Showing posts with label Gariane Phillips Gunter MD. Show all posts
Showing posts with label Gariane Phillips Gunter MD. Show all posts

Monday, January 24, 2011

When Divorce Happens

By Gariane Gunter, M.D. 



A recent study was published in Health Day that discusses the mental health of children of divorced parents. While I am not in the position to support or deny the findings, the topic of divorce when children are involved is often a difficult one. Every family is different, but the following are some general tips for divorcing parents that can be helpful.



1. Attempt to keep a positive attitude during the point of separation. This is often a very trying time for the family. Stick to a routine and embrace the activities your children have always enjoyed.



2. Don’t forget to nurture yourself. Going for a walk, having coffee with a friend, or reading a good book are ways to rest and regain energy. It’s normal to feel exhausted when separating; and possibly for many months to follow.


3. Encourage kids to openly discuss their feelings, positive or negative, about what's happening.


It's important for divorcing, as well as already divorced parents, to sit down with their kids and encourage them to say what they're thinking and feeling. But you'll need to keep this separate from your own feelings. Most often, children experience a sense of loss of family and may blame you, the other parent, or both of you for what is going on in their lives. You really need to be prepared to answer questions your kids might raise. They might feel guilty and imagine that they "caused" the problem. Kids and teenagers may feel angry or frightened, or worried about their future. Counselors can assist with this difficult conversation and provide a safe environment if safety is a concern.


4. Although very tempting, try not to speak negatively about your former spouse when your children are present. This issue, often called “parental alienation” can be a problem. Doing things such as putting your child in the middle, saying negative things about the other parent, and using your child as a messenger puts your child in a “no win” situation and creates lifelong relationship issues for all involved. The reasons include the following:



• The comments may confuse and frighten children.

• Many of your concerns about your former spouse are difficult for you to express. It is very important that you keep these concerns to yourself. Children just do not have the emotional maturity to withstand information/situations that adults find stressful.

• Your child’s identity and self concept is based on parental behavior. Even if it is next to impossible to say anything good about your former spouse, try to do so. If this is impossible then don’t say anything.

• Children love to eavesdrop. Telephone conversations are their favorite snooping ground. Make all effort to not discuss your divorce-related difficulties on the telephone when your children are around.



5. During the crisis point of separation try to remember that your children need you both parents more than ever. This is not a time to deny access unless a professional deems it necessary to do so for safety related reasons.


6. It is important to accept the fact that a separation involves feelings of loss for children. Try not to panic if the following behaviors occur during the first few months of separation:


• Sleep difficulties like disrupted sleep, an inability to sleep, exhaustion etc.


• Social isolation


• Anger, intolerance, grumpiness


• Avoidance of divorce related conversations


• Obsessing about the divorce


• Appetite changes


• Feelings of worthlessness


• Tears and feelings of overwhelming sadness


7. Although many children do not ask to see a counselor when their parents separate, they usually find counseling very helpful.

8. It is important to acknowledge that children are very loyal and protective of their parents. If children are placed in loyalty binds they can experience anxiety. Try to alleviate their anxiety if they decided to “pick a side.” This is a coping skill which teens in particular use. If your child engages in “picking a side” try not to feel rejected.



9. Think of yourself as a survivor not a victim. And be patient. Everyone takes different times to heal.

Friday, November 5, 2010

National Family Caregivers Month

By Gariane Gunter, M.D.



November is National Family Caregivers Month and what a worthy group to stop and recognize. Those who are caregivers for family members or friends with mental illnesses need support and encouragement just as those caring for loved ones with other illnesses. There are many groups and resources available across the nation that are available to help. I would like to tell you about one of them.





The National Alliance on Mental Illness is a grassroots organization that was started in 1979. I have had the wonderful opportunity to work with them in my area and have seen firsthand the difference they make in the lives of those suffering from mental illnesses as well as their families. One special program they offer for family members is called Family-to-Family. The NAMI Family-to-Family Education Program is a free 12-week course for family caregivers of individuals with severe brain disorders (mental illnesses). NAMI recognizes that family members of people with serious mental illnesses need information and support to cope with the considerable stresses they experience.



The Family to Family Education Program is a structured, peer-led, 12-week information and support self-help class for such individuals. Research shows reduced subjective burden and increased empowerment among graduates. Family-to-Family classes are offered in hundreds of communities across the country. You can find more information on this program as well as many other resources available in your area by visiting NAMI online at www.nami.org. There you can find a support group, connect online in NAMI's discussion groups, contact your state or local NAMI and more. Caregivers please take the time to take care of you this month.

Thursday, October 14, 2010

Working with Schools When your Child has Problems

By Gariane Gunter, M.D.




Well, we have made it through the first months of a new school year! However, for some students the start of a new year has been difficult. I have received many calls and heard numerous concerns from parents who are wondering how they can work with their child’s school to ensure a success. Below is a list of the Top Ten Tips for Working with Schools that was shared with me by a Lead School Psychologist in my area. I hope you have a great year!





Top Ten Tips for Working with Schools




  1. Let the school know up front if you have concerns

  2. It helps to be visible in the school but do not intrude on the learning

  3. Every school is a little different in its approach



  4. There are lots of different ways of working with student problems in schools. Not just one of them is right. 

  5. If you want to talk to a classroom teacher, ask to make an appointment with them. When teachers are with students, their first responsibility is to teach and supervise them.

  6. School folks got into education for the joy of working with students.

  7. School Psychologists and Special Teachers are there to study individual students. Help them by giving your specific observations. Your observations matter.

  8. Lots of teachers and other school folks use e-mail, but remember that teachers check e-mail when they have planning or breaks.

  9. If you have made a request and you haven’t received a response, don’t wait too long before asking about it. Sometimes requests do get lost.

  10. Schools can be fun places to be; it is where all children gather to learn. Enjoy your time there too!





Reference: Shirley A. Vickery, PhD




Wednesday, October 6, 2010

It's Not Your Fault

Healthy Minds. Healthy Lives. blogger Gariane Phillips Gunter, MD, talks about how individuals with mental illnesses cannot be blamed for mental illness and how to get help for someone struggling with mental health issues.



Tuesday, September 14, 2010

Could My Child Be Depressed?

By Gariane Phillips Gunter, M.D




Most of us know someone who has suffered from depression at some point in their lives. However, did you know that depression is not just something that affects adults? Depression is a serious illness that can affect anyone, at any age, including children and adolescents. When a youth is depressed nearly every part of the young person's life is impacted as well as the lives of their family. If left untreated, pediatric depression can lead to problems in school and with friends, to accidents, to substance abuse, and, in its most extreme cases, to suicide. It can disrupt relationships among family members and friends, harm school performance and limit other educational opportunities. It can lead to other health problems through its effects on eating, sleeping, and physical activity. Because it has so many consequences, it is important that depression is recognized and treated successfully. When it is, most children can get back on track with their lives.



Children suffering from depression may not have the same symptoms as adults with the same diagnosis. While adults may appear down or tearful to those around them, children may appear more irritable or complain about physical symptoms such as stomach aches or headaches. Below are differences in symptoms that may be seen in adults versus children.









Youth living with depression need a thorough evaluation and comprehensive treatment from an appropriately trained professional. Each treatment must be tailored to the individual child or adolescent. Cognitive-behavioral therapy (CBT), a form of talk therapy, has been demonstrated to significantly contribute to recovery. In addition some antidepressant medications, when monitored, can be an effective part of the treatment for pediatric depression. If you think that someone you know may be suffering from depression, please encourage them to see their doctor.




The American Academy of Child and Adolescent Psychiatry and the American Psychiatric Association released a revised and expanded version of The Use of Medication in Treating Childhood and Adolescent Depression: Information for Patients and Families, part of the ParentsMedGuide series of publications to help parents understand depression and treatment options.

Monday, August 23, 2010

School is in session! Lesson 1: ADHD



By Gariane Phillips Gunter, M.D.



School has started back for another year! Soon, many parents will be receiving calls about their child’s “behavior” and the quest will begin to discover the cause. An article recently published in USA Today included reports of a study conducted at Michigan State University which stated that kids who are the youngest in their grades are 60% more likely to be diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) than the oldest children.



The intent of this blog entry is not to validate nor dispute this data but to offer facts about the diagnosis of ADHD regardless if your child is the oldest or youngest in their class. First and foremost, the diagnosis of ADHD should only be made by a trained professional after a thorough assessment of the child and collateral information.



The main features of ADHD include hyperactivity, impulsiveness, and an inability to sustain attention or concentration. These symptoms occur at levels that cause significant distress and impairment and are far more severe than typically found in children of similar ages and developmental levels. More common in boys than in girls, this disorder often develops before age seven, but is usually diagnosed between ages eight and 10.



Children with ADHD:



• Have difficulty finishing any activity that requires concentration

• Don?t seem to listen to anything said to them

• Are excessively active?running or climbing at inappropriate times, squirming in or jumping out of their seats

• Are very easily distracted

• Talk incessantly, often blurting out responses before questions are finished

• Have serious difficulty waiting their turn in games or groups

• May have specific learning disabilities



Treatment can include the use of medications, psychotherapy and special educational programs to help a child keep up academically. Psychotherapy enables children to cope with their disorder and the reaction of others to it. An essential component of psychotherapy involves the work of the child psychiatrist with both the child and the parents to develop techniques for behavior management. 



If your child is diagnosed with ADHD there are effective treatments and medications available to help him/her have a successful year at school. Please contact your child's doctor if you need help.

Tuesday, July 27, 2010

Energy Drinks and Our Children



By Gariane Phillips Gunter, M.D.




I was giving a talk to a group of fifth graders regarding mental health issues when one young man raised his hand to ask a question. His question caught me a little off guard as he asked me about using energy drinks. 




Out of curiosity, I asked the group of 100 students to raise their hand if they drank these drinks. To my amazement, most hands went up!!! I then asked them where they got the drinks and they responded that their parents bought them for them. These children opened my eyes to a real problem.




Many children and teens today are choosing energy drinks as a part of their daily diet. And while some energy drinks are clearly labeled as unsuitable for children, others are specifically marketed to kids as young as four, promising boosts in energy and nutrition as well as enhanced athletic performance.




The problem is that this energy boost comes with a price. Most energy drinks, although packaged in smaller cans and bottles than regular soft drinks, are packed with sugar and caffeine — sometimes as much caffeine as in 1 to 3 cups of coffee! Too much sugar can put your child in the fast lane to the dentist's office and also contribute to weight gain. Excessive caffeine comes with its own set of problems — especially in younger kids, it can negatively affect attention and concentration as well as restful sleep.




As adults, we know how it feels to have too much caffeine and our children are no exception. Caffeine by design is a stimulant — though a widely used and accepted one — and because children are smaller than adults and haven't yet developed a tolerance to it, its effects on them may be more pronounced. As in adults, too much caffeine can cause:



• jitteriness and nervousness 

• upset stomach 

• headaches

• difficulty concentrating 

• difficulty sleeping 

• frequent urination



Many of these drinks also contain additional ingredients whose safety or effectiveness has never been tested in children — including herbal supplements, guarana (a source of caffeine), and taurine (an amino acid thought to enhance performance). Children and teens may ingest these drinks without realizing the potential danger. Even mild caffeine toxicity can cause nausea, vomiting hypertension, accelerated heart rate and tremors. Because the Food and Drug Administration does not regulate these drinks it is not possible to know the exact quantities, ingredients or effects they may cause. 




Despite all the hype, energy drinks offer no real health benefits or competitive edge for kids. A balanced diet, physical activity and adequate sleep will work to give our children all the energy they need, safely.

Thursday, May 20, 2010

Dads Get Postpartum Depression Too



By Gariane Phillips Gunter, M.D.



Over the past several years, with great help from Brooke Shields and others sharing their stories, postpartum depression in new moms has become well known. However, recent evidence suggests that new dads may be suffering too. A recent study in the May 19th issue of the Journal of the American Medical Association reports that “14% of American men develop depression, either during their partner’s pregnancies or in the first year after delivery”.



Unfortunately, dad’s depression may be overlooked as the symptoms may not present as sadness but as irritability, anger or isolation from their loved ones. Without identification and treatment of dad’s depression, negative outcomes for the new baby and family can occur.



New babies need secure, healthy attachments for their physical and emotional development and these attachments are strained when either parent is suffering from their own depression. If you are a new mom or dad and feel you may be suffering from depression, please talk to your doctor and ask for help.

Friday, March 5, 2010

Let’s Pay Attention: Some Facts on ADHD



By Gariane Phillips Gunter, M.D.



What is ADHD?



There is a lot of talk in the media, schools and community about ADHD, but what exactly is it? ADHD which stands for Attention-Deficit/Hyperactivity Disorder is one of the most common mental disorders affecting children. ADHD is a brain condition that is often first identified in school-aged children when it causes a disruption in the classroom or problems with school work. An estimated 3 to 7 percent of school –aged children have symptoms of ADHD.





What are the Symptoms?



Many of the symptoms of ADHD such as high activity levels, difficulty remaining still for long periods of time and limited attention spans are common in young children in general. However, the difference in children with ADHD is that their hyperactivity and inattention are noticeably greater than expected for their age and interfere with functioning in more than one environment i.e. at school, at home or with friends.



A child with ADHD may:



*squirm and fidget



*daydream a lot



*have difficulty following instructions



*appear not to listen when spoken to



*not be able to stay seated



*talk too much or interrupt



*be easily distracted



What Causes ADHD?



The specific causes of ADHD are not yet determined however there is evidence that genetics do play a part. Other factors that may contribute include being born prematurely, brain injury, and the mother smoking, using alcohol or having extreme stress during the pregnancy.



What is the Treatment?



The most effective treatment for ADHD is the combination of behavioral therapy as well as medication if needed.



What can Parents do to Help?



Children with ADHD perform much better with structure, established routines and clear expectations. It can be helpful to:



• Maintain routines



• Make sure instructions are understood-use simple words to describe



• Focus on your child when talking to them



• Maintain communication with the child’s teacher



• Model calm behavior



• Focus on effort and reward good behavior



What are the Consequences if Left Untreated?



Sadly, if left untreated, children with ADHD are at greater risk for potentially serious consequences including school failure and dropout, social difficulties, family problems, alcohol and drug abuse and depression. These problems or the consequences of them can persist into adulthood, including relationship and employment problems.



Does my Child have ADHD?



Simply having the above symptoms does not mean that a child has ADHD as these symptoms can be normal childhood behavior or could be due to another disorder. Symptoms differ from child to child and there is no lab test for ADHD.



Diagnosis involves gathering information from parents, teachers, and others often filling out checklists and a medical evaluation to rule out medical problems. If you feel that your child is at risk, talk to your doctor about your concerns.

Monday, January 25, 2010

Are You Shocked?













By Gariane Phillips Gunter, M.D.



I recently came across an interesting article in the Marie Claire magazine entitled, I Had Shock Therapy… And I’d Do It Again and thought we could talk about this type of therapy a bit. A special thank you to this woman for sharing her story with the world.



What is it? Electroconvulsive therapy also known as ECT, is a well-established psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Today, ECT is most often used as a treatment for severe major depression which has not responded to other treatment, and an estimated 1 million people worldwide receive ECT every year, usually in a course of 6–12 treatments administered 2 or 3 times a week.



Is ECT Effective? The 1999 U.S. Surgeon General's Report on Mental Health summarized psychiatric opinion at the time about the effectiveness of ECT. It stated that both clinical experience and published studies had determined ECT to be effective (with an average 60 to 70 percent remission rate) in the treatment of severe depression, some acute psychotic states, and mania. The report stated that ECT does not have a long-term protective effect against suicide and should be regarded as a short-term treatment for an acute episode of illness, to be followed by continuation therapy in the form of drug treatment or further ECT at weekly to monthly intervals.



What are the side effects? Aside from effects in the brain, the general physical risks of ECT are similar to those of brief general anesthesia. Immediately following treatment the most common effects are confusion and memory loss which usually disappears after a few hours.



Famous people who have undergone ECT



Kitty Dukakis, wife of former Massachusetts governor and 1988 Democratic presidential nominee Michael Dukakis and author of Shock, a book chronicling her experiences with ECT.



Carrie Fisher, American actress and novelist. Fisher speaks at length of her experiences with ECT in her autobiography Wishful Drinking.



In my experience, I have come across many people who feel that ECT saved their lives as well as others who did not feel that it was effective. Careful discussion with a mental health professional can help you make the decision that is best for you. I wish you all a healthy and happy 2010.











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