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  1. Back-to-school can be a time of heightened stress and excitement for kids in normal years, but this year, add in increased health worries and new routines associated with the covid-19 pandemic, and the level of ‘back-to-school anxiety’ is higher than ever. In fact, at Telemynd, we’ve recently seen an uptick in requests for mental health visits for kids and adolescents. So, with families in mind, this article will look at the reasons why back-to-school may cause extra anxiety this year and some actionable ways to address it. The number of mental health issues in young people has increased in the pandemic A recent study published in the Journal of the American Medical Association (Pediatrics) found that the number of young people struggling with mental health issues has likely doubled compared to pre-pandemic levels. The study found that 1 in 4 kids are experiencing elevated symptoms of depression and 1 in 5 have higher levels of anxiety. A CDC study found that in 2020, emergency room mental health visits increased 31% for kids ages 12 to 17, and 24% for ages 5 to 11, compared to the same period the prior year. And it's no wonder. For many young people, the pandemic has increased worries about sickness, family finances, separation from friends, disruption in routine – even coping with grief from loss. A year of remote learning, although necessary for safety, may have taken an emotional toll on many – some may have fallen behind in their studies, or suffered from lack of academic support. Back-to-school transitions will be harder this year Most mental health specialists agree that, in general, kids are realizing that the world is not as safe as we all thought it was – and that increases anxiety. Dr. Jennifer Louie, a clinical psychologist at the Child Mind Institute, says, “There’s just anxiety in the air, and I think kids feel that. They are wondering: Are we sure it’s safe to go back (to school)? And are other people safe? And is it safe to touch this?” To be sure, some kids have enjoyed homeschooling and spending more time with family. But for those who are predisposed to anxiety, depression, or other mental health issues, transitioning back to classroom learning this Fall may be harder than ever. How to help kids deal with back-to-school anxiety For parents and caretakers, it may feel complicated – on the one hand you want to reassure them that it’s safe to go back to school in-person, while also encouraging them to be cautious, and preparing them to be flexible if rules or situations change. Here are 5 ways to address additional back-to-school anxiety: Emphasize safety measures. Talk about how schools have done months of planning to minimize risk and keep everyone safe — and how kids can do their part by following the rules. It's fine to explain that we can never be 100% sure everyone will stay healthy, but that there are measures in place to try to ensure best possible outcomes if people get sick. Validate their feelings. Validate any worries by acknowledging that, like any new activity, going back to school can be hard, but with time, it will get easier. For younger kids, praise ‘brave’ behaviors, e.g., “I love how willing you were to take the bus this morning.” Make sure they know they aren’t alone - that teachers and administrators are watching out for them and that you’ll deal with any safety and health issues together. Have a routine. Making sure that your child has a predictable school morning routine can help everyone feel more secure. Try to do things at the same time, the same way every day. And practice problem-solving if issues come up; for example, if they worry they can’t find their way around school, help them think through who to ask for help. Make sure they get enough sleep and good nutrition. The shift from summer to school-year wake-up times can be challenging for a lot of kids, but lack of sleep can make them more vulnerable to anxiety. To deal with this, consider leaving TV, phone, or laptop outside the bedroom at night. And have lots of healthy snacks and lunch material in the house to ward-off unhealthy eating (which also contributes to stress). Observe your child's behavior. Watch for signs of depression or anxiety, for example, becoming more withdrawn, angry, or having trouble concentrating. Also watch for physical changes like abdominal or other physical pain - which also can be warning signs. Be sure to regularly and directly ask them how they're feeling. It is also not uncommon for kids who struggle with anxiety and depression to “hold it together” during the school day and have a “meltdown” when they arrive home to release some of the pent up feelings they have kept inside while in school. It is important for parents to be prepared for this type of response and to create space for their child to decompress when they arrive home before trying to engage them about their day. Understanding “why” your child may be acting in a way that is unlike them is the first step in recognizing the signs that they may be struggling with a mental health issue. When to seek additional help If you see any of the warning signs mentioned above (and see more here), or if a young person’s worries about school start to interfere with their ability and willingness to attend school or participate in normal activities, like sports, or socializing with peers, consider consulting a licensed behavioral health professional. In some cases, kids may be resisting going back to school because last year’s learning at home “felt” easier than going to school (e.g., kids with a lot of social anxiety, or those with learning disorders may have had an easier time when they could work at their own pace). Mental health professionals can sort out real anxiety and depression symptoms, and provide recommendations to help. If a young person in your life is showing signs of heightened back-to-school anxiety, consider contacting a mental health professional With the right mental health support, kids can adjust to school this Fall, make new friends, learn new things, and thrive. If you’re a client, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Harvard Medical School Centers for Disease Control (CDC) Behavior Analysis in Practice JAMA Pediatrics
  2. According to the Department of Defense, 37% of active-duty military families have children, and like their active-duty parents, military kids make sacrifices in their own ways too. From coping with the challenges of a parent’s deployment to starting a new school to accommodate a recent move (known as a Permanent Change of Station or PCS), military kids commonly experience stressors that can impact their mental health. On average, military kids attend up to nine different schools before graduating high school due to relocations. What kind of impact do these frequent moves have on the mental health of military kids and their families? And what are some ways to cope with the stress? Military Kids Move Every Two to Four Years, On Average Military families typically make a PCS move every two to four years (this is over 3 times the civilian family average), which means that the kids are constantly adjusting to new schools and environments, making new friends, and leaving old ones behind. In some cases, PCS moves can occur quickly and unexpectedly, leaving little time for closure, for kids to fully process what is happening to them, or to say goodbye. Multiple studies have been conducted to measure the impact on mental health of PCS moves. The Journal of Adolescent Health published findings that military kids who move frequently were significantly more likely to have a mental health issue. In addition, it found that age was a powerful predictor of the impact on mental health, i.e., military kids aged 12-17 were four times as likely to need help from a mental health professional as military kids aged 6-11. This makes sense intuitively, as teens are already going through the changes and stresses of puberty. Add in the need to rebuild their social connections and form new friendships, and one can see why PCS moves impact teens harder. The stress of PCS moves affects parents too. Another study by the School Psychology Review found moving increases tension in the home in general. Kids reported feeling anger or resentment toward their parents and the military because of the disruption to their lives. Some kids reported telling their parents that they refused to move or would run away to avoid moving entirely. Ways The Disruption Of A PCS Move Causes Stress What is it about frequent moves that causes so much burden? First, change itself is stressful to us all, as numerous studies have found over the years. And when families make a PCS move, they must adjust to a new home, new school, address, neighborhood, friends, teachers, religious community, routines, and potentially new local culture and weather. That’s a lot of change! In addition: Students involved in sports who move later in the year can miss team tryouts, or the new school may not offer the same athletic programs. They may feel the loss of having to end close relationships with friends at a previous school. It’s more difficult to gain acceptance in a new school where cliques and social networks are already established. Because of potentially limited experience with military families, civilian school staff may have a knowledge gap that affects their effectiveness working with military students. Parents themselves are swamped with new jobs and to-do lists, and may not have the patience or time to consider a kid having trouble with the transition. If one parent is deployed or at risk of being deployed, kids may experience further stress from the constant fear for a parent’s safety. All can lead to considerable stress, as kids find they lack a feeling of connection to others in their new community. As a result, symptoms of depression and anxiety can appear, such as separation anxiety, excessive worry, sleep problems, and physical complaints such as headaches or stomach pain. Tips For Coping With The Stress Of A PCS Move PCS moves are not all doom and gloom. Research suggests that many kids develop strength and resilience from adapting to frequent military moves. And there are steps parents and schools can take to support them through the moves in order to reduce the impact on their mental health. Number one is simply to be aware of the potential mental health impacts and to watch for signs and symptoms of distress. Our previous release discussing different symptoms of mental health conditions is really helpful. Parents can read up on the impact of PCS moves, and educate themselves on ways to support kids during the transition. And as with all mental health issues, the earlier that symptoms are noticed for intervention and treatment to begin, the better the prognosis and outcomes. Experts Suggest These Tips For Coping With The Stress Of PCS Moves Keep up established routines and rituals as much as possible, and start new rituals in the new place that encourage parent-child bonding time. Talk about the move as much as possible and give kids the opportunity to vent their negative feelings (and help them find positive ones too). Parents are advised to let kids in on a little of their own misgivings about the move and to find ways to address them as a family. This provides more positive feelings of validation and control. Connect with other military children and families when possible. As well, in the military community itself, most installations have a resource officer or School Liaison Officer who may be able to suggest appropriate resources. Even in a civilian school where there are few military kids, school guidance counselors are the best place to start a conversation between the family and the new school, as they are the gatekeepers to community mental health resources. Even if the counselor does not have experience with military students, he or she may be able to suggest local resources with more expertise. Finally, although it may seem simple, making sure that kids get enough sleep, eat healthy foods, and get out and exercise will go a long way toward maintaining better mental health. And when kids do exhibit symptoms of transition distress, seek out a mental health professional as early as possible. Sources Military Spouse Journal of Adolescent Health School Psychology Review
  3. Last week we talked about how to spot the warning signs of mental health issues in children and adolescents. This week, we’ll address how to go about finding the mental health professional that can best help. One in six children in the U.S. between six and seventeen years old have a treatable mental health issue such as Depression, Anxiety, or Attention-Deficit/Hyperactivity Disorder (ADHD), so understand that you are not alone - there are many parents and caregivers looking for help for a child or adolescent in their lives. But where to start? There are a bewildering array of specialists who can help. To help you sift through the wide-range of information out there, we’ve provided a list of the different types of professionals who can diagnose and treat your child, as well as questions to ask those providers during your search. Getting Started For most parents and caregivers, consulting your family or child’s physician can be a good first step. The benefit to starting with someone who knows your child is that they may be able to confirm or recognize when behavior is beyond the typical range. They can also conduct medical testing to rule out possible non-psychiatric causes for the symptoms you’ve noticed. The disadvantage is that family physicians or pediatricians may have limited experience in diagnosing psychiatric and developmental disorders; or may not have the proper time to allocate for lengthy assessments often required for accurate diagnosis. Best practices in diagnosing children and adolescents include using rating scales to get an objective take on symptoms, as well as collecting information from multiple sources, including the child, caregivers, teachers, or other adults in their lives. Other types of mental health professionals may be better able to assess and treat your child. Understanding The Different Types Of Mental Health Professionals Most professionals who diagnose and treat mental health issues in children and adolescents have at least a master's degree or more advanced education, training and credentials. Below you'll find some of the most common types of providers. Child & Adolescent Psychiatrist: A medical doctor with specialized training in general psychiatry, psychiatric diagnosis and treatment in young people; able to diagnose the full range of psychiatric disorders recognized in the Diagnostic and Statistical Manual (DSM); fully qualified if they have completed national examinations that make them board-certified in child and adolescent psychiatry as well as general psychiatry; can prescribe medication. Psychopharmacologist: A medical doctor who specializes in the use of medications in order to affect feelings, cognition, and behavior. Although they specialize in the use of medications, they should know when other kinds of therapy should be integrated with medication into the treatment plan and be able to refer patients to other professionals for that therapy. Child Psychologist: Trained to diagnose and treat psychiatric disorders, but are not medical doctors so cannot prescribe medication; have a doctoral level degree and may hold either a PhD or a PsyD; often work together with psychiatrists to provide care to patients who benefit from a combination of medication and cognitive behavioral therapy; can coordinate necessary evaluations and assessments. Neuropsychologist: Psychologists who specialize in the functioning of the brain and how it relates to behavior and cognitive ability; have completed post-doctoral training in neuropsychology with either a PhD or a PsyD. They perform neuropsychological assessments, which measure a child’s strengths and weaknesses over a broad range of cognitive tasks, and provide results in a report which forms the basis for developing a treatment plan. Pediatric Psychiatric Nurse Practitioner: Has either a master’s or a doctorate, and can prescribe medication depending on the state; has training in treating and monitoring children and adolescents with psychiatric disorders; may work as part of a team in a pediatricians’ office, or practice independently. School Psychologist: Trained in psychology and education and may receive a Specialist in School Psychology (SSP) degree; can identify learning and behavior problems, and evaluate students for special education services. Social Worker: A licensed clinical social worker (LCSW) has a master’s degree in social work and is licensed by state agencies; required to have significant supervised training; does not prescribe medication, but may work with the family and treating physician or psychiatrist to coordinate care. Questions To Ask Prospective Mental Health Specialists It's especially important to look for a child or adolescent mental health professional who has the right background and experience to treat the specific issues your child is exhibiting. Arming yourself with the knowledge to be able to ask the right questions and know what to look for in a professional will help you feel more confident that you are getting a specialist that's right for your child. Ask the following questions when meeting with prospective treatment providers: Tell me about your professional training? Are you licensed, or board-certified, and if so, in what discipline? How much experience do you have diagnosing children whose behaviors are similar to my child? How do you arrive at a diagnosis? What evidence do you use? Do you provide the treatments you recommend, or do you refer to others? How will you involve the family in the treatment? Will you be in contact with my child’s teacher or guidance counselor? How long do children usually stay in treatment with you? What are your thoughts about medication? Can I speak with a parent whose child has worked with you? Looking For A Qualified Mental Health Specialist For Your Child Or Adolescent? Telemynd is a nationally delegated telebehavioral health provider. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists – all the specialists discussed above – who can evaluate, diagnose and provide treatment for mental health issues in children and adolescents from the convenience of home. Find your current insurance provider to request an appointment today. Sources National Institute of Mental Health (NIMH): Children and Mental Health American Academy of Child and Adolescent Psychiatry: Family Resources
  4. According to the CDC, it’s estimated that one in six children in the U.S. between the ages of 6 and 17 has a treatable mental health issue such as Depression, Anxiety or Attention Deficit/Hyperactivity Disorder (ADHD). Mental health disorders in children and adolescents are generally defined as delays or disruptions in developing age-appropriate thinking, behaviors, and social skills. These issues can contribute to difficulty in school and in relationships with friends or family. The earlier a diagnosis is determined, a treatment plan can be started. Studies have shown that early treatment can help prevent more severe, or lasting problems. However, that’s sometimes easier said than done, as it can be hard to discern indicators of underlying mental health issues in children and teens from typical childhood “growing pains”. This article will help you learn what symptoms to watch for. Common Mental Health Issues In Children & Adolescents The most common behavioral health disorders experienced by children and adolescents fall into the following categories: Anxiety disorders Depression and other mood disorders Obsessive-compulsive disorder Attention-deficit/hyperactivity disorder (ADHD) Autism spectrum disorders Eating disorders Schizophrenia and related psychotic disorders (but to a much lesser degree) Compounding the complexity of identifying common issues is the fact that it’s very common for children and adolescents to have symptoms that cut across multiple disorders. For example, more than 25% of children with ADHD also have Anxiety, and another 25% meet the criteria for Depression and other Mood Disorders. Additionally, even though children can experience the same mental health issues as adults, their symptoms may be different. Mental Health Issues In Children May Be Hard To Identify; Therefore Initial Evaluations Should Be Done By Clinicians Who Specialize In This Age Group Evaluation of children and adolescents with mental health symptoms is typically more complex than that of adults. According to the National Institutes of Mental Health (NIMH), evaluation differs in the following ways: Developmental context is critical when evaluating children; for example, behaviors that are normal at a young age may indicate a serious mental disorder at an older age. Children exist in the context of a family system, and that system has a significant impact on their symptoms and behaviors; for example, children living in a family with domestic violence or substance abuse may superficially appear to have one or more mental health issues. In these cases, clinicians rely on direct observation, corroborated by observations of others, such as other relatives and teachers, to determine whether to make a true mental health diagnosis or not. Developmental and behavioral problems, like poor academic progress, or delays in speech and language can sometimes be difficult to distinguish from those that are in actuality due to a mental health disorder. In these cases, it's not unusual for formal developmental and neuropsychological testing to be recommended as part of the evaluation process. Watch For These Warning Signs Of Mental Health Issues In Children & Adolescents So how do you know if a symptom is just part of being a kid, or should be treated as a mental health symptom? How do you know when to request a formal evaluation for potential mental health issues? According to the National Institutes of Mental Health (NIMH), children and adolescents may benefit from an evaluation (and ultimately treatment) if they have more than one of these symptoms: Have frequent tantrums or are intensely irritable much of the time Talk about fears or worries frequently Complain about frequent stomach or headaches with no known medical cause Are in constant motion and cannot sit still Sleep too much or too little, have frequent nightmares, or seem sleepy during the day Are spending more and more time alone, are not interested in playing with other children or have difficulty making friends Struggle academically or have experienced a recent decline in grades Repeat actions or check things many times out of fear that something bad may happen. Have lost interest in things that they used to enjoy Fear gaining weight, or diet or exercise excessively Engage in self-harm behaviors (e.g., cutting or burning) Smoke, drink alcohol, or use drugs Engage in risky or destructive behavior alone or with friends Have thoughts of suicide Have sudden periods of highly elevated energy and activity, and require much less sleep than usual Say that they think someone is trying to control their mind or that they hear things that other people cannot hear Have You Noticed Any Of These Warning Signs In A Child Or Adolescent In Your Life? Telemynd is a nationally delegated telebehavioral health provider for Tricare members. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who can evaluate, diagnose and provide treatment for mental health issues in children and adolescents from the convenience of home. Click here to find your current insurance provider to request an appointment today! Sources CDC: Data and Statistics on Children’s Mental Health Merck Diagnostic Manuals: Overview of Mental Disorders in Children and Adolescents
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