Dr. Henry Paul, MD

Psychiatrist, Author and Educator

MOLLY

November 26th, 2013

MOLLY is the name of a new drug which has been flooding the party scene and especially been marketed to teenagers.  It is made mostly in China and is very easy to get over the internet.  It has become popular at electronic music parties just like ecstasy was for many years.  Actually, it was considered pure ecstasy at first, but now you usually have no idea what you are taking when you take MOLLY.  It is a combination of synthetic drugs-over 250 compounds has been found already.  The combinations vary, and there is no way of knowing what you are taking from batch to batch.  It is usually sold as a capsule or powder.

Like club drugs of the past it is taken with the idea of becoming euphoric.  It does accomplish that sometimes but also has side effects, which can be quite dangerous.  It stimulates the nervous system which can result in rapid heart rates, high blood pressure, seizures, sweating and sometimes panic to the degree of psychotic breakdowns.  Young people have been having breakdowns, becoming violent and out of control.  Deep depression often follows use of MOLLY.  This drug has also caused death.

We have always been aware of the dangerous effects of all sorts of drugs, but MOLLY use seems even more sinister because what is being ingested is unknown.  Thus, diagnosis and treatment is more difficult, and the danger is much greater.

STAY AWAY FROM MOLLY!!

 

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.

ANOTHER YOUNGSTER – ANOTHER CHILLING MURDER

November 25th, 2013

The chilling details about the brutal rape and murder of young high school teacher Colleen Ritzer, at the hands of one of her students 14 year-old Philip Chisholm, are now emerging.  Now, comes the questions as to how a seemingly “nice” kid could commit such a heinous crime.  According to CNN, “Philip Chism, the Massachusetts teenager accused of raping and killing his algebra teacher, became visibly upset when the teacher, Colleen Ritzer, spoke about the teen’s home state of Tennessee after class, according to a police affidavit unsealed Friday.”

Why would a student react this way and what were the missed warning signs?

Here, we are left to wonder again about a brutal homicide that occurred seemingly out of the blue. An outstanding athlete kills and rapes his teacher. He leaves a hate note at the body. He was seen talking to himself that day while in the presence of the victim after she talked about his home state of Tennessee from which he had just moved from a short time ago. We know little else. We have no knowledge of his prior state of mental health. We do not know if he used drugs or was intoxicated that day. We know nothing about his prior relationship with this teacher. We know he came from a divorced family but little else except some reports that his father might have had some problems leading to restricted visitation. But we do know that he came to school prepared to commit this crime. It appears to be premeditated. Thus, there were some factors leading to this violence. He did not just snap in a moment of fury. There were reasons in this youngster. He was already boiling that day. Sometimes our intuition is a help. I intuit that there was a combination of attraction towards the victim, feelings of rejection by, and anger at the victim. It is not so uncommon for young men to “fall in love” with their teachers. Sometimes an almost delusional preoccupation can occur in a fragile youngster leading to profound rejection when reality intrudes. Combine this with a feeling of alienation from his community, possible psychotic or drug induced dyscontrol and we have a perfect storm. But this is intuition. The facts will emerge, and then we will know more.

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.

WHEN IS IT SERIOUS?

November 12th, 2013

In my last blog I described quite serious calls I receive on a regular basis. But for the most part the calls I receive are from parents who are worried and really not sure if their child has a serious problem. I can categorically say that most calls are about children who do not have a serious problem. But are there some guidelines that we can use to know when it is serious?

We have to remember that a parent remains the best diagnostician of her child. No one knows the temperament, behavior patterns and moods of their child better than a concerned parent. So when a child has a change in thinking, mood or behavior most parents should assume that it is probably one of those ever present times when a developing child is changing and showing the enormously wide variations in the normal cycle of growing up. So an upsurge of anxiety, a sad mood, or a disruptive bout of behavior is no cause for great concern. It will probably pass as development proceeds and will soon be forgotten.

But there is cause for concern in the following circumstances:

  1. The change does not return to usual after a few weeks and especially after you have tried to help.
  2. If you have tried to understand the cause for the change and have failed to get a handle on it.
  3. The change is getting worse despite concerned parental intervention.
  4. The child seems to be suffering in his everyday ability to feel good and function in and out of the home.

In the above circumstances a consultation with a mental health professional might go a long way in helping you understand, intervene and possibly get you and your child professional help.

But there are certain circumstances that demand immediate professional intervention:

  1. Suicidal behavior including talk, threats, gestures, notes, plans, diary or internet postings or attempts.
  2. Violent behavior or threats including verbal threats and of course the involvement of weapons in any way.
  3. Bizarre or psychotic behavior including hearing voices, strange thoughts, suspicious paranoid behaviors or other out of control actions.
  4. Substance intoxication especially with any out of control activities.

In summary most children act in new and sometimes anxiety-provoking ways but these are usually normal events involved in growing up. But when the problem hangs on, does not respond to your curious exploration and support and especially if it is getting worse and affecting her life more and more then it would be wise to get help. It still might not be too serious but a bit of education and guidance can go a long way.

 

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.

 

 

THERE IS SOMETHING WRONG WITH MY CHILD

November 7th, 2013

These are three phone calls that I received in one week:

(Steven)
“The school principal just called and said our son Steven, a fourth grader, was overheard talking with some friends about bringing a knife to school. He has a history of misbehavior, but recently he has gotten worse. He has been fighting a lot, not following rules, talking back, leaving the classroom without permission, and now this. I’m freaking out. When can we see you?”

(Jessica)
“Our fourteen-year-old daughter, Jessica, has been sad since her grandma died six months ago. She’s been withdrawn, sleeping a lot, and hardly eats. At first we sympathized with her and gave her space. But this morning I looked in her diary and read a note in which she talked about yearning to be dead and join her grandma in heaven. I think this is much worse than just grieving. What should we do?”

(Marty)
“Marty, our eleven-year-old son, has always been shy. Ever since we can remember, he was scared to do anything new. We would have to accompany him everywhere — school, camp, after school activities, and the like. He could never go on a play date without great fear. He never made close friends. But now he is beginning to act really strange. He talks to himself, he is over-involved on strange websites, he smiles about things we can’t understand, and yesterday said something about being connected to other people through mind reading. I read something about psychosis on the Internet and he seems to fit the bill. I’m terrified something really serious is wrong with him.”

I get calls like these almost every day.  Realizing that your child may have a problem is really scary. It can be devastating to learn that your child is physically sick, but discovering that your child suffers from a mental disorder adds another layer of confusion and anxiety. Mental disorders are not as well understood as physical disorders, and it is only recently that they have begun to be talked about openly. Add the fact that new diagnoses come up seemingly weekly, along with all the misinformation in the media about the medications used to treat mental disorders, and you have some very confused and worried parents. Through my blog I want to address your questions, fears, and worries about treating your child.  I want you to ask me questions and I want to hear your concerns.

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.

ANOTHER SHOOTER: SOME TIPS ON PREVENTION

November 3rd, 2013

A new tragedy. Loss of life again. Several days ago we witnessed what has become a familiar story: a shooter enters a crowded venue, terrifies the crowd, kills with a high speed weapon and then we witness, repeatedly, the video clips of throngs of people running in terror, and also some blood on the airport floor. The “why he did it?” questions then abound. The answers are many and varied. From a focus on too available guns, early exposure of our children to violent media, and mental illness, to the national economic picture and the like. And lastly how can we apply what we know to preventing such horrific events. This last issue interests me the most and I will return to it.

Here are a few of the facts we know about mass murders. We know that the typical profile of a mass murderer is that of a single white male who is somewhat isolated, maybe depressed, and possibly feeling revengeful after a rejection perceived as an irreparable destruction to his life. Mention is also made of the fact that there might have been recent mood changes, increased aggression, or expression of or interest in ideas that seem unusual or bizarre often containing conspiracy theories or paranoid and even bizarre worries. There might have been statements, writings or readings about death, suicide, seeking of weapons, or blaming the government or others. Despite the fact that mental illness in and of itself does not confer a higher risk, there is some evidence that mentally ill individuals who stop needed medication and or use substances/alcohol have a slightly higher risk of committing violence. The availability of guns is a common part of the discussion and although I personally prefer better gun control laws I still have not seen direct evidence of gun availability, as a whole, causing these heinous acts by individuals. All in all we know a lot, but not enough, to somewhat accurately identify a potential mass murderer.

Thus, we can do something. We as family, friends, neighbors, teachers, doctors, clergy and others see people every day. We observe change in people we know. That is the key. We are in a position to start a dialogue, learn more about what is going on, or see what’s troubling someone. If we get too little cooperation we can call a mental health professional or even the legal authorities for help. This is not easy. It makes us anxious. We would like to ignore frightening truths. We hope it goes away like a passing bad mood. But it is possible to help.

Get concerned if you notice one or more of the following:

1.      Increased anger, aggression, tantrums, irritability, and revenge episodes especially when you can’t make any sense of the situation and the person seems more depressed, isolated and unruly than usual.

2.      The appearance of strange ideas especially having to do with anti-government themes, conspiracy theories, and other paranoid trends especially if accompanied by hearing voices.

3.      Interest in and ownership of weapons that are a new or heightened twist for the individual.

4.      Overt or thinly veiled threats, writings, interest in and worship of lethal ideas towards self or others, including suicide by cop which this most recent tragedy might have been.

5.      Increase in substance use by people with a history of violence and especially in those who have been treated for a severe psychiatric illness who have stopped their medication.

This is an incomplete list but a good starting point. While we cannot predict with total accuracy who will commit violence, we have enough evidence of when to act. If we have the courage, and trust ourselves about our observations we might make the world a bit safer.

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.

MY CHILD IS BEING BULLIED!

November 1st, 2013

In the last blog we discussed what to do if you think your child is a bully.  Now, let’s discuss what to do if you think your child is being bullied.

  1. First, help him or her to talk about it – establish an atmosphere conducive to talking about the feelings of shame and humiliation he/she may feel. Don’t leap in with suggestions or quick judgments; such attempts to help are often experienced by the child as a kind of psychic bullying. Encourage your child to speak directly with the authority figure responsible for harmony and safety (teacher, principal, swimming pool director, etc.) to give your child an active, assertive role in resolving the problem.
  2. For many parents, the first thing to do seems to be to call the parents of the other child, but rushing into fix it for your child (i.e. contacting the bullying child’s parents and demanding an apology) may ultimately worsen the situation; at the very least, you and your child should work together to deal with the bully. 
  3. If your child is being bullied you also should notify the organization or place where the bullying is taking place, such as the school, camp, or venue for an after-school activity.
  4. Your child will need some experience of “fighting back” so that he or she does not simply feel further victimized. It helps to have your child understand the psychology of the bully, that he or she is “egged” on by overly passive or insecure behaviors and that some amount of confident and even humorous self-assertion can often help your child to get through the next ominous encounter.
  5. Never encourage your child to fight physically because it can just escalate the violence (possibly with significant danger to your child) and reinforce fighting as a solution.
  6. If your child cannot overcome his or her fear and anxiety about a bully, it is wise to seek outside help, especially if fear, anxiety, and depression are interfering with day-to-day life.
  7. Support your child’s friendships and social network throughout the ordeal of dealing with a bully; this is the time when your child most needs to feel he or she is not ostracized because of being the bully’s victim.

The key issue in bullying is that intimidation occurs repeatedly and becomes a form of harassment and abuse of other children. It is important for parents to become active in their community in order to avoid bullying issues. For instance: there are effective intervention programs across the country that parents should get involved with in their children’s schools. Schools should be encouraged to create and enforce anti-bullying policies and to have class discussions about bullies. Conflict resolution classes can also be very helpful.

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.