Categories
Wellness

4 Mental Health Activities for Teens

Adolescence is a rough time. Teenagers are faced with a myriad of physical, social, and behavioral changes while learning to survive adulthood, coping with a growing awareness of the world around them, and facing brand new responsibilities each day.

For some teens, these challenges are coupled with the onset of unexplained and unfortunate mental health symptoms, some of which can drastically alter and affect their thoughts and behaviors. These symptoms can greatly amplify the already challenging road ahead.

A lot of teens enter the last years of their childhood feeling alone, overwhelmed, and anxious about the past, present, and future. Helping them navigate their way into the world while coping with their unique issues is difficult but never impossible. Finding support is crucial, both in the community and professionally.

But beyond therapy and support, it’s the day-to-day that makes the most impact on how a teen feels. It’s essential to find mental health activities that help your teen cope with their stressors and symptoms. Remember, as a parent, your influence on your teen is paramount – and in the grand scheme of things, you will always be your teen’s most prevalent therapist. Here are a few mental health activities that can help right away.

A Day in the Woods

It’s no panacea, but it’s still surprisingly effective most of the time. Simple woodland walks have a distinct effect on human psychology. This effect has been studied and cataloged for years, particularly on feelings of depression, confusion, and anxiety.

Also known by the Japanese term shinrin-yoku, or forest bathing, the act of taking a long stroll through a forest can immediately impact your teen’s mental wellbeing, coupling the soothing effects of being surrounded by nature with the physical benefits of natural light and fresh air, and the physiological benefits of a long, vigorous walk.

Forest bathing is more than just a therapy tool. It’s also an effective form of stress reduction and has been proven to be exceptionally useful in preventing stress-related health conditions. The stronger a person’s feeling of stress, or the heavier their overall burden of stress, the more effective the experience.

If you’re not exactly living to the closest access point to a natural forest, a walk in the park or a hike through nearby nature can still be an effective stress-reduction tool and a great bonding experience. Use the time to get to know your teen’s thoughts and interests better, and figure out how they’re feeling.

Starting a Handy Project Together

There are few things in life as satisfying as creating something with your own two hands, whether it’s in the form of tinkering with a soldering iron and a PCB or creating a birdhouse out of fresh lumber. If you’ve always been handy in one way or the other, consider inviting your teen into the garage for a two-person project.

Tune up the bike together, work on your project car or do whatever else you might enjoy. It doesn’t have to be woodworking, tinkering, welding, or mechanical work – you could work with your teen on another kind of creative endeavors, such as a joint painting exercise, a sculpture, or something completely unorthodox, like coding a game together. Think of which of your hobbies or interests your teen might have an interest in as well, as to give them a chance to experience it through their lens.

Exploring Your Teen’s Interests

Working on something together for the first time can be a great bonding experience and can help provide your teen with the satisfaction and self-esteem boost that comes from taking part in the creation of something unexpected and creative.

But that experience should go both ways. If you’ve helped your teen discover a new interest for themselves, you should give them a chance to share an experience with you as well. One of the most insidious symptoms of depression is that it saps the joy out of experiences that used to be fun.

Forcing oneself to pick up an old hobby and spend time with it can combat depressive feelings and help cheer a person up. Use this opportunity to ask your teen to share their interests with you and help them feel a bit better.

Train With Your Teen

If your teen is an athlete or enjoys sports, then another way to spend time together and simultaneously help them cope with their mental health is by getting active. Go for a jog together, hit the weight room together, practice drills, and train together.

Help your teen improve their skills on and off the field while benefiting from the mental and physiological effects of the enormous endorphin release of exercise.

If your teen isn’t very active, then this would be a great time to try and find a way for them to enjoy physical activity. Exercise is one of the most effective ways to modulate stress and reduce mental health symptoms over the long term, and it’s an incredibly potent coping mechanism for nearly any mental health diagnosis and multiple different physical chronic health conditions. And as with any other habit, it pays to get started young.

Forcing your kid to get up at sunrise and go for a jog each morning might not be the best approach, but you can consider setting an example by being more active yourself and encouraging your teen to try out different mental health activities with you. Not everyone is a fan of track-and-field, but if you can identify your teen’s unique physical talent and interest – whether it’s dancing, swimming, lifting, contact sports, ice skating, biking, hiking, climbing, or anything else – then you’re helping them discover an enormously beneficial therapeutic tool.

Letting Your Teen Spend Time Alone

Spending time together is beneficial for several reasons: it lets you keep an eye on your teen, encourages them through an activity they might not want to engage in to begin with, and help them see things through.

But teens are quickly becoming young adults and need boundaries, privacy, and a sense of self-determination. Of course, support is critical. But you can’t hover over them through every step of therapy, let alone life. Encourage your teen to make the most of these mental health activities and incorporate some of them into their daily schedules – and give them the space to choose how to spend their time and live their life.

Categories
ADHD Adolescence Mental Health

Does Your Child Have ADHD?

ADHD is a common disorder that mental health professionals encounter. It has become a go-to diagnosis for physicians, whose first line of treatment is typically Adderal or Ritalin. However, ADHD diagnoses are often determined using elementary questionnaires, the answers to which are relative and rely on a patient’s (i.e., parent’s) willingness to be transparent rather than psychological clarification.

 

It’s important to recognize that there are many psychological issues that have similar traits to ADHD.  Often times, someone will present with ADHD traits when their actual diagnosis is depression, anxiety, or PTSD.  Using drugs like Adderal or Ritalin isn’t always a wise course of action. These drugs are both stimulants and highly addictive. While these drugs will certainly increase focus and attention, they will also mask the relevant and underlying issues that may be present. Additionally, they have severe side effects: paranoia, irregular heartbeat, and an increase in blood pressure, tremors, restlessness, hallucinations, and muscle twitches.

 

Finding a skilled mental-health professional will shift the course of your teen’s treatment; a qualified clinician can skillfully diagnose disorders that are similar in symptoms but which may require different treatment.  Diagnosing ADHD requires investigation into several areas. Doctors look at the following to determine if there is an issue of hyperactivity and impulsivity. This is often the more obvious form of ADHD and more easily recognizable because of the negative social constructs that occur. Note, a child or teen has to experience 6 or more of these symptoms for a minimum of 6 months to qualify for this diagnosis. ADHD is diagnosed by looking at the following issues (following info via PsychCentral):

 

Inattention

  • Often has difficulty sustaining attention in tasks or play activities
  • Often does not seem to listen when spoken to directly
  • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
  • Often has difficulty organizing tasks and activities
  • Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
  • Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
  • Is often easily distracted by extraneous stimuli
  • Is often forgetful in daily activities–even those the person performs regularly (e.g., a routine appointment)

  

Hyperactivity

  • Often fidgets with hands or feet or squirms in seat
  • Often leaves seat in classroom or in other situations in which remaining seated is expected
  • Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
  • Often has difficulty playing or engaging in leisure activities quietly
  • Is often “on the go” or often acts as if “driven by a motor”
  • Often talks excessively

 

Impulsivity

  • Often blurts out answers before questions have been completed
  • Often has difficulty awaiting turn
  • Often interrupts or intrudes on others (e.g., butts into conversations or games)

 

Note, the DSM-5 lists three subcategories for ADHD, which are:

  • Predominantly Hyperactive-Impulsive Presentation — Symptoms of hyperactivity-impulsivity but not symptoms of inattention have been shown for at least 6 months.
  • Predominantly Inattentive Presentation — Symptoms of inattention but not symptoms of hyperactivity-impulsivity have been shown for at least 6 months.
  • Combined Presentation — Symptoms of both hyperactive-impulsivity and inattentiveness have been shown for at least 6 months.

 

Regardless of where your child lands in the ADHD field, it’s important to have the appropriate clinical support, the willingness to accept the diagnosis, and the courage to do the work to support and care for your child. Creating schedules that your child can adhere to, having a therapist that your child relates to, and building an infrastructure of support can make managing ADHD and other similarly related issues easier for families. While it’s no walk in the park, it’s better to know than not know. It’s better to ask for help than to watch your child needlessly suffer.

Categories
Mental Health Personality Disorder Recovery

New Study: Omega-3 Fatty Acids and Borderline Personality Disorders in Adolescents

In recent news, a study from the Dr. Paul Ammiger and his esteemed colleagues recently published the results of their study, which investigated whether or not Omega-3 fatty acids would “improve functioning and psychiatric symptoms in young people with borderline personality disorder (BPD) who also meet ultra-high risk criteria for psychosis.” The study showed a decrease in the severity of symptoms in young adults who were at high risk for developing psychosis. The study studied 81 young people between the ages of 14-18 who were at “high risk for psychosis.” From this group, they found 15 who had borderline personality disorder.

 

For a period of 12 weeks, half of the group took 700 mg of EPA and 480 mg of DHA a day, while the other half took a placebo. Of those taking the placebo, 29% showed signs of psychosis. However, those taking the Omega-3 fatty acids showed significant improvement.

 

This is really encouraging. Borderline personality disorders are tricky and can be hard to address. The major symptoms revolve around interpersonal interactions, negative sense of self, significant mood swings, and impulsivity. The work involved in treating all mental illness requires a nexus of therapeutic support and a desire for positive change from the patient themselves. We’ve learned that applying Dialectical Behavioral Therapy (DBT), for example, has shown positive results in the treatment of Borderline Personality Disorders–recent studies have confirmed this, showing lower suicide rates, less self-harming incidents, and less self-removal from treatment.

 

Psychiatry is still a relatively young science, and growth and change are happening quickly as practitioners eagerly seek resolution to some of the most challenging psychological issues. Dr. Ammiger’s discovery regarding the use of Omega-3 fatty acids is profound. The study, though small in scope, produced impressive results: the data “suggests that omega-3 fatty acids, at the right doses for a long-enough period of time, can significantly improve the quality of life for people with borderline personality disorder.”

 

More research around the use of Omega-3 fatty acids will need to be done to ultimately determine the long term efficacy of Omega-3 fatty acids, but Ammiger’s study has shone a light into what is a dark corner for many.

_______________________________

References used for this blog:

Omega-3s in adolescents with borderline personality disorder

Omega-3 fatty acid supplementation in adolescents with borderline personality disorder and ultra-high risk criteria for psychosis: a post hoc subgroup analysis of a double-blind, randomized controlled trial.

 

Categories
Addiction Anxiety Depression Mental Health Prevention

The Dangers of DMT and Psychedelic Experimentation

DMT (Dimethyltryptamine) is a short-acting, albeit powerful psychedelic drug in the tryptamine family. Additionally, the use of Monoamine oxidase inhibitors (MAOIs), an older class of anti-depressant drugs, has been found to increase the effects of DMT.  This chemical structure of DMT has the same or similar chemical structure as the natural neurotransmitter serotonin and the hormone melatonin found in the brain.  Our bodies actually produce DMT, but science hasn’t determined its purpose thus far. It is derived from the essential amino acid tryptophan and produced by the same enzyme INMT during the body’s normal metabolism. Some researches have postulated that brain’s production of DMT may be related to the organic cause of some mental illness.

 

Adolescents are naturally curious creatures. They want to know about the world that they live in and they want to understand why it is the way it is. Developmentally this leads to a natural curiosity about the nature of the world and spiritual matters. During the 1960s, well-respected researchers looked into the potential of psychedelic drugs to treat mental illness, including depression. The ’60s generation took this as a cue to experiment with their minds. What we have learned since then is such experimentation is potentially dangerous and harmful, especially for those with a latent tendency toward depression, anxiety, schizophrenia and other forms of mental illness.

 

Psychedelic drugs have a distinct effect on brain chemistry. Some of them have chemical structures similar to natural neurotransmitters and almost all of them are classified as alkaloid. Historically, psychedelic drugs have been used by ancient cultures for spiritual practice and ceremony. And science has used psychedelic drugs for research.

 

However, psychedelics are significantly abused.

 

One of the most dangerous components of psychedelic drugs is the potential negative effect on people already vulnerable to mental illness. The user is, in effect, playing with his or her brain chemistry without direct knowledge of any short- or long-term effects these drugs may have. And someone who has an undiagnosed or untreated mental illness can adversely affect his or her mental health with the use of psychedelic drugs, or any drugs for that matter. Drugs like DMT, though old, are no different. DMT works fast, it has an intense effect that lasts for 15 minutes but purportedly feels like several hours. This can be an overwhelming experience, especially in cases of untreated or undiagnosed mental illness.

 

The bottom like is this: Experimenting with your mind is dangerous. Curious or not, this type of psychological misadventure is not worth the risk and the potential fallout.

 

Categories
Bipolar Disorder Dialectical Behavioral Therapy (DBT) Mental Health Recovery Therapy Treatment

A Brief Overview of DBT – Dialectical Behavioral Therapy

In this brief overview of Dialectical Behavioral Therapy (DBT), we are illustrating the efficacy of  DBT for the treatment of patients with suicidal behavior, bipolar disorder, and borderline personality disorder. DBT has been shown to reduce severe dysfunctional behaviors in clients. DBT uses validation has a tool to the client accept unpleasant thoughts and feelings rather than react to them in a dysfunctional way.  Simply put, dialectical means that two ideas can be true at the same time. Validation is the action of telling someone that what they see, feel, think or experience is real, logical and understandable. It’s important to remember that validation is non-judgmental and doesn’t mean you agree or even approve of the behavior you are validating.

 

Over the last year, Visions has effectively trained the staff to be DBT informed. We hold regular DBT skills groups at our residential and outpatient facilities. We have adopted and incorporated DBT skills into our day-to-day interactions with clients and are finding it to be incredibly beneficial.

 

I took some time to speak to Jesse Engdahl, MA, RRW, about his observations and experience with running the DBT skills group. He said, “We are happily surprised that it’s (DBT) become a community within a community. It’s set itself apart through the kids’ commitment to not only use the skills but in their support of each other. There is a high level of trust. We have kids coming into IOP who’ve felt marginalized and who hadn’t felt a broader amount of support, but find their place in DBT.”

 

The emphasis on validation in DBT is profound. Someone suffering from borderline personality disorder often has a movie playing in their heads and when the validity of that “movie” is denied, it can create a waterfall of dysregulation which can include anxiety, depression, anger, and fear. Taking a counter-intuitive stance and validating one’s reality is has been shown to be particularly efficacious. It deescalates the anxiety, and it teaches the client to self-regulate.

 

Joseph Rogers, MDiv-Candidate and DBT skills group facilitator and mindfulness teacher succinctly illustrates the value of our DBT groups, “Our DBT skills group gives our clients the confidence that they have the ability to meet their difficulties with skills that can be found within themselves and their capabilities.  By utilizing daily skills diary cards and reporting on their results, clients are able to see where they are being effective and can acknowledge the positive outcomes they are responsible for through their actions.  DBT has the ability to move clients out of their diagnosis toward a confidence in their personhood.”

 

Categories
Addiction Mental Health Recovery

The Challenge and Freedom of Letting Go

Are you faced with a big breakup and having trouble letting go?  We all know breaking up is hard to do. It’s tough whether you’re in a failing relationship, a waning friendship, a job that isn’t working out, a partnership that feels splintered, or any relationship that has simply stopped serving you. What if that relationship you so desperately need to end is your relationship with drugs and alcohol? What if the relationship that isn’t serving you is your relationship with your anger or greed? Being faced with a breakup of this caliber is tough.

 

It’s not ironic to me that we stay when we should go. Letting go is hard. It’s scary. It’s full of what-ifs and the unknown. Letting go of something that isn’t working can mean failure, but really what it most often shows us is great success. Our attachment to the familiar holds us back from investigating and cultivating change. In fact, change is something many of us fear. I once knew someone who was so afraid of change that he stayed in the same house, wore the same clothes, ate the same foods, spoke to the same people, and lived in the same town, all to his detriment. Every time an opportunity for change appeared, he recoiled, and became angry, volatile, even. The unknown was unbearable; change was his bogeyman. He ended up stuck in the sticky bitterness of his fear.

 

Addiction and the behaviors around addiction represent an unhealthy relationship. Addiction is that relationship we attach to while spinning out of control, creating external and internal harm, along with a cycle of shame. This relationship with addiction reminds me of the abuse cycle itself:

 

  • We are intimidated by it
  • We feel threatened by it
  • We feel bad about ourselves because of it
  • It isolates us and controls our relationships
  • We deny its existence
  • We lose our jobs or can’t get a job
  • It makes us financially unstable
  • It lies to us, making us feel good so we forget and start all over

 

These relationships with addiction and anger are the ones we need to end. Breaking up is hard to do. In letting go and moving toward freedom, we face the unknown, and often times, we have to face the thing we were hiding with our addiction. Things like untreated mental illness, poverty, sexual abuse, domestic violence, alcoholic parents or caregivers, and untended trauma are daunting. They are the beasts in the shadows. Still, the relationship to addiction has to end in order for any truths to come out. We have to lean toward our difficulties so we can eventually move through them. This is the breakup of your life: the one that will change your life for the better, and the one that will ultimately set you free.

 

Your relationship to addiction does not serve you. It never did. This breakup? It will serve you well. Recovery will set you on a path to heal. You will learn to set healthy boundaries; you will learn to love yourself; you will learn to be of service. You will learn to let go.

 

Remember this: Asking for help is a form of self-care, and accepting it is a form of self-love. You are worth it.

 

 

 

 

 

Categories
Mental Health Mood Disorders Personality Disorder Recovery Self-Care

Mental Health is Mental Wealth

When someone suffers from mental illness, there is a deprivation of the joy and emotional wealth that’s present when there is ideal mental health. Mental illness can drain our joie de vivre, and make for a muddy emotional existence. Relationships with loved ones tend to be difficult, and there tends to be a propensity for loneliness and isolation. Worse yet, when mental illness is left untreated, the toll it can take on the one suffering and their loved ones can be taxing and sometimes devastating.

 

Some types of mental illness are more straightforward in their treatment: anxiety and depression, for example, are often treated with various modalities of psychotherapy and balanced with medication. Personality disorders are complex and there are some instances where the patient doesn’t recognize their illness despite their deep suffering. The work involved in treating all mental illness requires a nexus of therapeutic support and a desire for positive change from the patient themselves. The question many have is, Why are personality disorders so challenging?

 

Personality disorders are grouped into three clusters:

  • Cluster A personality disorders are “characterized by odd, eccentric thinking or behavior.” The disorders that fall into this category are:  paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder
  • Cluster B personality disorders are “characterized by dramatic, overly emotional or unpredictable thinking or behavior.” The disorders that fall into this category are: antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.
  • Cluster C personality disorders are “characterized by anxious, fearful thinking or behavior.” The disorders that fall into this category are: avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.

 

Psychotherapy is the most common treatment for all types of mental illness; the most efficacious modality is determined by the needs of the client. Findings show that DBT (Dialectical Behavioral Therapy) in particular is the most effective therapeutic treatment for personality disorders and bipolar disorders. Other effective tools used in treatment may include:

  • Individual psychotherapy
  • MBSR (Mindfulness Based Stress Reduction)
  • Yoga
  • Meditation
  • Somatic Experiencing
  • Neurofeedback

 

To date, the FDA hasn’t approved of any medications to treat personality disorders. However, medications are often used to treat symptoms that are detrimental to the individual’s recovery. Medications like:

 

  • Antidepressents: for depressed mood, anger, irritability, mood swings, impulsivity and hopelessness.
  • Mood stabilizers: to even out mood swings, and to reduce impulsivity, irritability and aggression.
  • Antipsychotic medications (also known as neuroleptics): if symptoms include losing touch with reality (psychosis), and sometimes anxiety and difficulty with anger
  • Anti-anxiety medications: For anxiety, agitation or insomnia. Note, in some cases, they may increase impulsive behavior and are avoided with some personality disorders.

 

Treating mental illness requires the cultivation of balance. Participation from the client, a cohesive treatment team, and the correct combination of medication can create the desired environment of mental health.  It takes work, dedication, and a willingness to unveil one’s difficulties in order to create a healthy shift toward mental health. I have experienced the shadow side of untreated mental illness with family members who are unwilling to get help. It does, in fact, take a toll on everyone involved. I have learned that one of the key pieces for my own recovery is developing clear communication skills, creating firm, compassionate boundaries, and building consistent program of self-care. Families struggling with mental illness need to ensure that their own wells are filled, that they are getting their own needs met, and that they have a community of support around them.

Categories
Mental Health Suicide

Suicide is Preventable When You Know the Signs

Suicide is a major, yet preventable mental health problem. According to the National Institute of Mental Health, “In 2007, suicide was the thirst leading cause of death for young people ages 15-24. Suicide accounted for 4140 deaths (12%) of the total 34,598 suicide deaths in 2007. ”

  • Suicide is the 3rd leading cause of death for 15- to 24-year-old Americans. (CDC)
  • There are four male suicides for every female suicide. (CDC, AAS)
  • There are three female suicide attempts for each male attempt. (CDC, AAS)

Though these numbers seem daunting, they are not a complete reflection on the youth of today or the way they manage or respond to stress or difficulty. These numbers do, however, indicate a significant problem that we need to be aware of so that we can act accordingly to prevent it.

 

Suicidal behavior is never a normal response to stress.

 

Some of the risk factors for suicide include:

  • Depression or other mental disorders
  • Substance abuse (often in combination with mental illness)
  • Family history of suicide
  • Prior suicide attempt
  • History of physical or sexual abuse within the family system
  • Firearms in the home
  • Incarceration
  • Exposure to suicidal behavior of others

Other things to watch for in yourself or your loved ones include:

  • Feelings of hopelessness or worthlessness, depressed mood, excessive guilt, low self-esteem
  • A loss of interest in family or social activities
  • Changes in eating and sleeping patterns (too much or too little)
  • Persistent anger, rage, need for revenge
  • Trouble concentrating
  • Problems at school: socially and academically
  • Feeling listless or irritable
  • Regular or frequent crying
  • Not taking care of yourself (not bathing regularly, etc)
  • Reckless and/or impulsive behaviors
  • Frequent headaches, stomachaches

Warning signs that someone may be thinking of committing suicide:

  • Always talking about or thinking about death
  • Feelings of hopelessness
  • Clinical depression — deep sadness, loss of interest, trouble sleeping and eating — that seems to get worse
  • Loss of interest in things you or your loved one once cared about
  • Comments about being worthless, hopeless, helpless
  • Putting affairs in order, like changing or creating a will all of a sudden, or seeming to “tie up lose ends”
  • Comments like, “It would be better if I wasn’t here,” or “I want out.”
  • A sudden, and unexpected shift from deep sadness to being calm and happy.
  • Talking about suicide
  • Saying their goodbyes

 

It’s not uncommon for someone who is suicidal to have attempted suicide before. Recognizing some of these warning signs is the first step to helping someone you love or helping yourself. Asking for help is a sign of great courage and strength. It shows deep character and a fierce sense of survival. It is in the act of reaching our hands out that we open ourselves up to attaining help.

 

Categories
Anxiety Mental Health Recovery

Does Your Teen Suffer From Anxiety?

Anxiety is a normal function of stress. It is the nervous system’s way of telling you it’s on overload and needs a break.  Scientists have discovered that the amygdala and hippocampus play a significant part in most anxiety disorders. The amydgala is the part of the brain that alerts the rest of the brain and lets it know a threat is present; this will trigger a fear or anxiety response. The job of the hippocampus is to convert threatening events into memories. Interestingly, research is showing that the hippocampus appears to be smaller in people who have suffered from child abuse or served in the military.

 

Further research will begin to provide clarifying information regarding not only the size of the hippocampus in PTSD sufferers, but also the cause of fragmented memories, deficits in explicit memories, and flashbacks.  Understanding the functionality of the brain will help scientists form more salient ways in which to provide medical relief for anxiety sufferers.

 

Fact: 8 percent of teens ages 13–18 have an anxiety disorder, with symptoms commonly emerging around age 6. However, of these teens, only 18 percent received mental health care.

 

How is anxiety usually treated?

Medication is one option typically given to anxiety sufferers. It is a cure, but rather a means of managing the symptoms.  Often patients are given:

  • >Antidepressants
    • SSRIs, Tricyclics, MAOIs, anti-anxiety medications
  • Anti-anxiety drugs:
    • Benzodiazepines
  • Beta-blockers – which treat the physical symptoms of anxiety

In addition to medication or sometimes in lieu of, therapists may use modalities like:

You can also try one or all of these 8 tools for managing anxiety:

1. Deep breathing exercises: Deep diaphragmic breath helps activate the body’s relaxation response.  Practice exhaling on a longer count than your inhale. This is a wonderful tool to use to bring the heart rate down, provide oxygen to the blood and to the lungs.

 

2. Use calming visualization: Close your eyes and visualize a place that elicits a state of calm. It could be the beach, the mountains, a forest, being in the ocean, or doing something else that you love. This is a way of accessing one of your resources—something that calms you and engages your body’s nervous system.

3. Do something physical: go to the gym, go for a run, do a strong yoga class, do some jumping jacks, skateboard, or roller skate. In other words, get your endorphins going.

4. Play a musical instrument. For example, one of our teens plays the bass when he’s anxious.  Perhaps you play the guitar, or the accordion. Get down and make some music!

5. Connect with a friend so you are not alone. Maybe watch a funny movie together or blast some music and have a silly dance party.

6. Create a gratitude journal.  Write down 5 things you are grateful for and challenge yourself to write this list every day .

7. Focus on a meaningful, goal orienting activity: playing a game with a friend, building something, creating art, or singing.

8. Accept that you are anxious – it is a feeling. It doesn’t mean you like it or want it to be there, it means you are accepting where you are in that moment. The more you talk about how anxious you are, the more anxious you will feel. Accepting where you are allows you to stay in the present–when we are anxious, we are stuck in the future.

 

Anxiety can be accepted and worked with or it can be ignored. Ignoring it leaves you vulnerable to persistent dysregulation and misery. Addressing anxiety and facing it head on allows you to develop self-regulatory techniques. The latter will facilitate emotional regulation and the ability to approach triggers and difficulties more skillfully.

Categories
Mental Health PTSD Recovery

Treating PTSD in Children and Adolescents

Post-Traumatic Stress Disorder (PTSD) is not just for adults:

it also occurs in children and adolescents. Children and teens that witness violence and have post-traumatic stress symptoms require psychological care, but studies are suggesting that while children may experience the full range of post-traumatic stress symptoms, the manifestation of symptoms can differ from that of an adult.

 

The Journal of Pediatric Psychology says, “in the DSM-IV, eight criteria require verbal descriptions of experiences and emotional states. The lack of developmental modifications may result in an under-diagnosis of PTSD. “(Pynoos, Steinberg, & Goenjian, 1996). Scheeringa et al. (1995) Additional  “evidence suggests that children may experience disabling PSS (post-traumatic stress symptoms) that warrant treatment, but not meet criteria for PTSD (Carrion, Weems, Ray, & Reiss, 2002).

 

What has become crucial in defining this diagnosis for adolescents is the way in which clinicians understand how PTSD presents in youth. There is still a debate within the field of pediatric psychology about whether or not distinct youth criteria should be established — thus far, post-traumatic stress symptoms have been assessed primarily using criteria outlined for adults.  When assessing youth for PTSD, the adaptation for youth includes the “simplification of language and concepts.” However, there continues to be discussion amongst clinicians about the need for separate qualifiers for youth.

 

Symptoms of PTSD might include classic stress responses such as nightmares, fear and a general response to distress, but according to the American Academy of Child and Adolescent Psychiatry, there may be some symptoms unique to children and adolescents like:

 

  • Reenactment of the event
  • Regressed behavior
  • Separation anxiety,
  • Specific forms of behavioral, academic, and somatic problems”

Did you know: Between 25 and 87% of youth report experiencing at least one traumatic event before age 20, with girls reporting more episodes (Elklit, 2002)

 

Noelle Rodriguez, Psy.D. and Visions Outpatient Psychological Assistant shared some of her experience working with teens who suffer from PTSD. She listed some of the manifestations she sees and how she helps treat them:

  • High levels of depression because PTSD is misdiagnosed
  • Inability to formulate trusting relationships
  • Drug use to attempt to access or regulate feelings

Noelle also finds teens with PTSD also present with some or all of the following:

  • Poor time management
  • A need to find a voice but feels silent inside
  • Loss of self, feeling fragmented
  • Somatic symptoms i.e., body pains, headaches, etc.
  • Disassociation
  • Sexual promiscuously–looking to feel connected
  • Paranoia
  • Lack of boundaries, which leads to more mistrust

Noelle takes her PTSD clients through a process of deep, insightful work that helps them strive toward shifting their paradigm to include:

  • Empowerment;
  • Sobriety (if applicable) on their own terms;
  • Replacing maladaptive behavior with healthy behaviors, for example:
  • Learning to ask for help, finding a support group, becoming able to  recognize and identify PTSD symptoms before they have a chance to fully manifest
  • Self-care
  • Learn how to identify danger vs. safety
  • Develop tools with which to to deal with blame, shame and doubt
  • Time management
  • Honesty in relationships
  • Finding their voice and learning how to speak up for themselves
  • Learning to get grounded when one is in emotional pain.

 

Peter A. Levine, Ph.D, originator and developer of Somatic Experiencing and the Director of the Somatic Experiencing Trauma Institute has transformed the way in which I personally view PTSD.  He says in his book In an Unspoken Voice, “I hope to convey a deeper appreciation that their lives are not dominated by a ‘disorder’ but by an injury that can be transformed and healed.” Like Noelle, he talks about the need for someone working with PTSD to learn to self-regulate. Levine says this self-regulation “allows us to handle our own states of arousal and our difficult emotions,” and that it is what fosters the ability to “evoke a sense of being safely ‘at home’ within ourselves, at home where goodness resides.” Trauma work is a deep process. It involves learning how to hold ourselves with a sense of compassion while we look at the darkness that has swaddled our hearts.

 

So whether or not the DSM catches up, knowing that we have clinicians who are well versed in trauma work and who are willing to guide our youth to recovery is profound. Triggers eventually become tools we work with instead of against. And ultimately, with deep, consistent work, we develop the skills to change our relationship to our trauma and to heal.

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