Dr. Henry Paul, MD

Psychiatrist, Author and Educator

CAN YOU REALLY PREDICT SUICIDE WITH A BLOOD TEST?

July 31st, 2014

Being able to identify those at high risk for suicide is vital for prevention, but there is not currently a reliable way to predict this risk. Now, researchers from Johns Hopkins University School of Medicine in Baltimore, MD, say they have found a chemical alteration in a gene linked to stress responses that could enable the creation of a blood test to predict a person’s risk of suicide consistently. (Medicalnewstoday.com)

In a press release today from John Hopkins University, researchers there say they have discovered a chemical alteration in a single human gene linked to stress reactions that, if confirmed in larger studies, could give doctors a simple blood test to reliably predict a person’s risk of attempting suicide. Researchers were able to predict who had experienced suicidal thoughts or attempted suicide just by looking at their blood. The experimental test was over 80% accurate.

When reading about a new study like this, we all get excited. This happened when it was announced that bipolar illness was linked with color blindness, or homosexuality (which was considered an illness until recently) was indicated by amygdala size. These types of simplistic correlations usually fade out or are quietly buried when further evidence is lacking or when contradictory evidence shows up. Suicide is a very complex topic having to do with cultural, subcultural, emotional, psychological and mostly unconscious strivings. While such reports whet my appetite for short-sighted simplistic solutions, I will wait on the sidelines before I order such a blood test. I will also remember the potential damage such announcements can have in light of the mistakes that can be made that raise hopes only to be followed by disappointment. Or becoming reliant on a simple blood test and ignoring the many other complex phenomena associated with a suicide evaluation. We should all support research in psychology, neuroscience and genetic biology, but let’s wait for any final blood test finality.

Link to the study.

Hashtags: #drpaul #drhenrypaul #henrypaulmd #whenkidsneedmeds #mentalhealthteens #suicide #suicidebloodtest #suicideJohnHopkins

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.

SYNTHETIC MARIJUANA – ONE MORE DRUG TO WARN YOUR TEENS ABOUT

July 30th, 2014

There is a warning from the New York City Health Department on the dangers of synthetic marijuana. Authorities say in the last four days, 15 people in East and Central Harlem as well as Chelsea have had severe reactions after using the products. (NEW YORK WABC)

The war on drugs has many opponents, the latest is synthetic marijuana. Yesterday, the New York City Health Department issued a warning against synthetic marijuana, also known as K2, Spice, Crazy Monkey, and Green Giant. The drug became illegal in 2012. It is a drug that apparently this week sent a man and his dog to the hospital for seizures, and despite serious health risks related to smoking synthetic marijuana, people are still doing it.

So what is synthetic marijuana? Well, it is a mix of plants and chemicals that produces mind-altering effects that are similar to marijuana. It can also produce anxiety, delusions, psychosis and other life-threatening conditions. Originating in Europe around 2006, the drugs made their way to the United States a short time later. The drug first came to the attention of the medical community in 2006, and the American Association of Poison Control Centers first raised alarms about synthetic marijuana in 2009 after receiving calls about people having serious, life-threatening reactions to the substances.

Why are so many people using it if it causes such dangerous side effects? I am sure there are many reasons, but one key point is that it is not detectable in urine tests. Also, this form of synthetic marijuana also seems to be more energizing and its effects can be up to ten times more intense than marijuana.

The other reason is that young people are experimental. Here is a story that CBS News did in 2012 when teen usage was noted to be on the rise, “Synthetic marijuana sending more teens to hospital, study finds.”

According to the NYC Health Department, the signs and symptoms of synthetic cannabinoid use include agitation, anxiety, nausea, vomiting, high-blood pressure, tremor, seizures, hallucinations, paranoia, and violent behavior. These effects can be similar to those of phencyclidine (PCP).

These drugs are especially dangerous because the exact products used to make the drug are not always the same, making the risks and adverse consequences unpredictable. There also is no antidote.

The first thing I recommend is that parents educate themselves on this new drug. Once you understand it talk to your kids about it. Let them know how dangerous it is. If you suspect drug usage by your child consult your family doctor, or substance abuse counselor or another mental health practitioner. There are also a number of groups that deal specifically with recovery.

Click here to read the full story at WABC-TV!

Hashtags: #drpaul #drhenrypaul #henrypaulmd #whenkidsneedmeds #mentalhealthteens #drugsandteens #syntheticmarijuana #K2 #Spice #CrazyMonkey #warondrugs

MENTAL HEALTH – AFTER TRAGEDY VIRGINIA TAKES THE LEAD!

July 24th, 2014

“At the end of the day, I want Virginia to come up with a model for treatment of mental illness,” Sen. R. Creigh Deeds, D-Bath.

By now many of you have heard the tragic story of Virginia Senator Creigh Deeds, who last fall was stabbed by his son, that same son who then took his own life. Gus Deeds, 24, had been released 13 hours earlier from an emergency custody order after local mental health workers failed to find a hospital psychiatric bed before the involuntary detention order expired.

In a statement to newsadvance.com, “His tragedy really gives voice to all of the families we hear from,” said John Snook, deputy director for governmental affairs at the Treatment Advocacy Center, a national organization based in Arlington.

“Those are families that struggle repeatedly to get help for people they love who are deteriorating in front of them — refusing to bathe and hearing voices. They say, ‘I know what is going to happen, but no one will listen,'” Snook said.

As a psychiatrist here in New York City, I see this same situation. I have met many family members throughout my career who have struggled with the same situation. Where do you go when you need mental health support for a loved one? Who will help the mentally ill if they don’t want to (or can’t) help themselves?

It’s evident that not just the state of Virginia has a fragmented and failing mental health system. Just one example is the clarion call from parents, victims and survivors of mass shootings across this country to make mental health a priority. Something I agree we desperately need to do. Let’s hope that the Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century will be a leader in finding solutions that other states across the nation can model.

In the meantime, it is important that you let your elected officials know that you too want to see mental health changes in your state. The last thing we want to be doing is cutting services!

Here are some other things you can do if you’re worried about your loved one:

Seek out resources – doctors, support groups, mental health clinics, mental health hotlines, etc. The National Alliance on Mental Illness (NAMI) is a great resource in helping to support families and educate them on mental illness.
If your loved one has a diagnosis – educate yourself about their illness.
If you already have a treatment team in place, work close with them.
Make sure to take care of yourself. Find a support group or friends to talk to.
Click here to read more on the mental health panel in Virginia that began work this week.

#drpaul #drhenrypaul #henrypaulmd #whenkidsneedmeds #mentalhealthteens

RAISING TEENS IS STRESSFUL PERIOD!

July 24th, 2014

Great show on NPR Morning Edition last week, Want More Stress in Your Life? Try Parenting A Teenager. If you’re feeling stressed and a bit crazy by your teenager, guess what? You’re not alone. The stress of dealing with teenagers is universal. Every parents has it. I raised two children of mine own, not to mention counseled hundreds of teens and parents, so I think it’s safe to say that I know what I’m talking about. When you are dealing with your teenager, there are many things to worry about. The trick is to figure out what is normal worrying – driving, college, dating, social media, etc., and what is more. What I want to focus on here are the normal things that are just part of teenagers growing up.

My advice is to:

Educate yourself about the wide varieties of normal teenage behaviors.
Take the time to know your child – their strengths, traits and vulnerabilities. Know the environmental stressors that affect them, and know the signs of trouble. Trouble includes substance and alcohol abuse, bullying, overly impulsive behaviors and school problems. Especially, look for deep changes that don’t go away-like sadness, withdrawal, talk of suicide, odd behaviors etc.
There’s some great advice also in the interview. Reach out to other parents for support. Don’t be afraid to open up, many of them are going through the same thing. Talk not just about your concerns, but also about the decisions. The other thing is to spend time with your teenager – without the techno world interfering. No cell phone, Facebook or tweeting. Just spend some quality time together. Make sure that you’re also ready to listen. This time is great for learning about what interests, as well as, concerns your teen.

For those of you who have concerns that the behavior is indicative of something more, I have written a number of blogs that specifically address the “more” including drugs, suicide, and many other disorders that are alarming for parents. Please check them out and if you have questions, please email me.

Hashtags: #drpaul #drhenrypaul #henrypaulmd #whenkidsneedmeds #mentalhealthteens #MorningEditionNPR

OBESITY AND TEENS – A GROWING HEALTH CRISIS FOR SURE

July 14th, 2014

Excessive screen-time use has been linked to elevated blood pressure, high blood cholesterol, and being overweight or obese among kids, the report notes. Screen-time behavior established in adolescence has been shown to continue into adulthood, it adds.

As a result, the American Academy of Pediatrics says children and teens should engage with entertainment media for no more than one or two hours per day, and the media content should be of “high quality.” The AAP says that children under age 2 should get no screen time. USA TODAY, July 8, 2014 “About 1 in 4 young teens meet screen-time guidelines”

We have all heard about it for years now – in the newspapers on television and from doctors — obesity is a major health problem in the United States, and it is a serious problem amongst children and adolescents! So should it be news to us that children sitting in front of the television or a computer all day is a problem? Of course not, but it is.

Research conducted at Harvard University more than 25 years ago first linked TV watching to obesity. Many groups hence recommended that children and teens limit TV/media time to no more than two hours per day. Now, new government statistics are showing that only 27% of kids ages 12-15 meet the recommended limit of two hours or less of TV/media time daily. More startling was that 7% of kids in the study reported watching five hours or more a day of TV, while 5% said they used a computer for five hours or more, according to the 2012 data analyzed by the National Center for Health Statistics. At the other end of the spectrum, just less than 2% reported no daily TV viewing, and 9% reported no computer use.

In 2012, the CDC released the following statistics about obesity in children:

Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years.
The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2012. Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to nearly 21% over the same period.
In 2012, more than one third of children and adolescents were overweight or obese.
Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors.3 Obesity is defined as having excess body fat.
Overweight and obesity are the result of “caloric imbalance”—too few calories expended for the amount of calories consumed—and are affected by various genetic, behavioral, and environmental factors. http://www.cdc.gov/healthyyouth/obesity/facts.htm

So how do we change this? First, you need to understand the causes. Obesity seems to run in families. Family dysfunction, poverty and socioeconomic status are also linked to a greater likelihood of becoming obese. Teens resort to overeating to quell feelings of anger, irritability, rage and other forms of distress. They also gain weight from too much television & media time. This habit renders them sedentary, and also encourages them to eat. This form of “sit time” does contribute to obesity.

What to Do If Your Teen is Obese

Educating your teenager about healthy eating is important, especially about portion size, calorie intake, and healthy food choices. It is also important to teach them to be active and to do some form of exercise daily – even walking for 30 minutes a day six days a week will make a difference. Encourage them to become involved in sports at school. There are many opportunities in school today for a young person to stay active.
Parents should provide good examples of healthy eating; a parent who overeats is more likely to have a teen who overeats. Showing by example is more powerful than lecturing, particularly if parents themselves are not abiding by the rules they want their teens to follow. Families should be sensitive to the role they may be playing in inducing the teen to resort to overeating. Counseling can help families address these concerns and help them make changes for the better.
Avoid harsh criticism or putting down your teen for overeating. Understand that there are almost always emotional problems underlying the teen’s urge to overeat. Open up the channels of communication to encourage your teen to talk about his/her anxiety.
Consulting a good nutritionist or source of information on healthy nutrition and then working out a healthy eating plan with your teen is also important. Let your teen decide on food choices, and make an effort to find healthy foods the teen likes.
Make it clear to your teen that many body types are acceptable and attractive. The aim in helping teens who overeat is to get them to eat more healthy foods for a better overall quality of life. It is not to turn them into magazine models, but rather to make them happy in their own skin.
Limit your child’s time on the computer and the television. They will thank you for it someday!
If obesity is severe, or you are seeing your teen making an effort to eat better and exercise, but getting very little results, then it is advisable that you schedule a diagnostic consultation with your teen’s doctor.

DOES LEGALIZING POT SOMEHOW MAKE IT A SAFE DRUG? I DON’T THINK SO!

July 9th, 2014

“Washington States First Legal Marijuana Shops Set to Open Amid Chaos”

That was the lead story on the NBC News website Tuesday, and a slew of other national media outlets, too. With the state of Washington now the second state to legalize marijuana, the controversy over the drug continues to grow. In November 2012, Washington and Colorado stunned much of the world by voting to legalize marijuana for adults over 21, and to create state-licensed systems for growing, selling and taxing the pot. Now, comes the question what should we tell our kids about marijuana?

If you did not already know, marijuana is the second most popular drug in America. Up to 63 percent of teenagers admit using it during high school, and some teens smoke it on a daily basis. There has long been controversy over whether-or-not marijuana is a “gateway drug,” one that leads to further and more serious abuse of other substances. While this debate is ongoing, it is known that a high percentage of people who use more serious drugs, such as cocaine or heroin, started by using marijuana. What the science is saying is that the marijuana does lead to some degree of physical as well as psychological dependence.

With the legalization of the drug in two states, and most likely with more states to follow, it is important that parents talk to their kids about the dangers of marijuana. Make it clear that marijuana is a dangerous and addictive drug and its use can impede functioning and possibly lead to more serious future consequences. Parents, particularly those who experimented with marijuana in their teens may have a tendency to minimize the drug’s dangers. If you have used pot and you have shared this with your kids, tell them why you stopped! Encourage them not to experiment with it and tell them why. Marijuana, in some people, can cause hallucinations and can precipitate severe anxiety to the point of paranoid mental states. Sometimes marijuana can also provoke the emergence of underlying psychotic disorders that may require hospitalization.

Look for the signs of marijuana use in your teenager. These include bloodshot eyes, short-term memory impairment, apathy or lack of motivation, acting silly or “drunk”, impaired body coordination, and the smell of sweet, acrid smoke on hair and clothing.

If you suspect marijuana usage by your child consult your family doctor, or substance abuse counselor or another mental health practitioner. There are also a number of groups that deal specifically with recovery from marijuana use. Most importantly talk to your child. That is always the best place to start.

SEXTING NEEDS TO BE PART OF SEX EDUCATION

July 2nd, 2014

A new study, “Sexting and Sexual Behavior Among Middle School Students”, published in Pediatrics online on June 30, 2014, says that more middle school children are sexting and that parents may be justified in assuming that more is going on, specifically sex.

“Even among kids as young as 11 to 13, those who sext are also sexually active,” Eric Rice, who led the study at the University of Southern California in Los Angeles, told Reuters Health in an email. “Parents, teachers, social workers and pediatricians all need to recognize that sexting is a contemporary adolescent sexual behavior. We need to be teaching kids about the ramifications of sexting as part of our sexual education programs,” he added.

After reading through the study, I would have to agree that the sexting does lead to more promiscuous behavior. I also believe that it is more important than ever that parents talk to their kids about sex and that the discussion includes talking about sexting.

The first thing for parents to do is to understand sexting. This is new for many parents and it is a behavior that brings with it many new problems to be dealt with. Sexting was first recognized in 2005, and according to Wikipedia, Sexting is the act of sending sexually explicit messages, primarily between mobile phones. What does this mean? It means that your teen has sent nude or semi-nude photographs of themselves electronically.

According to the new study, out this week, researchers have discovered that middle school students, not just teens are sexting. Here’s what the research found:

Three-quarters of the middle schoolers had easy access to texting-capable phones
20 percent of students with text-capable cell phone access said they had received at least one sext and almost five percent had sent one.
Students who had received a sext were about seven times more likely to be sexually active than those who hadn’t
Students who had sent a sext were about three times more likely to be sexually active
In total, 11 percent of the kids surveyed said they were sexually active. And 30 percent of them said that the last time they had sex it was unprotected.

The most important think we can do to avoid promiscuous behavior and all the dangers that ensue is provide appropriate education for our teenagers. You need to remember that teenagers and tweens want to hear accurate information from their parents and studies have shown that the more information they get from their parents the longer they generally wait to have intercourse.

In general, where academics and family values are stressed, the onset of having sex is delayed. Parents should make themselves available, be honest, use correct names for body parts, and admit when they do not know something. Sexting might certainly fit into the latter! You should not worry that too much education will encourage sexual behavior, but rather understand that it demystifies it for kids. You also need to be openly monitoring your child’s cell phone. Tell your child you will be checking their phone and looking to see who they are texting.

If you have concerns about your teen or tweens behavior do not be afraid to reach out to the school or to your child’s pediatrician. Trust your instincts, but above all talk to your child often and be honest.