Dr. Henry Paul, MD

Psychiatrist, Author and Educator

MISCONCEPTIONS ABOUT RUNAWAYS AND THEIR PARENTS

February 26th, 2015

“Debra Gwartney was trying to escape a failed marriage when she moved from Tucson, Ariz., to Eugene, Ore., in the early ’90s with her four daughters in tow. What the newly single mother didn’t foresee was that, as she fled from her past to a different city and job, her relationship with her girls would be forever transformed, too. Enraged by the divorce and the move, her two oldest daughters, Amanda and Stephanie, soon ran away, seeking adventure on the streets and shelter in abandoned buildings with other teenagers like them.” Salon.com, Runaway daughters, Katherine Mieszkowski, 3/7/09

6372318_sI just completed two blogs on why children runaway and thought it was important to make sure to discuss the stigma that is often associated with children who run away and their parents. It is almost always assumed when a child runs away that either the child is bad, the parents are bad or both. Children run away for many reasons, and they run away from “good parents,” too.

Children can be lured away, they run for the thrill of it, they believe that they are being treated unfairly, or they are abusing drugs or alcohol. They also run after divorce or after a move to a new community where they don’t feel they fit in. And, yes, children do run away from abusive homes – sexual abuse, physical abuse, drug abuse – all can lead a child to run.

There are many reasons that teenagers run. Whatever the reason for a child running the most important thing is to find them. First and foremost, a community needs to work together to find a missing child – much like they do when a child is abducted. Making sure children are safe is the priority, and they are not safe on the streets. Looking to blame or falling into the stereotypical “it must be bad parenting” or “they must be bad kids” accomplishes nothing. Never be quick to jump to conclusions.

When a teenager runs away, there are usually a lot of issues that will need to be addressed once the child is back in a safe environment. A lot of this can be done through counseling for both the runaway teen and the family. Understanding and working through the reasons that a teen ran in the first place is what will help prevent it from happening again.

Click the link above to read Debra Gwartney’s story for a glimpse into the world of teenage runaways. Here is an excerpt also from a blog that discussed what Gwartney encountered trying to find her daughters. She talks about the steps she took to find her daughters and the roadblocks she encountered because of laws she thought existed that didn’t.

Disclaimer
This blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

SIGNS A TEENAGER MIGHT BE PLANNING TO RUN AWAY

February 24th, 2015

“She crawled out her bedroom window with a bag of clothes and a stuffed cat she slept with every night.  At 14, Katlyn Ann Shope Williams was leaving home, and she wasn’t coming back. Only she knew what she was looking for.” Abuse haunted runaway teen found dead in Columbus, Columbus Dispatch, 9/22/14)

3661397_sSo what are the signs that a teenager is planning to run away from home? Let me assure you that there are usually signs that a teenager is planning to bolt. These include arguing more than usual, angry complaints about feeling abused, disagreeing with parents at every opportunity, accumulating money secretly, and/or expressing wild and enraged feelings. Potential runaways may make no bones about the fact that they want to run away, announcing it frequently to the family or telling friends at school they plan to leave. Performance at school generally takes a downturn. The teen may become isolated; markedly antisocial. There may be evidence of a mood disorder, with symptoms like eating or sleeping less, withdrawing from activities formerly found pleasurable, and, above all, clearly wanting to have as little to do with the family as possible. There is also the strong possibility that there is substance abuse. Drug and alcohol abuse also are a reason to run away. In some cases, the abuse has become so bad that the teenager is afraid to let their parents know. If they have an addiction they may feel they have to leave to be able to use more “freely and openly”.

What to Do

  • Most important for parents is to try to prevent the teenager from leaving. This means doing everything possible to keep the channels of communication open. Avoid reacting to your teen’s increasing isolation tactics and negativity by punishing or scolding for it. This doesn’t mean that you have to agree with your teen’s point of view, but you need to let them know you are listening and really hear them.
  • If your child does run away, use as much common sense as possible in your attempt to find them. Contact law enforcement and tell them what you know. Call your teen’s friends, call the school, contact anyone you think the teen might have gone to or confided in. Go to their room and see if they left any clues to why they left or where they might be going. In this instance, it is okay to check their diary, look at their social media, and so on. You should check with your cell phone carrier and also look at their computer for recently accessed websites that might yield some clues. Contact the local bus terminal and the local hospital.
  • Teens also need to learn problem-solving skills, build confidence, and know that they have a safe place to go – home! Make sure to “check-in’ with your teen. It’s important to ask, “How are you feeling?” “How’s it going?” These are important ways of keeping communication open.

The reality is that most teens return within several days, but that doesn’t mean the problem is solved. The family’s prevailing goal must be to investigate why the teen left in the first place. Although some families are able to explore the painful issues without help, I recommend that you consider involving a mental health professional to help you navigate these tricky, and sometimes, dangerous waters. Family therapy is helpful to all, but you may want to also get your teenager some ongoing individual therapy to help them deal with some of their issues that they might be uncomfortable, at first, talking about with the family.

Be ready to consider that the root of the problem could lie with an undiagnosed mood or behavioral disorder, an academic or learning problem, or even romantic problems (often kept very quiet). Be ready to listen, to hear things that you might not want to from your teen, to accept that medication may be needed to help your teen, and most importantly, be part of the solution. This journey is not just your teen’s, but for the family as a whole.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

RUNAWAY – NOT MY CHILD!

February 23rd, 2015

The problem of runaway teenagers constitutes a growing and urgent problem in this country. Some estimates indicate that up to a half-million teenagers run away from home each year. Although most return home within several days, many don’t, and many of those teenagers are at very high risk of becoming involved in an unnerving array of dangerous activities; crime, gangs, drugs, violence and prostitution.

“The Justice Department has estimated that about 450,000 children run away from home every year and that one-third of teenagers on the street will be approached by a pimp within 48 hours of leaving home,” according to a 2013 New York Times article. (Stubborn Cycle of Runaways Becoming Prostitutes New York Times, 9/15/13)

569994_sTeenage runaways are in conflict with their parents or guardian. Teens flee because they feel that their home has become a “them against me” place. They feel such a degree of hopelessness and frustration that the only option is to leave.

A child who runs away typically does not feel heard and does not feel their essential needs are being met. This does not place blame at the feet of their parents, but rather points to the fact that it is how the child feels, for example, dictated to, misunderstood or feeling they are being treated unjustly. Even if the teenager’s actions seem completely irrational to their parent, those feelings still need to be recognized.

When a teen runs away, there is also a belief that they are running towards something better. The hope of acceptance — hoping to find a new world of contacts and friends to whom they can relate and with whom they can feel more comfortable or simply have more fun. Unfortunately, many of the environments to which they run are filled with people who can only mean disaster – antisocial or rule-breaking acquaintances or sometimes even religious groups or cults. Some teenagers run away to avoid punishment by their parents, to avoid restrictions they find intolerable, to avoid physical or sexual abuse, and, in some cases, sometimes just to provide an exciting distraction in their lives. Teens may also run away after the death of a family member or because of an unwanted move to a new home. Predictably, teens who are oppositional and defiant tend to run away more than others.

Teens also run away because of substance and drug abuse. In some cases, the abuse has become so bad that the teenager is afraid to let their parents know. If they have an addiction they may feel they have to leave to be able to use more “freely and openly”. They also may be unable to stop and they leave because the drug “leads” them away.

Today, teens are also lured away. How many times have we head stories about sexual predators online luring young girls away. These are scary times with the Internet and the safety of our children online requires vigilance. Unfortunately, teenagers are smart and they find ways to hide their online activity. That is why it is important to keep communication open with your child and know what they are interested in online.

For all the reasons that children run away, and there are many, I can say that there are usually signs that a teen is planning to do so. I will discuss the signs and what to do in my next blog.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

TATTOOS – TEENAGERS WANT THEM — PARENTS NEED TO KNOW THE RISKS

February 18th, 2015

“In the last 10 years, we’ve seen more and more teenagers getting tattoos and getting larger tattoos,” said Patrick Dean, owner of the Tattooville Tattoo Parlor in Neptune, N.J. to ABC’s Good Morning America in 2010.

Tattoos– those permanent ink sketchings are now mainstream, and teenagers want them. Celebrities, big-name athletes and musicians are sporting more and more “tats” and teenagers are taking notice.

2126311_sWith some teens, wanting a tattoo may be a personal choice but for others peer pressure is a factor. In 2010, a Pew Research study found that nearly 40% of young people between the ages of 18 and 29 had a tattoo. An interesting trend in this study was that parents were increasingly supportive of their teenagers getting tattoos. So what do you do when your teenager comes to you and asks to get a tattoo?

First, parents need to have a frank discussion with their teenager about tattoos. Things to think about and discuss includes the risk of infection, the physical dangers, permanence of tattoos, how a tattoo might affect a job down the road and more.

What to Do

  • If your teenager is considering getting a tattoo, or has already gone out and done it – let this be an invitation to open a dialogue. First of all, give your teen the facts about the dangers and possible permanence of body markings. While you should be alert to possible deeper meanings or turmoil in the teen that tattoos may represent; talk to your teen about them. There is no need to overreact, especially if they are considering a small tattoo. You may want to suggest a temporary tattoo, which will give the same effect but be removable.
  • If you and your teenager come to an agreement about getting a tattoo you need to take some precautions.
    1. Make sure the tattoo place is clean, and that gloves and disinfectants are used. Make sure any pigments, trays or containers are new and unused and the needle and tubes should be taken from sealed packages before the procedure begins.
    2. Sterilization of equipment is most important. The tattoo artist you choose needs to use a heat sterilization machine (autoclave) to sterilize all non-disposable equipment between customers. Those things that can’t be heat sterilized — including drawer handles, tables and sinks — need to be disinfected with a commercial disinfectant or bleach solution after each use.
    3. Know that most tattoo parlors are not regulated by state or local regulations, so it is up to you to do the homework. In some states like New York it is illegal to tattoo a minor even with the parent’s consent. For information on regulations in your area, contact your county of city health department.
    4. Watch for an allergic reaction. The dyes used can cause irritation including redness and itching at the site.
    5. Tattoos generally heal in one to three weeks but be careful to watch for infection. If you suspect infection contact your doctor.
  • Communicate with your child before, during and after they get their tattoo. Threats are not the answer; calm and informed discussion is. Use this as an opportunity to increase communication with your teenager.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

CAFFEINE AS A SUPPLEMENT? IT CAN BE DEADLY

February 12th, 2015

White powder DRPAUL“It’s fundamentally irresponsible to be selling this powerful drug in this form to consumers. … It’s a dangerous, potent drug that, if taken in as little as a teaspoon, runs the risk of being a lethal overdose to people.” – Michael Taylor, FDA

This week, Sen. Charles Schumer (D – New York) urged the Food and Drug Administration to ban powdered caffeine, which has been linked to at least two deaths among young adults.

According to Schumer, two healthy, young male adults died in 2014 as a result of taking powdered caffeine. One young adult in Ohio died of cardiac arrhythmia and a seizure. The other, a newly married college graduate from Georgia, died after being in a coma caused by powdered pure caffeine. In both cases, the young men thought the powdered pure caffeine was a safe way to get an energy boost. They had even done some research on it.

Parents beware! Powdered pure caffeine can be deadly. “Powdered caffeine, marketed as a dietary supplement, is unregulated. One teaspoon of it concentrated is equivalent to 25 cups of coffee,” according to the FDA. “Pure caffeine products are potentially dangerous, and serious adverse events can result, including death. People with pre-existing heart conditions should not use them.”

How much is it and where can teenagers get it? It costs less than $20 for 250 grams and is easily purchased on the Internet. Websites tout the product as a “clean and pure bulk supplement” and claim that it boosts metabolism, and it increases fat oxidation. The small sample of websites that I visited did include a warning that caffeine is “dangerous” and can be toxic.

Schumer compared powdered pure caffeine to Four Loko as an example and said in a statement. “We all remember Four Loko, which combined an incredibly high level of alcohol and caffeine; after Four Loko caused a number of deaths and hospitalizations, the FDA stepped in and stopped companies from selling the Four Loko. Likewise, the FDA should step in and immediately ban powdered caffeine, before it claims the lives of any more young adults.”

In late December 2014, the FDA issued an advisory warning to parents regarding powdered pure caffeine. “Pure Caffeine is a powerful stimulant, and very small amounts may cause accidental overdose. Parents should be aware that these products may be attractive to young people,” the advisory stated. Parents should also be aware that caffeine is often taken by athletes to improve their performance.

The problem that the FDA faces in regulating caffeine powder, however, is that it is marketed as a supplement – a group of products that does not need FDA approval to be sold. So what can parents do? Like with MOLLY, marijuana, heroin, painkillers and any other dangerous drug out there today – you need to talk with your teenager about the dangers. Open the lines of communication so that your teenager is comfortable coming to you and talking with you about these drugs, and quite frankly any other drugs that are out there that you may not be familiar with. Also, know the warning signs and what to do if you suspect something is “off” with your teenager. Below are the FDA recommendations regarding powdered pure caffeine and some additional links to stories relating to the dangers.

What to do (FDA Advisory) 

  • The FDA advises consumers to avoid powdered pure caffeine.
  • It is nearly impossible to accurately measure powdered pure caffeine with common kitchen measuring tools and you can easily consume a lethal amount.
  • If you believe that you are having an adverse event related to caffeine, stop using it and seek immediate medical care or advice.
  • The FDA wants to know about adverse events associated with powdered pure caffeine and other highly caffeinated products. You or your health care provider can help by reporting these adverse events to FDA in the following ways:
  • By phone at 240-402-2405
  • By email at CAERS@cfsan.fda.gov

Read more on Powdered Pure Caffeine:

Tragic Deaths Highlight the Dangers of Powdered Pure Caffeine posted by Michael M. Landa FDA Voice, 12/16/14

Schumer Calls on FDA to Ban Powdered Caffeine, Citing Dangers to Teens by Joe Jenkins Putnam Daily Voice, 2/10/15

Potent Powdered Caffeine Raises Safety Issues, NPR Morning Edition, 12/31/14 – Click to listen.

FDA Hands Tied in Powdered Caffeine Abuse Cases, by Kimberly Leonard, USNews, 12/29/14

FDA Targeting Sellers of Pure Caffeine Powder by Mary Clare Jalonick, Associated Press, 12/23/ 2014

DISCLAIMER Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

POLICE AND SCHOOLS PARTNERING TO BETTER UNDERSTAND MENTAL HEALTH ISSUES

February 9th, 2015

Police and school officials in Fort Wayne, Indiana, are teaming-up to understand the basics of mental illness in young people in an effort to cut back on arrests of children in a mental health crisis. This partnership is inspiring to see because it is through collaborative efforts like this that young people who are at risk will get the best help.

16579192_sThe greatest way to help young people who have mental illness is to get them treatment and not to incarcerate them. The problem is that the symptoms of a mental health crisis are mistaken for delinquent behavior, and that can lead to arrest and possibly jail time.

There has been an ongoing debate in the medical community for years about the link between mental illness and criminal behavior. So why do so many Americans associate mental illness with criminal behavior? Because that is what is in the media and that’s what people remember. Think Sandy Hook. I’m sure what comes to mind for many is that the shooter was on the autism spectrum.

Behavior disorders in young people are often disrupting and bothersome to parents and teachers. It is normal for parents of teens to worry about their behavior, concerned that episodes of “acting up” may be harbingers of future antisocial, sociopathic development, or that their teens are on the road to violent criminality, substance abuse, living on the “edge,” and ending up in jail or prison.

The reality is that most normal teenagers do act up from time-to-time, sometimes in very disturbing and destructive ways. Adolescence is a time of testing limits. In young people who are still developing it remains self-evident that abnormal behaviors are often part of normal developmental progression, and they are temporary. In other instances it can be part of a disruptive behavior disorder, and if that’s the case the most important thing to do is to get the teen the proper treatment.

Young people with disruptive behavior disorders such as ADHD, Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD), do occasionally break laws, especially those young people with Conduct Disorder. If your teen’s behavioral problems have proven to be intransigent, they may suffer from a behavioral disorder that requires greater attention and more specific help. The upside is that these disorders in young people can more easily be treated than the adult syndrome of “Antisocial Personality” (the Psychopath), which is notoriously resistant to psychiatric intervention. Youth carries with it more hope of intervention and possible change. Thus schools, police and mental health professionals working together offer the most fruitful hope.

Click here to read about the partnership between police and school administrators in Fort Wayne.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.