars and saturated fats have been shown to have a “very potent negative impact on brain proteins,” Jacka says.

Moreover, we know that a high sugar, high fat diet decreases the healthy bacteria in the gut. Some studies have shown that a diet that is high in sugar may worsen the symptoms of schizophrenia. And, a 2017 study of the sugar intake of 23,000 people by Knuppel, et al., “confirms an adverse effect of sugar intake from sweet food/beverage on long-term psychological health and suggests that lower intake of sugar may be associated with better psychological health.”

Foods For Brain Health

It’s logical that the foods that are best for the body should also be the foods that promote brain health. This theory is supported by the results from a large European study that shows that nutrient-dense foods like the ones found on the Mediterranean diet may actually help prevent depression.

The nutrients that may help brain health include:

  • Zinc – low levels of zinc can cause depression.
  • B12 – A 2013 report by Ramsey and Muskin that was published in Current Psychiatry, noted that “low B12 levels and elevated homocysteine increase the risk of cognitive decline and Alzheimer’s disease and are linked to a 5-fold increase in the rate of brain atrophy.”
  • Omega 3s – may improve mood and do help improve memory and thinking.
  • Vitamin C – The report by Ramsey and Muskin also noted that, “Vitamin C intake is significantly lower in older adults (age ≥60) with depression.”
  • Iron – iron-deficiency anemia plays a part in depression.

Eating nutrient-dense foods like whole grains, leafy greens, colorful vegetables, beans and legumes, seafood, and fruits will boost the body’s overall health – including brain health. Both the Mediterranean diet and the DASH diet, which eliminates sugar, were found to significantly improve symptoms in the patients who took part in one study.

Adding fermented foods like sauerkraut, miso, kimchi, pickles, or kombucha, to your diet can improve gut health and increase serotonin levels. Serotonin is a neurotransmitter that helps to regulate sleep and stabilize mood. About 95% of serotonin is produced in the gut, so it is understandable that eating these foods can make you feel more emotionally healthy.  The next time your child reaches for the chips and soda, ask yourself if those empty calories are benefiting their developing brains. Since they probably aren’t, hand them some cultured yogurt or an apple instead. Remember – every bite counts!

Note: Dietary changes shouldn’t substitute for treatment. If your child is on medications for a mental health disorder, don’t replace or reduce them with food on your own. Speak with their pediatrician or mental health professional about what they should eat, as well as what they shouldn’t. Medications will work better in a healthy body than an unhealthy one.

Questions? We Can Help

For more information about how your child’s diet could be affecting their mental health, talk to the professionals at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us today at (561) 223-6568.

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Suicide Contagion And The Parkland Tragedy

It’s just one month past the first anniversary of the massacre at Marjorie Stoneman Douglas High School and we have all been saddened to hear that two students who survived the attack recently took their lives within days of each other. Also, the father of a child who was killed in the 2012 Sandy Hook school shootings died this week in an apparent suicide. Now experts are concerned that these deaths may be the result of suicide contagion.

What Is Suicide Contagion?

There is strong evidence to suggest that suicides can occur in groups. When the media reports that someone famous has died by suicide, it seems that other, similar deaths quickly follow. It is almost as if suicide somehow becomes “contagious.”

We saw this happen last summer when Anthony Bourdain took his own life within days of Kate Spade’s death. Now we have this most recent suicide cluster involving the Parkland students and the Sandy Hook father. Were they due to suicide contagion?

Suicide contagion is also known as the Werther Effect – a phrase coined in the 1970s by suicide researcher, David Phillips. The name refers to a character called Werther from a 1774 novel by Johann Wolfgang von Goethe. In the book, Werther takes his life when he learns that the woman he loves has married another man.

After its release, Goethe’s novel was blamed for numerous copycat suicides across Europe. In this early example of suicide contagion, many of the victims died in a similar manner to the way the Werther character killed himself in the book. Some people used the same type of gun and some dressed in the style of clothing that Werther wore. Some were even found with a copy of the novel on or near their bodies.

The News Media’s Connection To Suicide Contagion

Phillips’ research into suicide clusters led him to conclude that copycat suicides rise when there is excessive news coverage of the suicide of famous figures. In addition to Phillips’ investigations, several other studies have found that suicide rates go up after media coverage of a notable death. These rates also fall when the media coverage stops.

“The way suicide is reported is a significant factor in media-related suicide contagion, with more dramatic headlines and more prominently placed (i.e., front page) stories associated with greater increases in subsequent suicide rates,” says Dr. Madelyn Gould, a suicide researcher from Columbia University.

As with Goethe’s book, suicide clusters also occur when fictional characters die by their own hand. Dr. Gould has reported that, “Research into the impact of media stories about suicide has demonstrated an increase in suicide rates after both nonfictional and fictional stories about suicide.”

There is an ongoing debate among experts about why suicide contagion follows these reports. Is it that the news coverage itself causes someone else to take their own life or do they do it because they are already in a vulnerable state?

Regardless of the reason, media guidelines for reporting a death by suicide have been in place in many parts of the world since the end of the twentieth century. Both the Centers for Disease Controls and Prevention (CDC) and the World Health Organization (WHO) have issued policies for how news reports should cover notable and celebrity suicides.

Today, however, we have a new concern. In the twenty-first century, we rely less on standard media reporting and depend more on online sources to find out what is going on in the world. In particular, young people get their news from social media and the internet. These methods can spread a topic far more quickly than a news broadcast and – unfortunately – will do so with no filtering.

Suicide Risk Factors

In the case of the Parkland tragedy, we know that the first student to take her life was struggling with post-traumatic stress disorder (PTSD). She also suffered with survivor’s guilt, as do many of the teens who were at the school that day.

Suicide is already the second leading cause of death for young people between the ages of 10 and 24 and this is without factoring in the trauma of a massacre like the one in Parkland. Clearly, we need to talk more openly with young people about suicide prevention.

We all can help avert this type of suicide by watching for youth suicide signs and risk factors and by asking direct questions.

A risk factor can’t predict if someone will take their own life, but having one or more of them makes it more likely the person will either consider or attempt suicide. These risk factors are:

  • Talking a lot about the suicide of someone important (or having recently lost someone close to them)
  • Making jokes about dying or about suicide
  • Losing interest in activities or relationships they used to enjoy
  • Sharing feelings of self-contempt or worthlessness, or talking about feeling hopeless and unsure if they will ever being happy again
  • Giving away possessions they used to care a lot about, such as favorite clothes or mementos
  • Isolating themselves
  • May exhibit extreme mood swings or have violent outbursts of grief or anger
  • Might have insomnia or may over-sleep or be lethargic
  • Indulging in risky behavior, especially if this is not characteristic of the person

Asking Questions That Can Help

The first step in preventing a suicide is the awareness that someone is considering ending their life. The next step is determining whether immediate intervention is needed.

If you think someone you know may be at risk, you can help them by using the Columbia Protocol suicide risk assessment. The Columbia Protocol was developed jointly by researchers from Columbia University, the University of Pennsylvania, and the University of Pittsburgh, along with the National Institute of Mental Health (NIMH). It was adopted by the CDC in 2011 and today it is used worldwide to assess at-risk individuals.

The Columbia Protocol is a series of three to six direct questions that you ask the person you are worried about. Their answers will provide enough information to know if they need help and if urgent action is necessary (click here to download the free Columbia Protocol toolkit now).

If your child or someone you know tells you they are considering suicide, don’t judge them. Instead, show empathy for their feelings and let them know you care about them. Next, get help from a mental health professional or a suicide crisis hotline. A crisis hotline is especially critical if the person is in immediate danger of attempting suicide.

Never leave someone alone if they are threatening suicide. If you believe they are in immediate danger, call 911 or the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) in the United States. The line is open 24/7.

Talk To Us

If you are worried about your child or a loved one who may be at risk for suicide, talk to the specially trained mental health professionals at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us today at (561) 223-6568.

References

Forum on Global Violence Prevention; Board on Global Health; Institute of Medicine; National Research Council. Contagion of Violence: Workshop Summary. Washington (DC): National Academies Press (US); 2013 Feb 6. II.4, THE CONTAGION OF SUICIDAL BEHAVIOR.Available from: https://www.ncbi.nlm.nih.gov/books/NBK207262/

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Protecting Kids From The Momo Challenge

Protecting Kids From The Momo Challenge

Recently, the media has been reporting that 2018’s online Momo challenge has resurfaced. They talk about children encountering it in seemingly innocent YouTube videos. Originating on WhatsApp, the reemergence of the scary social media game has prompted schools and police stations to issue warnings about the challenge so that parents can discuss it with their kids.

What Is The Momo Challenge?

The Momo figure was actually a sculpture called “Mother Bird”. It was created by Japanese artist, Keisuke Aisawa. The sculpture featured a wraith-like figure with bulging eyes and long, stringy hair. To date, no evidence suggests that the artist or his special effects company had anything to do with the Momo challenge and the sculpture has since been destroyed.

Reports say that when the game first started, children were contacted to participate in the Momo challenge through their interaction with WhatsApp. More recently, however, the media is warning that the figure has apparently been popping up in Peppa Pig or Fortnight YouTube videos.

When a child participates in the game, they are actually interacting with someone who tells them to perform certain tasks to avoid being “cursed.” Reportedly, these assignments often require the child to do something harmful to themselves or others. They might be told to take pills or stab or otherwise hurt someone. The tasks even go as far as telling the child to take their own life.

The Momo figure asks the child to prove they have completed a task by providing a photograph of themselves while engaged in the assignment. To advance through the game, the child must show this proof. At the end of the game, the child’s final assignment is to commit suicide while recording it for social media.

Is The Momo Challenge A Hoax Or A Real Thing?

When the Momo game initially came out on social media, critics were quick to dismiss it as a hoax. While there have been a few child suicides that were thought to have been a result of the challenge, there has never been any definitive proof linking them to the game.

Additionally, it is difficult to find online images of kids participating in the game. Doubters think that if the challenge was real, there would be many more social media pictures of Momo collaborations.

ReignBot, a YouTuber who is famous for videos that explore creepy things on the Internet says, “Finding screenshots of interactions with Momo is nearly impossible and you’d think there’d be more for such a supposedly widespread thing.”

Often, the warnings about dangerous online challenges spread farther and faster than the actual game. That said, it is potentially dangerous for a child who is vulnerable to self-esteem and other psychological issues to be exposed to something that could be harmful.

Talking To Your Kids About Momo

Regardless of whether the game is real, experts agree that parents need to address the topic with their children preemptively. Dr. Ryan Seidman, a child and adolescent psychologist and the Clinical Director at our Children’s Center, says parents should warn their kids about these online challenges.

“Discuss with younger children what to do if they see the face,” she advises. You might start by asking the child if they have heard of Momo, then tell them to get a parent or other adult if something scary or threatening ever pops up on an app or video.

For teens and adolescents who want more independence, it’s good to have periodic discussions about online encounters, as well as anything in their lives that is frightening or threatening to them.

Encourage your kids to tell you if they are being bullied (by the way, Momo is a form of cyber-bullying). Be sure they understand that you are trusting them to let you know.

Self Harm And Suicide – Who Is At Risk From The Momo Challenge?

It’s unlikely that an online challenge would affect a psychologically healthy child, but it could push kids who self harm or who are contemplating suicide to act on their thoughts.

Self Harm

Self harm isn’t restricted to a certain age group or race, or to someone with a certain socioeconomic or educational background. Anyone may engage in self harm, but the behavior happens most often in teens and young adults.

Self harm happens most frequently in:

  • People who have difficulty expressing their emotions
  • Those individuals who have a background of childhood trauma, such as physical, verbal, or sexual abuse
  • People who don’t have a strong social support network. Conversely, we know it happens more often in those who have friends who also self harm
  • Those who also have post traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), borderline personality disorder, eating disorders, or in those who engage in substance abuse

Suicide

Keep in mind that suicide is the result of a mental illness. People who are vulnerable to online cyber-bullying and content like the Momo challenge are often already suffering from mental health issues, such as low self esteem, anxiety, or depression.

As mentioned above, the Momo game is thought to have led to several teen suicides last year, although the link hasn’t been proven.

Suicide is the second leading cause of teen deaths, but could a dangerous challenge increase risky behavior in an susceptible teen?

Madelyn S. Gould, Ph.D., a psychiatrist at Columbia University, thinks so. She says, “The magnitude of the increase [in the number of suicides] is proportional to the amount, duration, and prominence of media coverage. We know from a number of studies that the celebrity status of a suicide victim increases the impact of the suicide.”

Add to that the feeling of being alone in their pain and it’s possible a challenge could push a distressed teen over the edge.

Adolescents and teens who are considering suicide usually give unmistakable warning signs:

  • Making jokes about dying or about suicide
  • Sharing feelings of self-contempt or worthlessness, or talk about feeling hopeless and unsure they will ever being happy again
  • Giving away possessions they used to care a lot about, such as favorite clothes or  mementos
  • Losing interest in activities or relationships they used to enjoy
  • Talking a lot about the suicide of someone important (or may have recently lost someone close to them)
  • Isolating themselves
  • Might have insomnia or may over-sleep, may be lethargic
  • May exhibit extreme mood swings or have violent outbursts of grief or anger
  • An increase in drug or alcohol use
  • Indulging in risky behavior, especially if this is not characteristic of the person

Your child needs to know you are taking them seriously and that you care about them. If you are concerned that they are exhibiting some of these signs, ask the child directly if they are considering suicide (or have someone else they trust ask them). Be assured that it is okay to use the word “suicide” – saying the word will not raise the chance that they will act on the idea.

If your child admits that they are considering suicide, be empathetic about their feelings – don’t judge them. Seek help from a mental health professional such as those at our Children’s Center, from your child’s pediatrician, or from a suicide crisis hotline. The crisis hotline is especially critical if you think your child is in imminent danger of attempting suicide.

Worried about the Momo challenge’s influence on your child? Talk with a Child Psychologist at our Children’s Center

For more information about our children’s mental health services,  contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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Destigmatizing Mental Health Services For Youth

Studies have shown that children in the United States have many mental health needs that remain unidentified. In 2015, the Centers for Disease Control and Prevention (CDC) reported that about 20% of the nation’s youth have or will have an emotional, mental, or behavioral disorder. Only about 7.4% of these children report having received any type of mental health services, however.

A 2014 National Center for Biotechnology Information (NCBI) study by Jane Burns and Emma Birrell noted that many mental health problems escalate in adolescence and young adulthood. The effects of these under treated childhood mental health issues can be higher rates of substance abuse, anxiety, and depression, as well as suicidal ideation and self harm.

There is a stigma surrounding mental illness and its treatment. This disapproval is a barrier that keeps young people from seeking assistance. The consequence is that they are not receiving appropriate care, which translates to an increased chance of dropping out of school, employment or relationship problems, future incarceration, or even suicide.

Impact of Childhood Mental Disorders

The most prevalent mental disorder in children is attention deficit hyperactive disorder (ADHD). Other common conditions are:

  • Depression
  • Anxiety
  • Autism spectrum disorders
  • Substance abuse
  • Learning disorders
  • Eating disorders

A 2013 study by Khong, et. al. stated that “The highest-ranking top 25 causes of disability include anxiety disorders, drug and alcohol problems, schizophrenia, and bipolar effect disorders. By age 5, mental health and behavioral problems become an important and soon dominant cause of years lost to disability, peaking between ages 20–29.”

There is often a gap of up to 15 years between the onset of symptoms and the person getting the appropriate care. Because behavioral and mental health concerns are not being addressed early enough, they become issues down the road – major depression is one of the top four causes of disability in adulthood.

As the study noted, mental health conditions can begin to emerge as early as 5 or 6 years old. Symptoms of anxiety disorders often include:

  • trouble sleeping
  • trouble concentrating
  • fatigue,
  • irritability
  • restlessness
  • numerous, lingering, or intense periods of stress, anxiety, or fear that seem out of proportion to the triggering event and which affects the child’s daily life

Ways to Destigmatize Mental Health Services

Children with mental health challenges are often marginalized or bullied by their peers. This social exclusion keeps them suffering in silence, discouraging the majority of adolescents and teens from seeking help.

To destigmatize mental health in general, we need to:

  • Equate mental illness with physical illness. Mental illness is a disease, just the same as physical illnesses like diabetes or cancer, but mental health conditions are often thought of as something the person could overcome if they just “tried harder.” They are disorders of brain function, however, which means they are based in the physical body in much the same way as something like a heart condition or high blood pressure. We certainly wouldn’t expect a heart patient to just “try harder” to get their blood pressure or irregular heartbeat under control.
  • Show compassion to those with mental illness and don’t treat them differently. People with mental health conditions live meaningful lives, but they often have to fight to keep from being judged.
  • Watch what you say. Don’t use words like “freak” or “crazy” because this type of language continues the negativity against mental illness.
  • Change the culture by taking a good look at children who are acting out. Try to figure out why they are behaving in certain ways, instead of writing them off as bad kids.
  • Don’t judge yourself if you are struggling with mental health issues. Your condition is out of your control. Being ashamed only adds to the burden and can keep you from seeking help.
  • Encourage family members or friends to seek help if they are facing mental health challenges.
  • Familiarize your child with mental health concerns like anxiety and depression from a young age. For example, help them understand that everyone has days when they are sad or angry or feel stressed, but if they can’t shake those feelings, it is okay to ask for help.

People who are challenged with mental health issues often feel alone. The reality is that the majority of us have some type of mental health condition. Great examples include the new mother with postpartum depression, the college student with ADHD, and the coworker who has post-traumatic stress disorder from their military service.

By destigmatizing mental health problems and services from a young age, we can teach children to challenge negative attitudes so they are more comfortable asking for help.

Connect with a Child Psychologist at our Children’s Center

For more information about our services to treat mental disorders in children, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

References

Monshat K, Khong B, Hassed C, et al. “A conscious control over life and my emotions:” mindfulness practice and healthy young people. A qualitative study. J Adolesc Health. 2013;52(5):572–577.

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Self Harm – Is Your Child Engaging in it?

Self harm or self-injury is the intentional wounding of one’s own body. Most often, people who self harm will cut themselves with a sharp object.

Self harming may also include:

  • severely scratching areas of their body with a fingernail or sharpened object
  • carving words or patterns into their skin
  • burning or branding themselves using lighters, cigarettes, lit matches, or other hot objects
  • biting themselves
  • excessively picking at their skin (dermatillomania) or wounds
  • hair pulling (trichotillomania)
  • head banging
  • punching or hitting themselves
  • excessive skin-piercing or tattooing may also be indicators of self harm

Generally, people who self-harm do so in private. Often, they follow a ritual. For example, they might have a favorite object that they use to cut themselves or they may listen to certain music while they self injure.

Self harmers will target any area of the body, but the legs, arms, or front of the body are the most commonly selected. These areas are not only easy to reach, they are also easy to cover up, allowing the person to hide their wounds away from judgmental eyes.

Additionally, self harm can include actions that don’t seem so obvious to others. Activities like excessive substance abuse or binge drinking, driving recklessly or having unsafe sex can all be signs of self harm.

Causes of Self Harm

There are many reasons that people engage in the unhealthy coping mechanism of self-injury.

Oftentimes, a self-mutilator may have trouble understanding or expressing their emotions. Those who self harm report feelings of worthlessness and rejection, loneliness or isolation, guilt, self-hatred, and anger.

When a self harmer attacks their own body, they are really seeking:

  • distraction from painful emotions
  • to release intolerable mental anguish
  • a sense of control over their feelings, their body, or their lives
  • a physical distraction from emotional pain or emotional “numbness”
  • to punish themselves for supposed faults

People who self injure often feel an intense yearning to injure themselves. Even though they know it’s destructive, this feeling grows stronger until they complete the act of mutilation.  Feeling the resulting pain releases their distress and anxiety. This relief is only temporary, though, until their shame, guilt, and emotional pain triggers them to injure themselves again.

Who is At Risk for Self Harm?

Self injury happens in all walks of life. It is not restricted to a certain race or age group, nor to a particular educational or socioeconomic background.

It does happen more often in:

  • people with a background of childhood trauma, such as verbal, physical, or sexual abuse
  • those who have difficulty expressing their emotions
  • those without a strong social support network or, conversely, in those who have friends who also self harm
  • people who also have obsessive compulsive disorder (OCD), post traumatic stress disorder (PTSD), eating disorders, borderline personality disorder, or those who engage in substance abuse

Although anyone may self harm, the behavior occurs most frequently in teens and young adults. Females tend to engage in cutting and other forms of self-mutilation at an earlier age than males, but adolescent boys have the highest incidence of non-suicidal self injury.

Self-Harming Symptoms

Physical signs of self harm may include:

  • unexplained scars, often on wrists, arms, chest, or thighs
  • covering up arms or legs with long pants or long-sleeved shirts, even in very hot weather
  • fresh bruises, scratches or cuts
  • telling others they are clumsy and have frequent “accidents” as a way to explain their injuries
  • keeping sharp objects (knives, razors, needles) either on their person or nearby
  • blood stains on tissues, towels, or bed sheets

Emotional signs of self harm may include:

  • making statements of feeling hopeless, worthless, or helpless
  • isolation and withdrawal
  • impulsivity
  • emotional unpredictability
  • problems with personal relationships

Help for Self Harm

The first step in getting help for self harm is to tell someone that you are injuring yourself. Make sure the person is someone you trust, like a parent, your significant other, or a close friend. If you feel uncomfortable telling someone close to you, tell a teacher, counselor, religious or spiritual advisor, or a mental health professional.

Professional treatment for self injury depends on the specific case and whether or not there are any related mental health concerns. For example, if the person is self harming but also has depression, treatment with address the underlying mood disorder as well.

Most commonly, self harm is treated with a psychotherapy modality, such as:

  • Cognitive behavioral therapy (CBT), which helps the person identify negative beliefs and inaccurate thoughts, so they can challenge them and learn to react more positively.
  • Psychodynamic psychotherapy, which helps identify the issues that trigger their self-harming impulses. This therapy will develop skills to better manage stress and regulate emotions.
  • Dialectical behavior therapy (DBT), which helps the person learn better ways to tolerate distress. They’ll also learn coping skills so they can control the urge to self harm.
  • Mindfulness-based therapies, which can teach them skills to effectively cope with the myriad of issues that cause distress on a regular basis.

Treatment for self injury may include group therapy or family therapy in addition to individual therapy.

Self care for self-harming includes:

  • Asking for help from someone whom you can call immediately if you feel the need to self injure.
  • Following your treatment plan by keeping your therapy appointments.
  • Taking any prescribed medicines as directed, for underlying mental health conditions.
  • Identifying the feelings or situations that trigger your need to self harm. When you feel an urge, document what happened before it started. What were you doing? Who was with you? What was said? How did you feel? After a while, you’ll see a pattern, which will help you avoid the trigger. This also allows you to make a plan for ways to soothe or distract yourself when it comes up.
  • Being kind to yourself – eat healthy foods, learn relaxation techniques, and become more physically active.
  • Avoiding websites that idealize self harm.

 If your loved one self-injures:

  • Offer support and don’t criticize or judge. Yelling and arguments may increase the risk that they will self harm.
  • Praise their efforts as they work toward healthier emotional expression.
  • Learn more about self-injuring so you can understand the behavior and be compassionate towards your loved one.
  • Know the plan that the person and their therapist made for preventing relapse, then help them follow these coping strategies if they encounter a trigger.
  • Find support for yourself by joining a local or online support group for those affected by self-injuring behaviors.
  • Let the person know they’re not alone and that you care.

Need More Information?

Are you concerned that your child is engaging in self harm? Don’t wait to seek help – speak to a compassionate child psychologist at The Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us for more information or call us at (561) 223-6568.

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7 Tips for Overcoming Back to School Anxiety

Another school year has come around and with it, the possibility of extreme fear and separation anxiety for some children. Although it’s normal for any kid to have a certain degree of back to school anxiety, there is a huge difference between a child who is nervous about the new school year and one whose anxiety is severe enough to seek professional care.

Kids often worry about things like fitting in or whether the teacher will pick on them, which increases their stress. In the week leading up to the beginning of the school year or in the last few days before the end of a school break, younger kids may show some separation anxiety by crying frequently, throwing temper tantrums, or being more clingy than usual. Older children’s school anxiety symptoms can include being moody or irritable, complaining of headaches or stomach aches, or withdrawing into themselves.  So how can a parent tell if their child just has school jitters or if they truly have back to school anxiety?

Fears about new teachers, harder school work, and being away from their parents are common for kids and usually stop within a couple of weeks once the child settles into the routine of the new school year. For those children whose anxiety symptoms continue beyond the first four or five weeks of school or seem extreme or inappropriate for their developmental level, a consultation with a therapist may be in order.

Tips to Ease School Fears

If your child is worried about the new school year, these back to school anxiety tips can help

  • Help you child identify what it is they are worrying about. Assure them that it’s normal to have fears. Give them your full attention and be sure to set a regular time and place to talk to them about their concerns. For example, bath time might be a good time to talk to a younger child, while a teen might be more receptive later in the evening.
  • Focus on the positives: In order to redirect your child’s attention from their worries, ask them to tell you a couple of things that are positive about school. Generally, even the most nervous child can think of something they like about it. Maybe they have a new friend or enjoy a certain subject or look forward to working on an art project. Looking for the positives can make the negatives seem a little less overwhelming.
  • Don’t pacify the child, instead coach them to come up with ways to solve their problem. Telling your child that “things will be okay” doesn’t help them get past their fears. What does is giving them some control. Encourage the child to give you some ideas of ways they can deal with what’s concerning them. This type of problem-solving helps them learn coping skills and teaches them critical thinking so they can develop a plan instead of simply reacting negatively.
  • Try role-playing. Going through a particular scenario can often help your child feel confident. Let the child be the “bad guy” teacher or scary bully, while you play the part of the child. Your responses can help them learn how to deal with the situation appropriately and allow them to respond with less fear.
  • Reinforce positive behaviors and reward their successes and their bravery in facing what they fear.
  • Be supportive, but don’t allow them to stay home from school. Even though it is normal for your child to worry about going to school, it is crucial that they attend. Allowing them to avoid school only increases and reinforces their fears. The longer they stay out of school the harder it can be for them to go back.
  • Seek professional help for back to school anxiety that gets worse or lasts more than about four weeks. Additionally, medication is sometimes appropriate in severe cases of separation anxiety.

Help Your Child Overcome Back to School Anxiety

If your child is struggling with back to school anxiety, it may be time to seek help from 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.

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Does Rapid Onset Gender Dysphoria Exist?

When a person feels strongly that they don’t identify with the biological gender they were born with, the American Psychiatric Association terms them as having gender dysphoria. Although children as young as age four may express gender nonconformity, many times gender dysphoria doesn’t become evident to the person until they reach puberty and realize they are not comfortable with the changes going on in their bodies. For a gender dysphoria diagnosis, the person must feel these symptoms for at least six months. Recently, however, some researchers have been exploring a new development in gender dysphoria that seems to occur very suddenly and without the child having expressed any prior distress with their physical gender. This is called Rapid Onset Gender Dysphoria (ROGD).

What is Rapid Onset Gender Dysphoria?

Rapid Onset Gender Dysphoria is a term that has sprung up within the past couple of years. It is important to note that ROGD has not been established as a distinct syndrome. This dysphoria has been casually (not scientifically) observed.

In ROGD, an adolescent or young adult who has always identified as their physical (birth) gender suddenly starts to identify as another gender. Prior to this, the child would not have met the criteria for gender dysphoria nor would they have displayed any discomfort with their gender. Additionally, often multiple friends within the same peer group simultaneously identify with another gender and become gender dysphoric around the same time.

Why is ROGD Controversial?

Recently a Brown University researcher published a study “to empirically describe teens and young adults who did not have symptoms of gender dysphoria during childhood but who were observed by their parents to rapidly develop gender dysphoria symptoms over days, weeks or months during or after puberty.” The study author was Lisa Littman, an assistant professor of the practice of behavioral and social sciences at Brown’s School of Public Health.

Littman surveyed over 250 parents whose children had suddenly developed gender dysphoria symptoms. Of the parents who answered the survey, about 45 percent reported that their child had increased their social media use and that the child had one or more friends who became transgender-identified around the same time as their child.

This led to Littman’s hypothesis that gender dysphoria could be at least partially spread by social contagion. She proposed that social media and a child’s peers could cause the child to embrace certain beliefs, such as the idea that feeling uneasy with the gender you were born with meant you were gender dysphoric. Because many RODG teens also push for medical transition to another gender, Littman suggested that this could actually be a harmful coping tool in the same way that drugs, alcohol or substance abuse are negative coping mechanisms.

Transgender advocates fiercely criticized Littman’s study, saying it was methodologically flawed because Littman only interviewed parents and not the transgender-identifying children themselves. They also called the study “antitransgender” and a denial of transgender affirmation while citing the fact that a person who is questioning their gender and seeking answers would naturally read up on the subject and spend time with supportive friends who may have similar thoughts and feelings. Advocates pointed out that a true gender dysphoria diagnosis requires evaluation by specialists, while Rapid Onset Gender Dysphoria only required the parent’s perspective.

As a result of the criticism, Brown withdrew its press release about the study and wrote a statement explaining its decision to conduct a post-publication re-review. They worried that the study “could be used to discredit efforts to support transgender youth and invalidate the perspectives of members of the transgender community.”

Gender Dysphoria Treatment

Clearly, more research is needed in order to settle the question of whether Rapid Onset Gender Dysphoria is real, however we know that gender dysphoria exists. Early diagnosis, gender-affirming approaches by parents, and individual and family counseling can help the transgender person and their loved ones deal with the emotional challenges of gender transition.

Many transgender people take action to be more in alignment with who they feel they are. They might change their name to one more suited to the gender they express or dress as that gender. Other options include taking puberty blockers, hormones to develop physical traits for the gender they identify with, or sex-reassignment surgery.

We know that people with gender dysphoria have higher rates of mental health conditions like depersonalization disorder, anxiety, depression and mood disorders, and increased substance abuse. They also experience higher suicide rates, therefore it is important for them to seek mental health treatment. The goal of treatment is not to change the person’s feelings about their gender, rather it is to give them a way to deal with the emotional issues that come with gender dysphoria.

Get Answers about Gender Dysphoria and ROGD

If you or a loved one are distressed, anxious, or depressed about your gender identity, we can help. Contact the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida for more information or call us today at (561) 223-6568.

 

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Bullying Kids With Food Allergies

anti bullying group counseling for teens in Delray Beach, FLImagine being a child who lives with severe food allergies. Ingesting even the tiniest amount of the allergen (or having it touch your skin) can be enough to trigger anaphylaxis, which can kill you. Your condition is so severe that you must extremely vigilant about your food and you carry an epinephrine injector everywhere you go in case your inadvertently miss something and begin having trouble breathing or your throat starts to close. Now imagine fellow students bullying you because of your life-threatening allergies or having a fellow student force you to touch or eat the food that might kill you. It sounds far-fetched in view of the danger, but that’s a real life scenario for approximately 31.5% of children with food allergies, according to a 2013 study reported in Pediatrics.

These children are being singled out for harassment and are more than twice as likely to be bullied specifically because their food allergies.

Food Intolerance or Food Allergy?

5.9 million kids in the U. S. have food allergies. In fact, the Centers for Disease Control and Prevention (CDC) reports that “among children aged 0–17 years, the prevalence of food allergies increased from 3.4% in 1997–1999 to 5.1% in 2009–2011”. That means about 1 child out of every 13 in a given classroom has a food allergy.

According to the American College of Allergy, Asthma & Immunology, food allergies occur “when your body’s natural defenses overreact to exposure to a particular substance, treating it as an invader and sending out chemicals to defend against it.”

A true food allergy isn’t the same as the more common food intolerances we think of when we avoid a certain food because it will negatively affect our body (for example: lactose intolerance). Instead, food allergies trigger a person’s immune system, sending it into overdrive. This overreaction can bring on symptoms ranging from mild (like hives, itchiness, or gastric problems) all the way up to anaphylaxis, which can be life-threatening.

Food allergy reactions can start in as little as two minutes and as long as two hours after eating or touching the food. The Mayo Clinic reports that the most common food allergy signs and symptoms include:

  • Tingling or itching in the mouth
  • Hives, itching or eczema
  • Swelling of the lips, face, tongue and throat or other parts of the body
  • Wheezing, nasal congestion or trouble breathing
  • Abdominal pain, diarrhea, nausea or vomiting
  • Dizziness, lightheadedness or fainting

Anaphylaxis

In some people, a food allergy can trigger a severe allergic reaction called anaphylaxis. This can cause life-threatening signs and symptoms, including:

  • Constriction and tightening of the airways
  • A swollen throat or the sensation of a lump in your throat that makes it difficult to breathe
  • Shock with a severe drop in blood pressure
  • Rapid pulse
  • Dizziness, lightheadedness or loss of consciousness

Emergency treatment is critical for anaphylaxis. Untreated, anaphylaxis can cause a coma or even death.

Impact of Food Allergy Bullying

Often, kids think it is funny to tease and bully kids who have food allergies. This may be because they don’t really understand what can happen to children who have severe food allergies, although older kids and teens clearly have an idea. A 2018 New York Times article reported that a parent stated on Twitter that his son was “taunted by ‘friends’ with a PB & J sandwich,” who said, “‘let’s see if he dies.’” In other cases, “children with food allergies have had milk poured over them, peanuts waved in their faces, cake thrown at them, and peanut butter smeared on them.”

This harassment and stress can cause allergic children to fear school, leading to school refusal, and can make them depressed or cause them to isolate themselves socially. Parental involvement can help keep down the attacks, but children only report the harassment to their parents about 52.1% of the time. Additionally, teachers often make insensitive remarks or single-out and exclude children with food allergies from certain activities or school functions, further contributing to the child’s feelings of isolation and anxiety.

Increasingly, there have been legal consequences for food allergy bullying. In 2017, a 13 year-old U. K. boy was arrested for attempted murder after flicking a piece of cheese into a fellow student’s mouth, causing an anaphylactic reaction that led to the victim’s death. That same year in the U. S., a Michigan student with a peanut allergy (who was unconscious due to a hazing incident) was smeared in the face with peanut butter, resulting in an anaphylactic reaction. Thankfully, he later recovered, but the perpetrator pleaded guilty to assault and battery charges.

What Should Parents Do?

  • Know what’s going on by staying involved at your child’s school.
  • Know the signs of bullying: your child refuses to go to school, has stomach aches, stops talking about peers or friends, their grades may drop, or their sleep patterns may change.
  • Teach your child what to do if they are being bullied – make sure they know they should tell the school nurse or their teacher. Also teach them to tell you. Studies show that children experience a reduction or cessation in bullying if a parent knows they are being bullied.
  • Discuss your child’s allergies and their severity with the school principal and with your child’s teacher before your child starts the school year. Find out about the school’s anti-bullying policies and the procedures for handling an incident.
  • Seek help from your child’s friends and classmates. They will often see things a teacher may not and can report any threats to your child’s teacher or warn your child of impending danger.
  • Teach your children compassion and caring so they learn it’s not funny to bully others and that people can be hurt or can die from what might seem like a harmless prank.

Get Help for Bullying

It’s important to seek help as soon as possible if your child becomes the target of food allergy bullying. For more information about how a child psychologist at the Children’s Center can help your child stand up to bullying, contact the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

 

Article Resources

https://www.allergicliving.com/2017/09/06/michigan-student-pleads-guilty-in-peanut-butter-face-smearing-case/

https://www.nytimes.com/2018/02/15/well/family/in-allergy-bullying-food-can-hurt.html

https://snacksafely.com/2017/07/food-allergy-bullying-leads-to-death-of-13-year-old-boy-arrest-of-another/

 

 

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Signs Your Child May be a Hypochondriac

Signs Your Child May be a Hypochondriac

A hypochondriac is someone who lives with the fear that they have a serious, but undiagnosed medical condition, even though diagnostic tests show there is nothing wrong with them. Hypochondriacs experience extreme anxiety from the bodily responses most people take for granted. For example, they may be convinced that something as simple as a sneeze is the sign they have a horrible disease.

Hypochondria accounts for about five percent of outpatient medical care annually. More than 200,000 people are diagnosed with hypochondria (also known as health anxiety or illness anxiety disorder) each year. While health anxiety generally begins in early adulthood, children can also experience hypochondria.

Hypochondriac Symptoms

True hypochondria is a mental health disorder. Hypochondria may show up in a child after they or someone they know has gone through an illness or a serious medical condition. Its symptoms can vary, depending on factors such as stress, age, and whether the person is already an extreme worrier.

In children, hypochondriac symptoms may include:

·         Regularly checking themselves for any sign of illness

·         Telling you about a new physical complaint almost every day

·         Fearing that anything from a runny nose to a gurgle in their gut is the sign of a serious illness

·         Frequently asking their parent to take them to the doctor

·         Asking to have their temperature taken daily (or more than once per day)

·         Talking excessively about their health

·         Happily wearing bandages like badges of honor, has one on almost constantly

·         May focus excessively on things most children typically don’t: a certain disease (example: cancer) or a certain body part (example: worrying about a brain tumor if they have a headache)

·         Having frequent pains or finds lumps that no one else can feel

·         Fearing being around people who are sick

Health anxiety can actually have its own symptoms because it’s possible for the child to have stomachaches, dizziness, or pain as a result of their overwhelming anxiety. In fact, illness anxiety can take over a hypochondriac’s life to the point that worrying and living in fear are so stressful, the child refuses to go to school or participate in outside activities.

You may be wondering what triggers hypochondria. Although there really isn’t an exact cause, we do know that people with illness anxiety are more likely to have a family member who is also a hypochondriac. The child with health anxiety may have gone through a serious illness and fear that their bad experience may be repeated. Or, they may already be suffering from a mental health condition and their hypochondria may be part of it.

Hypochondriac Treatment

Self-help for child hypochondria can include:

  • Letting your child know that sometimes focusing too much on being sick can cause anxiety that makes their bodily sensation worse
  • Trying to not talk about your own aches or pains in front of your child
  • Helping your child learn stress management and relaxation techniques
  • Encouraging older children to avoid online searches for the possible meanings behind their symptoms
  • Focusing on outside activities such as a hobby they enjoy
  • Working to help your child recognize that the physical signs they experience are not a symptom of something ominous, but are actually normal bodily sensations

Professional treatments for hypochondria include:

  • Cognitive Behavioral Therapy (CBT), which is very helpful for reducing patient fears. In this type of therapy, the child learns to recognize and understand the false beliefs that set off their anxiety. Research has shown that CBT successfully teaches hypochondriacs to identify what triggers their behavior and gives them coping skills to help them manage it.
  • Behavioral stress management or exposure therapy may be helpful
  • Psychotropic medications, such as anti-depressants, are sometimes used to treat health anxiety disorder

Get Help for Hypochondria and Health Anxiety Disorder

Being a hypochondriac negatively affects the lives of the child who suffers from it.  The child psychologists at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida are experienced in helping those with illness anxiety. For more information, contact us or call us today at (561) 223-6568.

Reference: https://jamanetwork.com/journals/jama/fullarticle/198437

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Dermatillomania (Skin Picking Disorder)

While it’s simply “being human” to occasionally pick at your skin, at calluses, or at the cuticles on your fingers, when a person obsessively self-grooms, it could be a sign of dermatillomania or excoriation disorder. In layman’s terms, this is a skin picking disorder. The condition is a form of obsessive-compulsive disorder and is one of a group of body-focused repetitive behaviors (BFRB). Dermatillomania damages skin and is characterized by compulsively picking, touching, pulling, rubbing, digging into, scratching, or even biting at one’s own skin as a way to get rid of perceived skin irregularities.

Signs of Dermatillomania

Research shows that anywhere between 2% and 5% of people compulsively pick at their skin. Females make up about 75% of those who are diagnosed with excoriation disorder. Skin picking can begin at any age, but commonly shows up in adolescence or at the onset of puberty. The condition made come and go over time, and the location the person picks at may change, but the disorder is generally chronic.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) signs and symptoms of dermatillomania include:

  • Skin picking that results in visible lesions, skin damage, scars and possibly disfigurement
  • The person has made repeated, unsuccessful attempts to stop picking at their skin
  • The symptoms cause clinically significant distress or impairment
  • The symptoms are not caused by a medical or dermatologic condition or by a substance (example: opiate withdrawal)
  • The signs and symptoms are not better explained by another psychiatric disorder

Picking at the skin can cause anxiety, depression and embarrassment in those who have dermatillomania. They may attempt to cover their skin lesions with makeup or clothing and may avoid situations in which their condition may be discovered. This can lead to isolation and emotional distress, which can increase the risk of having a mood or anxiety disorder in addition to their dermatillomania. Another complication can be the need for medical care because it isn’t uncommon for the person to get a skin infection, open wound, or scars from picking too much.

Treatment for Skin Picking Disorder

It is thought that fewer than one in five people will seek treatment for excoriation disorder, however Cognitive Behavioral Therapy (CBT) is very helpful for those who do. CBT helps patients identify the negative or inaccurate thoughts, feelings and behaviors that have become problematic and teaches them how to challenge and change their reaction to them.

While the main therapy for dermatillomania is behavioral therapy, medication is sometimes used to reduce the feelings that lead to compulsive skin picking. Although psychiatric medications have limited success, there are some people who benefit from temporary use of them, particularly if they have a concurrent condition, such as anxiety or depression. Additionally, some skin medications can help the underlying condition (such as acne) that causes the individual to pick at their skin.

As a family member, it can be difficult to be supportive of a person with dermatillomania or other BFRBs. The behavior can strain relationships with friends and family. Remember to communicate with patience and empathy and remain calm when talking to the person. If you feel overwhelmed, join a support group or explore the resources in self-help groups or in books on the subject.

Get Help for Dermatillomania

For more information about how a child psychologist at the Children’s Center can help your child overcome skin picking, contact the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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