Make Mental Health Your Priority Every Month

By Felicia Wong, M.D



As the month of May comes to an end, make a promise to yourself that personal mental wellness will remain a daily priority.  Mental Health America has been working for 100 years to promote well-being for all Americans and recently developed a resource called 10 Tools to Live Your Life Well based on extensive scientific evidence.

Each day, we face all sorts of demands and drama which can lead to insomnia, lack of concentration, problems in our relationships, and other mental health issues. 

These "10 Tools" provide proven, healthy ways to cope with stress and boost your overall well-being.  Make a commitment to follow this list and feel more relaxed, fulfilled, and focused long after Mental Heath Month is over. . .  

1) Connect with Others. People who feel connected are happier and healthier--and may even live longer.

2) Stay Positive. People who regularly focus on the positive in their lives are less upset by painful memories.

3) Get Physically Active. Exercise can help relieve insomnia and reduce depression.

4) Help Others. People who consistently help others experience less depression, greater calm, and fewer pains.

5) Get Enough Sleep. Not getting enough rest increases risks of weight gain, accidents, reduced memory, and heart problems.

6) Create Joy and Satisfaction. Positive emotions can boost your ability to bounce back from stress.

7) Eat Well. Eating healthy food and regular meals can increase your energy, lower the risk of developing certain diseases, and influence your mood.

8) Take Care of Your Spirit. People who have strong spiritual lives may be healthier and live longer. Spirituality seems to cut the stress that can contribute to disease.

9) Deal Better with Hard Times. People who can tackle problems or get support in a tough situation tend to feel less depressed.

10) Get Professional Help if You Need It. More than 80 percent of people who are treated for depression improve.

So now you know the tools. . . Today is the perfect time to start incorporating this list into your day-to-day routine.  For more information, go to http://www.liveyourlifewell.org/ . 

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Posted in: anxiety,balance,coping,depression,exercise,faith,Felicia Wong MD,getting help,happiness,health,healthy eating,mental health,mood,sleep,therapy,worry

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

Adult ADHD? Not just a diagnosis for kids

By Felicia Wong, M.D.

There have been several posts addressing ADHD in children on our blog, but did you know that ADHD can affect adults as well? An interesting article in the Wall Street Journal discusses adult attention-deficit/hyperactivity (ADHD) disorder, a condition that may affect up to 10 million Americans, only 4.4 percent of whom know it.

According to government data, an estimated eight percent of U.S. children have ADHD, and some 50 percent outgrow it. But what happens to those who don’t?




It was only in 1980 that therapists began to recognize that ADHD could persist in adults, and even now, getting an accurate diagnosis is tricky. It is controversial topic that has people taking sides. Some experts think that too many adults (and children) are being medicated for ADHD, often by doctors who have little knowledge or experience with this disorder. Others argue that those adults who have experienced functional impairment could benefit from ADHD medications and behavioral therapy.




Some adults whose ADHD is left untreated can encounter negative consequences including high incidence of substance abuse, automobile accidents, difficulty staying employed and maintaining relationships. Yet, adults with ADHD can also be highly intelligent, energetic, charismatic and creative. Those with ADHD may have the ability to focus intently on a narrow range of topics that interest them.




Many adults with ADHD have developed skills to compensate for their distractibility. Some excel in school at an early age, and don’t run into any problems until college/ grad school or starting at a challenging new job. Suddenly, their coping mechanisms are not as effective anymore.



An excerpt from the Wall Street Journal article:

We see people from all of the professions who have managed to succeed despite the limitations,  but they have often done it at significant cost," says Dr. Solanto. "They don't have time to enjoy life. They don't get their work done in the course of a day. They have to stay late after hours, or they are doing without sleep, frantically trying to meet deadlines. It ultimately takes a toll on their wellbeing and a toll on the people around them.

Adult ADHD is tricky to diagnosis and deciding whether to get help for it can be difficult as well. The symptoms that traditionally describe ADHD: restlessness, impatience, procrastination, chronic lateness, and difficulty getting organized, focusing, and finishing tasks are common in busy adults. But how can one tell if it’s just stress, or too much caffeine that is causing their symptoms? What about the stigma and perceptions associated with ADHD? What does it mean to suddenly discover at the age of 40, that you have ADHD?




The key word in determining whether an evaluation should be considered is impairment. As Dr. Jaksa from the article puts it, "Everyone gets distracted. Who's not late occasionally? But if you are chronically late, you lose your job and maybe your friends as well."




Experts say that those who suspect they have ADHD should have a thorough evaluation, with a psychologist or psychiatrist who specializes in the disorder, looking at how they functioned in early childhood, in school and social settings and personal relationships. Once ADHD is diagnosed, most experts recommend treatment with both medication and behavioral therapy.




Here are some adult ADHD key points:




• Adult ADHD can be comorbid with bipolar disorder, anxiety, and depression, further complicating diagnosis and treatment.




• For adults diagnosed with the condition, treatment can consist of behavioral therapy, medication, or both.




• People who think they may have ADHD should be evaluated by a psychiatrist who understands the disorder.




A recent study published in the August 25 issue of the Journal of the American Medical Association, cognitive behavioral therapy (CBT), "a form of psychotherapy that focuses on changing patterns of thought and behavior that are counterproductive, can help" adults with ADHD. For more information on that study and recent news about Adult ADHD – please visit the following links:




Los Angeles Times (8/24, Healy)




CNN (8/24, Landau)




HealthDay (8/24, Gardner)




Reuters (8/25, Pittman)




WebMD (8/24, Hendrick)

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Posted in: ADHD,Felicia Wong MD,therapy,treatment

What do the holidays mean to you? It’s how you frame the question.

R. Scott Benson, M.D.



Thanksgiving seems to be the one time a year we can get a national focus on family and sharing with others. And before we finish that pumpkin pie everyone seems to start working on the next holiday which comes in different names in different cultures, but typically involves gifts. In the Santa tradition the focus is on what will he bring me.



But then we realize that is not the real meaning of the holidays.





A tool from cognitive therapy might help at this point, reframing. Reframing involves recognizing distorted thinking and focusing on other thoughts that reflect the reality that we want.



Let’s try an example. Typically we ask children “what do you want?” and later we ask “what did you get?” And these are the questions that define the meaning of the holiday season for them.



I don’t think that is the meaning we intended. So we can try a different approach. And it takes a lot of practice. In working with children or in my community I try to start the conversation with “What have you been thinking about doing for your mother during the holidays?” Or “What do you think your brother would like this year?”



And after the presents have been opened I ask, “Who really liked the present you gave?” And always in this era of instance messaging and Tweeting it never hurts to ask “Have you started on your thank you notes yet?”



Well? Have you?

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Posted in: family,holidays,therapy