Thursday, October 30, 2008

Sue Scheff - Mistreated Depression




“Basically, psychiatrists are pretty busy. They don’t want to spend a lot of time with people. They want to get people in and out, maybe two or three an hour. … It pays better to do that than spending an hour doing psychotherapy.”

– David Gore, Ph.D., clinical psychologist

Fifteen-year-old Sarah McMenamin suffers from depression. It started a year ago with the death of her father.

“I was just like, ‘I just want to die,’” she says, describing her feeling before seeing a therapist. “I would never kill myself, but I just wish I was dead, I just wish I was never going to wake up.”

For depressed teens, experts at the American Academy of Child and Adolescent Psychiatry say what can help is medicine – combined with talk therapy.

“I think the therapist helped me,” explains Sarah, “’cause it was talking, you know, I got it out. I didn’t bottle everything up.”

“The advantage to getting some therapy along with medication is that you get to the root of the problem,” explains Dr. David Gore, clinical psychologist. “You get to see why you’re feeling that way. And if you start understanding why you’re feeling that way, chances are pretty good you’ll stop feeling that way.”

But according to a new study from Thomson-Reuters, more teens than ever are getting medication without psychotherapy. Why? Gore has an answer.

“Basically, psychiatrists are pretty busy,” Dr. Gore says. “They don’t want to spend a lot of time with people. They want to get people in and out, maybe two or three an hour. … It pays better to do that than spending an hour doing psychotherapy.”

Three months ago, Sarah started seeing a new doctor.

“Right away he put me on Zoloft,” she says. “He didn’t even know me for an hour and he put me on it.”

But psychologists say medicine alone just won’t work as well.

“You take your pill, you’ll get some immediate relief,” explains Dr. Gore, “but the problem’s going to crop up again in two months or four months or six months. You’ve got to get to the root of the problem.”

Sarah will resume talk therapy again in a few months. She says she is looking forward to it.

“You get it out on the table and you know your feelings’” she says, “and you go in thinking it’s one thing and you come out finding out it’s like 10 different things and you’re like, ‘Wow.’”

Tips for Parents
All teens experience ups and downs. Every day poses a new test of their emotional stability – fighting with a friend, feeling peer pressure to “fit in” with a particular crowd or experiencing anxiety over a failed quiz – all of which can lead to normal feelings of sadness or grief. These feelings are usually brief and subside with time, unlike depression, which is more than feeling blue, sad or down in the dumps once in a while.

According to the Nemours Foundation, depression is a strong mood involving sadness, discouragement, despair or hopelessness that lasts for weeks, months or even longer. It also interferes with a person’s ability to participate in normal activities. Often, depression in teens is overlooked because parents and teachers feel that unhappiness or “moodiness” is typical in young people. They blame hormones or other factors for teens’ feelings of sadness or grief, which leaves many teens undiagnosed and untreated for their illness.

The Mayo Clinic reports that sometimes a stressful life event triggers depression. Other times, it seems to occur spontaneously, with no identifiable specific cause. However, certain risk factors may be associated with developing the disorder. Johns Hopkins University cites the following risk factors for becoming depressed:

Children under stress who have experienced loss or who suffer attention, learning or conduct disorders are more susceptible to depression.


Girls are more likely than boys to develop depression.


Youth, particularly younger children, who develop depression are likely to have a family history of the disorder.


If you suspect that your teen is clinically depressed, it is important to evaluate his or her symptoms and signs as soon as possible. The National Depressive and Manic-Depressive Association cites the following warning signs indicating that your teen may suffer from depression:

Prolonged sadness or unexplained crying spells
Significant changes in appetite and sleep patterns
Irritability, anger, worry, agitation or anxiety
Pessimism or indifference
Loss of energy or persistent lethargy
Feelings of guilt and worthlessness
Inability to concentrate and indecisiveness
Inability to take pleasure in former interests or social withdrawal
Unexplained aches and pains
Recurring thoughts of death or suicide


It is important to acknowledge that teens may experiment with drugs or alcohol or become sexually promiscuous to avoid feelings of depression. According to the National Mental Health Association, teens may also express their depression through other hostile, aggressive, risk-taking behaviors. These behaviors will only lead to new problems, deeper levels of depression and destroyed relationships with friends and family, as well as difficulties with law enforcement or school officials.

The development of newer antidepressant medications and mood-stabilizing drugs in the last 20 years has revolutionized the treatment of depression. According to the Mayo Clinic, medication can relieve the symptoms of depression, and it has become the first line of treatment for most types of the disorder. Psychotherapy may also help teens cope with ongoing problems that trigger or contribute to their depression. A combination of medications and a brief course of psychotherapy are usually effective if a teen suffers from mild to moderate depression. For severely depressed teens, initial treatment usually includes medications. Once they improve, psychotherapy can be more effective.

Immediate treatment of your teen’s depression is crucial. Adolescents and children suffering from depression may turn to suicide if they do not receive proper treatment. Suicide is the third leading cause of death for Americans aged 10-24. The National Association of School Psychologists suggests looking for the following warning signs that may indicate your depressed teen if contemplating suicide:

Suicide notes: Notes or journal entries are a very real sign of danger and should be taken seriously.


Threats: Threats may be direct statements (“I want to die.” “I am going to kill myself”) or, unfortunately, indirect comments (“The world would be better without me.” “Nobody will miss me anyway”). Among teens, indirect clues could be offered through joking or through comments in school assignments, particularly creative writing or artwork.


Previous attempts: If your child or teen has attempted suicide in the past, a greater likelihood that he or she will try again exists. Be very observant of any friends who have tried suicide before.


Depression (helplessness/hopelessness): When symptoms of depression include strong thoughts of helplessness and hopelessness, your teen is possibly at greater risk for suicide. Watch out for behaviors or comments that indicate your teen is feeling overwhelmed by sadness or pessimistic views of his or her future.


“Masked” depression: Sometimes risk-taking behaviors can include acts of aggression, gunplay and alcohol or substance abuse. While your teen does not act “depressed,” his or her behavior suggests that he or she is not concerned about his or her own safety.


Final arrangements: This behavior may take many forms. In adolescents, it might be giving away prized possessions, such as jewelry, clothing, journals or pictures.


Efforts to hurt himself or herself: Self-injury behaviors are warning signs for young children as well as teens. Common self-destructive behaviors include running into traffic, jumping from heights and scratching, cutting or marking his or her body.


Changes in physical habits and appearance: Changes include inability to sleep or sleeping all the time, sudden weight gain or loss and disinterest in appearance or hygiene.


Sudden changes in personality, friends or behaviors: Changes can include withdrawing from friends and family, skipping school or classes, loss of involvement in activities that were once important and avoiding friends.


Plan/method/access: A suicidal child or adolescent may show an increased interest in guns and other weapons, may seem to have increased access to guns, pills, etc., and/or may talk about or hint at a suicide plan. The greater the planning, the greater the potential for suicide.
Death and suicidal themes: These themes might appear in classroom drawings, work samples, journals or homework.


If you suspect suicide, it is important to contact a medical professional immediately. A counselor or psychologist can also help offer additional support.

References
American Academy of Child and Adolescent Psychiatry
American Foundation for Suicidal Prevention
Johns Hopkins University
Mayo Clinic
National Association of School Psychologists
National Depressive and Manic-Depressive Association
National Institute of Mental Health
National Mental Health Association
Nemours Foundation
Thomson-Reuters

Monday, October 13, 2008

Sue Scheff: Better ADHD School Behavior


How teachers and parents can inspire better ADHD school behavior with help from these impulse-controlling exercises for children with attention-deficit.




The problem: The student with attention deficit disorder (ADD ADHD) interrupts the teacher and classmates by calling out answers or commenting while others are speaking.


The reason: Children with ADHD have difficulty controlling their impulses. Scientists believe that a problem with dopamine, a brain chemical, causes them to respond immediately and reflexively to their environment — whether the stimulus is a question, an idea, or a treat. That’s why they often seem to act or talk before thinking, and ADHD school behavior suffers as a result.


The obstacles: Children with ADHD may not be aware that they are interrupting. Even if they are, they have difficulty understanding that their behavior is disturbing or disruptive to others.Simply telling them their behavior is wrong doesn’t help. Even though they know this, their impulsivity overrides their self-control. Many ADHD children can’t understand nonverbal reprimands, like frowning, either.


Sunday, October 5, 2008

Sue Scheff: Teen Truancy


Truancy is a term used to describe any intentional unauthorized absence from compulsory schooling. Children in America today lose over five million days of their education each year through truancy. Often times they do this without the knowledge of their parents or school officials. In common usage the term typically refers to absences caused by students of their own free will, and usually does not refer to legitimate "excused" absences, such as ones related to a medical condition. It may also refer to students who attend school but do not go to classes. Because of this confusion many schools have their own definitions, and as such the exact meaning of the term itself will differ from school to school and district to district. In order to avoid or diminish confusion, many schools explicitly define the term and their particular usage thereof in the school's handbook of policies and procedures. In many instances truancy is the term referring to an absence associated with the most brazen student irresponsibility and results in the greatest consequences.


Many educators view truancy as something much more far reaching than the immediate consequence that missed schooling has on a student's education. Truancy may indicate more deeply embedded problems with the student, the education they are receiving, or both. Because of its traditional association with juvenile delinquency, truancy in some schools may result in an ineligibility to graduate or to receive credit for class attended, until the time lost to truancy is made up through a combination of detention, fines, or summer school. This can be especially troubling for a child, as failing school can lead to social impairment if the child is held back, economic impact if the child drops out or cannot continue his or her education, and emotional impact as the cycle of failure diminishes the adolescent's self-esteem.

Thursday, September 25, 2008

Sue Scheff: Addictions and Inhalants




Daniel Jordan raises some interesting questions in his summary of an addictions presentation byDr. Carlton Erickson, Ph.D., Professor of Pharmacology, and director of the Addiction Science & Research Center in the College of Pharmacy at the University of Texas at Austin.


What are your perspectives or thoughts on his following two points?


1. Inhalants and Addiction:“Dr. Erickson calls the likelihood that a person will become dependent on a drug its “dependence liability.” Some drugs have a dependence liability while others do not.


The criteria for dependence liability is how it acts on the mesolimbic dopamine system. Caffeine, antidepressants, and newer anti-seizure medications do not have dependence liability. However, some drugs do and the following chart shows that a certain percentage of people (depending on the drug) will become dependent *:


Drug / Percentage of People Who Become DependentNicotine - 32%, Heroin - 23%, Cocaine - 17%, Alcohol - 15%, Stimulants - 11%, Cannabis - 9%, Sedatives - 9%, Psychedelics - 5%, Inhalants - 4%.


Source: Anthony, J.C., Warner, L.A., & Kessler, R.C., (1994). Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: Basic findings from the national comorbidity survey. Experimental & Clinical Psychopharmacology, 2, 244-268.”


2. Use the term “Abuse” in Inhalant Abuse:“I was particularly fascinated by Dr. Erickson’s claim that many of the words, or terminology, that the general public and the treatment field use to describe drinking and drugging are leading to continued prejudice and discrimination in North American culture. This stigmatizing, Dr. Erickson argues, is a big part of why governments are not providing adequate funding for addiction research, prevention, and education


“Abuse” is a Perjorative Term and Should be Retired. In his book, The Science of Addiction, Dr. Erickson calls the term “abuse” the number 1 myth that prevails in the treatment field or in the minds of the public. The word abuse * is an inappropriate term for several reasons, such as:


the term being used, for centuries, as a morally sinful act such as child abuse, sexual abuse, spousal abuse
the implication that alcohol, an object, is being abused by someone just like a child is being abused by someone (a preferred term in Europe is misuse)


the use of the term substance abuse does not distinguish between voluntary use (”misuse”) and uncontrolled use (”dependence”) similar to the generalized use of the term “addiction”


“By continuing to refer to people as drug, alcohol, or substance abusers, according to Bill White *, “misstates the nature of their condition and calls for their social rejection, sequestration, and punishment.”


Visit http://www.inhalant.org/ for more information.

Saturday, September 20, 2008

Parents Universal Resource Experts: Preventing Addiction by Dr. John C. Fleming


How can concerned parents predict if their kids will become addicted to drugs or alcohol? With the effect of media and the current wide availability of addicting drugs, parents face more challenges raising children than ever before. Opinions vary on the question of who will become addicted. Some think that people become addicted because of their heredity, while others think addiction is not a disease at all, just a weakness of will.


Visit http://www.johncfleming.com/ for more information.

Thursday, September 18, 2008

Sue Scheff Featured on Talk Radio


Sue Scheff talks about Wit's End! and the struggles parents are facing today with their teens. Learn more and list live! http://www.kandeeg.com/

Sunday, September 14, 2008

Parents Universal Resource Experts - Sue Scheff- American School Counselors Association


The American School Counselor Association (ASCA) supports school counselors' efforts to help students focus on academic, personal/social and career development so they achieve success in school and are prepared to lead fulfilling lives as responsible members of society. ASCA provides professional development, publications and other resources, research and advocacy to more than 24,000 professional school counselors around the globe. Join today!