Anxiety

Anxiety is the most common emotional problem in children. Children and adolescents can develop crippling worries about many things, from germs to vomiting to their parents dying. Some anxious children and adolescents are painfully shy, and avoid things that other children and adolescents enjoy, some have tantrums and meltdowns, and others develop elaborate rituals, like compulsive hand washing, aimed at diminishing the fear.

If you or your child’s fears are persistent, overly intense, or begin interfering with daily life, it might be time to seek help. Signs that a fear may be something more include:

• Obsessive worrying: You or your child fixates on the object of his fear, thinking or talking about it often, or even when the trigger isn’t present. For example, becoming terribly anxious months before the next dentist visit.
• Fears that limit you or your child’s ability to enjoy her life or participate in activities. For example, refusing to go on a trip to the park because there might be dogs there.
• Intense, specific fears that cause impairment. Signs of severe anxiety like panic attacks, compulsive or disruptive behavior, or withdrawing from activities, school or family.  If you or your child’s fears seem like they might be something more serious, make an appointment with a professional to see if more help is necessary.

Attention and Executive Function

Many people think of ADHD as a disorder of attention or lack thereof.  ADHD is much more complex. It involves issues with executive functioning, a set of cognitive skills, which has far-reaching effects.   Understanding the role of executive function in ADHD is critical for parents, so they can find the right tools to address their child’s ADHD. Plus, what may look like deliberate misbehaving may be an issue with ADHD, a symptom that requires a different solution.

And if you’re an adult with ADHD, learning about the underlying issues can help you better understand yourself and find strategies that work — versus trying harder, which often doesn’t work.

Behavior

It’s not unusual for children to behave differently in different settings. Behavior of some children and adolescents — especially those with issues such as anxiety, learning disabilities, ADHD, and autism — can vary especially when they are at home versus school.  Some children may do a good job meeting expectation at school, but not at home.

Children and Adolescents with some disorders, including anxiety and OCD, are very concerned about how people perceive them, especially when they get into the middle and high school years.  Children with challenges like ADHD and anxiety often have a very low frustration tolerance; asking them to be patient or persistent at school can be a stressor.  Children and adolescents with autism may be allowed very ritualized or self-directed behavior at home but the structure of school settings may be very challenging for them.

Depression

All children and adolescents have their ups and downs, but if you or your child is unusually irritable, sad or withdrawn for a prolonged period of time you may be showing signs of depression. Depression is more than moodiness — it can affect all parts of life, including behavior, appetite, energy level, sleep patterns, relationships and academic performance.

Getting treatment for depression can feel daunting. Often the depression itself gets in the way. A person who is depressed might be feeling overwhelmed, tired and hopeless. They might also be unfairly blaming themselves or their circumstances for the way they feels. These are some of the characteristic symptoms and thoughts that accompany depression, and they can make it hard for someone who’s depressed to speak up and ask for help.

Treatment can help children, adolescents or adults struggling with depression. The kind of treatment recommended for your child will depend on her symptoms and preferences, and the expertise of her clinician.

Dysautonomia and POTS

Dysautonomia (POTS): Professional bias or mysterious illness?

Doctors learn from evidence, experience, education, and their patients. Of course, professional biases exist. You may have heard “I don’t understand your illness; therefor you are not ill” or “You have too many symptoms, you report your symptoms as too severe, you act too diabled, etc; therefor you are making things up” or even “This is too mysterious to be a medical problem, therefor it is a psychiatric problem.”

It is estimated that over one million Americans are impacted by a primary autonomic system disorder. Autonomic dysfunction can occur as a secondary condition of another disease process, like diabetes, or as a primary disorder where the autonomic nervous system is the only system impacted. These conditions are often misdiagnosed.

While some physician will tell you “it is all in your head” there are some conditions of Dysautonomia and POTS that are best treated by psychiatrists.

Learning

Teachers are often the first to notice that a child might have a learning disorder. Sometimes the signs are easy to spot — a student who just isn’t making headway in reading, for example or a child who, despite obvious effort, can’t seem to master the times tables. The signs are not always as clear, and many children, embarrassed that they are struggling to do things that seem easy for other children and adolescents, go to pains to hide their difficulties.

Here are some less-obvious signs of learning disorders in children.

• Not living up to his potential — This is often described as a discrepancy between ability and aptitude i.e. a gap between what it seems a student should be able to do and what he’s actually able do.
• A student who writes fantastic essays but has serious difficulty getting through basic math assignments, or vice versa.
• A kid who’s great at answering questions in class but can’t get her point down on paper.
• A student whose intelligence is obvious in person, but isn’t reflected on his report card.
• Not trying hard enough — Children and adolescents may appear to be lazy or just not applying themselves, when in fact they may be struggling with a learning disorder.
• Off track — If a student constantly has to be reminded what to do next could be a sign that he’s having difficulty with what’s called “working memory” — holding, processing and building on new information. This is a common issue for children and adolescents with learning disorders.
• Difficulty following directions — especially if the student is hearing the information for the first time or there are several steps to remember
• Acting up or Hiding out — Where some students shrink down, hoping to go unnoticed, others act out, drawing attention away from deficits by becoming the class clown, being defiant, or pretending to be “too cool” to care how they’re doing in school.
• Missing homework — Students with learning disorders often struggle to get homework in on time — or at all. Homework troubles happen for a number of reasons. Every kid is bound to miss an assignment once in a while, but if a student routinely fails to turn in her homework it’s time to take a closer look at what’s going on.
• Timing troubles — Children and adolescents with learning disabilities often struggle with time management, transitions and organization. These timing troubles can cause problems both in school and at home. Tell-tale signs to watch for include:
  • A child who always seems to take ‘too long’ to complete tasks – from assignments to putting on his shoes after gym.
  • A student’s who’s parents report that it takes him hours to get through his homework at night.
  • A kid who’s chronically late to school (I missed the bus – again!) or always seems to be rushing from one class to another.
• Test Stress — Most children and adolescents will have test anxiety now and then, but if a student seems to have more trouble than expected it can be a clue that he has a learning disorder.

Mood

A mood swing is simply a noticeable change in one’s mood or emotional state. Everybody has mood swings and they are a natural part of most people’s lives. We get happy, we get sad. We have a period of feeling on top of the world, and then later in the same day, we feel tired, lethargic and beaten down. Small mood swings are a part of most people’s lives.

People who are experiencing a mood swing that’s been going on for more than a few weeks and is seriously affecting their friendships, relationship, school work, etc. should consider seeking professional help for the issue. A professional can help accurately diagnose the problem, and prescribe a course of treatment to reduce the mood swings.

Sexual orientation during adolescence

Adolescence is a period when people separate from their parents and families and begin to develop autonomy. Adolescence can be a period of experimentation, and many youths may question their sexual feelings. Becoming aware of sexual feelings is a normal developmental task of adolescence. Sometimes adolescents have same-sex feelings or experiences that cause confusion about their sexual orientation. This confusion appears to decline over time, with different outcomes for different individuals.  Therapy can often help alleviate the stress and anxiety that may come with this period of growth.

Parenting Challenges

They can be too numerous to count.  Here is list of a few we can help with:

When Siblings Won’t Stop Fighting, Postpartum Depression, Preventing Parent Burnout, Supporting vs Enabling, Teaching Kids About Boundaries, How to Help Anxious Kids in Social Situations, How to Work Well With Your Child’s Therapist, Having a Child in Emergency Inpatient Treatment, Bringing a Child Home From Psychiatric Hospitalization, When to Push Your Children, How to Discipline Toddlers

Social Skills

Social skills are the building blocks of social interaction. If you have social anxiety, you may have missed out on developing some of these important skills. However, you can always learn them no matter your age. Social skills training (SST) is a type of behavior therapy used to improve social skills like assertiveness, nonverbal communication, and verbal communication.

Stress and Resilience

We want our children to be successful, but we also know that learning how to rebound from failure is an important part of developing a healthy, self-confident outlook.

Not learning to tolerate failure can leave children feeling vulnerable or anxious.  When the inevitable failure does occur, whether it happens in preschool or college, it may create a unnecessary hurdle or reaction. Distress or frustration tolerance is an important life skill to master. Building that skill set is necessary for children and adolescents to be able to become more independent and succeed in future endeavors, whether it’s personal goals, academic goals, or just learning how to effectively deal with other people.

If a child can’t function because of a fear of failure, therapy may be a good option.

Trauma

Adult suffers may develop emotional disturbances such as extreme anxiety, anger, sadness, survivor’s guilt, or PTSD. They may experience ongoing problems with sleep or physical pain, encounter turbulence in their personal and professional relationships, and feel a diminished sense of self-worth due to the overwhelming amount of stress.

Many children experience trauma through ongoing exposure, throughout their early development, to abuse, neglect, homelessness, domestic violence or violence in their communities.

Traumatic experiences often arouse strong, disturbing feelings that may or may not abate on their own. In the immediate aftermath of a traumatic event, it is common to experience shock or denial. A person may undergo a range of emotional reactions, such as fear, anger, guilt, and shame. Feelings of helplessness and vulnerability are also common. Some may experience flashbacks and other signs of PTSD. Traumatic memories fade naturally with time. Persistence of symptoms is a signal that professional help is needed.