Author: drstephaniesmith

Life Through the Eyes of a Psychologist

The Toughest Thing About Panic Attacks

It’s Tuesday.  That means Dr. Raison, The Chart’s resident mental health expert answers a reader’s psychiatric question.  Today Dr. Raison answered Stephanie’s (not me) question about panic attacks and their treatment.  Dr. Raison did a nice job discussing treatment options including psychotherapy and medication. 

Dr. Raison’s post got me thinking about panic attacks.  They are buggers (understatement) for several reasons:

They can make you feel like you are dying.  Trouble breathing, chest pains, dizziness – all symptoms of panic attacks.  And, oh by the way, the same symptoms as heart attacks. That’s why it’s important to talk to your physician about your overall health if you start having panic attacks – it’s better to be safe than sorry.  Once you get a clean bill of health, it may be easier (albeit marginally) to realize you are not dying when a panic attack hits.

They can make you feel like you are going crazy.  I’m not sure what the official definition of “crazy” is, but panic attacks can make you feel like you have arrived there. Folks often tell me they feel like they are losing their minds when panic sets in.  While disorienting, experiencing panic attacks doesn’t mean you are headed for psychosis, it just means you might need to learn a few coping strategies.

They can make you feel embarrassed.  People who suffer panic attacks often feel a level of embarrassment after they’ve had one, as they are sure the people around them could tell what was going on.  The good news is, they usually can’t.  While panic attacks feel ovewhelmingly awful to the person having them, the folks around them are typically oblivious to what’s going on.

*They can happen anytime.  And here is the toughest thing about panic attacks – they can happen anywhere, anytime.  Many of us assume we’ll have an attack when we are feeling stressed or nervous (right before giving a big speech or driving over a bridge).  That might happen, but they can also happen when you are happily eating a slice of chocolate cake while watching Dirty Dancing.  What’s the deal with that?  I’m not sure.  But I do remind my clients that panic attacks can strike at any time, and it doesn’t mean they have a phobia of Patrick Swayze.  It just means that panic attacks are irritating and unpredictable.

The good news is, there are a lot of treatment options available for people suffering from panic attacks.  For some thoughts about treatment, check out the American Psychological Association’s Help Center.

Choosing After School Activities

Photo by: Kingbob.net

The time for choosing after school and extracurricular activities is upon us.  I don’t know about you, but this task can feel more daunting than picking my child’s school!  I’m lucky that my community has many options to choose from.  But like anything else, sometimes too many options can be too much of a good thing.  So how does one narrow down the possible choices to just one or two?

Cost:  I have found that high cost does not necessarily equal high quality.  Some sports tend to be cheaper (like soccer) because they do not use as many supplies as say football. It doesn’t mean the activity is better because it costs more.

Interest: This may be a no-brainer, but sometimes we parents forget to assess our children’s interest in the activity in question.  Sure piano lessons might be good for them, but if they have absolutely no interest, it will be a painful year of forced practicing for everyone involved.

Family Fit: I’m a big proponent of making sure after school activities fit with the messages we are trying to teach our children at home.  Is sustainability and environmental health something you strongly believe in?  Then perhaps an after school science club would be a good fit.  Believe in the power of musical theater?  Choir might be a good bet.

Schedule: As much as we’d like to be, none of us can be two places at once.  Before signing up for extracurriculars, check out the schedules for all your children and balance against your own activity and work calendar.  No one will have fun doing anything if it means arriving late, leaving early, and going without dinner on Tuesdays and Thursdays.  Be realistic about your family’s timeline and limits.

Usefulness:  If you’ve narrowed down the options and are stuck between two sports (or other activities) that are equal in every way, you may want to consider the activity’s usefulness.  For example, football is great, but perhaps learning to golf might prove to be more do-able over the course of your child’s life.  Similarly, drum lessons might be cool, but if it’s all the same to your child, learning to play the guitar might have wider applicability down the road.  It’s kind of like this:  French may be a beautiful language, but if you live in the Southwest, Spanish wins out in terms of practicality.

I don’t have a rule about how many activities kids should participate in, because each child (and each family) is different.  Some do best with an activity everyday, others do best with more minimal commitments.   Check in with your kids about how they’re feeling about their workload.  Ask them now, and ask them again throughout the semester.  Are they enjoying school and clubs like they used to?  Are they getting enough sleep and down time?  Use this fall’s observations to inform your decisions about the spring semester.

How do you pick activities for your child?

 

 

 

 

Glee Wins at The Voice Awards

Peter Krause was the host of the 2011 Voice Awards Photo by: SAMHSA

Have you heard of the Voice Awards?  Here’s a description:

Sponsored by the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), and Center for Mental Health Services, the Voice Awards honor consumer/peer leaders who have played a vital role in raising both awareness and understanding of behavioral health (mental health and/or addiction issues) and promoted the social inclusion of individuals with behavioral health problems. Through their exemplary leadership and advocacy, they demonstrate that recovery is real and that individuals with behavioral health problems are valuable, contributing members of their schools, workplaces, and communities.

This year the focus of the awards program was recovery from trauma, and the ceremony was held last night.  While just a teeny bit disappointed that I didn’t get to go and cover the red carpet (dang it!), I am thrilled that Glee won an award for its portrayal of Obsessive Compulsive Disorder (OCD).  As a gleek, I couldn’t be happier for the show.  Check out my post on Glee’s portrayal of Ms. Pillsbury’s OCD.

Check out more of the winners at last night’s Voice Awards.  Mad Men, another favorite of mine, is among the honored.  Sally’s treatment with a psychologist may just be in my blogging future.

In honor of Glee’s award, here’s the trailer from their new season starting next month:

Sympathy for the Hot Sauce Mom?

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Have you heard the story about the mom who poured hot sauce into the mouth of her 7 year old adopted son?  I first read about it a few months ago, and the story is resurfacing again as the legal battle heats up.  If you aren’t familiar with the story of the mom, her family, and The Dr. Phil Show, check it out here.   And if you want to watch the video of the mom (Jessica Beagley) actually inflicting the punishment, here it is:

So, what do I have to say about this incident?  To be honest, I’m not sure.  The prosecutors sure paint an ugly picture of Ms. Beagley as a mom hungry for notoriety on a reality show, and willing to do anything to get it.    The defense wants the jury to see her as a stressed out, desperate mother of 6, doing what she could to get help from the country’s most infamous psychologist.  I don’t know who to believe, but a couple things seem certain:

1.  There are lots of folks who are willing to do lots of crazy things to get on TV.  Whether the intentions are good (win a million dollars, find true love, get free parenting advice), or not so good (destroy the reputation of a colleague) this sets up a slippery slope of stupid, and sometimes even dangerous behavior.  Perhaps we all need to re-think our obsession with reality TV and the drama it invites.

2.  Parenting is super hard.  Parenting children with special needs is even harder.  While it is never OK to abuse or torture children, we must have sympathy and understanding for parents who are pushed to their limits.  Furthermore, affordable, user-friendly parenting resources need to be closer to home than in the LA studios of The Dr. Phil Show.

What are your thoughts about this disturbing story?

Save the Strong, Smart Man!

Photo by: Jason Edward Scott Bain

When reading this recent post on CNN’s The Chart I started thinking about men and boys in a new light.  CNN’s article was about some new research suggesting that testosterone levels in men has decreased in recent decades.  They also mentioned that male birth rates have been declining in some populations.  The authors speculated that environmental exposures might be the reason.  What I started thinking was: how is American culture and media affecting men and boys?

I am a woman and I have daughters, so I typically think and write about how the world is affecting females.  But that is pretty one-sided of me.  Just as important to societal health is how men and boys are being portrayed in the media and treated in real life.  We’ve all heard about ADHD and autism being more prevalent in boys, and the current educational system being more conducive to female rather than male minds.  But what I am focused on is how pop culture is portraying the roles of men.  And it isn’t pretty.

I’m thinking of the lunchmeat (or was it cellphone?) commercial where the woman is making lunch.  She yells for her male mate to come to the table.  She calls him multiple times to come to kitchen with no luck.  Finally she resorts to texting him a picture of his waiting sandwich.  Seeing it, he quickly comes to the table to eat.  Just like a hungry dog.  Is this really the type of male partner we want our boys (and girls) to see?  One that responds only when his most basic needs are being met?  Why not show the couple working together as a team to make lunch while having a smart discussion?  For a list of more male-bashing commercials check out AskMen.com’s Top Ten List.

When I’ve talked to other folks about this phenomena, I’ve been reminded of the many TV programs that portray men as bumbling, selfish, and irritable people.   The Simpsons, Family Guy, and even Friends have done the men and boys in our lives a disservice.  What role models are we giving our boys to look up to?  Where are the strong, smart, capable, and responsible males being highlighted and celebrated?

I am on the lookout for strong male figures in our culture.  Ideas?

Tears and Cheers: Back to School Emotions

Photo by: Dawn Ashley

Today is back to school day in my neck of the woods.  The backpacks are packed, the outfits picked out, the teachers assigned.  The only thing left for us parents to do is experience the flood of emotions that come with waving goodbye.  Whether our kids are heading off to class for the first time or are seasoned pros, this is an emotional time of year for many families.

I have talked to lots of moms who are relieved that the long, unstructured days of summer are over.  And I’ve talked to many who dread the early wake up times and homework assignments of the school year.  I think most of us feel both the dread and excitement simultaneously.  Emotions can be especially strong for parents of preschoolers and kindergartners, families who have moved to a new town, or parents who have children who struggle socially or academically.

If you find yourself alternating between crying and shouting “Yahoo!” know that the fluctuation is totally normal!  After a few weeks in school we will all be back into a routine, and our emotions will likely return to normal, too.  In the meantime, find support from other parents in your neighborhood or school.  Chances are they are feeling the exact same thing.

Does your child have worries about going back to school?  Read some tips here.

APA offers tips for coping with Back to School Blues here.

Back to School Worries

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Photo by: MerelyMel13

It’s not unusual for even the most confident kids to have worries associated with heading back to school.  New teachers, new expectations, new classroom – there are a lot of unknowns when entering a new school year.  Anxieties can grow even more intense when a child is starting a new school.  How can parents help?

Be Prepared.  Worries breed when we are unprepared.  Do you have a list of school supplies, clothing, and other materials that need to be purchased?  Try shopping well ahead of time so that you aren’t scrambling at the last second.  When you are prepared and relaxed – your kids will follow.

Dress Rehearsals are Good.  I’m a big fan of practicing events about which we are worried.  A few days or a couple weeks before the big day, try a dress rehearsal.  Have your child dress in their back to school outfit, eat a typical school day breakfast, pack their lunch, grab their backpack, and head off to school.  Make a fun event out of it.  If your school allows for a visit before classes start – do it!  It can help ease worried minds to be able to visualize the hallways and classrooms in which they will learning.

Don’t Say “Don’t Worry.”  None of us wants our kids to worry or be stressed.  So when your son says, “Mom, I’m nervous about the first day of school” most of us answer by saying, “It’ll be fine!  Don’t be worried!”  But in the interest of encouraging our kids to talk to us, a better response might be: “What are you worried about?”  This will give your child the opportunity to explain their worries, so that you can respond appropriately.  A conversation might go like this:

Child: “Mom, I’m nervous about the first day of school.”

Parent: “What are you feeling nervous about?”

Child: “I’m afraid I won’t know anyone with my lunch period and I will have to sit alone.”

Parent: “I can see why you’d be worried about that.  Let’s come up with some ideas about what to do if that happens.”

Child: “I don’t know what to do!”

Parent: “Could you sit with a teacher?  Sit next to someone else sitting alone?”

Child: “Yea, maybe I could sit next to someone else who’s alone.”

Parent: “Great!  Sounds like a good plan.”

Perhaps the most important thing about helping your child learn to manage worries is to check in after the first day is over.  See how it went.  Was there a reason to worry, or not?  How did they cope with the lunch room situation?  If the day was a success, use it to build confidence for the next worrisome situation.  If it wasn’t, try brainstorming more solutions for a better outcome.

 

 

 

Kids and TV – What to Watch?

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On a recent family vacation I was forced had the opportunity to watch TV with my kids more than usual.  I was appalled at what I saw.

My ideas about TV might be a little different than others.  I’ve written before that I let my kids (ages 5 and 7) watch Glee with supervision.  The sex, drinking, homosexuality and other mature topics don’t bother me.  Why?  Because my kids come across these issues in their everyday lives, why not be sitting right next to them when the topics arise?  Of course I have my limits.  For example, I recently thought it would be fun to watch Grease with my oldest.  Luckily I pre-screened the movie.  Though I have seen the movie literally hundreds of times, I never watched it through my “mom eyes.”  I’m so glad I did!  The constant sexual innuendos and smoking were just too much for a 7 year old brain to understand.  Maybe in a few years.

The TV programs on my Do Not Watch list are the ones dripping with disrespect and sarcasm.  Before my trip I thought I had screened all the kids’ shows which portray ungrateful, entitled youth.  Namely, the shows on the Disney Channel (i.e., Hannah Montana).  These and similar shows literally make my stomach turn.  The way the kids talk to their parents, siblings, and each other is shocking.  Sarcasm is such a nasty form of humor – do we really need to teach it to our kids before they are out of grade school?

During my trip I noticed sarcasm and disrespect in other shows, too.  Sponge Bob Square Pants and Johnny Test to name a couple of my kids’ favorites.  I started to wonder, what could they watch that would be consistent with the values of our family?  What would be entertaining for them (they have moved past Dora and Bob the Builder) but consistent with what we are trying to teach them at home?  I am open to suggestions!  In the meantime I have settled on the following programs:

The Smurfs - One of my old faves made relevant by the new movie. Photo by: Coolspotters.com

19 Kids and Counting: My kids love this show, luckily it is all about the importance of family. Photo by TLC

Any show about making cakes, like TLC's Cake Boss Photo by TLC

What great shows am I missing?  I know there are other families out there struggling with the same questions.  What do you encourage your kids to watch?

Antidepressants, Therapy, Side Effects, and Efficacy

 

CNN’s The Chart is one of my favorite blogs.  I particularly look forward to Tuesdays when Dr. Charles Raison writes about the world of mental health and

Photo by JasonTromm

psychiatry.  A couple of weeks ago Dr. Raison responded to a question about the safety of long-term antidepressant use. Dr. Raison did a much better job than I can describing the recent findings on antidepressants, including their long-term use, use  in pregnancy, and their effectiveness compared to placebos.  What he didn’t write about (and he usually does) is how psychotherapy is used in treatment of mental illness.

Obviously, given my chosen field, I am a believer in the power of mental health counseling and psychotherapy.  While I am not at all anti-psychiatric medication (far from it) I do believe that no conversation about antidepressants is complete without at least a brief mention of psychotherapy.  The reason is that psychotherapy/counseling (the terms are interchangeable) are a crucial part of the treatment plan for all forms of mental illness that I know of.  Schizophrenia, depression, ADHD, bipolar disorder – they can all be helped by psychotherapy.  In fact, the latest research tells us that therapy is just as effective as medication (if not more so) for many mental health disorders.  Research also suggests that a combination of therapy and medication is the best course of treatment for several diagnoses including many types of anxiety and depression.

Other than being highly effective, perhaps the coolest thing about psychotherapy is its lack of side effects.  We’ve all heard the list of unpleasant side effects that can be experienced on psychiatric medications (sexual problems, stomach upset, headaches, etc).  But therapy’s list is comparatively short.  In fact, some would argue there are no negative side effects at all.  I’m not sure I’d go that far (for example, sometimes talking about painful experiences can be tough and cause thoughts about these experiences to increase in the short term), but I agree that the risks of therapy are dramatically lower than for medication.

With therapy’s efficacy and lack of negative side effects in mind, it makes sense why it should always be included in any discussion of mental health treatment.

 

 

It’s a Vacation…Not Working from the Beach

It’s vacation season!  Beach trips, mountain excursions, National Park adventures.  What could be better than a trip with loved ones to an awesome place?  In my opinion, not much.

Vacations are an important part of family life.  They provide us with new experiences with our family, create memories to treasure, and sometimes even give us the opportunity to make new friends.  Vacations are also an important part of maintaining mental health.  They give us a break from the stresses of work, maintaining a household, and other everyday chores.  Vacations can also give us perspective on how other people live and how we might be placing too much importance on non-important things.  One of my favorite summer vacation rituals is setting goals for the year ahead.  Work goals, family goals, personal goals.  Vacations give me the time and space to be able to think about such things.

My pre-vacation goal for this summer is to let my vacation actually be a vacation.  Not an on-location working trip or a working holiday.  Off go the ipads, laptops, and smart phones.  On go the out-of-office vacation responses on email and voicemail.  Bring on the fun, relaxation, and memory-making…who’s with me?