All Posts Tagged: The Children’s Center for Psychiatry

child wearing face mask in empty classroom

Separation Anxiety: Going Back To School During The Pandemic

As the 2020 – 2021 school year begins, children who normally go through separation anxiety may be even more anxious about going back into the classroom during the pandemic. After all, the beginning of a new school year can be threatening during normal times, but returning into a situation where the coronavirus is likely to be present has raised anxiety levels in many kids and parents.

For parents who live in school districts that offer a choice between virtual or in-person learning, how do you make a decision about which is best for your child? Being safe at home means that kids who have special needs or who learn better in person will lose out on many learning opportunities. Children who are fearful of being in a classroom, however, will struggle more if they have to go back into the school.

All this stress can bring up school refusal in kids, not to mention heightened school anxiety in parents.

Separation Anxiety And Classroom Learning During Covid-19

Sometimes separation anxiety and school refusal begin for a child who has gone through an illness or an emotional trauma, such as moving from one neighborhood to another. In the case of the pandemic, however, illness and death is all we hear about on the news, so a child who may already be inclined to separation anxiety will only worry more.

Parents hardly fare better – in many cases they are having to choose whether to stay home with kids who will be learning virtually (thus, risking their jobs) or sending their child into a possibly contagious environment. Either way, the decision is highly distressing.

Separation Anxiety Definition

If an anxious child shows excessive concern about a separation from a parent or caregiver, or from their home, they might have developed a separation anxiety disorder. In addition, separation anxiety may be present if they show fear about the situation that is inappropriate to their age or stage of development.

Parents who are extreme worriers may show similar symptoms, which could indicate their own anxiety disorder. This is particularly true if they have been overly anxious about the safety of their child during the pandemic.

Emotional and Physical Symptoms Of Separation Anxiety

Children (and parents) who have separation anxiety may show the following symptoms including:

  • Constantly imagining worst-case scenarios
  • Difficulty going to sleep, fear of the dark, and/or nightmares
  • Avoiding activities that result in separation from the parent or child
  • Excessive worry about potential harm or illness happening to them
  • Children may be clingy, may fear being alone in a room, or may need to see a parent at all times
  • Adults may feel anxious about the child’s safety if they aren’t within sight
  • Trembling
  • Headaches
  • Stomach aches and/or nausea
  • Vomiting
  • Needing frequent trips to the toilet

If a child or a parent exhibits three or more of these symptoms for more than four weeks, they are likely suffering from a separation anxiety disorder.

Separation Anxiety Treatment

While you can’t control the things that happen around you, you can learn how to control your responses and actions. When treating someone for separation anxiety, therapists try to help them learn to identify and change their anxious thoughts. Then, they teach coping methods to help the person react less fearfully to the situations that trigger their anxiety.

Remember – it is natural to worry, but we can learn to keep our fears from spiraling out of control by “naming” and identifying our thoughts. For instance, if  your child starts to imagine getting sick in school, and then pictures getting so sick they end up in the hospital, have them practice labeling these thoughts as something less threatening (ie:”That’s just a Bugs Bunny thought hopping around!”). This can often help remind the child that they are just thoughts and we are in charge of how we react to them.

Sometimes, however, self talk still can’t calm the fear and an anxiety disorder can begin. If you suspect that your child is developing an anxiety disorder, it’s important to seek treatment as soon as possible. The longer the anxiety continues, the harder it can be to treat.

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.

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Psychological evaluations

Psychological Evalutations

The Children’s Center for Psychiatry, Psychology and Related Services is pleased to again offer psychological evaluations to the community. To best serve the need of our clients we will be offering both in person appointments or remote video conferencing to get a better understanding of your child, their strengths and weaknesses, and what accommodations and interventions they would benefit from.

We are able provide our typical in person evaluations with procedures and materials to ensure safety during COVID-19 concerns. Additionally, while the evaluation process is typically a hands-on experience and the assessment tools require face-to-face interactions, we have also made adaptations to provide remote evaluations via video appointments.

As part of the evaluations we are conducting now, we will take the following steps:

  • Meet with parents via video conferencing and collect information so we can learn about your child’s emotional, behavioral, and social functioning.
  • Meet with the child via video conferencing to assess if they would be a good fit for a remote evaluation. If so, we will proceed with evaluating cognitive and academic abilities and social and emotional functioning via video conferencing. We will also be able to assess aspects of attention, impulsivity, language, and memory. We may decide that additional in person testing will be helpful.
  • Collect information from your child’s teacher through teacher rating forms and interviews.
  • Collect information from your child’s medical and school records if needed.

This information will help us gain a better understanding of your child and their unique needs and will allow us to provide consultation and recommendations to support your child both at the home and at school environments.

Additionally, we can provide psychological evaluations to help with diagnosis of mental health concerns and to assist with treatment planning.

Schedule a psychological evaluation for your child.

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.

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COVID paradox

The COVID Paradox

Never before in modern memory has the human race been faced with such a stressful and anxiety provoking foe. The novel coronavirus or COVI-19 has resulted in untold emotional unrest and fear among all nations and peoples of our world. There has been a lot of talk about the “invisible enemy,” an RNA based complex protein that looks like a World War 2 anti-ship mine with spikes sticking out of its surface. We are informed daily by the media that young and old victims of this virus are ending up on ventilators for weeks at a time if they survive. To “flatten the curve” and avoid overwhelming our hospitals we have had to become socially isolated, settle in place in our residences, wear masks when going out and remembering to wash our hands and not touch our faces. And after three months of dealing with this enemy of grown ups we are now being informed that children who we believed were not at risk of being made seriously ill have suffered as cases of a strange multi system inflammatory syndrome much like Kawasaki disease began to appear at hospitals.

The reality of this plague is bad enough to fathom by any rational person. The facts we are presented with certainly evoke fear and apprehension. Our frontline healthcare providers who are by their profession somewhat desensitized to run-of-the-mill suffering as they treat patients with terminal illness, heart attacks, metastatic cancer or debilitating strokes, find themselves traumatized by the COVID crisis.

So what is generating this degree of emotional suffering? Much of it comes from the unseen enemy, this virus that is only visible under special microscopes. Some of it comes from the fact that its genetic structure is novel. No human being had been exposed to it prior to its appearance in Wuhan so our immune systems had no defense against its onslaught. It is extraordinarily infectious so that an infected person will infect several people in close proximity over time.

What is the paradox that I am referring to? Actually, there is more than one paradox. The first one involves the media explosion that began last century and has exponentially continued this century. We appreciate all the benefits from being plugged in 24/7 to social media, internet messaging and an abundance of television news all day long. The digital revolution that amazed us has also proved to be harmful to our emotional well being. Multimedia exposure during the COVID pandemic has been like watching a horror movie that never ends! What we valued and embraced has turned out to be a traumatizing process. If you check the Centers for Disease Control website for data on the influenza outbreak for the 2018-2019 season you will find that 35.5 million Americans came down with the flu, 490,000 hospitalizations resulted, and there were 34,200 deaths. Imagine if the media tracked the annual flu season like they have tracked the COVID pandemic. Every flu season would be emotionally traumatizing. We certainly don’t go into lockdown every year for the flu nor do we social distance. We do have a flu shot available, but data on its effectiveness suggests a 45% effectiveness this past season. Our advantage with influenza is that over time, all of us have had some level of exposure to this family of viruses imparting a degree of “herd immunity.”

This brings us to the core paradox. If we stay locked down and isolated indefinitely there will be no herd immunity developing. The concept of herd immunity means that if enough of our population is exposed and develops immunity to this virus, ongoing spread becomes very difficult. For example, smallpox, chicken pox, measles and mumps had been the scourge of society until the administration of vaccines essentially created a herd immunity.

We will eventually have an effective vaccine for COVID-19 but it will be some time before we will be able to provide mass inoculation. If there had been no COVID-19 social isolation our healthcare system would be over run, resulting in a tsunami of fatalities.

So the course that is being taken is to gradually open up our lockdown while we carefully prepare for future waves of illness. Be reassured that there will come a day in the not too distant future that this horrible virus will be no greater a threat than the annual flu. That time will come.

Connect With A Child Psychologist At Our Children’s Center

If your child is experiencing anxiety related to the COVID-19 pandemic, our child psychologists are available for online services. 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.

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Coping With COVID-19

The virus pandemic has certainly had an impact on all of us. Not being able to meet with my patients in person has required a major clinical adjustment. Thankfully, telemedicine has provided me with the ability to provide necessary ongoing treatment. But I also know firsthand how difficult and taxing social isolation and sheltering in place can be.

What has made this viral illness so stressful? After all, we have been dealing with annual episodes of influenza for decades. We also successfully made it through the fears of the bird flu, SARS, and swine flu. What makes Covid 19 so special and so scary? Covid 19 is called a novel virus because it is a protein that is totally new to the world’s human population’s immune systems. Our immune systems therefore do not have the capacity to adequately fight off this infection. The elderly and those with chronic illnesses are especially at risk. But 20 to 65 year olds are not immune from infection and risk severe illness if they are not cautious and follow CDC guidelines.

We can all agree that there are reasons to be fearful of this unique virus. We would all agree that sheltering in place and social isolation plays a role in our unease and insecurity. The inability to see loved ones and friends certainly takes a toll. Job loss and the subsequent financial stressors contributes as well. Lack of definitive treatment or a protective vaccine adds to our worries. But the level of emotional unrest seems to be much greater than what these issues would suggest. So what accounts for our level of apprehension?

It is my belief that our emotional upset and fearfulness is being fueled by an incessant level of media exposure, a 24/7 bombardment of our senses by vivid and at times sensationalistic accounts of the impact of this illness on our society. The negativity is inescapable. The drama can be horrifying. I do believe that we are being psychologically traumatized by the effects of this multi-sensory media explosion. Modern theories of post traumatic stress disorder have now implicated the impact of day to day low level traumatic experiences. We certainly deserve to be kept up to date, but non-stop communication of human suffering at this level can be seriously problematic.

So what can we do to minimize the stressors of these times? The answers are rather straight forward and simple. When the world around you seems out of control, frightening and foreign it is important to pay attention to our own personal world and life space. You may not be able to change what is outside of you but you certainly can have the ability to influence your own world. These are some basic guidelines to follow:

  1. Add consistency, structure and predictability to your day to day life.
  2. Go to bed at the same time every night and awaken at the same time the next day.
  3. Schedule exercise, studying, work (if you are lucky enough to still be working), meals, fun etc. at set times.
  4. Get outside while following CDC guidelines on a regular basis, even if it means sitting on a balcony or patio for extended periods.
  5. Do not allow yourself to isolate. Maintain social contacts through phone calls, video chats, emails, etc. Socialize with a friend or family member while maintaining the appropriate safe distance.
  6. Limit your news media exposure. Get the data you need to be adequately informed but don’t give in to the tendency to be a news voyeur. Sensationalistic news coverage can be addicting. Be careful and avoid over exposure.
  7. Attend to your basic activities of daily living that include your appearance and hygiene, maintaining healthy nutrition and caring for your living space.
  8. And most importantly, recognize that this period of difficulty and sacrifice will come to an end.

There will be life after Coronavirus. At some point in the near future, this virus will be treated no differently than the annual influenza virus. The same way that pharmaceutical companies formulate the year’s flu vaccine by taking into account the types of flu viruses prevalent that year, it will also include the coronavirus as part of the vaccine recipe.

The real challenge for the future will consist of what we can learn from this experience. How can we be better prepared? How can we improve our healthcare system and its inequities? How can we maintain the improvement in our environment that has resulted from reduced pollution, crowding overuse of natural resources? How can we return to person to person human contact and minimize communication through digital media only? How can the media learn to balance coverage with more hope and support? I wish that I had the answers. We shall have to wait and see.

For more information or to schedule an appointment call us at (561) 223-6568 or contact us here.

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Telehealth

A Message About Telehealth Amidst COVID-19

We hope that you, your children and families are doing well in the midst of this unprecedented time. After carefully considering the CDC guidelines, we at The Children’s Center have decided that we will no longer be conducting therapy in our office at this time.

In good news, we have the capability to conduct appointments either over the phone or via Telehealth. We are happy to keep all appointments during this time. If you already have a scheduled appointment but you would prefer to postpone your to a later date or an alternate time, we are happy to do that as well.

We greatly appreciate your understanding during this difficult time. Please do not hesitate to contact us with any questions or to schedule an appointment at (561) 223-6568.

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child crying

Hurricane Anxiety

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.

Symptoms Of 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:

  • Trembling
  • Having headaches
  • Saying that they feel dizzy or lightheaded
  • Stomach aches, vomiting, nausea
  • Experiencing nightmares, having trouble sleeping, or being afraid of the dark

Emotional symptoms can show up in the form of:

  • Being clingy or wanting to keep you or another caregiver in sight at all times
  • Crying or being overly whiny
  • Talking incessantly about what they experienced in a past storm
  • Being jumpy and on edge
  • Getting physically ill or acting distressed if they are being separated from their loved ones for any reason
  • Expressing fears about them or someone they love possible being harmed because of the storm
  • Being afraid to be in a room by themselves
  • Refusing to participate or avoiding taking part in activities that will keep them away from their parents or caregivers, even briefly

How To Help A Child Who Has Hurricane Anxiety

If your child shows a heightened level of concern or fear about storms, our child psychologist recommends that you:

  • Talk to your child about their fears and let them know that it is okay to be worried.
  • Talk positively about the preparations you will be making to keep them safe and where you all will go if you have to evacuate. If the child knows they will be in a safe place, it can help to reduce their anxiety.
  • Assist them in soothing their fears by letting them sleep with a favored stuffed animal or allowing them to keep a nightlight or hallway light on at night during a storm.
  • Help your child choose something to take with them just in case you do have to go to an evacuation shelter. For example, they can pack a backpack with toys, books and games, then keep it nearby so they feel more prepared for the storm.
  • Remind your child that hurricanes can and do routinely change course. Many times, the storm won’t impact your area, despite the warnings. We saw this when Hurricane Dorian skirted the shore of Florida instead of hitting the state directly as forecasters first thought would happen.
  • This should go without saying, but do not tell your child about any bad experiences you might have had during a hurricane or bad storm! There is no need to add to their fears.

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.

Talk With A Child Psychologist At Our Children’s Center

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.

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Counseling Adults with Autism

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.

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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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child looking at computer screens

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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