All Posts Tagged: The Children’s Center for Psychiatry

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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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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Social Skills Training can help children and young adults connect with other.

Toxic Stress and Child Development

Stress surrounds us on a daily basis. From traffic delays to work projects, worries about finances or health, and news reports of world events, the demands of our everyday lives produce both positive and negative stress. Stressors (which are the things that cause your stress) can be physical, emotional, theoretical, or environmental. Even positive events like weddings and job promotions cause stress.

Whether negative or positive, one thing is certain – stress raises the body’s anxiety levels. When we’re under stress, the “fight or flight” response kicks in. It raises your heart rate and your blood pressure. It sometimes causes you to lose sleep or feel like you can’t breathe. While this response generally subsides after the stressor is removed, a prolonged or permanent stress response can develop in someone who is under frequent or constant stress. This is called toxic stress and it can affect children just the same as adults.

Effects of Stress on Kids

The incidence of diabetes, obesity, heart problems, cancer and other diseases increases when a child lives with toxic stress. Additionally, a child’s chances of smoking, depression, substance abuse and dependence, teen pregnancy and/or sexually transmitted disease, suicide and domestic violence escalates. So does their tendency to be more violent or to become a victim of violence.

Studies done by the Centers for Disease Control and Prevention (CDC) show that when a child is subjected to frequent or continual stress from thing like neglect, abuse, dysfunctional families or domestic abuse – and they lack adequate support from adults – their brain architecture is actually altered and their organ systems become weakened. As a result, kids who live with stress risk lifelong social and health problems.

Of the 17,000 people participating in the CDC study, two thirds reported an Adverse Childhood Experiences (ACE) score of 1 or higher. Of these, 87% had more than one ACE. By measuring and scoring ten types of trauma ranging from neglect or bullying to childhood sexual abuse and even divorce, researchers could assess the chronic disease risk for the study’s mostly white, middle class participants. Their results showed that the problem of toxic stress isn’t limited to children of certain ethnic groups or those who face poverty – children from all walks of life can have high ACE scores which will affect their entire lives.

If you would like to find out your ACE score and what it might mean for you, go here.

Signs of stress

Children who are exposed to toxic stress exhibit:

  • Poorly developed executive functioning skills
  • Lack of self-reflection and self-regulation
  • Reduced impulse control
  • Maladaptive coping skills
  • Poor stress management

Research on children who face continued toxic stress shows they are more likely to have:

  • Trouble learning in school
  • Difficulty trusting adults, forming healthy relationships and will have an increased chance of divorce as an adult
  • Higher incidence of unhealthy behaviors such as engaging in sexual experimentation and unsafe sexual practices, participating in high-risk sports, smoking, substance abuse and alcohol abuse
  • Higher incidence of depressive disorders, post-traumatic stress disorder (PTSD), behavioral disorders, and even psychosis
  • Poor health outcomes such as heart disease, obesity, diabetes, cancer, and have a higher suicide risk

Help for Toxic Stress

The key to preventing and reducing toxic stress in kids is awareness. Now that we know about the effects of ACEs, many states have conducted their own research. Some cities formed task forces, while others are working with pediatricians, schools, daycare centers and the justice system to set up screening programs that can turn lives around.

Protecting children from toxic stress involves a multi-faceted approach that targets both the caretaker and the child in order to strengthen family stability. Treatment includes intervention and implementation of methods that reduce stressors and reinforce the child or caregiver’s response to stress.

As more programs are formed, researchers have found that children can benefit even when the solutions are solely focused on their caregiver and aren’t aimed at the child. This is most likely because the caregiver’s altered interaction with the child makes the child feel safer. Parenting classes, family-based programs, access to social resources for parents, peer support and telephone support are beneficial. Cognitive behavioral therapy and relaxation methods like yoga and mindfulness are also helpful. Additionally, community-based programs like Head Start have been shown to be effective.

Do you have Questions?

For more information about toxic stress and its effects on child development, 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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Tips to Improve Your Child’s Executive Functioning Skills

The first time you hear the term “executive functioning”, you may think it refers to the leaders of a worldwide conglomerate, but nothing could be further from the truth. Executive functioning is actually a life skill we learn in childhood. It forms the basis of the actions we perform every day. From taking a bath and getting dressed, to getting ready for school or doing homework, executive functioning helps us plan things, organize our lives, control our emotions, and learn from our mistakes. It lets us evaluate information, come up with a solution, and carry it out.

Some kids learn executive functioning with ease, but for others, it can be difficult to choose appropriate actions, develop time-management skills, or anticipate the consequences of their actions. Kids who have poor executive functioning often need constant guidance for simple tasks, such as packing their backpacks for school. They may forget to turn in the homework they worked on so diligently the evening before or have difficulty making decisions because they get bogged down in the mental strain of weighing pros and cons. Fortunately, there are ways to help these children acquire organizational skills. Apps, like our Giant Leap app, are great learning tools for, among other things, teaching behavior strategies and generating lists to help kids start and complete tasks.

Learning Tools for Executive Functioning

Executive functioning learning tools help children overcome struggles with organization and follow-through.

Some keys to building executive functioning abilities are:

  • Checklists – Checklists make tasks easier for a child with executive dysfunction. Often, these kids don’t follow through because they can’t visualize the steps required to complete a task, but a checklist lays it all out in front of them. You can make a checklist for anything. If your child consistently misses the bus, for example, you can make a checklist of the things he/she needs to do before leaving the house. This eliminates their need to ponder what they’ve just done and trying to decide what they must do next. Instead, when they follow a checklist, they know they have to move from brushing their teeth to putting on their clothes, then onto putting on their jacket, and picking up their back pack. Laying things out the night before can also help eliminate morning drama.
  • Planners – Teach your child to write things down. No one can remember everything, and noting tasks in a planner or on a checklist ensures they won’t forget to do it.
  • Rationale – Remember when your child was about two years old and constantly asked, “Why?” In the same way, children who have trouble with executive functioning do better when they understand the reason behind what they need to do. Without a rationale, they may feel like planning or following a chart is a waste of time.
  • Figure out how your child learns best. Are they visual learners? Then charts and apps are great for them. Are they tactile learners? Counting necessary steps on their fingers might be better for these types. Do they learn more easily when they hear something? Try laying out the steps for something like a homework routine in story form or in a song.
  • Make it a routine – this is especially good for older children. Set a time to start the task and a time limit in which to finish it. Practice breaking down tasks with your child so they develop an awareness of how long something takes, which allows them to better plan their time. For instance, a child might need thirty minutes to write a book report, but not think about the fact they need three days to read the book. Learning to think through each step of a task also builds organization skills and helps the child anticipate that Step A comes before Step B, etc. In the book report example, a child might think about the task of selecting a book and the task of writing the report. If they have executive dysfunction, they may completely forget they have to read the book or turn in the report.

Apps Turn Daily Routines into Fun Activities

For children who can’t read (and even those who can), the colorful images on an app can make all the difference. Eye-catching charts and graphics give the child something to focus on. They also make it easier for these kids to understand the bigger picture – for example, by showing when a task needs to be completed or by listing action steps that need to be taken.

Once parents set up their child’s chart, these visual aids help the child see the tasks they need to complete. Additionally, engaging images capture kid’s attention, making it more likely that these visual reminders will instill the routine in the child’s mind.

Some apps, like our Giant Leap app, are customizable. This flexibility allows parents to generate personalized charts with the specific behaviors their child needs to learn. Giant Leap gives children executive functioning issues an easy way to stay organized and can support their unique needs. Additionally, Giant Leap permits parents to update their child’s charts in real time within the app and allows them to print each chart out for daily or weekly use.

Apps encourage consistency and make daily routines easier to set and follow. When a child completes the tasks on their chart, they not only begin to acquire executive functions, they also gain self-confidence. Successfully learning organization skills translates to self-reliant, responsible in kids and gives them the tools they need for future success.

Learn More about Giant Leap and Executive Functioning

For information about how our Giant Leap app can help your child improve their executive functioning skills, 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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SMART Goals Method Teaches Kids About Goal Setting

SMART Goals Method Teaches Kids About Goal Setting

We’ve gotten through the first month of a new year and many of us have already abandoned our New Year’s resolutions. As adults, we have good intentions about goal setting for things we want to work on or change throughout the year. Stating a goal is easy, however, while actually seeing it through can be much tougher. Goal setting and accomplishing objectives can be even more challenging for kids because they have a much harder time envisioning the future outcome, which makes it difficult for them to keep their eye on the prize. But, what if there was a way to help children learn how to set specific goals and teach them how to attain them? This is where working on SMART goals can help.

SMART is an acronym that stands for:

  • Specific
  • Measurable
  • Attainable, Achievable
  • Realistic and Relevant
  • Time-Limited and Trackable

For kids (and some parents), goal setting through the SMART goals method teaches an important life skill that simplifies an ambition and breaks it down into actionable steps, making it more likely to be achieved. The great thing about SMART goals is that this method can be used for any type of goal setting, ranging from something like aiming to read a certain amount of books as a child, to more difficult tasks like paying off debt as an adult – and everything in between.

SMART Goals Examples

A goal is an outcome that will make a difference when you achieve it. Measurable goals can’t be too ambitious that they’re out of reach, but they also shouldn’t be so simple that it’s not challenging to attain it. The goal should be realistic, but should require attention and effort to achieve it. That’s one of the reasons goals need to be trackable and time-limited, and why measurable action steps need to be step up. That way, you can keep track of progress and make adjustments to the steps as necessary.

Breaking down each step, here are some SMART goals examples:

  • Specific – Don’t say, “I want to get better grades in school.” Do frame the desire for better grades in the form of something such as, “I will get all B’s and higher on my report card.” Stating the specific goal in concrete terms helps it become measurable.
  • Measurable – How will you know when you’ve achieved your goal? In the case of getting better grades, you’ll know if you’ve succeeded when the next grading period ends and you can see the results of your efforts.
  • Attainable (Achievable) – It’s probably unlikely that a student could go from mid-level grades to making straight A’s in one grading period, so they would want to set a goal they know they have a good chance of hitting. Don’t say, “I will make all straight A’s on my next report card.” Instead, do say, “I will raise all my grades by one letter by the end of the next grading period.
  • Realistic and Relevant – Again, it’s going to be tough (and, therefore, self-defeating) to try to go from C-grades to straight A’s all at once. Raising grades by one level is realistic, however, setting this goal won’t matter unless it’s relevant to the child. Is the goal something they are excited about attaining?
  • Time-limited and Trackable – Using the goal of raising grades on a report card, a time-limited goal would be to set the goal of achieving the result by the end of the next grading period or maybe the end of the school year. This goal is trackable if the child (and you) have a way of keeping tabs on their grades. Talk to the teachers to see if they’d be willing to give the child progress reports to help keep them motivated. Another way to track results is by keeping a chart of grades from papers, tests, and projects, so your child can get an idea of their progress. Keep the age of the child in mind – preschoolers have much shorter attention span. Their goals need to have a shorter time period.

The biggest barrier to attaining goals is that they are often too lofty and hard to achieve. By using the SMART goals method of goal setting, you can break your goals down into detailed, manageable chunks and set up action plans and benchmarks that will keep you focused on the end result.

Our Giant Leap App Helps with SMART Goals

Our Giant Leap app contains customizable charts that give your child a visual reminder of their SMART goals. Eye-catching charts and graphics give kids something to focus on and makes it easier for them to understand the bigger picture – for example, by listing actions that need to be taken. In addition, the app’s colorful images engage and hold children’s attention, which is particularly important for young children who can’t read. For added convenience, Giant Leap lets parents update their child’s charts in real time within the app and allows them print charts out for daily or weekly use, if needed.

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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Is Medical Marijuana Use Linked to an Increase Anxiety and Depression?

Is Medical Marijuana Use Linked to an Increase Anxiety and Depression?

As of this blog post, 30 states, the District of Columbia, Guam and Puerto Rico have all approved the broad use of medical marijuana. In addition, several other states allow limited medical use and 8 states (plus the District of Columbia) allow recreational use of pot. Even though the use of marijuana is becoming more acceptable, the Drug Enforcement Administration (DEA) still classifies pot and weed (marijuana) as a Schedule I substance, meaning it is likely to be abused and it completely lacks medical value. Because of this classification, there hasn’t been much research into the efficacy of the drug for medical conditions. In particular, we lack long-term studies that would tell us whether it is safe and/or effective when used over a long period of time.

What we do know is that, in our clinical practice – and in those of colleagues in other practices – we have seen an increase in the number of incidents of anxiety, depression, panic attacks and even psychotic reactions since marijuana use has become more mainstream.

Did you know that:

  • THC, the primary chemical in marijuana, is believed to stimulate areas of the brain responsible for feelings of fear.
  • A 2015 study found that university-aged young adults are more likely to have a higher risk of developing depression from heavy marijuana use.
  • Numerous research studies show that marijuana is an addictive substance. The more you use it, the more you need to use in order to get the same “high.”
  • Frequent or heavy use in adolescence can be a predictor of depression or anxiety later on in life – especially for girls.
  • According to available scientific literature, people who use weed have higher levels of depression and depressive symptoms than those who do not use cannabis.
  • Scientific evidence suggests cannabis use can trigger the onset of schizophrenia and other psychoses in those already at risk of developing it.
  • Even if using cannabis seems to alleviate symptoms in the short-term for some users, it can lead to delay in getting appropriate treatment.

Recreational Marijuana vs. Medical Marijuana

Whether it’s used recreationally or medicinally, both forms of pot are the same product. The medical version contains cannabinoids just like recreational marijuana. Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the main chemicals found in the medical form.

Although medical marijuana is used for many conditions (among them: multiple sclerosis (MS), seizure disorders, cancer and glaucoma), its effectiveness hasn’t been proven. “The greatest amount of evidence for the therapeutic effects of cannabis relate to its ability to reduce chronic pain, nausea and vomiting due to chemotherapy, and spasticity[tight or stiff muscles] from MS,” says Marcel Bonn-Miller, PhD, a substance abuse specialist at the University of Pennsylvania Perelman School of Medicine.

Mental Illness and Psychoactive Substances

As we’ve said, right now there aren’t many studies out there on the relationship between marijuana use and mental illnesses, such as anxiety, depression and bipolar disorder. However, there was a study done in 2017 which examined marijuana use in conjunction with the depression and anxiety symptoms in 307 psychiatry outpatients who had depression (Bahorik et al., 2017). The results of this study showed that “marijuana use worsened depression and anxiety symptoms; marijuana use led to poorer mental health functioning.” In addition, the research found that medical marijuana was associated with inferior physical health functioning.

A big part of the problem with using marijuana either medically or recreationally is that there is no way to regulate the amount of THC you’re getting in the product, because the Food and Drug Administration (FDA) doesn’t oversee it. This means that both the ingredients and the strength of them can vary quite a lot. “We did a study last year [in 2016] in which we purchased labeled edible products, like brownies and lollipops, in California and Washington. Then we sent them to the lab,” Bonn-Miller says. “Few of the products contained anywhere near what they said they did. That’s a problem.”

Another area of concern is that, as we know from regulated psychiatric medications, one dose may affect you differently than it affects your sibling or a friend. People are unique – each person’s reaction to a medication will vary, which is why psychiatric medications are monitored by the prescribing doctor so that the dosage can be adjusted for your specific needs.

Be Careful with Marijuana Use

In summary, if you choose to use marijuana either recreationally or medically, be careful. Talk to the physician who authorized it, or speak with a mental health professional if you find yourself experiencing the symptoms of depression or anxiety, or if you have panic attacks that begin or worsen while you are using marijuana. Additionally, be sure your doctor knows your psychiatric history before they authorize medical marijuana for you, especially if you have been diagnosed with anxiety, depression, experience panic attacks or have bipolar disorder or psychosis.

Do You Have Questions?

We can answer your questions about marijuana use and how it affects anxiety, depression, or other conditions. The mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are here to help. For more information, contact us or call us today at 561-496-1094.

Reference:  Bahorik, Amber L.; Leibowitz, Amy; Sterling, Stacy A.; Travis, Adam; Weisner, Constance; Satre, Derek D. (2017). Patterns of marijuana use among psychiatry patients with depression and its impact on recovery. Journal of Affective Disorders, 213, 168-171).

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