Category: teens

Unsettling: What psychosis looks like in children and young people

Unsettling: What psychosis looks like in children and young people

kill him street
This eerie painting is by a young woman of 22 diagnosed with schizophrenia. She is encountering a threat, real or imagined, and her paranoia is compounded by being watched from the window above. Note the symbolic references to communications links and satellites.

Odd, eccentric, a little weird:  people experiencing psychosis are living in dream space.  If you haven’t experienced psychosis yourself, it’s a little like the period just before you awake, when you’re in a dream but also aware of your surroundings.  Your dream and emerging consciousness weave together in a wonderful or horrible or simply odd narrative.  If you try to explain it someone, you realize it makes no sense, yet it made a lot of sense while you were dreaming.

To a parent watching a psychotic child, you may observe that they see, feel, hear, move about, and respond to you as if fully conscious, but it’s important to know that they simultaneously inhabit the subconscious. As a result, they don’t notice that what they do and think is any different from anyone else.  The term “anosognosia” refers to their inability to recognize this, and it explains why so many resent being told they have a problem and need treatment.  They simply aren’t aware that anything is different about them.

Evidence of psychotic behavior

Parents of a child who was eventually diagnosed with a psychotic disorder often report that their child was always a bit different from their peers–slightly eccentric, a unique individual who had an interesting way of looking at the world. Parents have also reported the following behaviors when their child was exhibiting psychosis.  (Not all of these are present in each child.)

  • A belief in something that isn’t rational, and the belief is unusual or unreal or impossible.  The person cannot be talked out of the belief.  And rational, logical reason only increases resistance to reason.
    • If the psychotic episode is positive or magical, the person may have powerful religious feelings and a sense of omnipotence or clairvoyance. They may believe they have been instructed to give a message to save the world, for example.
    • If the episode is negative and paranoid, they can become very agitated, fearful, or they may panic.  They may act negatively on irrational beliefs.  They are attracted to paranoid or extremist views, especially those with high emotional content.
  • Smiling or laughing at nothing in particular and for no apparent reason. It’s as if someone has just told them a joke.
  • Yelling or ranting, this could be at an object or at someone or at nothing apparent. The ranting can happen online.  The ranting has repeated themes, and the themes are unique to each person.
  • Intense, crushing anxiety, irritability, accusations, and obsessive troubling thoughts.
  • Talking and gesturing as if they’re in a conversation with an invisible someone. (Normal people also gesture they think, but they are aware they are not literally communicating with someone.)
  • Wandering eyes and shifting body language as if they are seeing or feeling things that aren’t there.
  • Abrupt personality change from seemingly normal behavior.  Often, a child’s eyes will have a disquieting faraway ‘look’, as if the child is not in their body, and a they’ve been overtaken by a demon.
  • Fear, anxiety, and paranoia–they feel watched, trapped, and controlled in some way. They stop trusting people.  They hide or try to block experiences to protect themselves.
  • Intense obsessions with ideas, things, or events (even if they occurred long past). Themes emerge which often refer to actual events that elicited strong emotions.
  • Seeing patterns and connections in events that aren’t connected.
  • Unusual and confusing responses when communicating with others—a comment that doesn’t seem to apply, or a a string of words that defy interpretation.
  • A preference for solitude and closing themselves off from others.  This is for self-protection.
  • Loss of interest in self-care: not wearing clean clothes, bathing, or organizing their surroundings.

The most common diagnoses that have psychotic features are schizophrenia, schizoaffective disorder, bipolar disorder, and depression.  This story about schizoaffective disorder gives some real world examples of psychosis:  “Life with a Schizoaffective Teen.”

Psychotic behavior can have a long slow onset

brain degeneration in schizophrenia
The image on the left is of a 15-year-old boy with early onset schizophrenia. The purple regions have normal neuron density, red regions have low neuron density. In the 2nd image, the red area at the top of the brain is in the cerebral cortex, the region of executive function and rational thought.

It’s easy to miss signs of early psychosis!  Sometimes a child or young person starts showing eccentric behaviors that aren’t serious or are easy to interpret as something else: creativity and imagination; immaturity; puberty; influences from immature friends; too much video gaming…  Your child may have been experiencing mild visual or aural hallucinations for some time, even a couple of years, and just assumed it happened to everyone so they never reported it.  As psychosis emerges in the early teens, their thoughts and behaviors start affecting friendships or school work.  The child stops doing things they once enjoyed.  Someone might assume they’re experimenting with drugs.  They seem so much like other difficult, distracted, or defiant teens that a parent can be lulled into thinking they are not seriously mentally ill… but psychosis is very serious.

If this describes your child, immediately (and I mean immediately) find a psychiatrist and get an assessment.  The earlier you can treat psychosis, the better the outcome for your child.  Psychosis is degenerative.  The longer a brain stays in a state of psychosis, the more neurons it loses.  Early treatment via therapies, medication, diet, and other physical supports can literally prevent neuron loss and future psychotic breaks that require hospitalization.

Psychosis can emerge abruptly

For disorders on the schizophrenic spectrum, this is common in young men in the late teens and early 20’s.  However, adults in their 30’s and 40’s have also been known to have sudden onset of psychosis.  It’s tragic, you witness this young person launching into adulthood, studying in college or starting employment, and suddenly his or her personality changes.  Their behavior worsens, and it becomes evident they’ll never be able to have the future they planned.  They need immediate treatment, possibly hospitalization if the psychotic break reaches a crisis point.  If this is your child and they are past age 18, use every means possible to get help for them!

Kendall art
Self-portrait by a 24-year-old woman diagnosed with schizoaffective disorder. Her image is a modified mug shot photo taken of her after an arrest.

What worsens psychosis and what you can do to relieve it

  • Poor sleep and reduced sleep.

Help your child get enough hours of sound sleep. The best sleep environment is a cool very dark room.  Once my child became unable to attend high school, I allowed her to nap any time of the day.

  • Closing themselves off from the world.

Your child needs mental and sensory stimulation to keep their mind from spinning out on their obsessions, hallucinations, and paranoia, but the amount must be tolerable.   Stimulus must come from the tangible, sensory world (e.g. not screen time, videos, books).  Concrete interaction with reality diverts their attention from obsessive thoughts or voices.  They will benefit from regular (perhaps limited) social interaction*, an undemanding therapy animal, creative work (such as art and music), and being out in nature.

  • Marijuana use–specifically the THC in marijuana

CBD in marijuana has many medical benefits and is considered safe, but the THC is not.  THC is also addictive, and available in very highly concentrated oils… extremely dangerous.  Like THC, any addictive substance, from alcohol to methamphetamine, will interfere with treatment for psychosis.  The drug’s influence trumps everything.  Drugs are literally self-induced psychosis.  See:  “Marijuana is Uniquely Harmful to Troubled Teens”;  “Marijuana is Dangerous.”

  • Continual exposure to things they already obsess on or that make them paranoid, angry, or anxious.

In every way possible, keep your child away from any material, people, or messages that upsets them.  These only add gasoline to the fire and increase the likelihood of future psychotic breaks.  They may obsess on the same things for the rest of their lives.  If someone who’s psychotic is exposed to intense emotional experiences that feed their obsessions and paranoia, people have been known to do to horrible things to themselves or others.  An example at the time of this writing is of a young woman with psychotic bipolar mania who tragically pulled out her own eyes.

Find ways to redirect your child’s attention elsewhere and help them get a grasp on the reality.  Help them calm down (“deescalate” them) and help them learn ways to calm themselves down.

A diagnosis of an illness that includes psychosis is devastating

Face to facePsychosis and/or a psychotic crisis in a child who previously led a normal healthy life blindsides everyone, especially the family.  Allow yourself to go through the stages of grief as you would after any death…  because it can feel like the ‘death’ of your child and their future and your hopes for them.  Get help from others as you would after any death.  Here you are, grieving, but your child needs you to be strong!  Get help for your own mental health.

Reason for hope

Children who receive regular social support from family and loved ones do well over the decades.  They can avoid homelessness, hospitalizations, harm.  They can get advanced education, keep strong relationships, maintain employment.  They get a life of wellbeing.  This has happened with my adult child after years of horrendous experiences.

Cognitive Enhancement Therapy

A relatively new therapy has been developed and tested that meaningfully helps people with chronic psychotic disorders.  “CET attempts to increase mental stamina, active information processing, and the spontaneous negotiation of unrehearsed social challenges. It does so with a focus on enhancing perspective taking, social context appraisal, and other components of social cognition… CET has been shown to have remarkable and enduring effects in a study of persons with schizophrenia or schizoaffective disorder…”
–CET Training LLC, “approved and recognized by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) as an evidence-based practice.

What are your experiences?  Have you found anything that helps?

–Margaret

 

*Social Interaction Increases Survival by 50%
Psychiatric Times. July 30, 2010

Theoretical models have suggested that social relationships influence health through stress reduction and by more direct protective effects that promote healthy behavior. A recent study confirms this concept.  Findings from a meta-analysis published in PLoS Medicine indicate that social interaction is a key to living longer. Julianne Holt-Lunstadt, PhD of Brigham Young University and colleagues analyzed data from 148 published studies (1979 through 2006) that comprised more than 300,000 individuals who had been followed for an average of 7.5 years. Not all the interactions in the reports were positive, yet the researchers found that the benefits of social contact are comparable to quitting smoking, and exceed those of losing weight or increasing physical activity.

Results of studies that showed increased rates of mortality in infants in custodial care who lacked human contact were the impetus for changes in social and medical practice and policy. Once the changes were in place, there was a significant decrease in mortality rates. Holt-Lundstadt and colleagues conclude that similar benefits would be seen in the health outcomes of adults: Social relationship-based interventions represent a major opportunity to enhance not only the quality of life but also of survival.”


If you would like to get ongoing updates on the latest news and research in child & adolescent mental health, follow my Facebook Page.

Use the “S” word: talk openly with your child about suicide

Use the “S” word: talk openly with your child about suicide

Don’t be silent on the subject of suicide, even if there’s no evidence your child has considered it.  Bring it in the open, especially if you have a hunch something is wrong and they may have suicidal thoughts.  This article addresses:

  1. Why you should talk about suicide with your child
  2. How to respond if there’s been a threat
  3. How to respond if there’s been an attempt

Parents talk about many uncomfortable subjects with their child; and suicide must be one of them.

Don’t let suicide become a ‘sensitive’ subject.  Your child needs to hear about it from you.  They should feel safe talking about it.  Don’t expect them to bring this subject up.  They may fear you will overreact, and worsen their depression, or you could under-react or dismiss it because you’re uncomfortable.  Neither response helps.

Won’t this give my child ideas and encourage suicidal thoughts?

No.  Children usually know what suicide is and will have wondered about it—even young children. Ask what your child thinks. Children as young as 7 and 8 have asked about suicide or communicated they had suicidal thoughts.  Children as young as 10 and 11 have attempted or completed suicide.  The ages of highest suicide risk are between 10 to 24.

Talk with your child. Don’t leave him or her alone with thoughts or questions about suicide.

An 11-year-old boy died of suicide a couple of weeks before this article was written. There had been no prior signs.  He killed himself after receiving a prank text saying his girlfriend had committed suicide. He told no one beforehand.  His parents had no idea he was even at risk.

Why might my child become suicidal?

Mental health professionals assess risk by using the Biopsychosocial Model.  The more negatives in the biological, social, and psychological aspects of one’s life, the higher the risk of suicide or other mental health problems.

The major risks of suicide are in the central part of this diagram: drug effects, temperament, IQ, family relationships, trauma.

From Pinterest and the blog, Social Workers Scrapbook

What can you control and change at home?
What do you and family members need to reduce these risks?
Communicate about these with everyone. (Can be hard to do, but try.)

What can trigger suicidal thoughts?

Examples from two states that did the research:

Oregon: Survey results for an exceptionally high suicide rate among 10-24 year olds by population, 180 individuals in one year (“Suicide circumstances by life stage, 2013-2014”).

  • 62% – Current depressed mood
  • 53% – Relationship problems
  • 47% – Current mental health problems
  • 43% – Current/past mental health treatment
  • 42% – History of suicidal thoughts/plans
  • 31% – Recent/imminent crisis
  • 22% – Family relationship problems
  • 21% – Non-alcohol substance abuse problems
  • 8% – School problem

New York: Life situations of children completing suicide, 88 individuals; (“Suicide Prevention, Children Ages 10 to 19 Years”, 2016)

  • Feeling hopeless and worthless (often because of bullying at school, home, or online)
  • Previous suicide attempt(s)
  • Physical illness
  • Feeling detached and isolated from friends, peers, and family
  • Family history of suicide, mental illness, or depression
  • Family violence, including physical or sexual abuse
  • Access to a weapon in the home
  • Knowing someone with suicidal behavior or who committed suicide, such as a family member, friend, or celebrity
  • Coping with homosexuality in an unsupported family, community, or hostile school environmental
  • Incarceration (time in juvenile detention or youth prison)

What if my child has threatened suicide?

A threat opens a door for a discussion.  A good approach is to interview your child about their feelings, plans, needs, and reasons.  Listen earnestly without input.*  You might be surprised to find their problem is solvable, but their depressed mood paints it as hopeless.  Listening helps them get clarity and feel heard and respected.  Once you understand their problems, you assist them in identifying options and provide emotional support.

* I have a friend who worked for a suicide hotline, and he said the job wasn’t difficult at all.  He said, “All I did was listen and show understanding of their feelings and just let them talk. “

After a frustrating discussion about my teenage daughter’s suicidal threats, I gave up and said “No.  I’m telling you not to commit suicide.”  She was incredulous; “You can’t tell me what to do!  You can’t stop me!”  I responded, “Don’t commit suicide. You’re important to us.  You have important things to do in life.”  She made a few attempts in the following years (they were always public… as if she wanted to be discovered and prevented), and she always reached out to her family afterwards for support.  Did my words make a difference?

What if a threat is just for attention?

It’s hard to tell. It could be genuine  or manipulative.  Some children use threats to prevent parents from asserting rules.  Angry children, especially teens, use threats to blame and hurt parents emotionally.  If you think a threat is not genuine, open up the suicide discussion.  “Talk to me about this”, “It seems like an extreme reaction to something we can fix.” “What needs to change?”  “How can I help?”  Focusing on the threat will either expose the ruse or draw out important information for addressing an underlying problem.

What else can I do if my child threatens suicide?

  1. Observe and investigate.
  • Do they have access to unsafe objects or substances?  You can legally search their room.
  • Do they frequent unsafe places or spend time with people who encourage drug use?
  • Do they have extreme mood swings (up or down), or a chronic dark mood?
  • Do they take dangerous risks and seek dangerous activities?
  • Are there any other danger signs?
  1. Build a network of eyes–choose people who will observe your child and keep you advised of risk, e.g. a mature sibling, a teacher, your child’s friend or the friend’s parents, your child’s boyfriend or girlfriend, a relative, or a trusted person who knows your child.
  1. Make changes you have control over, and solidly commit to these changes. Bring the whole family along on the plan.  FOLLOW THROUGH.
  • In family life – reduce chaos, fighting, blaming, or bullying; express appreciation; neglect no one including yourself; create 2 – 3  house rules that are easy to enforce and everyone follows, even you.
  • In social and online life – learn as much as you can about the nature of your child’s relationships, whether romantic or social. Support them if they distress your child. Can they remove themselves from a toxic relationship? or cope effectively with anxiety? Can you help them address bullying at school or online?
  • Biological health – Sleep, Exercise, Diet.  Limit screen time at night because blue light inhibits sleep.  Pay attention to digestive health, which affects mental health. These are some natural approaches.
  • Psychological health – Ask a school counselor about your child.  Seek a working diagnosis and mental health treatment.  Help your child find outlets for personal self-expression:  journaling, music, art, poetry, or a website such as this one, where teens help teens.  Mind Your Mind is an excellent example.

What if my child attempted suicide?

He or she is still very fragile, even if in treatment!  They have taken the action, they’ve been there, and have the option for taking it again—a high percentage try againSuicide attempts are long-term emergencies. You need to be on alert in the following days, weeks, months, and possibly years.  In addition to intensive mental and physical health treatment, ensure your child gets regular deep sleep, exercise, and a good diet.  Ask them if they’ve had suicidal thoughts if you sense something is wrong.  Don’t be shy about checking in.

Pay attention to events that trigger suicide.

Check-in with your child when something traumatic happens or might happen, especially if someone he or she knows attempted or committed suicide, or a suicide was in a TV drama or covered in the news.  Triggers are an emergency, act immediately.

You have the power to prevent a child’s suicide.
Be strong. You can do this. 

Take care of yourself.

–Margaret

Mothers and Teenage Daughters: a School Counselor’s Story

Mothers and Teenage Daughters: a School Counselor’s Story

This article contributed by Benjamin Dancer.

I’m a high school counselor, which means I work with parents every day. Because I’ve made a career out of my work with adolescents, I see what a parent might be seeing for the first time. This includes a long list of unfortunate life events.

Back when we were teenagers, there wasn’t a massive network of servers positioned strategically across the globe to capture and record, forever, the embarrassment of our adolescent choices.

As a parent, I have a lot of empathy for other parents. It’s not easy, especially when you’re going through something for the first time. My life, on the other hand, is a little bit like Groundhog Day. In a sense, I’ve never left high school. Every school year I see the same things. Different kids, but the same behavior: alcohol, drugs, tobacco, bullying, kids running away from home, pregnancy and something new: sexting.

Take an adolescent boy with an underdeveloped prefrontal cortex, which by definition means he is incapable of fully contemplating notions such as consequence; take this teenager raging with sex hormones and give him a tiny device that he will carry with him everywhere, a device capable of sending messages instantly to anybody, anywhere in the world, and install a camera in that device. What do you imagine might go wrong?

facebook sextingWhen you and I were adolescents, we were no less reckless, no less idiotic with our choices, no less eager to use our bodies as grownups. The difference is that our stupidity has been forgotten by history. Back when we were teenagers, there wasn’t a massive network of servers positioned strategically across the globe to capture and record, forever, the embarrassment of our adolescent choices.  Sexting changes everything.

Over the last seventeen years in my work of mentoring adolescents and partnering with their parents, I’ve seen a lot of parenting styles. I’ve learned some important strategies in dealing with the situations teenagers present–strategies the average parent doesn’t have the time, through repetition, to learn. I feel confident telling you that there are some really good ideas out there. And some really bad ones, too.

Because I’m a writer, it occurred to me to write it down, what I’ve learned over the years. I’m a parent. I know it just as well as you do. We need a little grace in our lives.

Sexting book coverExcerpt from SEXTING AT SCHOOL:

The police called the sexting child pornography. So I understood Nicole’s concern: she wanted to talk to me about her daughter. Jessica was fourteen and three years younger than her boyfriend. He had been distributing images of Jessica through his phone. Nicole was worried; she was scared, and understandably so.

Jessica still thought she was in love.

“He calls her a bitch,” Nicole told me. “I read the texts. He says horrible things to her.”

“And she still wants to be with him,” I said.

The pain I felt for her was communicated in my voice. As a teacher, I see the scenario every year, but Nicole was experiencing this for the first time. Jessica was her daughter. Not long ago she was her baby. I could only begin to imagine the suffering the situation provoked. Nicole was in no position to hear how common this was.

Why do girls throw themselves at boys who treat them badly?

In Jessica’s circumstance there was a tremendous amount of grief. She had barely processed the loss of her dad. He was killed in an accident over the summer.

“I can’t stop her from being with him. I’ve tried. I took away her phone. I grounded her. She sneaks out of the house. I drop her off at school, and she ditches to be with him.” The mascara was now running beneath Nicole’s cheekbones, “Last night, she told me that she wished it was me who was dead. He was waiting for her out front. I saw her get into his car.”

sexting image“I can’t imagine what that’s like,” I told her. “I’m sorry.”

“Unless I physically restrain her, she will find a way to get back to him.”

I allowed for a long silence, as I thought there might be more Nicole needed to say.


“What did I do? What did I do wrong?”

I didn’t answer her question. And I didn’t dismiss it. I sat with her in it.

* * * * *

My role with Nicole is not all that different from my role with Jessica. It doesn’t matter whether you’re fourteen or forty, what you need is for someone to listen. What you need is for someone to understand.

Jessica and I talked later the same day.

“She went through my phone,” Jessica was angry. “She read my texts.”

I let her know that I understood her frustration.

“She won’t let me leave the house.”

“Why?”

“She’s trying to keep me from him.”

“Have you told her that you love him?”

“Yes.”

“And…?”

“She hates him. She doesn’t want me to see him.”

“Why does she hate him?”

At this Jessica paused. We had already talked about the pictures. She had told me stories about the boy. The way he had flaunted his sexual conquests. He was in my English class, and I had seen it firsthand: there were countless other girls.

After a long silence, she answered my question, “She thinks he’s not good for me. Is he?”mean boyfriend

It was ground we had already covered. In past conversations Jessica told me that she respects her mom for trying to protect her. I handed Jessica a box of tissues. She wiped the tears and told me, “No. He’s really, really mean.”

I listened to her cry for several minutes. I was thinking about her father. I knew the man well. I liked him. I was thinking about her mother. I was thinking about my own daughter.  It was true for all of us. What we need is empathy.

“I’m sorry,” I told her.  She questioned me with her eyes.

So I answered it, “I’m sorry you’re so alone.”

Jessica’s whole body shook when she sobbed.

* * * * *

no cell phoneThe last time Nicole was in my office she asked me if she should return Jessica’s phone. We had a similar conversation the day she asked me if she should call the police.

“What do you think?”

“I think Jessica needs to figure this out for herself. I’ve tried to protect her, but I can’t. I just can’t protect her from everything.”

“Does that mean you’ll give it back?”

“No. She’s not ready for that.”

“I don’t know the answers to the particulars,” I told Nicole, “but I know this. You’re a good mom. Jessica needs you right now. She needs you to be confident in your role.”

I saw the tears washing through the mascara, gave Nicole the box of tissues, and kept on going.

This is universal: the teenager wants desperately to have her independence, and she is terrified of it.

“Jessica loves you, and she knows that you love her.  Jessica is not aware of the fact that she is conflicted about this. She’s just a kid. As much as she pushes you away, she wants you to be strong, to love her.”

* * * * *

I talked to Jessica again a week later.

“Do you still see him?” I asked.

She was embarrassed, “Yeah.”

“Is he good to you?”

“Sometimes.”

“How about last night?”

She hesitated then said, “Last night he left me in a parking lot. I had to borrow a phone and call my mom to come pick me up.”

“Why’d he leave you?”

“To hook up with someone else.”

“Will you see him again?”

“Probably.”

“I have a vision for you,” I said.

Jessica smiled, like she had heard lines like that from me before.

But that didn’t deter me. I have an advantage over most parents of teenagers: I’ve made a career out of the adolescent. Their behavior can be alarming, infuriating and even demoralizing, but after seventeen years of guiding teenagers as they come of age, I have established proven routines.

I have a pretty good idea of how many repetitions it will take, of how many times I’ll have to say it before Jessica can even make sense of the words, of how many more times I’ll have to repeat it before she begins to adopt the language as her own.

So I told her again, “In my vision of your future, you will love yourself too much to let a boy treat you badly.”

* * * * *

BenjaminDancerThe story above is a composite of a dozen mothers and a dozen daughters I’ve work with over the years. In my FREE e-book, I analyze that narrative–elucidating what I believe to be the important parenting considerations.  

Find out more at: SEXTING AT SCHOOL, a FREE download at Goodreads.com, or if you’re feeling generous, you can buy it for $0.99 at Amazon.com.

About Benjamin Dancer:

Benjamin is a high school counselor at Jefferson County Open School where he has made a career out of mentoring young people as they come of age. He wrote the novels PATRIARCH RUN, IN SIGHT OF THE SUN and FIDELITY. He also writes about parenting and education. You can learn more at:

Website:      BenjaminDancer.com

Facebook:    https://www.facebook.com/benjamin.dancer

Twitter:        @BenjaminDancer1


Like this post or have a comment?  Please give it a rating (above) and share your thoughts. Your comments are helpful for other parents who read Benjamin’s article.  Thank you.

Margaret

Understanding and supporting a child with ADD or ADHD

Understanding and supporting a child with ADD or ADHD

Boy-with-ADD

This article contributed by the Diamond Ranch Academy.

Life with a child with ADD or ADHD can be trying and overwhelming. However, as a parent there are practical measures you can take to effectively control and minimize your child’s symptoms without controlling and monitoring their every move.

You help your child overcome daily challenges by redirecting his or her energy into positive activities. You start by having a dialogue with your child and family that honestly communicates the situation in a way that does not accuse them of being “bad”.  Their behavior needs improvement, but speak as if it’s a ‘normal’ problem that must be addressed.

Children with ADD or ADHD typically have shortcomings in executive function: the ability to think and plan ahead, organize, control impulses, and complete tasks. This means that you need to take over as the executive, providing extra direction while your child progressively obtains executive skills of his or her own. With tolerance, kindness, and plenty of family teamwork, you can help your child manage childhood ADD or ADHD and maintain a steady, happy home

You must to be able to master a combination of support and predictability.

Living in a home that provides love and lots of structure is the best thing for a child or teenager who is learning to manage ADD/ADHD. There are effective and simple changes you can make that are easy to implement; we offer four practical tips to help you understand and support your child with ADD or ADHD:

1.  Be honest with your child about ADD or ADHD
distracted girlIt is important not to avoid or ignore your child’s condition. ADD or ADHD is not your child’s fault, it is a brain disorder that causes young people to have trouble focusing, completing tasks, or planning the future. Most parents can reframe things, but don’t look at the negative. Your child should understand it is something they can and should manage. The rest of your family should do this too.

2.  Stay Positive
dad-and-sonWhen calm and focused, you are more likely to get your child’s attention and help him or her to be peaceful and attentive. And keep things in perspective. Your child’s behavior is related to a disorder, so most of the time it is not deliberate. Don’t sweat the small stuff; be willing to negotiate certain matters. For example, if one chore is left undone but your child has already completed two chores and their homework for the day, let it go and appreciate what they were able to complete. Staying positive also means believing and trusting your child. Trust that your child will learn, change, mature, and succeed.  Trust that your child wants to!

Taking care of yourself will allow you to take better care of your child.

It is vital to live a full, healthy life because you are the child’s role model and source of strength. Eat right, exercise, and find ways to reduce stress. Getting involved with organizations related to ADD or ADHD will also provide you with safe places to vent your frustrations and share experiences.

3.  Establish structure, enforce rules and consequences calmly

boy and garden

Help your child with ADD or ADHD to stay attentive and prepared by setting a strict routine. Set a time and place for everything to help your child with ADD or ADHD comprehend and meet expectations. Allow extra time for what your child needs to do, such as homework, chores, and getting ready in the morning.  Keep them busy but not too busy—a child with ADD or ADHD will become more distracted and act up if there are too many after-school activities going on.

Create structure in your home so your child knows what to expect and when.

Children with ADHD are more likely to succeed if they can complete tasks when the tasks occur in probable patterns and in foreseeable places. Children with ADHD need rules because it helps them track time and progress. Make the behavior rules simple and clear. Write down the rules and hang them up in a place where your child can read them. Children with ADD or ADHD respond exceptionally well to prearranged systems of rewards and consequences. It’s important to explain what will happen when the rules are obeyed and when they are broken. Finally, stick to your system by following through each and every time with a reward or a consequence.

4.  Encourage movement and sleep

teenstalkingChildren with ADD or ADHD often have a lot of energy to burn. Organized sports and other physical activities can help them get their energy out in healthy ways, and refine their focus while enjoying the development of new skills and abilities. Exercise leads to better sleep with children with ADD or ADHD, which also reduces symptoms of ADD or ADHD. Children with ADD or ADHD often find “white noise” to be calming when sleeping. You can create white noise by putting a radio on static or running an electric fan, for example.

Guest Post by: Diamond Ranch Academy
Diamond Ranch Academy is one of the premier youth residential treatment centers for struggling teens. Since 1999, the highly trained staff at this facility has provided guidance and support for teens with varying emotional and behavioral issues including; substance abuse, depression, ADHD, impulse control, peer pressure, anger management, oppositional defiance, self-esteem, grief/loss issues, family relationships, communication, and academic struggles.

Note from blog owner, I am not personally familiar with Diamond Ranch Academy and this post is not an endorsement, but this post offers good information for any parent of a child with ADD or ADHD.  For ideas on what to look for in a good residential program, see the post Residential treatment checklist

–Margaret

Why teens run, and what you can do about it

Why teens run, and what you can do about it

It’s an emotional shock when your teen runs away the first time. Your feelings are complex:  anger at his or her rebelliousness; fear for his or her safety; shame that you may be called a “bad” parent or that your behavior caused your child to run.  Runaway teens also have complex reasons for running, and they may or may not be the parents’ fault.

Why they run

Basic teenage development All teens go through a stage where they define themselves as unique, and start demanding two things: 1. freedom; 2. a say in their life.  These are necessary and important for maturity—some do it gracefully and some don’t.  Even teens with a mental illness will go through this normal phase.

Rebellion Most rebellious teens do not run away because they may have better survival instincts.  If a teen is emotionally behind their peers, using drugs or alcohol, and part of a risky crowd that encourages them and undermines their parents’ authority, it’s likely they’ll run.

Mental disorders Mental health problems magnify any or all negative aspects of rebellion and immaturity.  They also disrupt a teen’s thought patterns and cause irrational ideas and fantasies.  They have a high likelihood of running.

Family stress This is the biggest reason: “65% of youth reported running away because of family conflict.”* Think about what’s going on at home that a teenager can’t handle (they are not as strong as they act).  Is there non-stop fighting between members?  Are they being nagged or constantly criticized, and not shown support or love?  Like all children, teens still deserve support and love.  Are they being bullied, or physically or sexually abused?  *National Runaway Switchboard at 1-800-RUNAWAY

What you might observe that foretells running

  • Changes in behaviors or normal patterns mean something is wrong.
  • Teens who suddenly stop eating or begin to overeat, sleep all day or never sleep, spend all their time with friends, or never want to leave their room.  Sudden mood swings mean teens are unsettled and restless, and they’re not coping well with stress.
  • Outward rebellious behavior is often the start of trouble, but not always.  Inward rebellion is also a problem, such as depression and isolating from their family.
  • Falling grades, truancy, school behavior, and breaking house rules are all symptoms that your child is having problems.
  • Disclosure of intentions to run away.  Some teens will hint that they want to run away and some will outright threaten their family with running.
  • Expressing fantasies that they will ‘divorce’ their family.  Teens often believe they can be legally emancipated before age 18, skip high school and get a GED* and a job, and be free.  A juvenile court judge told me otherwise!  The legal test for emancipation is very restrictive.  *General Educational Development exam–a less valuable substitute for a high school diploma.
  • Accumulation of money and possessions. To survive, runaway teens need resources. Some prepare for their run by saving any money they receive.  They might keep a bag or backpack of clothes and food in the closet to make a quick escape.
  • Risky friends have a very powerful influence on the decision to run away.  Relationships like these almost always include substance abuse.  The risky associates include adults who undermine the parents, and who coach teens how to get away from home. They provide them with cigarettes and drugs, and possibly take advantage of them.
  • Full time access to unmonitored and unrestricted communication, and easy access to transportation, especially a car or an at-risk acquaintance with a car.

What to do if you suspect your teen might run away

“Clearly and calmly let your teen know you are concerned about them, and that their behavior makes you afraid they might run away from home. Invite them to talk with you or someone else about what is troubling them and be supportive of finding positive ways of dealing with their stress.”

Let them know you don’t want them to run away and you’re committed to helping the family work things out, and let them know you are concerned about their safety.

If your teen is intent on running away, give them the phone number of the National Runaway Switchboard* so that they can find safe options while out on their own.”  This does not mean you approve.  A good analogy is informing your kids about contraceptives even though you don’t want them to have sex.  *1-800-RUNAWAY

Give them some facts: Your teen should know the laws, and they should know about youth shelters.  This may help them recognize that you are concerned for their safety… just like you told them.

– – – – – – – – – –

Are you thinking about running away?

Are you worried about staying with a friend and getting your friend or their parents into trouble? Does it matter if you’re reported as a runaway or not? Deciding on whether or not to run away and where to go can be difficult. Here’s what you should know:

  • In most states it is not illegal to run away.
  • If you leave home without permission or stay away longer than you’re supposed to, and you are under the age of 18, your parents can file you as a runaway with the police.
  • If the police find you, you will be taken home or to police headquarters, and your parents will be called to pick you up.
  • If you are staying at a friend’s house or somewhere your parents didn’t give you permission to be, they can face possibly legal consequences.
  • If you are filed as a runaway, your parents can press charges against those allowing you stay with them or abiding you.
  • If you go to a youth shelter, generally they have to contact your parents within a certain amount of time to obtain consent for your stay.  Often, you are allowed to stay only 72 hours (3 days) before you must return home.  This gives you and your parents time to cool off.
  • If you are staying with a friend, in most cases the police are only allowed to do a courtesy check; which means they are not allowed to search your friend’s home without a warrant.
  • It is always best to check with your local non-emergency police hotline or legal aid when it comes to specifics because the law varies.

Hopefully the information listed here answered some of the questions you may have had. If not, you can give us a call and we can help.  1-800-RUNAWAY

(Parent: list the names and addresses of local youth shelters here—not adult shelters)

 – – – – – – – – – –

Get to know their friends and their friends’ parents.  If anyone who knows them is concerned about your child’s safety, they may help you if there’s a problem.  Other parents can keep an eye out for your child as well as their own.

Statistics indicate that most children stay in the same general area that they live in. Some go only as far as a friend or relative.  You must know where and be able to communicate with the responsible adults.

Get to know the at-risk youth

and adults that your teen associates with. “At-risk kids hang out together, they know each other’s stories (true or not), protect each other, and keep parents out of the loop.  What if parents got together too, shared stories, and supported each other?  Everyone has the same goal of protecting their child.  Kids’ unsafe plans and activities are no match for the many eyes and ears (and cleverness and wisdom) of all their parents combined.”  Gang up on your kids: Parent networks for tracking at-risk children

If your teen is staying at a friends’, this may be helpful.  You might negotiate with the parent for a friendly arrangement for ‘shelter’ until things calm down.  If you cannot communicate with this parent, they may be guilty of custodial interference.  This is illegal and should be reported to the police.  More often than known, some parents actively encourage other parents’ children to leave home, as well as provide them with alcohol and drugs.

What to do if they run

Notify the police and file a missing persons report.  If your teen has a mental disorder, bring this up on the call and be specific (he needs to take medications, she has a history of assaulting others, he has threatened suicide, she might be out of control and unable to respond if you shout at her…).

Are you worried that your police report will go on your child’s record?  Don’t.  Even if your child is charged and convicted as a juvenile, his or her record can be expunged (erased) at age 18 with good behavior.

The National Runaway Switchboard at 1-800-RUNAWAY operates a 24-hour confidential hotline for teens and their families. Leave a message with them for your child, www.nrscrisisline.org. They also provides bus tickets to get kids back home to their families

Spread the word among friends and your child’s friends that you reported your child, and ask them to ask your child to call or give a message to you if they see them.  Also spread the word that protecting a runaway is a crime.

Track.  “Friend” your child on Facebook, or find someone who can and will report to you.  Set your computer up to track and store web search history and email.  Search their room.  Get their cell phone contacts if possible, track their GPS location by cell phone, and get every address and phone number of every friend.  All of this is legal.

Investigate.  This is not a situation where you respect your teen’s privacy.  Besides tracking their activities above, drive around and look for them.  Be sure they and their friends see you because then the risky friends will avoid your child.

Check in with your child’s teachers or counselor for any information that might be useful.

Take care of yourself and your other children. This is a difficult time and you don’t have to deal with it alone. Turn to people you know and trust for support. The NRS is available 24 hours every day and offers information and support for parents too.

Ask yourself the hard questions:  Is life at home that bad?  Is there abuse (emotional or physical)?  What changes am I willing to make to reduce my child’s stress at home or at school.

Good news from statistics

  • 85% parents reported that the issues that led the youth to run away were somewhat, mostly, or completely resolved within a month.
  • Most parents reported that their youth used alcohol or other substances less once they returned (68%).
  • Most reported they engaged in physical fights less (64%).
  • Most reported they broke the law less (66%).
  • Of those who ran once, 75% did not leave home again.

Creative things other parents did that worked

True story.  A father made business cards to give to everyone who was ever in contact with his 15-year-old daughter.  It had her photo, contact information, and the message that he and her mother loved (name) and wanted to ensure her safety and appropriate behavior.  He made a point of personally visiting with her friend parents where daughter went.  She hated her dad for this, but never ran again, and every time she visited a friend, the parents always reminded her to call her own parents and report her whereabouts

True story.  Two 13-year-old girlfriends decided it would be fun to run away and party.  During the week they went missing, their frantic mothers collaborated on a ‘full court press’ to notify others and get their daughters back safe and sound.  They printed flyers with photos of their daughters, their phone numbers, and offered a $25 reward, no questions asked.  These were given to the police, posted at school, at youth shelters downtown, and at business hangouts the girls were known to frequent (a mall, a fast food place, a big box retailer).  Both girls were eventually returned safe and sound, and they were really angry.  Apparently, street kids and risky adults spurned the girls because of the flyers, for fear of attracting the attention of law enforcement.

–Margaret

 

Do you have a runaway story?  Please comment on what worked to return your child, or what didn’t work.  Thank you.

The Good Things about Bad Kids

The Good Things about Bad Kids

Take an average car.  If a salesman calls the car a “cherry”, it means it’s in perfect condition. But if a salesman calls the same car a “lemon”, it means it has expensive mechanical problems.  The name means everything to a buyer, whether it’s accurate or not.

See strengths

If you see a ‘lemon’ child, it will change the way you anticipate behavior and treat him or her.  Start noticing your child’s “cherry” behaviors.  What’s great about him or her?  Even problematic behaviors are strengths in some circumstances.  For example: resistance and wilfulness are good survival traits for the future:

  1. Your child will need to resist being taken advantage of.
  2. He or she will need to resist ‘friends’ who pressure them to use drugs.
  3. Your child will need to stick with schoolwork or a job without the distractions of parties or alcohol or other time bandits.

Make a list of ‘awesome-ness’

Mom carries this in her purse, always.

What is your child or teen good at?  When is he or she at their best?  What character “flaw” is actually a good thing?  What shows intelligence, nimble thinking, a sense of right and wrong, athletic prowess, social maturity, artistic depth, or compassion for those who are vulnerable?

It’s not important to know why they have problems.  It’s important to know what strengths they have to overcome them.

An overwhelmed mom once asked for help with her adult son and daughter. They were still not ready for adulthood, in fact, they were both falling apart.  They needed her more than she could handle emotionally.  After she shared all her concerns, I asked her to list what was great about them.  It took her off guard at first, but she scribbled out a few things and kept the list, and many months later pulled it out to show me that she still referred to it. She said it totally changed her mindset.

Instead of working on your child’s weaknesses, help your child master existing strengths.

Allow your child ample time to do the positive things he or she is already good at, the things that bring out self-esteem and confidence.  Proactively provide the materials and time to attend a class or camp, join a team, write poetry, make art or music, train the dog, style a friend’s hair… anything he or she can be proud of that has value for their future.  Your child’s behavior will improve, and your mutual interactions will improve.

Use the positive power of self-fulfilling prophecy

In her list , my friend wrote that her daughter had compassion for people and wanted to make the world a better place.  What would you suggest this mother do to support her 24-year-old daughter’s interests and strengths?  One idea:  tell her daughter she believed she would be “a natural” at this.  Another idea:  encourage her daughter to get involved in a charity organization.  And the daughter did.

Video game skills translate to other, more useful activities.

Lets take another situation where your troubled son plays online video games to the exclusion of all else.  What do you see?  Rapid mental processing, hand-eye coordination, focus, a passion for technology.  If you need to limit the video-gaming, what can you replace it with?  There are robot kits for kids; he could build a robot and program its behavior.  A remote control helicopter could be given an obstacle course to go through.  Perhaps the obstacles are altered to make them harder to get through. Perhaps there’s a reward for getting through a really difficult course.  Use your imagination, and ask your son to do the same.  Collaborate.  It’s a better form of interaction and it plays to his natural gifts and interests.

Make a point of noticing the good side. They ALL HAVE A GOOD SIDE.

It’s a disability, that’s why they can’t be good at everything

Let’s be realistic, some children with serious mental health problems may never be well-rounded or competent in the many subjects and skills they need for adulthood.  (It is the tragedy of their disability.)  If this is your child, they’ll probably do better in the long run if not pressured to overcome their weaknesses with extra classwork, homework, or incessant behavioral modifications.  Your son or daughter can catch up later, or if they can’t, they at least have something to carry with them into adulthood.

Now about YOU

What are YOUR strengths as a person and as a parent?

  1. You care enough to go online and learn how to be a better parent.
  2. You admit that you need help, and you know how to find it.
  3. (now add your own… and be generous with yourself)
  4.         “
  5.         “

 

–Margaret

Faith can help, and harm, a family’s mental health

Faith can help, and harm, a family’s mental health

When faith helps

Most of the time, people can heal and find peace and self-acceptance through faith. All the world’s great faiths, those that have lasted centuries, are kept alive for this reason. All have common themes of healing and service to others. When things go poorly, meditation and prayer, with others or in private, lead to connection and wholeness. Faith reveals that things are better, and will be better, than they seem.

When families are in crisis because of their troubled child, parents tell me they depend on faith, even parents who don’t profess a faith practice. They say it’s their only source of strength. Most families with a child who is sick, disabled, or mentally ill will go through dark times, when a parent’s world is simply too overwhelming. Most often, no answers are forthcoming, nor any rescue. The only choice is to hand over their burden to a “higher power,” God, the Buddha, Allah, the Great Spirit… This act of “handing over” is a foundation of healing in Alcoholics Anonymous, Narcotics Anonymous, and dialectical behavioral therapy (DBT).

Few things help a family more than a supportive community of believers.  There will be one person who listens to a frightened parent on the phone, and another person who takes a traumatized sibling on an outing, and another person who provides hugs and cookies. If a mentally ill child continues to decline, a good faith-based support network will stay on. The child may not thrive, but the family does, and has the strength and forbearance to handle the years’ long task of supporting their mentally ill loved one.

Science shows that faith results in better lifetime outcomes for a child

This writer typically trusts science, but in the depths of my family’s despair, only faith and the prayers of others kept me from falling apart.

There are scientists among the faithful who have asked the question: does faith really help the mentally ill? In another blog post, Spirituality and mental health, some research are summaries of research going back 36 years.  (Follow this link for the research citations.)  The answer?  Yes, faith makes a real and measurable difference in improving mental health.

More recent scientific research shows clear evidence from brain scans that meditation and prayer change brain electrical activity, from anxious or agitated to serene and grounded.  The person actually feels and behaves better.  This article has more information on this, Yoga – Safe and effective for depression and anxiety.

Like prayer, “talk therapy” or psychotherapy also shows improvement on brain scans. Imagine, just talking with someone improves the physical brain. According to the article appended below, “When God Is Part of Therapy,” many prefer therapists who respect and encourage their faith. It just makes sense.

When faith harms

This section is a personal appeal to faith communities who have unconscionably failed families and their children with mental disorders.

Faith communities depend on people, and people have biases and foibles.  Many of ‘the faithful’ hold negative beliefs about others, right or wrong.  Children who suffer, and their families, are identified as possessed, of evil character, disbelievers, victims of abuse, or cruelest:  those who are paying for their sins. Families are repeatedly told these very things today.

“Sometimes, people hide from the Bible. That is, they use the Christian holy book as an authority and excuse for biases that have nothing to do with God.”
–Leonard Pitts Jr., Miami Herald

Stigmatization from a faith community is a cruel betrayal.

A child’s inappropriate behavior is not a choice, it is a verifiable medical illness, one with a higher mortality rate than cancer:  Mental illness more deadly than cancer for teens, young adults.  Families with sick children need support; our sense of loss is devastating.

Testimonials

Mother with five children, one with bipolar disorder:

“We were members of our church since we were first married, all our daughters grew up here, but when my youngest spiraled down, I was told the sins of the father are visited on the sons. Or we weren’t praying enough. I knew they thought (Dad) had done something bad to her. We left and went church shopping until we found a pastor who understood and supported us.”

Mother of two children, one with acute pervasive development disorder:

“I wish we had a “special needs” church. We’re so afraid our kid is going to say something and we’re not going to be accepted. We haven’t gone to church for years because of this. They just turned their backs on us, it happened to another family with a deaf child. They avoid parents in pain. Deep down in my heart I believe in the Lord, but there are days when I wonder “where is God?” People call out to pray for a job, or a kid’s grades, but we wouldn’t dare ask for us, no one would get it, we’d be told we were bad parents or didn’t punish him enough.”

Mother of two children, one with schizoaffective disorder:

“When I went up to the front to light a candle and ask for a prayer for my daughter, I expected people would come up afterward and give a hug or something, just like with other families with cancer and such. But it didn’t happen. No one even looked at me. I left alone and decided never to go back.”

Some good news

FaithNet

The National Alliance on Mental Illness (NAMI) has recognized the need for the mentally ill to be part of faith communities, and the negative experiences most face when they attempt to participate in a religious community. NAMI started FaithNet to encourage and equip NAMI members to engage with and share their story and NAMI resources with local faith groups, and appeal for their acceptance.

Key Ministry

Key Ministry: Welcoming Youth and Their Families at Church
Stephen Grcevich, M.D., president, Key Ministry and child & adolescent psychiatry in private practice, Chagrin Falls, Ohio

“Key Ministry believes it is not okay for youth living with mental illness and their families to face barriers to participation in worship services, educational programming and service opportunities available through local churches.”

Churches in American culture lack understanding of the causes and the needs of families impacted by mental illness, which poses a significant barrier to full inclusion.

“A study published recently by investigators at Baylor University examined the relationship between mental illness and family stressors, strengths and faith practices among nearly 5,900 adults in 24 churches representing four Protestant denominations. The presence of mental illness in a family member has a significant negative impact on both church attendance and the frequency of engagement in spiritual practices.” When asked what help the church could offer these families, they ranked “support for mental illness” 2nd out of 47 possibilities. Among unaffected families, support for mental illness ranked 42nd.

________________________________________

When God Is Part of Therapy
Tara Parker Pope, March 2011, New York Times

Faith-based therapy is growing in popularity, reports Psychology Today, as more patients look for counselors who can discuss their problems and goals from a religious frame of reference.

Studies show that people prefer counselors who share their religious beliefs and support, rather than challenge, their faith. Religious people often complain that secular therapists see their faith as a problem or a symptom, rather than as a conviction to be respected and incorporated into the therapeutic dialogue, a concern that is especially pronounced among the elderly and twenty-somethings. According to a nationwide survey by the American Association of Pastoral Counselors (AAPC), 83 percent of Americans believe their spiritual faith and religious beliefs are closely tied to their state of mental and emotional health. Three-fourths say it’s important for them to see a professional counselor who integrates their values and beliefs into the counseling process.

The problem for many patients in therapy is that many patients are far more religious than their therapists.

Nearly three-fourths of Americans say their whole approach to life is based on religion. But only 32 percent of psychiatrists, 33 percent of clinical psychologists and 46 percent of clinical social workers feel the same. The majority of traditional counselor training programs have no courses dealing with spiritual matters.

When children are hospitalized with other ailments, the family draws sympathy and support from others.  But because of mental health stigma, most families like ours don’t when our child is hospitalized.  If not blame, we are second-guessed, or as bad, met with silence or a change of subject.