Talking to Kids about the Earthquake in Japan

By Adair Parr, M.D.

Our hearts and condolences go out to the people of Japan and the families involved in the earthquake and subsequent tsunami in Japan last week. 

Everyone has seen the live images, captured on cell phones and video cameras, coming from Japan.  They are vivid, dramatic, compelling, and scary.  We have all watched the coverage on television and online as more and more photos and videos circulate showing the massive tsunami wave rolling over the sea wall, shaking houses and buildings, fires, explosions,  and the massive destruction afterwards.  The subsequent explosions of the nuclear reactor and news of a nuclear reactor meltdown near Sendei, Japan are also extremely disturbing. 

Our 24 hour news cycle enhances the impact of these images which can be traumatizing for viewers of all ages.  Media has a particularly powerful influence on children and adolescents, and the pictures it shows shapes a child’s perception of the world.  Young children watching images of disaster believe that the event is happening in real time, and they’re in danger.  At such times, helping children feel safe and protected in their own home and community is important.  Parents should keep in mind the following tips when viewing photos and videos during and after disasters:

• Be vigilant!  Not all sources of media provide warnings about upcoming traumatic images.


• Viewing traumatic images may be re-traumatizing.


• Limit children’s exposure to media coverage of the event.


• Co-view media coverage of the trauma and discuss content with children and adolescents.


• Encourage children to draw, write, play music, and exercise in ways to express their feelings about the traumatic events.


• Maintain structure and family routines. 

HealthyMinds.org has more information on how to talk to your children about disasters.

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Posted in: Adair Parr MD,children,disaster psychiatry,natural disasters,parenting,television

Caring for the Mental Health of Your College Student

By Roberto A. Blanco, M.D.

A recently released national survey on the state of mental health for entering college students revealed that this year's freshmen class has the highest stress levels in the history of the 25 year survey.  There are several reasons.  According to study authors, students face increased competitiveness and demands in high school as well as more financial challenges due to today's economy.

Although it's an exciting time, your child's transition to college can be a difficult one - especially if he or she suffers from a mental illness.  Here are some things that you and your prospective college student should be thinking about prior to choosing a university and heading off to school:

1.    What can I do to ease the college transition? 

Some schools offer an orientation program over the summer to help students become comfortable with the campus and surroundings, learn organizational and study skills and socialize with fellow freshmen.  

Apart from these organized programs, it is important that, as a parent, you work on transition issues and independence.  Make sure that your child has all materials needed for school including an organizer and a computer.  If your child is getting psychiatric treatment, teach your son or daughter the importance of their medicines, therapy and attending their appointments regularly.  If they haven’t yet been self-administering their medications, before going to college, it is important that they learn and start taking their medicines without supervision.

If you have serious concerns about how your child will do with the college transition, you may want to consider schools close to home.  Depending on the amount of concern, it may be best to choose a school which would allow your child to drive home for the weekend if needed.

2.   What’s the quality of the college's mental health program?

Some colleges and universities do not have mental health services available through the school.  If they don’t, you need to understand how a student can go about getting help.  If the school is not in a major city, you need to make sure that there are enough providers close by so that your child can get the services that he or she needs in a timely manner.

Some universities have therapists but no psychiatric providers on staff.  Others offer both counseling and psychiatric services but put a cap on the number of appointments at the university mental health center prior to referring students out to the community.  All of this information should be provided by each individual school.  And you should know all of this information prior to committing to a particular school, especially if your child is likely to use mental health services.

3.    What is the educational environment of the university?

Some universities are known to be high-pressure, unforgiving environments.  This could be due to the rigor, expectations or challenges of courses.  Sometimes, this can be eased by a strong academic support team or advising system.  Often, peers can make the university culture overly competitive in unhealthy ways.  Some places are notorious for students stealing other students’ lecture materials and notes or not helping out when needed.  If your child is particularly sensitive to stress, it may be best to go to a school where the environment is more collegial and supportive.

Other schools are notorious for having easy access to drugs or alcohol on campus.  While drugs and alcohol are available at most schools, they are easier to get at some schools which are located in major cities or areas of high accessibility.  If your child has a history of drug or alcohol abuse, you should be extra considerate of these location factors.

4.    Will the financing of this school put my child in overwhelming debt?

While a good college education is one of the most important investments, your child should not mortgage his or her future by creating large amounts of unnecessary debt.  In addition, universities with higher tuition may necessitate your child working during school to avoid excessive debt.  This can also add stress.  If schools are relatively equivalent in meeting your child’s long-term career goals, choose the college which will put your child in a better financial position after he or she graduates.

Of course, after your children go to college, you will want to monitor how they are doing intermittently.  Particularly stressful times are usually at the beginning of school, around exam time (midterms and finals) and anytime a romantic relationship ends.  Checking in around these times may be the most beneficial.  If it turns out that they need more help than some parental TLC, make sure that they see a professional.

I hope that these suggestions have been helpful.  Feel free to leave comments or questions for further discussion.

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Posted in: ADHD,alcohol,anorexia,anxiety,college,depression,drug abuse,eating disorder,financial,getting help,parenting,Roberto Blanco MD,school,stress,substance abuse,teens,worry

Talking To Kids About Disappointment In Sports

By Claudia Reardon, M.D.



Participating in sports is generally thought of as a physically and emotionally healthy activity for children and teenagers. However, it is inevitable that children who play sports will at some point deal with disappointment. Not every play or game will go their way. While dealing with this disappointment can be difficult for children, it's also a great opportunity for growth. The excitement of the Super Bowl and other winter sporting events provide a chance to talk with your children about disappointment.

Here are some tips to keep in mind if you parent or coach a child or teenager who is dealing with disappointment in sports:



1. Acknowledge your child’s feelings about what happened. For example, you can say, “I understand that you are feeling really upset that you didn’t win the race.” Of course, this does not mean that you should agree with catastrophic statements that they might make, such as that they are the worst player that ever played or that their life is ruined because of a bad game.



2. It’s okay if kids don’t want to talk about a disappointing game or event immediately. You might simply acknowledge their feelings and tell them that you’re there for them to talk whenever they want to.



3. Help your children shift focus to what they did RIGHT on the playing field. This is especially important if your child is a perfectionist, in which case he or she is likely to focus on the one mistake rather than seeing the “big picture” of everything he or she has done right.



4. It’s certainly okay if your children’s disappointment leads them to want to improve their sports skills. Help them figure out exactly what skill they would like to improve, and then brainstorm ways to improve in that area. They might even ask for suggestions from the coach. Help your children set realistic goals and then give them praise as they work toward those goals.



5. Ask your children if they think their favorite athletes ever make mistakes in their sport. If these athletes said that they were terrible players and wanted to quit after one bad play or bad game, would your children agree with that? Of course not!



6. Disappointment is a great opportunity to reinforce resilience and determination. Remind your child that he or she is “the kind of person who doesn’t give up easily.”



7. If a child is disappointed in his or her sporting performance, that is not an excuse for poor sportsmanship. It is not okay for them to express their disappointment as anger toward the winner.



8. Remind your children that failing to make a good play or to win a game does not mean that they’re a failure overall. There still are lots of great things about them, and everyone fails sometimes. Remind them of all the things they have done well recently.

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Posted in: caregivers,children,Claudia Reardon MD,coach,coping,disappointment,parenting,sports,teens

The Truth About Domestic Violence

By Roberto Blanco, M.D.



In my work with patients across the world, I can´t help but notice how many come to psychiatric clinics as a result of domestic violence. Despite its prevalence in other countries, domestic violence is also quite common in the United States. In the United States alone, 22 percent of women are physically assaulted by an intimate partner during their lifetimes and over 5 million are victims every year. Domestic violence touches all elements of society regardless of age, race, or socioeconomic status.

As a child psychiatrist, I can´t help but think of the smallest victims of domestic violence as I often see them in my clinical work. These are the children who are either involved secondarily by witnessing the abuse or become victims directly themselves. The effects of domestic violence on this population are far ranging and long lasting. As these children develop, they may struggle to deal with conflict. They may also become aggressive or experience severe depression, nightmares and other symptoms of post-traumatic stress, as well as other anxieties or fears.



The effects of domestic violence on children are dependent on the nature and severity of the abuse and on the developmental level of the child. Young babies and infants cannot understand why violence occurs in the home and so violence in this population can cause deep-seated changes in personality, self-esteem, and ways of interacting with others that can last for a lifetime. Often older children have a better understanding of what is going on, but still often blame themselves for the abuse and can have excessive guilt or anger as a result.



Domestic violence does not need to be only physical to qualify as a form of abuse. Abuse can also take the form of emotional, financial, or sexual control or disregard. Initially, characteristics of an abusive relationship can often be endearing such as wanting to be with you all of the time. Over time, this can become intense jealousy for no reason, excessive control over relationships and behaviors, and aggression or violence. Options for milder forms of emotional abuse can include family and/or individual therapy. For severe cases, there may be a need to get out of the situation or to a safe house. For more information on domestic violence, please see the American Pyschiatric Association's brochure  Let´s Talk Facts About Domestic Violence.

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Posted in: abuse,children,depression,domestic violence,family,parenting,PTSD,Roberto Blanco MD,women

Bipolar in kids? Probably not.

By Scott Benson, M.D.



The 5-year-old little girl had been referred to a therapist by her school because of her severe disruptive behavior. The almost daily tantrums had everyone concerned. She was uncooperative with the assessment and arrangements made for further evaluation. The therapist wrote a diagnosis of bipolar disorder.

The patient was certainly reactive to any limits and her tantrums seemed like they would never end. But she slept well at night; she rarely had behavior problems with her grandparents who provided afterschool care.

After a few parent training sessions with the little girl and her parents her behavior control improved. But continued treatment was threatened when her dad tried to get her on his new health insurance. The diagnosis of bipolar got the application bumped by the computer and it took a lot of calls and several letters to get her on the policy so that her treatment could continue.

At times it seems we are a little too quick to throw a label on a child’s behavior, and bipolar disorder seems to be the most popular current label.

But new research at the October meeting of the American Academy of Child and Adolescent Psychiatry found that children with some symptoms of mania probably do not have bipolar disorder.

Boris Birmaher, M.D., a child and adolescent psychiatrist at the University of Pittsburgh presented his group’s research. More than 2,000 children presenting to 10 different academic centers were included in the Longitudinal Assessment of Manic Symptoms (LAMS) study. 621 were found to have elevated symptoms of mania, but the full evaluation did not find sufficient symptoms for a diagnosis of bipolar disorder. Most had attention deficit hyperactivity disorder (ADHD), others had another disruptive behavior disorder. Children who did have bipolar disorder have poor function and are likely to require treatment in hospitals.

"Kids with manic symptoms don't necessarily have bipolar disorder," he told Reuters Health. On the other hand, "Many children with bipolar disorder are not being correctly diagnosed."

The LAMS study which will follow these children for five years should provide direction for the assessment and treatment of children with severe behavior problems. In the mean time parents should insist on an adequate evaluation for children with severe behaviors.

The Parents' Medication Guide for Bipolar Disorder in Children & Adolescents is a great source of information for understanding the evaluation process and treatment options. Or visit HealthyMinds.org for more information on bipolar disorder or mental health issues in children.

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Posted in: bipolar disorder,children,family,mental illness,parenting,R Scott Benson MD

Parenting in the Internet Age

By Molly McVoy, M.D.

Facebook, blogging, Twitter, email, texting. How is a parent supposed to keep up with all of the technology available to children and teens in today’s world? Many parents and children struggle with safety on the Internet. Although there are no easy answers, some simple steps can help keep you and your child safe.

First, and most important: all of the things that make a good parent in everyday life also make a good parent on the Internet. Spend time with your child in their daily life and spend time with them learning about what they do online. Educate yourself on your child’s school and social life. In the same way, educate yourself about the websites they visit and who they are talking to online.

In addition, keep their access to technology limited and in public settings. Put the computer in the kitchen or the living room – in other words, in a place where secrecy is difficult and monitoring is easy. Online time should only come after homework and other activities are done for the day. Also, talk about what they are doing online, but do not invade their privacy by reading emails unless absolutely necessary. If you suspect dangerous things are happening by or to your child online, then invading their privacy may be necessary. Otherwise, encourage open communication and respect their privacy.

For more information:

http://www.webwisekids.org/

http://www.kids.gov/6_8/6_8_computers_internet.shtml

http://www.attorneygeneral.gov/uploadedFiles/Consumers/cybersafety.pdf

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Posted in: children,internet safety,Molly McVoy MD,parenting,teens

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.

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Posted in: caregivers,Gariane Phillips Gunter MD,mental illness,NAMI,parenting

Concussion: Getting Back in the Game?

American Psychiatric Association Healthy Minds blogger and sports psychiatriy expert Claudia Reardon, M.D., discusses concussions in young athletes in this video blog:

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Posted in: athletes,Claudia Reardon MD,concussion,head injury,parenting,sports

Family-Based Treatment May Benefit Teens with Anorexia

By Molly McVoy, MD



A recent Wall Street Journal article reported on a study regarding teens with anorexia. The results of the study, published in the Archives of General Psychiatry, indicate that having parents actively involved in the treatment of adolescents with eating disorders is more effective than the traditional one-on-one treatment with a therapist.

The study looked at 120 teenagers using the Maudsley model versus traditional one-on-one therapy. The Maudsley model encourages parents to take charge of the eating habits of their children with eating disorders, such as anorexia. At one year, the study found that about 50 percent of patients treated with this family based therapy were in remission versus 23 percent in the more traditional individual therapy.



Anorexia nervosa is a serious, often life-threatening illness in which patients fear gaining weight to such a degree they restrict their diet and maintain a body weight below the 85 percent of a healthy weight. Successful treatment is intensive, involving medical monitoring, dietary interventions, therapy and, at times, medication.



This study adds to accumulating evidence that family involvement is critical in successful treatment of adolescents with eating disorders. As more studies are published with similar data, treatment centers for eating disorders and increasingly involving families in the intensive treatment programs.



The HealthyMinds.org has more information on eating disorders. 

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Posted in: anorexia,eating disorder,healthy eating,Molly McVoy MD,parenting,teens,treatment

Won’t he just outgrow it?

By R. Scott Benson, MD





Won't he just outgrow it? This is the wish of every parent – that a little time, a little more love, or discipline, or happy thoughts will solve what might be a serious problem. And I hear this question often from parents of pre-schoolers who are having behavior problems in pre-K programs or daycare settings.

But we can’t wait. And now there is even more research to support the importance of a careful evaluation and treatment when indicated. This month’s Archives of General Psychiatry reports the results of a long term study of children who were diagnosed with ADHD between the ages of 4 and 6 years old. There was a control group of children without ADHD. As adolescents the children with the early diagnosis of ADHD had higher rates of depression and suicidal thoughts. Fortunately, there were no suicides in this study. Benjamin Lahey, Ph.D., the study director is a professor of health studies and psychiatry at the University of Chicago. He said the study “reinforces our belief that parents of young children with ADHD should pay close attention to their child’s behavior and its consequences and seek treatment to prevent possible long-term problems.”



So the better question is “What treatment is recommended for pre-schoolers?” And we have good science to help answer that question. Carefully managed studies have shown that pre-school children and their families should have at least 12 weeks of behavior management training as a first level of care. And this is not just any behavior management. At a conference in Florida, Dr. Regina Bussing recommended that families should consider a number of behavior training programs – the Positive Parenting Program, The Incredible Years, and Parent Child Interaction Therapy. These are intense programs that are very different from a few words of advice from a well-meaning pediatrician or the do-it-yourself manuals that are so prevalent in the bookstores.



There are likely to be other programs that have good evidence to recommend them. Let me know of programs in your community and will can include those links.

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Posted in: ADHD,children,parenting,R Scott Benson MD,therapy,treatment

Supporting Gay Youth as a Way to Prevent Suicide

By Tristan Gorrindo, MD



Coming out of the closet is one of the hardest things that a gay, lesbian, or bisexual person will do.

“Coming out,” is the process of revealing to friends, parents, family members, and acquaintances that he or she is gay. It is more that just a simple act or decision to announce that a person is gay, but rather a process that unfolds overtime, usually in small steps. For many people, it involves telling one person, then a group of friends or family members, then classmates or co-workers, and finally the world at large. But for each person, the journey is different and often filled with emotional ups and downs.

Recent events in the national media have highlighted the issues surrounding coming out and youth suicide. By some estimates, as many as nine gay youth died by suicide since September 1, 2010. Government officials and celebrities have publicly referred to this as a national crisis.



Many population scientists have tried to understand why gay teens are at such high risk for suicide -- by some estimates 7 times the national average for their age. And although there are many possible contributors to what might make a gay teen suicidal, we must first remember that all teens, gay and straight alike, are struggling with basic questions about self-identity.



A friend of mine once described being a teenager is like, “being at a costume ball where the costumes and guests are constantly changing.” As part of normal teenage development, teens are “trying on” different roles, different groups of friends, and even different kinds of dress. It is a time when teens are first experimenting with the idea of romantic relationships and at the same time trying to separate from their parents. Gay teens have the added burden of sorting out the confusing, often negative messages from the culture about what it means to be gay. When these ingredients mix -- unsure sense of self-identify, novice experience with romance, trying to separate from one’s parents, and fear of what it means to be gay -- gay teens run the risk of feeling quite isolated and alone.



Regardless of one’s personal views of homosexuality, I think we can all agree on the importance of supporting our youth during difficult times. The American Psychiatric Association is committed to reducing the stigma around homosexuality and to promoting the psychological health of gay, straight, and bisexual individuals.



We owe it to our teens to make sure that they know that coming out is not a process that they have to go through alone. A wide variety of resources exist, from grass-roots YouTube videos which offer gay teens hope, as in The Make It Better Project, to 24-hour suicide hotline for gay teens offered through The Trevor Project. Additionally, The National Suicide Prevention Lifeline also is available 24/7 at 1-800-273-TALK (8255) to anyone struggling with suicidal thoughts. The Healthy Minds website is a source of clear factual information on sexual orientation. And let us not forget the parents that may also be struggling with how to help their gay child; for them there is support and advice offered through PFLAG.

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Posted in: gay/lesbian/bisexual,getting help,LGBT,parenting,sexual orientation,stigma,suicide prevention,teens,Tristan Gorrindo MD

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

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Posted in: family,Gariane Phillips Gunter MD,parenting,school,teachers,women

A Parent’s Guide To Social Networking

By Adair Parr, M.D.

If you are like most parents, your teenager knows more about social networking than you do. According to a Pew Internet Project study, nearly three-quarters of teens online use social networking sites. What’s more, many teenagers now access social networking through cell phones, further increasing their online presence. The phenomenal rise of Facebook is documented in the movie, The Social Network, which was number one at the box office this past weekend.

Are your teenagers on Facebook? Are you wondering where to draw the line? Many parents feel overwhelmed by understanding media and technology and feel that they will never catch up to their kids. While you may not text as fast as they do, making an effort to learn about social networking is important. Teens are designed to experiment with risky behavior and social networking is one area in which they may try such behaviors. By educating yourself on the topic, you will be better prepared as a parent to help your child to use media and social networking responsibly.

What can you do to help ensure your teen’s responsible use of social networking?

1. Talk to your kids about the media in their life. Ask your teen how social networking changes lives.


2. Keep the lines of communication open with your teen. Know who they are communicating with online.


3. Remind your teenager to limit the amount of personal information online.


4. Remember that everything your teenager posts is public information. Once it is posted, it is online forever.


5. Educate your teenager about cyberbullying and what to do if he or she is a victim of cyberbullying.


6. Model responsible media use behavior for your teenager.

The Healthy Minds website has additional information about mental health for college-age students and children. Check out these resources to help parents navigate the murky waters of social media:

• Common Sense Media


• Be Net Savvy


• Net Lingo


• Facebook Safety


• Frontline, KidsOnline 

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Posted in: Adair Parr MD,children,college,internet safety,parenting

Does the sandman still come to your house?

By R. Scott Benson, M.D.

Keeping children up at night?

Some worrisome stories were on the evening news last week; but the part of the news broadcast that caught my attention were six ads for medication to promote a peaceful night of sleep.



These ads are having their desired effect as I have more and more families expressing concern about their children’s sleep. They read the stories about shifting school start times to improve teens’ school performance, but the first question they ask me is usually about the latest new medications.

Research is clear: there are many things that should be done before we reflexively open the medicine cabinet.

1. Consider the impact of 24-hour access to electronic communication tools. Does your child keep a cell phone in their room overnight? To talk to whom? 


2. Remove televisions and computers from children’s bedrooms. There is strong evidence that easy access to these devices interferes with sleep.


3. Watch out for shifts in sleep schedules on the weekend. Most of us thought we could stay up late on weekend nights, make up for the sleep by staying in bed until noon on Saturday, and sleep in again on Sunday. But it only takes these two days to reset your biologic clock. No wonder that Monday finds a body at school but the mind is home in bed.


4. Plan evening routines so your child finishes activities (including homework) more than an hour before planned bedtime. It takes a while to settle after an hour of frustrating work on spelling words.

The first step in evaluating any concern about sleep is keeping a careful sleep diary. There are samples available at SleepEducation.com, the website of the American Academy of Sleep Medicine. The University of Michigan has a wealth of material on their website devoted to children’s sleep problems.



Sleep tight.

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Posted in: cell phones,children,family,parenting,R Scott Benson MD,Sleep

TXT me when U get there: Helicopter parenting as kids go off to college

By Tristan Gorrindo, M.D.



Thousands of teenagers have headed to college and for many it is the first time that they lived away from home. And while this process of separation is often anxiety provoking for the college freshman, their parents may be equally anxious.



With modern technology, it has never been easier to stay in touch. Text messaging, cell phones, social networking websites, video chatting and email, have all made constant contact simple and expected. But at times it can go too far. In my clinical practice I have heard stories of parents who call each morning to wake their child up for class; parents who panic if they don’t get at least two text messages a day from their child; or, even parents who require that their child parade new college friends in front of a Skype camera before granting permission for their teen to befriend them.



But what is the developmental cost of this collegiate level helicopter parenting? Certainly parents want (and should) be involved in the lives of their child as they branch out into adulthood, but when parents’ constant checking in distracts or disrupts the process of development, college-aged kids have a problem.



The goal of moving away to college is just as much about forming one’s identity as it is about late-night cramming and classes. Further, it is a time for the young adult to develop self-reliance and responsibility for one’s actions. It’s also a time for teens to form new friendships. Well-meaning, but over-eager parenting has the ability to disrupt all of these normal developmental steps. Young adults need the chance to find others to depend on, to learn to pick up after their own disappointments, and to experiment with new behaviors without having to report back.



The exact amount of contact that parents and their college kids should have is a personal negotiation between each child and each parent. The best time for such negotiation is before a child departs for college, preferably before both parent and child are deep in separation anxiety. Parents need ground rules about how often they should expect texts from their child and guidance about how long they should wait before panicking if a phone call isn’t returned or a Skype call goes unanswered.



Kids can be asked how they would like to be contacted, and with what frequency. Establishing a regular routine around check-ins -- like calling Dad each Sunday morning on the phone for a debriefing of the past week and planning for the week to come -- can go a long way in managing parental anxiety. Perhaps, after a few weeks at school, parent and child can check-in on how these check-ins are going. With some experience at being apart, students may want to adjust the type and quantity of contact that they have with their parents.



Never before have college students and their parents had such a rich array of ways to stay engaged with one another. While kids continue to benefit from their parents guidance and interest, they also need to know that their parents believe in their new skills to pilot their own planes.

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Posted in: college,parenting,teens,Tristan Gorrindo MD

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.

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Posted in: caffeine,children,Gariane Phillips Gunter MD,healthy eating,parenting

Cyberbullying: How do you Protect Children from Online Bullies?

By Roberto Blanco, M.D.

With the proliferation of cellular phones and social networking sites, bullying as we once knew it has been changed forever. Gone are the days where the classic nickname pasted on the back or intimidation on the playground were the main forms of peer-to-peer humiliation. Cellular phones with texting and Internet capabilities have allowed adolescents to bully and intimidate their peers at all hours of the day and night. In fact, this type of bullying can begin as early as elementary school.

The meaning and value of friendships and relationships has also been changed. If adolescence wasn´t bad enough, gossip, secrets, and fallouts from former relationships are being broadcast online for all to see. In addition, several high-profile teen suicides have highlighted the importance of educating children about how to protect themselves from cyberbullying and the vicissitudes of the social networking world.

An article in The New York Times identified some of the challenges surrounding cyberbullying, including the roles and responsibilities of children, parents, the schools, and the legal system. The article raises more questions than it provides answers. It makes it clear, however, that children need to be educated about how to prevent cyberbullying, what to do if they are being bullied, and how to use digital media responsibly. Here are some ideas for you and your child to prevent or manage cyberbullying:

• Talk to your children about cyberbullying as they are getting a cell phone or a social networking account. Explain the warning signs of cyberbullying for themselves and towards others. They should have had a firm lesson in the golden rule and how they should be treated and treat others.

• Discuss with your children how to protect themselves from cyberbullying. They should only “friend” actual friends and not just acquaintances on social networking sites. They should not post or send via cell phone anything that they would not want everyone to see. ´Sexting´or the sending of nude photos is strictly prohibited and talk to them about the possible consequences of this type of behavior. Let them know that any photos posted on the Internet, stay on the Internet.

• Monitor your child´s behavior on cell phones and online through frequent conversations. If you think that they may be in danger, you may need to increase the amount of monitoring by getting account passwords or using random cell phone checks.

• Discuss who they can talk to if they are being bullied – parents, a trusted teacher, counselor, or a responsible friend. Adolescents are often wary of talking to parents about this for fear of overreaction, so give them other good options.

• If bullying continues to be a problem, problem-solve with your child. Consider talking to the bullies' parents, school administrators, or if severe enough, to the legal system or law enforcement. Consider changing cell phone numbers or closing accounts.

• If your child is doing the bullying or using the cell phone or social networking account inappropriately after re-direction, consider taking away the cell phone or closing social networking accounts. While there are many positives to this type of technology, remember that it is a privilege and not a right.

For more information, check out the National Crime Prevention Council and http://www.stopcyberbullying.org/. Read more about bullying on HealthyMinds.org. 

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Posted in: bullying,cell phones,children,cyberbully,internet safety,parenting,Roberto Blanco MD,suicide prevention

“What do I tell my kids?” Tips for talking to children about the Gulf Oil Spill

By Molly McVoy, M.D.





I did a quick Google search of kids and the Gulf oil spill, and I found everything from “Why are they killing all the birds and sea turtles?” to resources for environmentally minded children on how to start an environmental action plan of their own.





The oil spill in the gulf coast has many worried, from children through adults. The resources for how to talk to them are varied and sometimes confusing. Below are some basic tips for talking to children about the oil spill threatening the gulf coast.





Talking to your children about disasters can be challenging. Children ask tough questions and it can be difficult to know how best to answer them. However, times like this, during disasters, can be a golden opportunity with your children. When current events are scary or confusing, it can be a great opportunity for parents to show their children that there are people to help them and the country get through them.





The best advice I can give for talking to children about anything, but disasters in particular, is this - be honest, be simple and repeat, repeat, repeat. Don’t force your child to talk about the oil spill, but, if they ask, tell them the truth in language that fits with their age. Children know if they’re being told the truth, so answer them as simply and straightforwardly as you can. But, being a child, they will likely ask again and again (and again!). It’s okay if you have to repeat yourself, it’s the open dialogue and the reassurance that children are looking for during times of crisis.





So, as Bill Cosby said of fatherhood “You just need a lot of love and luck - and, of course, courage.”

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Posted in: children,coping,crisis,disaster psychiatry,Molly McVoy MD,natural disasters,parenting,television

But not my kid!

By R. Scott Benson, M.D.



A recent study by the Jed Foundation and the American Psychiatric Foundation showed that most parents of college age children understand that there is a high rate of depression, suicide, and substance abuse problems in college.



“But not my kid!” Nearly two-thirds thought these problems would not affect their children.



Surveys of college students show that most experience important mental health issues in themselves or a friend. And other studies have shown that emotional problems are a leading impediment to college success.



Now that the excitement of senior trips and graduation has settled families are putting the finishing touches on a transition plan as their teenager moves to the excitement of higher education. Most families have discussed the obvious needs – a place to live, what courses to take, how to pay for all of it. But families should take time to discuss the possibility of problems and how to get help.



Since this new territory is fraught with emotional pitfalls the American Psychiatric Foundation has teamed with the Jed Foundation to develop a website of information that will provide a framework for this important discussion. Transition Year has material to help parents and teens learn the warning signs of problems. And systematically collect contact information preparing for the situation where help is needed. The site has collected links to reliable sources of information about psychiatric conditions that are often seen in college age youth.



The site would be useful to families who are still considering their child’s college options. An entire section on “Choosing a school” provides guidance on important issues to explore in order to find a best fit.



Of course in some communities the choice is simple. Go, Gators!

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Posted in: college,family,parenting,R Scott Benson MD,suicide prevention,teens

The Kids Are Out of School, Now What?

By Gariane Phillips Gunter, M.D.



Summer is here, whoohoo! People of all ages, across the nation are having fun in the sun. However, the U.S. Consumer Product Safety Commission (CPSC) warns that summer also is the time of year consumers are most likely to be injured.



What can you do to keep you and your family safe?




• One of the easiest and most effective ways to stay safe this summer is to wear a helmet and other safety gear when biking, skating and skateboarding, and when riding scooters, all-terrain vehicles, and horses.




• If you are sending the kids to camp, be sure to check out the camp to ensure that your children will be supervised adequately for safety.




• Protect to prevent a swimming pool tragedy. This includes placing barriers completely around your pool to prevent access, using door and pool alarms, closely supervising your child and being prepared in case of an emergency.




• When cooking outdoors with a gas grill, check the air tubes that lead into the burner for any blockage from insects, spiders, or food grease. Check grill hoses for cracking, brittleness, holes, and leaks. Make sure there are no sharp bends in the hose or tubing. If you ever detect a leak, immediately turn off the gas at the tank and don't attempt to light the grill until the leak is fixed. Newer grills and propane tanks have improved safety devices to prevent gas leaks.




• Make sure your home playground is safe. Use safe surfaces that cushion falls. Concrete, asphalt or packed dirt surfaces are too hard.




• Use softer-than standard baseballs, safety-release bases and batting helmets with face guards to reduce baseball-related injuries to children.




• If you are a soccer mom or dad, beware that movable soccer goals can fall over and kill children. Make sure the goal is anchored securely at all times and never allow anyone to climb on the net or goal framework or hang from the cross bar. Remove nets when the goals are not in use.




• To prevent serious injuries while using a trampoline, allow only one person on at a time, and do not allow somersaults. Use a shock-absorbing pad that completely covers the springs and place the trampoline away from structures and other play areas.




• Don't allow a game of hide-n-seek to become deadly. CPSC has received reports of numerous suffocation deaths involving children who crawled inside old cedar chests, latch-type freezers and refrigerators, iceboxes in campers, clothes dryers and picnic coolers. Childproof old appliances, warn children not to play inside them.




• If summer plans include camping and you want heat inside your tent or camper, use one of the new portable heaters that are equipped with an oxygen depletion sensor (ODS). If oxygen levels start to fall inside your tent or camper, the ODS automatically shuts down the heater before it can produce deadly levels of carbon monoxide (CO). Do not attempt to use alternative sources of heat or power to warm a tent or camper. Traditional camping heaters, charcoal grills, camping lanterns, and gas generators also can cause CO poisoning.




• Install window guards to prevent children from falling out of open windows. Guards should be installed in children's bedrooms, parents' bedrooms, and other rooms where young children spend time. Or, install window stops that permit windows to open no more than 4 inches. Whenever possible, open windows from the top - not the bottom. Also, keep furniture away from windows to discourage children from climbing near windows.




• Summer also means yard work. When mowing, keep small children out of the yard, and turn the mower off if children enter the area. Never carry children on a riding mower.




• Although summer schedules can be chaotic, don’t forget to follow up with your mental health provider for appointments as directed!




Have a safe and happy summer!!

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Posted in: children,family,head injury,Molly McVoy MD,parenting