Mother’s Day is a celebration of mothers and motherhood. I recognize that Mother’s Day can bring mixed emotions to both children and mothers impacted by social distancing and other challenging circumstances related to trauma, grief and loss.
Depression is very common in youth who have T1D, if you are a parent who is concerned that your child may be having a difficult time, there is treatment and resources available.
Struggling with planning this week’s sessions – take advantage of resources for more directed therapy sessions.
The group of parents now raising tweens is the last to grow up — basically — without the Internet.
The good news is that, having received our first email addresses on dinosaur systems as college students, we DO know how the web works.
We all have Facebook (well almost all of us), plus most of its cousins. We’re hooked on getting answers to questions instantly as well as the ease of texting versus calling or — oh, please — talking face to face.
We know, too, of the web’s dark corners — limitless pornography, angry gamers, false information, lurkers and trolls.
This puts today’s parents in a crazy sort of limbo: I get it, I use it, I’m scared to death of it when it comes to my kids.
There’s also inappropriate content, predators, cyberbullying and technology addiction. And that’s not to mention the risk of growing up without knowing how to communicate verbally and always needing to know an answer or order that product — instantly, now, yesterday, if possible.
What’s a parent to do?
While you can and should limit use of the Internet in a way that’s age-appropriate and encourages other activities — such as participating in sports, reading books and playing outside — you can’t keep your child from going online forever.
In fact, complete avoidance could do more harm than good.
“Parents shouldn’t focus on instilling fear of the Internet in the child. Instead, start a conversation about technology and the Internet in today’s world,” said Karina Hedinger, a training and education coordinator for the Minnesota Crimes Against Children Task Force, a group led by the Minnesota Bureau of Criminal Apprehension.
Much like your family rules for exploring the neighborhood, true online safety comes from preparation and communication. (Check out the AAP’s new screen-time recommendations in this article’s sidebar.)
Tips for parents
Don’t freak out. Teaching your kids to fear the Internet isn’t going to keep them safe.
Do talk. Discuss the proper use of websites and what behaviors are inappropriate. Discuss the dangers in a non-threatening way.
Ask. Get your kids talking, too, so you’re not just in boring lecture mode. What do you most like to do online? What if someone online asked you to meet?
Befriend! Sure, you can have a Facebook or Instagram account … if you make me your first friend.
Be a watchdog. “Monitor, monitor, monitor. Monitor what your children are doing on all technology. Have daily conversations about being safe and keeping information safe,” Hedinger said. Be aware that you can set up “restrictions” on various devices (under Settings) to block or allow specific websites or types of content. You can also set blanket permissions based on age ranges. Also know that the top three internet browsers — Mozilla Firefox, Google Chrome and Apple Safari — offer settings and add-ons to help make your kids’ online experience’ more age-appropriate. There are even kid-safe browsers for a variety of age ranges. (See Page 33 to learn more.)
Limit locations. Keep the family computer in a communal space in the home. Insist that all phones go to charge or “rest” in a designated location at a certain time each night (not your kid’s bedroom).
Get an all-access pass. Though most parents wouldn’t read a child’s diary (at least not without cause for concern), many parents today reserve the right to read their kids’ phones each night after they’re placed in a designated “rest” location. Why? A diary is private by nature, and one might argue that everyone is entitled to his or her own private thoughts. But when it comes to living life on Instagram — where children can easily “go public” with things that perhaps should be private — the rules are bit different. Phone reading not only keeps parents involved, but it also helps kids practice better behavior (or self-censoring) if they know Mom or Dad might take a peek.
Research and explore. The list of apps you should know (and perhaps even know how to use) is honestly too long to name and goes beyond what you might think (SnapChat, Tinder, Musical.ly, Kik and the like). Did you know there are actually apps to hide apps? Yep. And there’s also a whole language developed to keep parents clueless. Deep breath. It’s going to be OK. But do study up! Talk to other parents as often as you can (ideally with kids a bit older than yours) and make friends with commonsensemedia.org, an indispensable website and app for evaluating all media.
Think beyond your home. Which friends have smartphones? Which friends use SnapChat? Would your child’s friends be willing to create an account in your child’s name to get around your rules? What are the rules at the neighbors’ house, where your kid spends half his time?
Make your expectations clear. Setting up formal house rules can help you stand firm in your decisions around digital media. Check out the new, free Family Media Plan tool from the American Academy of Pediatrics — at healthychildren.org — for help creating written guidelines for your entire family. If your child is receiving a smartphone this year for the holidays, you might want to customize one of the many mobile phone contracts online such as those at connectsafely.org and joshshipp.com as well as Gregory’s iPhone Contract written by author Janell Burley Hofmann for her 13-year-old son. Hofmann is the author of iRules: What Every Tech-Healthy Family Needs to Know About Selfies, Sexting, Gaming and Growing Up (janellburleyhofmann.com).
Tips for teens and tweens
Be discrete. The saying goes, “If you would feel uncomfortable with something plastered on a billboard, don’t share it on the Internet.” Personal information should never be shared in public forums. Turn off location services for most apps, and set them to “On While App is Running” for things that make sense, like navigation programs.
Be private. Gaining scores of fans and followers might feel like popularity — but it’s really just broadcasting a bunch of stuff that could embarrass you someday. Would you invite your whole block over to watch you lip sync in your pajamas? If the answer is “no,” reevaluate your public social media “brand.”
Know real people. You should be friends with someone in real life before being friends online. And you should spend screen-free time with your real-life friends.
Trust your gut. If something feels scary, weird or inappropriate, it probably is. If you feel tempted to hide something on a technological device from your parents, you probably shouldn’t.
Tell. If you see something inappropriate, violent, suspicious or mean online, talk to your parents or another adult you trust.
Be skeptical. It might be normal for an adult to mentor a child or teen, but it’s never normal for an adult to seek a relationship as a peer or romantic partner with a child or teen. Also note that online, a person can say they’re anyone or anything. An adult can easily claim to be 15.
Shut it down. In cases of cyberbullying, be a heroic bystander and report bad behavior when you see it. If you’re the victim of cyberbullying, shut down your device, walk away and talk face to face with someone who cares about you.
I love teaching writing; it’s where revelations happen, where children plumb the dark corners, nudge the sleeping dogs, and work out solutions to their most convoluted dilemmas. As much as I adore reading student work, I still get a little nervous about what I’ll find there. Among the stories of what my teenage students did last summer and what they want to be when they grow up are the more emotionally loaded accounts: firsts (periods, kisses, or failures), transitions (moves, their parents’ divorces, or custody disputes), and departures (dropouts, graduations, or suicide attempts).
Over the years, my students have entrusted me with their most harrowing moments: psychotic hallucinations, sexual molestation, physical abuse, substance abuse, HIV exposures, and all sorts of self-injurious behavior ranging from cutting to starvation to trichotillomania. When students write about delicate and dangerous experiences, there are decisions to be made and judgments to be called. And yet, for much of my career, I have been horribly unprepared and have failed to secure the services my students needed as a result.
Teachers are often the first person children turn to when they are in crisis, and yet they are, as a profession, woefully unprepared to identify students’ mental-health issues and connect them with the services they need—even when those services are provided by schools. Aside from the obligatory professional-development session on mandatory reporting laws for child abuse and neglect we have to attend during new faculty orientation, teachers receive little or no education in evidence-based mental-health interventions. According to Darcy Gruttadaro, Director of Advocacy and Public Policy at the National Alliance on Mental Illness, “Most teachers are not trained about mental health in their formal education and degree programs, and yet an unidentified mental-health condition often interferes with a student’s ability to learn and reach their full academic potential.”
According to the National Institute of Mental Health, approximately one in five children currently have or will experience a severe mental disorder. For some disorders, such as anxiety, the rates are even higher. For people who do experience mental-health disorders, most experienced their first symptoms before young adulthood. Half of all people with mental disorders experienced the onset of symptoms by age of 14; 75 percent by age 24. Half of these students will drop out of school. As suicide is the second-leading cause of death among adolescents and young adults, lack of appropriate mental-health interventions and treatment can mean the difference between life and death. Given the amount of time children spend at school, teachers are likely be the ones to identify and refer children for mental-health services. For children fortunate enough to be identified and given access to those services, treatment will mostly likely take place at school, as schools serve as the primary providers of mental services for children in this country.
However, all the mental-health services in the world won’t help if teachers don’t understand the nature of the services available in school and can’t identify the students in need of intervention.
In 2011, researchers at the University of Missouri looked at whether teachers understood the 10 evidence-based mental-health interventions or resources their schools employed. The results were disheartening, to say the least. While two-thirds of the surveyed teachers held graduate degrees, and the remaining third had earned undergraduate degrees, more than 80 percent had never heard of some of the interventions or strategies their own school utilized. Half of the teachers surveyed did not know if their schools provided functional behavioral assessment or intervention planning at all. Given that the response rate for this study was only 50 percent—and it’s likely that teachers with a heightened interest in student mental health would be more likely to respond to the survey—these results probably overstate teachers’ understanding of the tools their own school districts use to support students’ mental and emotional health.
As an increasing number of schools roll out evidence-based mental-health programs such as Positive Behavioral Interventions and Supports (PBIS), teaching that promotes appropriate student behavior by proactively defining, teaching, and supporting positive student conduct, and Trauma-Sensitive Schools, programs aimed at reducing the effects of trauma on children’s emotional and academic well-being, educators need to be at least minimally conversant in the terminology, methods, and thinking behind these strategies. These programs provide strategies that can be highly effective, but only if the teachers tasked with implementing them are sufficiently trained in the basics of mental-health interventions and treatment.
Teachers routinely receive first-aid training in CPR, EpiPen use, and safe body fluid cleanup, but it’s rare for schools to offer training in mental health, said Todd Giszack, Academic Dean of Fork Union Military Academy in Fork Union, Virginia. Recognizing that schools are responsible for their students’ mental, as well as physical health, Fork Union Military Academy designed and implemented its own curriculum with the help of two mental-health professionals, and now offers eight-hour certification programs in Mental Health First Aid. “It has taken two years, but nearly all of our faculty and staff has become certified in Mental Health First Aid. This has allowed our school community to become familiar with trends and warning signs associated with adolescent emotional and mental health” Giszack said.
Dr. Michael Hollander, Assistant Professor in Psychology at Harvard Medical School and director of Training and Consultations on the 3East Dialectical Behavioral Therapy program at McLean Hospital in Belmont, Massachusetts, urges teachers to use caution when intervening in students’ mental-health crises. “In my experience, teacher response tends to be bi-modal; either they get solicitous, over-involved, and in over their head, or they mistake mental health issues for behavioral problems that require in-class discipline.”
Programs such as NAMI’s Parents and Teachers as Allies presentation are beneficial, Dr. Hollander said, because they help teachers understand both the benefits and limitations of in-class interventions. Despite his worries about teacher-facilitated mental health interventions, he’s grateful for the trend toward a greater understanding of students’ mental health. “We have arrived at a place where we finally understand that teaching is not just about educating someone’s rational mind, but also educating their heart,” he said.
Children with untreated mental-health issues can get by. They can limp along toward adulthood until an inevitable, eventual mental-health crisis lands them in the hospital, in jail, or even at an inpatient drug and alcohol rehabilitation facility for adolescents, where I teach. But by then, a lot of damage has been done to their young minds and hearts—damage that could have been prevented if they had received support when their symptoms first appeared.
As I read their essays about crippling childhood anxiety, alcoholic parents, and/or domestic violence, I can’t help but mourn for all the lost opportunities and squandered potential that was wasted on the way.
I recently saw a meme on social media that said “It’s almost time for my normal anxiety to turn into my fancy holiday anxiety.” I had to chuckle when picturing anxiety showing up in a glittery ugly sweater or draped in all things sparkly. Humor aside, it shows that during the holidays, our existing anxiety (or depression) does not just “take a holiday” but rather increases due to stress and societal pressures.
This time of year can be an incredibly stressful and frustrating time. On one hand, we fill our days to the brim with spending time with family and friends, social events, potlucks, baking, preparing meals, finding the right present within your means, and many other tasks guised in the name of the holidays. All of this “fun” can turn to chaotic quickly. Then on the other hand, some of us may have unwelcome reminders or memories associated with the holidays or feel more alone during this time as we watch others join together and celebrate. Whatever the reason for your distress, here are some helpful strategies to help manage the rise of our fancy anxiety (or depression) in finding ways to relax during the busy time of year or help with our perspective on the season.
Feel free to make these tips your own by adding your own personal flair to them. It is important to find what works for you and your fancy holiday distress.
Happy holidays,
Dr. Alison Dolan
It seems everyone is talking about anxiety these days, and that’s not a bad thing. Shining a light on mental health helps reduce the stigma that keeps many people from seeking support.
At the same time, it can be hard to know if the worries and racing heart you experience at the thought of, say, meeting new people, is run-of-the-mill stress, or if you’re actually experiencing some level of anxiety and could benefit from seeing a professional.
“I can’t tell you how many people I see who say, ‘I don’t know if I should be coming in here,’” clinical psychologist Robert Duff, Ph.D., author of Hardcore Self Help: F**k Anxiety., tells SELF. “On a broad scale, [talking about anxiety] is positive, but I don’t blame anyone for the confusion.”
“Anxiety is a reaction to a situation we perceive as stressful or dangerous,” Monique Reynolds, Ph.D., licensed clinical psychologist at the Center for Anxiety & Behavioral Change in Rockville, Maryland, tells SELF. This produces a stress response in your body—specifically, your brain’s hypothalamus triggers your sympathetic nervous system to release norepinephrine (aka adrenaline) and cortisol (a stress hormone) to get you out of harm’s way.
This is actually a good thing when there is a real threat of danger present. “A major part of our brain’s job is to keep us alive, and fear and anxiety are a big part of that,” Reynolds says. For example, the anxiety you would feel at seeing a truck hurtling towards you would make you move from its way more quickly.
But if you have anxiety, that stress response can kick in when it shouldn’t. “You feel very much the way you do when in a dangerous situation…[but] there’s no real danger there,” Duff says. Instead of being helpful, this misfiring of your fight or flight reaction can hinder you.
While a little anxiety can also help you to perform at an optimal level under stress, giving you a burst of adrenaline and hyper-focus to finish a business proposal before deadline or nail that dance number at a performance, living in a constant heightened state of anxiety can be distracting at best and debilitating at worst. When anxious thoughts are interfering with your life and causing you significant distress, that isn’t something you should just chalk up to nerves and push through. That’s something you can get help with.
Anxiety affects about 40 million American adults each year, according to the Anxiety and Depression Association of America (ADAA). But it’s not as cut-and-dry as saying that anxiety is simply when you feel nervous all the time. This mental health condition comes in many forms.
Generalized anxiety disorder (GAD) is characterized by having excessive worries and fears for months, according to the National Institute of Mental Health (NIMH). Per the ADAA, GAD affects 6.8 million U.S. adults each year. Panic disorder involves spontaneous bouts of debilitating fear known as panic attacks, along with intense worry about when the next attack will come, according to the NIMH. Per the ADAA, it affects 6 million American adults each year. Social anxiety disorder (also known as social phobia) happens when you have a marked fear of social situations in which you might be judged or rejected, as well as avoiding these situations or experiencing symptoms like nausea, trembling, or sweating as a result.
Then there are other issues that are closely related to anxiety, like obsessive-compulsive disorder, which involves intrusive thoughts and urges, and posttraumatic stress disorder, which happens when people have a prolonged stress response to harrowing situations.
These are just some of the various anxiety and anxiety-adjacent disorders out there. That these issues can present in myriad ways can make it even harder to know if what you’re experiencing is anxiety that could benefit from outside help.
“Some people feel they can control their anxiety, some feel it’s something they ‘should’ be able to manage, some feel shame, some fear they might be ‘crazy,’ and others downplay how much their anxiety is impacting them,” Reynolds says.
“When your world starts to become limited because of anxiety, that is a good signal that it’s time to seek treatment,” Reynolds says. “What is it doing to your life, your relationships, your sleep, health, work, and ability to learn and pursue things that are important to you?”
This “functional impairment,” as Reynolds calls it, can show up in different ways in different people. Is anxiety making you avoid doing things with loved ones because you’re too nervous to go outside? Do you skip school or work out of fear of what people may think of you? Can you not get enough sleep because you’re up all night worrying about the next day? Is your anxiety over certain tasks, like paying bills, leading to procrastination so extreme it comes with consequences, like getting your lights turned off?
Keep tabs on whether you’re blowing up at people, too. Anger and irritability can sometimes be a sign of anxiety. “We often forget that fight or flight includes ‘fight,’” Reynolds says. “If you have a shorter fuse or are always on edge for triggers, it could be related to anxiety.”
So, too, could physical issues. “We think of ourselves as these disembodied heads floating around,” Reynolds says. “We forget that there is a big feedback loop between the nervous system and the body.” Every part of you, from your head to your stomach to your feet, has nerves to regulate important processes, which is why your sympathetic nervous system’s stress response can be so far-reaching. You even have an entire nervous system reserved for gastrointestinal function, known as your enteric nervous system, which may help explain why there’s such a strong link between issues like irritable bowel syndrome and anxiety.
Constant fatigue can also kick in if your anxiety is in overdrive. “The physical reaction to anxiety, by nature, is supposed to be short-term. The body is supposed to come back down to baseline,” Duff says. “But a prolonged period of anxiety depletes your resources and exhausts you.”
“If your anxiety is bothering you and you are suffering, you deserve to get help,” Duff says. That’s true whether or not you think your anxiety is serious, whether or not you think you meet diagnostic criteria you read online, and whether or not your friends and family treat your anxiety with the weight it deserves. And if your anxiety is getting to the point where you’re worried for your safety, call 9-1-1 or the National Suicide Prevention Lifeline (it’s available 24 hours a day, seven days a week at 1-800-273-8255), or go to the emergency room, Reynolds says.
Knowing what to expect at your first therapy session may make the experience less scary. Although every professional is different, you’re likely to get a lot of questions at the first visit. Ultimately, your psychologist or therapist’s goal is to learn what troubles you’re having so that they can create a plan to help you build the skills you need to address your anxiety.
They’ll also want to figure out which kind of therapy best matches your needs. Different forms, like cognitive behavioral therapy, which aims to help people change negative thought patterns, work for different people.
Since the cost of therapy can be prohibitive, know that there are resources to help you find affordable treatment, like the National Alliance on Mental Health’s HelpLine at 1-800-950-6264. The HelpLine is available Monday through Friday, from 10 A.M. to 6 P.M., and you can explain your specific situation to the staffer or volunteer who answers. They may be able to refer you to local organizations that offer more affordable treatment. You can also try the Substance Abuse and Mental Health Services Administration (SAMHSA) treatment locator tool, which can help you find mental health providers who take various forms of insurance, offer payment assistance, or use a sliding scale. Resources like GoodTherapy also allow you to limit search results to therapists who use sliding scales.
And don’t stress about meeting some arbitrary threshold of anxiety for your appointment to be worth the effort. “Somebody with anxiety [may] think there is a risk to seeing someone. ‘If I go and don’t have an anxiety disorder, there’s something bad about that,’” Duff says. “That’s not true. If you are suffering and seeing some of these signs, that’s enough.”
It may be that all you need is a few sessions, or you may meet weekly for months or years based on your goals. Your psychologist or therapist might decide medication would help you live your healthiest, happiest life, or just having someone to talk to might work for you. Also, if you decide you’re not really into the person you’re seeing but you still want help, there’s absolutely nothing wrong with trying someone else, Duff says.
Ask yourself what kind of life you want to live and what’s holding you back from achieving it, Reynolds says, adding, “If there’s anything related to fear and anxiety, it’s a great sign that maybe you need support around those things.”
