 By Jean Gauvin PhD, MD
1. What is the rate of mental disorders in children and teenagers? According to the National Institute of Mental Health, up to 50% of children and adolescents meet criteria for a mental disorder in the diagnostic and statistical manual (DSM) by age 18. That means that up to half of children and adolescents are struggling significantly with emotional issues to the point that they are suffering and have impaired functioning. Medication is often used to help relieve the suffering caused by mental illnesses and disorders by targeting chemical imbalances in the brain. 2. How do you determine whether to prescribe medication? Several factors are taken into consideration when determining whether a dose of medication is appropriate. These include but are not limited to a patient’s symptoms, his or her age, sometimes his or her gender, possible interactions with other medications that he or she is also taking, the duration of treatment, as well as potential side effects. This is especially important since some psychiatric medications can have more severe long–term side effects. For example, antipsychotics and mood stabilizers can cause obesity, high cholesterol, and diabetes. These side effects, in turn, can lead to blockages in the arteries that increase the risk of heart disease and stroke. 3. Are there any child-specific considerations that factor into the decision to prescribe a medication? Whether it comes to treatment for an adult or a child, the prescribing of medication generally occurs when the benefits outweigh the risks. However, in children, there is an added subtle risk that may be difficult to accurately assess: the risk on the developing brain. Though all of our medications are tested and proven to be generally safe, we are never exactly sure what subtle effects they may have on the developing brain of a child. There is not a reliable way to determine exactly what kinds of subtle effects they may have over, let's say, twenty years on factors such as personality or cognitive development. That is why I adhere to a conservative approach in the treatment of all patients, but especially when it comes to the treatment of children.
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 Depression... the cloud of sadness over life. Sometimes the clouds lightly shadow the joys of life but they still shines through. It’s a mild discomfort but you have learned to live with it. And even when the sun is out, you know there will be another sad day to come.
Sometimes depression is seen as dark angry clouds. Have you ever known someone to be easily angered and frustrated at the drop of a hat? That can also be an expression of depression. We think depression is always expressed through sadness but sometimes its through anger, especially for men. For other people the clouds move in and the sunshine is just absent. The world is colored by thoughts and feelings of pain or deep numbness. The hurt can come and go in waves or stay for days or weeks at a time. Some times it feels unbearable to survive. And it is hard to see any sunshine at all. Depression isn’t the same for everyone. But you might experience:
What happens in the brain of depression: Historically, research studies on depression proposed that depression is caused by low levels of individual neurotransmitters - serotonin, dopamine, norepinephrine, and/or histamine - in the brain. However, we now understand that depression is caused by a complex interplay between genetics, dysfunctional systems of brain circuits, temperament/personality traits and environmental stressors. In the brain, the most common abnormalities found on MRI are bright spots in the basal ganglia and the thalamus and reduced sizes of the hippocampus and caudate nucleus, all of which are deeper, more primitive regions of the brain with complex functions preserved across mammalian species. PET scans of depressed patients commonly show decreased metabolism/brain activity in the frontal brain regions which are responsible for attention, memory, concentration, mood regulation, and other higher-level brain functions that make humans uniquely prone to bouts of depression.  Ever Wonder: What is Habit Forming Alcohol Use?
You know you have habit forming alcohol use when:
Why does alcohol mute happiness? In the brain, alcohol initially boosts the effect of calming neurotransmitter GABA and releases feel-good endorphins that stimulate opioid receptors. However, as blood alcohol level rises, so does its toxic by-product acetaldehyde which is thought to be responsible for the next-day hangover and moodiness. Alcohol also negatively impacts sleep, as waning blood alcohol levels disrupt the brain’s natural sleep cycle and impede the ability to have a deep, restorative sleep that is crucial for next-day energy and mood stability. Can habit drinking become a bigger problem? A seemingly harmless habit can escalate into dependency as the brain’s feel-good receptors grow accustomed to the presence of high levels of alcohol in the blood to maintain a new homeostasis. In turn, the absence of alcohol signals the brain’s opioid receptors and reward pathways to cue alcohol-seeking behavior (i.e. cravings); in severe alcohol use disorder, the sudden discontinuation of alcohol can result in alcohol withdrawal symptoms that can progress to life-threatening seizures and delirium tremens – a syndrome that may include involuntary body shaking, confusion, hallucinations, and irregular heart rhythms.
There are some common thoughts and behaviors people who are diagnosed with ADHD report. Doing the behaviors listed below does not mean you have ADHD but that you might want to get a formal assessment to determine if a diagnosis of ADHD fits for you. To know will help you identify ways to cope better, improve the way you feel about yourself and how you impact close relationships.
You may have ADHD if:
Why this happens... In the brain of someone with ADHD, you’re dealing with a frontal lobe that is under-responsive to dopamine and norepinephrine – neurotransmitters crucial for problem solving, organized decision making, maintaining the motivation to carry out a task, and for blocking out distractions from the environment. In individuals who do not have ADHD, their brains are better able to pump the brakes on making rash decisions, making easier for them to resist the many distractions around them and to think more mindfully. The ADHD brain is functioning as if the brakes have been cut and less able to slow down the urges to act on each thought that comes to mind.  By Amanda Craig, PhD, LMFT
 By Jenna Hendriksen, MA, MFT-LP
As a country, we are suffering. We are overwhelmed with emotion; trying to grasp what is going on in the world. Between Covid-19 and yet another act of police brutality shining light on racism and injustice in our country, we are feeling at a loss. Be kind to one another; It is important to remember we are all in this together. Here are some ways you can cope with what's going on in the world and contribute in a positive and meaningful way. Emotional Awareness and Expression. It is important to acknowledge our feelings as it pertains to the recent series of events. How are you processing each emotional experience? To truly understand how you are feeling, slow down and get curious about how your body feels in your emotion. Our emotions are a neurological experience and we explain it using feelings words. Most often emotion is felt in your heart, lungs and digestive system because the nervous system drives emotion through the body. Now you know where your emotion is held. Next, access the emotion stored in those places of tension. Name the feeling, name its root cause, perhaps even see what defenses the emotion leads you to do in behavior. And then what underlying messages are you telling yourself that calm or agitate your emotional state? And what behaviors are we proud of and feel guilty about?  By Michelle Woodward, LPC
In the recent months, we’ve had to face unexpected changes and hardship of a pandemic and there is no doubt that we are in the beginning stages of a huge mental health crisis involving psychological trauma. COVID-19 will leave a large percentage of our population traumatized and not knowing where to get the help they need. I recently watched a video by Bessel Van der Kolk, leading expert in trauma and author of The Body Keeps Score. In the video he discusses Psychological Trauma in the Age of Coronavirus. I've highlighted six points from the video on how we can minimize the impact of this trauma on ourselves throughout (and after) quarantine. Though the video was created specifically with Coronavirus in mind many of the points can be applied to all traumas. So, what sets people up for trauma and what can we do about it? See these helpful tips below:
 By Sarah Trance, LMFT
If you’re a therapist or mental health counselor, you’ve likely been thrusted into virtual sessions during COVID-19 and I know it's not ideal. I think we can all agree that face-to-face sessions feel better to us; our norm in many ways, and during time of crisis and chaos, it makes sense to crave your normal. But, we’re in a time where it’s vital to focus on the silver linings! I'm learning that there can be some great aspects to telehealth including our ability to have access and give care to our clients, continuously. So, how do we make this work?! I've compiled some tips over the last few weeks based on my own experiences, feedback from colleagues and open dialogue with clients on how to transition to or begin virtual sessions:
situations. This isn't going to be possible for all clients so how can you process with them what will and will not work? -Be straightforward in what you're hoping for, set your boundaries but be willing to be flexible – it’s needed right now! -Make note of something that feels like a ‘clinical issue’ versus ‘necessary’ during this time (re: what does it mean if the client is eating during session or are chatting from their bed?  By: Jenna Hendricksen, MA, MFT-LP Right now we are experiencing a new norm. Something we have never experienced before which has left us in a place of confusion, uncertainty, and in a state of anxiety. We do not know what our world has in store for us and that is alarming. Fortunately, we do know that if you are not an “essential” worker you have one very specific job. STAY HOME. This is likely the only time in our lives that laying around in pajamas can save the world. However, the safety of your home does not mean your anxiety goes out the window. We are all feeling worried and it is valid. I saw a quote this week that caught my attention, and I challenge you to take a moment and think about it... “Try to remember that anxiety is a blend of fear and hope, and see if you can keep the hope part in mind too.” (unknown)  By Sarah Trance, LMFT We’ve begun settling into the new normal in NYC and the Greater New York area. Many are already experiencing cabin fever and feeling ‘stir crazy’ with the daunting idea of time. Scott Kelly retired NASA astronaut, wrote a great article in the NYTimes about how he dealt with isolation and encourages us all to remember that we are connected. Although we realize that tidying-up is a great way to clear your mind and feel organized, not everyone has that bandwidth at the moment. Take a look at some tips we’ve collected throughout the week the help you find some calm and connected moments in spite of social distancing.
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