Friday, August 27, 2010

Teach Teens and (Yourself!) how to W.A.I.T

By Tristan Gorrindo, M.D.

By now, over 80 percent of teens have an account with Facebook, Twitter, or some other social networking site. A common feature on almost all of these sites is the ability to share with your friends whatever is on your mind. Commonly these posts appear on a “wall” or other profile page for everyone to see.

Postings come in several versions: short bits of text, pictures, movies, and links to other websites. And the content of these posts can range from mundane observations about the weather, to the exuberant joy of being accepted to a highly desirable college, and everything in between. With the average teen having hundreds of “friends” on Facebook every post is fairly public event.

Teenagers are often defined by their impulsivity and their limited appreciation of long-term consequences. As a child psychiatrist, I see how poorly thought through social network posts can have real-life consequences. For example, a teen facebooking, “I’m so mad at Jessica, I could kill her,” might result in suspension from school. Even posts about, “getting wasted last night,” can have consequences for participation in school athletics or college recruitment if adults stumble across them.

In my work with teens, I try to get them in the habit slowing down the entire process of posting, with the hope that they’ll think before they post. One such tool I’ve created is the mnemonic W.A.I.T.

W. Wide-audience

“W” asks the question: Would I say this in front of a school assembly? If a teenage boy, for example, has 800 friends on Facebook, it is then helpful for have him visualize standing in from of 800 peers at an assembly school assembly reading his Facebook posting aloud. Still sound like a good idea?

A. Affect

“A” asks the question: Am I in a good emotional place right now? Drawing from the basic notion that thoughts and feelings are connected, here teens learn to think about the ways in which their mood might be affecting what they are about to say.

I. Intent

“I” asks the questions: Might my intent be misunderstood? The teen tries some perspective-taking to determine if his or her comment might be misunderstood.

T. Today

…tomorrow, or the next day? “T” asks the question: Can this wait a day? In an effort to slow the emotional drive that pushes teens to post to the Internet, this intervention asks teens to evaluate the urgency of what they are about to say. Why is it so urgent? What will happen if I wait?

I recognize that it’s unrealistic to expect that teens will W.A.I.T. every time they want to share something on a social media site, but I ask the teens I work with to write it on a post-it and stick it on their computer with the hope that it’ll slow them down. Using this technique, teens learn a structured way of evaluating whether or not something belongs on the Internet. It also provides clinicians and parents with a structured conversation tool to engage teens in discussions about what they are posting online.

Happy posting.

Monday, August 23, 2010

School's in Session - Lesson 1: ADHD

By Gariane Phillips Gunter, M.D.

School started just a month or so ago, but some parents may have already received calls about their child’s “behavior." An article published in USA Today reported on a study conducted at Michigan State University which stated that kids who are the youngest in their grades are 60% more likely to be diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) than the oldest children.

My goal for this blog posting is not to validate nor dispute this data but to offer facts about the diagnosis of ADHD. First and foremost, the diagnosis of ADHD should only be made by a trained professional after a thorough assessment of the child and collateral information.

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

Children with ADHD:

• Have difficulty finishing any activity that requires focus  
• Don't seem to listen
• Are excessively active, running, or climbing at inappropriate times, squirming in or jumping out of their seats
• Are very easily distracted
• Talk incessantly, often blurting out responses before questions are finished
• Have serious difficulty waiting their turn in games or groups
• May have specific learning disabilities

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

If your child is diagnosed with ADHD there are effective treatments and medications available to help him or her have a successful year at school. Please contact your child's doctor for further guidance.

Friday, August 13, 2010

Maternal Mental Health: Can Stress Harm Your Chances of Getting Pregnant?

By Felicia K. Wong, M.D.

Getting pregnant is an exhilarating experience for some couples. But it can also be a very frustrating, and heart-wrenching, experience for others. Age, smoking, obesity, and alcohol are studied and known factors to effect pregnancy success.

Anecdotal reports have long linked stress with infertility, but to-date, there has not been much scientific evidence to prove the connection. On August 11, 2010, the BBC published an interesting article describing an Oxford University study that demonstrates for the first time that high stress levels may delay pregnancy. Their findings suggest that perhaps the best thing a couple can do to prepare for pregnancy is to relax.

Dr. Cecilia Pyper, of the National Perinatal Epidemiology Unit at the University of Oxford, measured stress hormones in 274 healthy women aged 18-40 planning to have a baby naturally. They found that those who were most stressed had a reduced chance of becoming pregnant that month. Dr. Pyper said: "The findings support the idea that couples should aim to stay as relaxed as they can about trying for a baby....In some people's cases, it might be relevant to look at relaxation techniques, counselling and even approaches like yoga and meditation."

The study, aimed to improve understanding of the factors that influence pregnancy in normal healthy women, was published in the journal Fertility and Sterility. The research was carried out in collaboration with the Eunice Kennedy Shriver National Institute for Child Health and Human Development in the US. It is part of a larger study looking at the effect of factors like smoking, alcohol, and caffeine on chances of pregnancy.

This being the first of such studies, more research is needed to further link the role of stress and pregnancy. In the meantime, it can’t hurt to relax

Thursday, August 5, 2010

How to Help Someone Who Refuses Help for a Mental Illness: Tips for Family Members and Friends

By Molly McVoy, M.D.

What do I do if my husband won’t listen to me? My mom? My friend? My daughter? I hear this question all the time. Someone recognizes the possibility of depression, anxiety, ADHD in a friend or relative, but the other person just doesn’t see it. They refuse to go see someone for help. What do you do?

You keep talking to them. It is quite common for individuals to be unaware of a mental health problem they may have or to actively deny that such a problem exists. Sometimes it takes hearing it for the tenth or even the 100th time before someone listens and seeks care. Even though you may feel you’re not being heard, you may be the one person who’s willing to plant the seed and start that person thinking about getting help.

Finally, you’re not alone. If you are worried someone in your family or group of friends is seriously ill, at risk of hurting themselves or hurting someone else, call for help. Most cities in the United States have a 24 hour suicide hotline, and nationally, you can call 1-800-suicide. There are people trained to help you with this, even if your friend or family member won’t call, you can and start the journey towards mental health.