Kids Are Not Getting Enough Sleep February 16, 2012

I can’t tell you how many times I worked with teens and realized they were sleeping less than I was!  Kids and teens need more sleep than adults do and it is starting to be a real problem.

According to the American Academy of Pediatrics, sleep recommendations for school-age children and teenagers have changed and kids might not be getting enough rest. Here is information about kids and sleep.

How much is sleep should kids get?

Scientists aren’t quite sure, but the Pediatrics study revealed that in the last century the suggested amount has changed. The study compared trends in medical and parenting wisdom and found great variance. From 1897 to 2009, about a minute was shaved off the recommended time per year. Only one of the studies compared by Pediatrics was based on medical evidence, says Parents magazine.

What is the current recommended amount?

According to the Centers for Disease Control and Prevention, elementary school-age kids need 10 to 11 hours of sleep and kids ages 10 to 17 need 8.5 to 9.25 hours daily. 

How much sleep does the average child get?

Kid’s Health says children ages 5 to 12 get an average of 9.5 hours of sleep at night. A 2006 survey from the National Sleep Foundation found kids ages 11 to 17 were getting less than eight hours per night.  The Pediatrics study backed up that information; whatever the current recommended amount was per year, most kids got about 37 minutes less than that. I was working with students getting around 5-6 a night because they were up late doing homework and on their computers. The Pediatrics study backed up that information; whatever the current recommended amount was per year, most kids got about 37 minutes less than that.

What are the risks from lack of sleep?

According to NSF , kids who don’t get enough sleep don’t do as well in school. They tend to have more behavior problems. Kids who don’t rest well are at risk for obesity, frequent illness and autoimmune problems, too.

Why are so many kids sleep-deprived?

There are several health reasons such as complications from medicine, illness, insomnia, snoring, sleep apnea and disturbed circadian rhythms, says WebMD. Teenagers often prefer to sleep during the day and stay awake at night. Parents are advised to discuss any health problems with their pediatrician. Many sleep problems in children are environmental and within a parent’s power to impact, too. I also think many adults are sleep deprived and if we aren’t taking care of our sleep needs how can we expect our children too.  The pharmaceutical industry for sleep medicine is a very lucrative business these days, but what is really going on that we can’t sleep?

How can parents help kids sleep better?

Parents can do like establish a regular bedtime, create a restful environment and remove a TV. Phones, and Computers from a child’s room. Parents should put children to bed drowsy but not fully asleep. This helps children get to sleep better if they awaken during the night. Kids should avoid foods and beverages with caffeine, especially before bed. As for bedtime drinks, a little is fine. Scary movies can cause restlessness as can taking vitamins or exercising before bed. Parents are advised to check medications for ingredients that cause sleeplessness. Children should also use the bed only for sleep.

Truancy Signals Depression in Kids December 22, 2011

Missing school appears to be both a cause and a symptom of depression, researchers have found.

Middle school students with absenteeism in one year were more likely to have depression and conduct problems the next year independent of other factors in an analysis of longitudinal studies by Jeffrey Wood, PhD, of the University of California Los Angeles, and colleagues.

But during middle and high school, having depression and conduct problems in one year also independently predicted absenteeism the next, the group reported online in Child Development.

“These findings are consistent with the hypothesis that these two aspects of youth adjustment may at times exacerbate one another, leading over the course of time to more of each,” Wood’s group noted in the paper.

For example, depression can promote missed days through lack of energy and interest, while missing a lot of school can lead to academic failure and social isolation that leads to or worsens depression, they explained.

“Absenteeism could be a useful target for preventive intervention if it indeed plays a contributing role in the development of psychological problems,” the researchers suggested.

During any given year, missing more school was associated with higher levels of depression and anxiety, as well as conduct problems.

The teenage years may bring hormonal changes, less monitoring by parents, and more independence and peer influence, they pointed out.

The reason for some relationships in middle school not found in high school may be that early absenteeism predicts dropping out of school, they suggested.

The evidence also tended to be stronger for depression, anxiety, and conduct problems to predict absenteeism than the other way around, they added.

While the relationships varied from cohort to cohort, “there was at least some support in each dataset that a higher level of one of these factors in one year tended to presage the onset of increases in the other factor in the following year, over and above autoregressive associations and covariation with demographic variables,” the group explained.

They cautioned that their analysis was limited by methodological differences between the studies and self-reporting by the students in the Add Health study.

Moreover, the log-transformed models used for the largest cohort (Add Health) could only be interpreted in terms of direction, not magnitude of effect, making it possible that the associations were small.

Amoreena Berg, MFT

Primary source: Child Development
Source reference:
Wood JJ, et al “School attendance problems and youth psychopathology: structural cross-lagged regression models in three longitudinal datasets” Child Dev 2011; DOI: 10.1111/j.1467-8624.2011.01677.x.

Helping Your Child to Succeed May 3, 2010

Children, no matter what age group they belong to, have to undergo several ups and downs. Some kids learn naturally, while some struggle with their studies. It is the parents’ responsibility to help the struggling child succeed with their studies. Parents can have a big impact on a child’s performance if they concentrate on their child’s schooling.

There are several reasons why children in the adolescent age group may be finding it hard to succeed. As a parent, you first need to identify the reason or what is troubling them. The child’s intelligence should be the last of your concern as every child who goes to normal school is intelligent.

For most adolescents the problem is distraction. They may be distracted for several reasons. It could be due to the changing physical appearance, or due to lack of emotional support from family. In such case, the parent should have a calm talk with their child. If there is any problem, they should solve it immediately. Also, if it is the physical changes that are bothering, then the parents should reassure them that it is only a temporary phase which is not going to last very long.

For other adolescents, it could be over-confidence and other interests that are taking over. The parent should step in and not allow other distractions like peer pressure to take over the adolescent’s life. They should try counseling them about the importance of studies.

More recently we are discovering how much technology is interfering with adolescents and their academics.  It is true that most assignments require students to use computers, but what parents should be aware of is all the multitasking that goes on while on the computer that causes distractions.  Students are frequently checking their social networking sites, chatting online, and surfing the net.  Limiting computer “social” time might not be a bad idea for students who are struggling academically or who are staying up too late at night.

Only after a parent identifies the key problem associated with their adolescent’s attitude towards studies, they can begin to help them succeed.

Stress Reduction Group for Teens in Oakland, CA February 3, 2010

  Stress Reduction Group for Teens

Mindfulness-Based Stress Reduction

5 Week Series for Teens Ages 13-18

Monday Evenings 5:30 – 6:30pm

 Starting March 1st 

3300 Webster Street, Suite 408, Oakland

Facilitator:

Amoreena Berg, MFT is trained in teaching mindfulness and stress reduction to children and teens. She has a private practice in Oakland and also works for a high school specializing in treating adolescents.

In a supportive group environment, learn techniques for:

• Reducing stress
• Managing emotional ups and downs
• Experiencing inner calm
• Increasing self-awareness
• Improving relationships with family and friends

 

To Register:

Amoreena Berg

650-224-1796

amoreena@gmail.com

Teen Depression Help January 25, 2010

Once a young person has been diagnosed with teen depression, help is available. The teen years can be quite turbulent, and it’s normal for a teen to feel down sometimes. They are going through a lot as they deal with the changes that occur once they hit puberty, as well as try to navigate through trying to figure out who they are and what type of career they want to have as adults.

On top of all the other issues are facing, teens also have to deal with high school and all the stuff that goes with it, including trying to fit in with their peers and dealing with dating. With all the changes going in in their bodies and around them, it’s no wonder that a teen can go through some major changes in mood. A blue mood that sticks around for more than a couple of weeks is not just someone feeling sad; it could be a sign of depression and it needs to be treated just like any other medical condition.

Adolescent depression treatment can be effective, but the person who is feeling depressed may not know how to ask for help. If you know a young person who seems to be more down than usual or who isn’t showing his or her usual enthusiasm for things they used to enjoy, it’s time to make an appointment to see a doctor. If it turns out that the young person is depressed, reassure them that this condition is treatable and they will get better.

It will take some time, but with proper treatment, the young person will start to have a more positive outlook. Family members can provide support and reassure the teen that there are many factors that can cause depression. It’s not his or her fault, any more than having to get treatment for a physical condition is something that they should be blaming themselves for.

Once the condition has been diagnosed, the next step is to start depression treatment. Teens may be prescribed certain antidepressant medications as part of an overall treatment plan. A combination of talk therapy and antidepressants is an effective way to deal with depression, and the teen should see a therapist to discuss his or her feelings.

If the young person expresses suicidal thoughts, then the level of teen depression help needed is more serious. The young person needs to be seen by a doctor immediately. If the family doctor isn’t available, then a trip to the local Emergency Room is warranted. Other signs to be on the lookout for when it comes to getting suicide help are when the teen starts giving his or her possessions away or talks a lot about death and dying.

It would be a mistake to assume that the teen is simply going through a phase or is making those statements for shock value. While it’s possible, parents would do well to err on the side of caution and take all of these types of statements seriously. Depression is a highly treatable condition, and no one has to live in that state when there is effective help available.

Source: fyidepression.com

Treating Teen Depression December 17, 2009

Depression in teenagers could be a drawback for an entire nation. However, it can be cured with therapy and proper medication.
The remedies available and which the therapists commonly advice include the Cognitive-behavioral therapy which deals with the patients pessimistic thinking pattern. Group therapy and Family therapy are the solutions that help to break down the patient’s isolation, from which many of the teenagers suffer nowadays.
Additionally, it also helps the teenager reunite with his family and express their selves by verbal communication and help release their stress. Other remedies could be introduced to the patients, such as physical exercises and medication. Physical exercises can be very effective in driving away depression. They help to replenish the endorphin and seratonin secretion in the brain, which results in an alteration of temper.
Extra curricular activities such as drama, music, painting can help bring about fruitful results and help shape the emotions of the teenagers. Volunteering can also help teenagers to overcome depression. This allows the adolescents to see other people’s problems from a different point of view. So this takes some of their stress off as it gives them a feeling of satisfaction while helping out the people in need.
Mass increase in the number of patients with depression has given rise to different types of medications and hospitals. If some kind of medication has been prescribed for the patients, it should be administered with serious caution and under supervision. If the depressed teen is extremely suicidal, he should be kept under continuous observation, which is only possible if the patient is kept in a hospital.
Apart from these therapies, teenagers could be introduced to special programs such as schools that are especially designed for stress relief. Theses types of institution are ideal for troubled adolescence. These schools serve as rehabilitation centers for the teens and help them learn to cope with their community, build up composure and acquire skills and learn to trust others and work with them.
The school also helps in the improvement of the adolescent’s grades and their pessimistic behavior. Whether the options for special schools are worth or not mostly depend upon the teachers and the staffs conducting the schools. At times the staff in charge of the schools might not be trained professionals and might harm the teenagers by misguiding or mistreating them rather than trying to put away their depression.
Parents and guardians of the teenagers are strongly advised to monitor their child’s behavior and if any abnormal changes are observed then the particular teenager is advised to be taken to a therapist. Before deciding to go with these therapies it is important to conduct some careful researches on their philosophy and their way of teaching and also the qualification of the staff working within the institution.

Source: TeenMentalHealthInfo.com

Treating Depression Online? October 24, 2009

Treating depression and other mental health issues online is becoming the wave of the future.  Most therapists think that without the relationship what healing can be done, but I disagree…there are some issues that can be worked on this way.

The Australian National University’s Centre for Mental Health Research is one of the unsung heroes in the development and research of programs to treat depression online, for both adults and teens. What they have done over the past decade is not exactly rocket science, and yet, surprisingly, most people have never heard of one of their free online programs. They’ve taken cognitive behavioral theories and techniques and translated them into online tutorials and programs. Then they did something a lot of organizations (and virtually all companies) fail to do — they did solid, randomized controlled trials to show their designed interventions work.

Their simplest intervention is an educational website about depression called BluePages. Yes, it offers the usual array of information about depression symptoms and treatments, but they’ve gone a step further and provided an evaluation of what treatments work for depression by evaluating the clinical research. Most interesting is that the BluePages website itself has clinical evidence backing its usefulness.

A more involved intervention offered by the same researchers from the CMHR is the MoodGYM training program. This is a web-based, self-guided program based upon cognitive-behavioral and interpersonal therapy techniques that is intended to help people with depression. MoodGYM is comprised of 6 modules.

MoodGYM has eight published research citations, and a few of them are randomized controlled trials.

MoodGYM is not for the faint of heart, however. In many ways, it is just as in-depth as a face-to-face clinical intervention and therefore takes nearly as much time and effort. And that’s one of its drawbacks — few people stick with the program to fully benefit from its positive effects. Despite this challenge, over 34,000 people visit MoodGYM every month and they have over 200,000 registered users. MoodGYM is reaching a lot of depressed people who want help for their depression, but can’t (or won’t) see a professional for it.

Another self-help program presented at the e-Mental Health Summit 2009 was Beating the Blues, a UK-based program composed of 8, 50-minute weekly sessions conducted on a computer or online. This program is available for free to most people living in the UK; it’s meant to be “prescribed” by a general practitioner. In the early research data presented at the conference, for those who completed the program, researchers saw a decrease of approximately 50 percent in patients’ outcome measure scores — they got significantly, clinically better after completing the program.

The Beating the Blues program suffered from the same problem that seems to plague all self-help programs — poor followup and completion by participants. Out of the people referred to the program in the research discussed by Kate Cavanagh of Newcastle University, only about 37 percent actually completed it. This leaves a lot of room for improvement for non-completers.

As Helen Christensen, the Director of the Australian National University’s Centre for Mental Health Research noted in her presentation to the conference, web-based interventions are attractive for many reasons. Their costs actually decline the more we can get people to use them, which is one of the few treatment interventions that can be said for. They are easy to make available and administer to the entire population, and they don’t require a professional’s oversight in a one-on-one environment.

She also mentioned a few ways of combating the drop-out problem in these programs. One is to start designing online interventions that are tailored for the individual. For instance, a teen might see a more entertainment-oriented, video-based program while an older adult might be more comfortable with text-based images and information. Voluntary reminders administered via your mobile phone, Twitter, Facebook or email might also be helpful. Incentives for completing major steps in the program — for instance, each module in the MoodGYM — might also help drive a person to finish the intervention.

This article touches upon only a few of the online depression interventions now available presented at the conference. The key point is that there are many of these kinds of online interventions available that directly treat mild to moderate depression — the most common form of depression that affects the greatest amount of people. If you’re suffering from depression, I encourage you to try out one of these free online depression programs. Help may be, literally, just a click away.

Resource: Psych Central, By John M Grohol PsyD
October 23, 2009

Adolescent Depression October 8, 2009

Everyone young and old will feel periods of sadness sometime in their lives. What is an increasing problem though is the use of antidepressants for adolescents. What is a parent to do when their child is depressed and contemplating suicide? Should they let their child’s physician prescribe their child an antidepressant, which controversial findings have showed to increase the likelihood of suicide. Or should they try to find an alternative treatment?

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In a recent study done on 1100 children, half of whom took Paxil (an antidepressant) the other half took a placebo those children who took Paxil were three times more likely to attempt suicide than those who took the placebo (Waters, 2004). Critics are now claiming that the widespread use of antidepressants has become a national experiment, especially considering that antidepressants have been more largely studied on the use of adults rather than adolescents. It is a scary truth that no one knows the consequences of long term use on the growing brain of adolescents (Feldman, 2006). Most physicians have little or no training in Psychopharmacology, and are quick to say that it is a chemistry imbalance rather than an imbalance in life issues (Waters, 2004). Drugs are almost always given before therapy or other interventions have been taken. This is a huge risk we are taking with our children since studies show that antidepressants can cause suicidal behavior in adolescents. Suicide is the third leading cause of death among adolescents in the U.S (Neal,2005). Some of the specific risk factors include: instability, hostility, changes in eating habits, writing a will and, direct talk about suicide (Feldman, 2006).

There are other ways to try to treat adolescent depression before the use of antidepressants, some of them are: Cognitive DevelopmentBehavioral Therapy, which is based on the theory that adolescents have distorted views of themselves, the world and the future, and CBT works to change those distortions. CBT is a time limited therapy and only about 45% of those treated do not go into remission afterward. There is also a new innovative school based program led by psychologists that teaches at risk youth problem solving skills and relaxation techniques. Six months later those who had learned the new skills had fewer depressive symptoms than those who did not (Gillham,2006). Supportive group therapy with others who are at risk and family therapy are also some options. Since anxiety and depression often go hand in hand, relaxation therapy might work. There are numerous hotlines that are always there for adolescents also. And sometimes a simple change in diet might be all that is needed.; when children are saying to each other “I’m on Zoloft what are you on” we have a problem. If I am ever faced with the decision on whe

It seems to me that antidepressants have become very fashionable among adolescents I’m on Zoloft what are you on” we have a problem. If I am ever faced with the decision on whether or not I should consider antidepressants for my child, I will first try other methods, like therapy and relaxation techniques. And remember that sometimes all that is needed is a good listener.th Edition). New Jersey: Pearson Prentice Hall.

Teaching Mindfulness to Teens September 4, 2009

Starting simple is the best way to be successful with teaching mindfulness to kids. For example, an adult who begins learning meditation may start off with 15 minutes of meditation a day, for a child it would be better to start off with 5 minutes. They also write that whomever teaches the child should be comfortable with teaching mindfulness exercises and the person should also have some experience practicing mindfulness.

Three areas of mindfulness activities are suggested for use with kids. These areas are: mindfulness of the environment, mindfulness of the body, and mindfulness meditation. The first area activities deal with directing a child’s attention toward the things in their environment. The exercises are designed to help the child become aware of the things they are aware of and the things they are not aware of. Take for example this exercise — awareness of an object

Ask the child to select an object to draw. Examples of objects might be a telephone, a shoe, scissors, or a clock. Tell the child to draw a picture of their object. Remind them that the activity is not focused on their ability to draw, as this could cause frustration in some children, and to simply do the best job they can. Then the child should spend time looking at the actual object, paying attention to smaller and smaller details. If this exercise is done in school or some other setting, it may be a homework assignment to spend time looking at the object. Then the child should draw the object again. Compare the drawings, and ask the child to identify the details missing from the first drawing that they remembered in the second. In most cases,the second drawing will be more accurate and life-like. Ask the child what it was like to spend time really looking at the object that might otherwise have been something they never took time to notice.

The second area children focus on is mindfulness of the body.  An exercise used in Jon Kabat-Zinn’s MBSR program is called raisin meditation to demonstrate this principle. Raisin meditation “involves being aware of an object in the environment— in this case, a raisin—and then being aware of one’s own experience of that object.”  This exercise helps the child focus on their senses.

The final area of focus for kids is mindfulness meditation. The authors describe this as “the focused awareness on the thinking process.” The point of this practice is multifaceted. The exercises in the area are about letting go and not engaging thoughts, and having children learn how to slow down, observe thoughts, and “release them or let go without judgment.”

They present the bubble meditation for this area of focus.

Begin by sitting in a comfortable position, with your back straight and shoulders relaxed. Softly close your eyes. Imagine bubbles slowly rising up in front of you. Each bubble contains a thought, feeling, or perception. See the first bubble rise up. What is inside? See the thought, observe it, and watch it slowly float away. Try not to judge, evaluate, or think about it more deeply. Once it has floated out of sight, watch the next bubble appear. What is inside? Observe it, and watch it slowly float away. If your mind goes blank, then watch the bubble rise up with “blank” inside and slowly float away.

Hopefully by now teaching mindfulness to your child or the children you may be teaching isn’t too scary of a concept. But if you still find the idea scary, you can usually find a Buddhist center that has a children’s program that you and your child can participate in. And if you are a teacher in the Bay Area, you contact the Mindful Schools program.

Good luck!

Is it more than ADD? August 10, 2009

Symptoms of ADHD and bipolar disorder are often confused—and often coexist in the same person. How to make the distinction, and suggestions for treating bipolar disorder along with ADHD.

It can be difficult enough to obtain a diagnosis of attention deficit disorder (ADD ADHD), but to complicate matters further, ADHD commonly co-exists with other mental and physical disorders. One review of ADHD adults demonstrated that 42 percent had one other major psychiatric disorder. Therefore, the diagnostic question is not “Is it one or the other?” but rather “Is it both?”

Perhaps the most difficult differential diagnosis to make is between ADHD and Bipolar Mood Disorder (BMD), since they share many symptoms, including mood instability, bursts of energy and restlessness, talkativeness, and impatience. It’s estimated that as many as 20 percent of those diagnosed with ADHD also suffer from a mood disorder on the bipolar spectrum — and correct diagnosis is critical in treating bipolar disorder and ADHD together.

ADHD

ADHD is characterized by significantly higher levels of inattention, distractibility, impulsivity, and/or physical restlessness than would be expected in a person of similar age and development. For a diagnosis of ADHD, such symptoms must be consistently present and impairing. ADHD is about 10 times more common than BMD in the general population.

Bipolar Mood Disorder (BMD)

By diagnostic definition, mood disorders are “disorders of the level or intensity of mood in which the mood has taken on a life of its own, separate from the events of a person’s life and outside of [his] conscious will and control.” In people with BMD, intense feelings of happiness or sadness, high energy (called “mania”), or low energy (called “depression”) shift for no apparent reason over a period of days to weeks, and may persist for weeks or months. Commonly, there are periods of months to years during which the individual experiences no impairment.

Making a diagnosis

Because of the many shared characteristics, there is a substantial risk of either a misdiagnosis or a missed diagnosis. Nonetheless, ADHD and BMD can be distinguished from each other on the basis of these six factors:

1. Age of onset: ADHD is a lifelong condition, with symptoms apparent (although not necessarily impairing) by age seven. While we now recognize that children can develop BMD, this is still considered rare. The majority of people who develop BMD have their first episode of affective illness after age 18, with a mean age of 26 years at diagnosis.

2. Consistency of impairment: ADHD is chronic and always present. BMD comes in episodes that alternate with more or less normal mood levels.

3. Mood triggers: People with ADHD are passionate, and have strong emotional reactions to events, or triggers, in their lives. Happy events result in intensely happy, excited moods. Unhappy events — especially the experience of being rejected, criticized, or teased — elicit intensely sad feelings. With BMD, mood shifts come and go without any connection to life events.

4. Rapidity of mood shift: Because ADHD mood shifts are almost always triggered by life events, the shifts feel instantaneous. They are normal moods in every way, except in their intensity. They’re often called “crashes” or “snaps,” because of the sudden onset. By contrast, the untriggered mood shifts of BMD take hours or days to move from one state to another.

5. Duration of moods: Although responses to severe losses and rejections may last weeks, ADHD mood shifts are usually measured in hours. The mood shifts of BMD, by DSM-IV definition, must be sustained for at least two weeks. For instance, to present “rapid-cycling” bipolar disorder, a person needs to experience only four shifts of mood, from high to low or low to high, in a 12-month period. Many people with ADHD experience that many mood shifts in a single day.

6. Family history: Both disorders run in families, but individuals with ADHD almost always have a family tree with multiple cases of ADHD. Those with BMD are likely to have fewer genetic connections.

Treatment of combined ADHD and BMD

Few articles have been published about the treatment of people who have ADHD and BMD. It’s important to always diagnose and treat the BMD first, as ADHD treatment may precipitate mania or otherwise worsen BMD.

Outcomes for my patients treated for both ADHD and BMD have thus far been good. The majority have been able to return to work. Perhaps more importantly, they report that they feel more “normal” in their moods and in their ability to fulfill their roles as spouses, parents, and employees. It is impossible to determine whether these significantly improved outcomes are due to enhanced mood stability, or whether treatment of ADHD makes for better medication compliance. The key lies in the recognition that both diagnoses are present and that the disorders will respond to independent, but coordinated, treatment.

Source: ADDitude Magazine