Dr. Henry Paul, MD

Psychiatrist, Author and Educator

SITTING AROUND ISN’T GOOD FOR ANYONE’S HEALTH

September 30th, 2015

“Children who sit too much may face adult-sized health consequences, according to a sobering new study of healthy young girls.” NY TIMES September 23, 2015

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Whether it’s online or on television, in school or at work, from our elected officials or at the doctor’s office we have all heard the message loud and clear – American’s need to lose weight! Obesity is a problem in this Country, and it’s a crisis for our children. So I wasn’t surprised by the new study out this week about children and the dangers to their health if they sit too much.

We all know that adults are sitting too much at their jobs and because of it have all kinds of health issues from weight problems to back and neck pain. In addition there are metabolic and vascular medical problems that emanate from inactivity.

There have been plenty of studies on adults to see how sitting too much effects overall health, but until now there haven’t been any studies on children. Researcher Ali McManus decided it was time to have children sit still so she could study how it affects their overall health. What she discovered in her study was that excessive sedentary behavior has serious clinical and public health implications on children. Were you surprised? I wasn’t.

Here are some things that I recommend to help keep your child active.

  • Encourage your child to join a sports team at school. Intramural sports are as good as joining a team.
  • Sports that are off the playing field such as skiing, swimming, Tae Kwon do, running, kick-boxing, resistance/weight training, etc. are very good for exercising. These days with extreme sports kids are finding where they “fit in” so take an interest in what they’re interested in and encourage them to pursue it.
  • Enlist your kids to do chores that include; helping outside with lawn mowing and gardening, washing the car, helping in the house, raking, and so on. And, when they run out of things at home encourage them to help others. Grandma usually always has a little yard work she needs to be done!
  • Get outside with your kids. Throw a ball, play hop-scotch, go to the track and run with your son, or bike ride with your daughter. Set a good example. It is not only good for your kids, but it is good for your health, too.
  • Limit the things that keep your children sedentary such as television and computer time.

It’s not easy for any of us – young or old – to integrate exercise into our daily routine. As much as our kids will benefit from it adults will benefit too. Making exercise a family affair will 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

HEAD-ON – CONCUSSIONS, KIDS AND THE ALL-AMERICAN PAST TIME

September 30th, 2015

22493562_sVery sad news this past weekend as yet another high school athlete has died from injuries sustained while playing high school football.  This time, it was football.  It has been reported by several news outlets that quarterback Evan Murray, a senior at Warren Hills Regional High School in New Jersey, died Friday night.  He was just 17 years old.

More than one million high school students in the United States play football each year. And, although other sports have seen their fair share of deaths and life-threatening injuries it seems that football raises the most concerns.  And why not?  The NFL has put a lot of focus on concussions making it a top priority for protecting their athletes.

Here are some basic facts on concussions from the CDC:

  • All concussions are serious.
  • Most concussions occur without loss of consciousness.
  • Recognition and proper response to concussions when they first occur can help prevent further injury or even death.

The CDC is taking a proactive position on dealing with concussions and has developed an online program called Heads Up to help ensure the health and safety of young athletes. The HEADS UP Concussion in Youth Sports provides coaches, parents, and athletes important information on preventing, recognizing, and responding to a concussion.

Other organizations, including the NFL, are also exploring safer ways to tackle. The Seattle Seahawks put out a YouTube video on “Hawk Tackling” that focuses on tackling with the shoulder.

The bottom line is that how to tackle is going to be debated for some time. Whether “Heads Up” or “Hawk Tackling” are better will be a matter of time before anyone can tell. The hope is that by teaching the young kids that begin to play to keep their heads “out of the tackle” that over time the game will become safer. The Chicago Tribune ran a story last week (see link below) that looked at the pros and cons to teaching the different styles of tackling to kids.

While the debate rages on, I think that tackle football should be banned. High school football should be played as touch football. I know this is a lot less exciting, but it is also less fatal. Another fact to consider with school-age children playing tackle football is the lack of education, equipment, and money that many schools have to run a safe program.

As much as I would like to see touch football the reality is that tackle football is what is being played right now. That being the case, coaches and parents need to know the inherent dangers of hard hits leading to concussions and other serious back, neck and internal organ damage. Parents and players need to know how to properly perform a concussion evaluation and should be familiar with the school’s and the league’s injury and concussion policies. Below are some links to help educate parents, coaches and students about concussions.

LINKS:
Chicago Tribune: New tackling methods aim to make football safer, but proof still lacking
CDC facts on concussions
CDC Heads Up Concussion in Youth Sports
CDC Heads Up Youth Sports Online Training – 3o minute online class.
CDC Concussion Information Sheet

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.

 

 

HOW DOES THIS HAPPEN?

September 28th, 2015

20639318_sThe discovery last week of who “Baby Doe” is has been bittersweet.  Her name is Bella Bond, and she was just a little over two years old.   After many months and millions of views online finally this week someone recognized this little girl was killed and did the right thing and notified the authorities.  There is relief in knowing that this child has a name.  There are disbelief and anger as the details of her death unfold.

This is a situation where we have a neglectful and abusive couple who used drugs.  Some may question whether the drugs are the reason for the neglect and abuse, but whatever the reason the outcome is that this child was abused and that abuse led to her death.

Michael Sprinsky, who said he had lived with the mother, her boyfriend and Bella, finally put the pieces together about the disappearance and called law enforcement.  CNN reported that Sprinsky said “he had briefly lived with the couple and was disturbed by how they yelled at the girl, demeaned her, spanked her and, on two occasions, locked her in a closet for 30 minutes to an hour.”

To make matters worse, the mother’s boyfriend thought the child was possessed by demons, so he killed the little girl.  The mother helped to cover it up, and so became an accessory to murder after-the-fact.

Why would any mother cover up such a horrendous crime? In many cases like this dependency is the main reason. Many such women I have examined have been highly dependent on their abusive boyfriends, and she might have stayed with him to fulfill these dependency needs, and to avoid abandonment, to avoid punishment and also for drugs.  News reports say she is also dependent on Heroin. Apparently her judgment was impaired-her dependency and drug use are powerful judgment destroyers.

When it comes to the death of Bella, the lingering question in people’s minds is how did the State Department of Children and Families Services (DFS) miss this?  After all DFS handles investigating allegations of child abuse and the agency had dealt with this mother before.   She was known to have drug problems.  She had two other children taken away from her, and she had already been investigated twice for neglecting Bella.  I’m certain that this investigation will look at the policies and practices of DFS and whether-or-not the agency responded appropriately in this case.

When it comes to child abuse each State has a system to receive and respond to reports of possible abuse and neglect. Professionals and concerned citizens can call statewide hotlines, local child protective services, or law enforcement agencies to share their concerns.

Childhelp® is a national organization that provides crisis assistance and other counseling and referral services. The Childhelp National Child Abuse Hotline is staffed 24 hours a day, seven days a week, with professional crisis counselors who have access to a database of 55,000 emergency, social service, and support resources. All calls are anonymous.

Links:

Death of Bella Bond: Blame game begins CNN

In a Year, Child-Protective Services Checked Up on 3.2 Million Children

2.5 million of those kids were declared ‘non-victims.’ Another 686,000 were ‘abused’ or ‘neglected.’ And an estimated 1,640 kids died as a result.

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.

SHOTS OF DOMESTIC TERRORISM

September 18th, 2015

42864195_s“The string of shootings has been called domestic terrorism.” NBC News 9/15/15

The random shootings on I-10 in Phoenix Arizona has terrified a city and has residents staying off I-10 out of fear of being shot.

“The image is murky, but threatening: A phantom skulks along freeways randomly shooting into vehicles, getting an adrenaline rush or satisfying some dark compulsion,” says the reporters in the AZCentral story “Task force battles Phoenix freeway shootings with crime-solving arsenal”.

I can tell you that the crime solving arsenal that has been brought in to solve this case includes a team of the Country’s top profilers. This team analyzes the crime(s) the person committed in an effort to detect and classify the major personality and behavioral characteristics of the individual.

So what kind of person becomes a shooter of innocent people? Usually, people who do this sort of thing are seriously narcissistic individuals who harbor intense ideas of grandiosity and control. They plan these events and get a perverse excitement from terrorizing others due to their deep insecurities or chronic feelings of rejection. A narcissistic person is self-centered, selfish and lacks empathy for others. Here’s a link for more information on narcissism.

Trying to find the person or persons responsible for the I-10 Arizona shooting spree is going to rely on great detective work and on tips. Somebody knows something. It is up to us as a community — as the family, friends, neighbors, teachers, doctors, clergy and others to observe changes in the people we know and love.

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.

WAITING FOR REHAB TO TAKE YOU

September 16th, 2015

“Wait time is among the most commonly cited barriers to access among individuals seeking entry to substance abuse treatment, yet relatively little is known about what contributes to it.” The American Journal of Drug and Alcohol Abuse

So what do you do if you are put on a waiting list to get into rehab?  Worse yet, what do you do if you are a parent waiting to get your child into rehab?  Waiting to get into drug rehab is a very stressful situation for the addict as well as their family and friends.  The shortage of beds is due to the growing opiate and heroin epidemic.

Just this week, NBC News reported some startling numbers on the wait list for federally-funded rehab.  States like Massachusetts, Florida and Ohio have waits that span from weeks to months.  In Maine, according to the NBC report the wait is as long as 18 months.   More startling is that our prisons are becoming detox facilities.  Most certainly you will detox in prison, but there is no support system in there for helping you find the tools to stay clean and put your life back together when you get out.

The shortage of rehab beds and the growing opiate and heroin epidemic have created a crisis in this country.  One that will have to be seriously addressed by the medical community, as well as our elected officials.  In the meantime, until a solution arises, I support referring patients who can’t get into rehab to a lower level of care such as an outpatient drug program.  Outpatient rehab is a temporary solution but right now next to getting into a rehab it’s the only real option for many addicts.

Look, it certainly isn’t the ideal solution, but it does offer the professional oversight and the support that is needed to help an addict start recovery.  These outpatient programs now allow for drugs like Subutex and Suboxone to be dispensed.  Before these two drugs were added to the outpatient treatment programs drugs like methadone could only be dispensed in specialized addiction treatment centers where you were admitted.

The FDA website confirms that “there are not enough addiction treatment centers to help all patients seeking treatment. Subutex and Suboxone are the first narcotic drugs available under the Drug Abuse Treatment Act (DATA) of 2000 for the treatment of opiate dependence that can be prescribed in a doctor’s office. This change will provide more patients the opportunity to access treatment.”

Subutex and Suboxone help with opiate addiction because they both contain the active ingredient, buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence.

The American Journal of Drug and Alcohol Abuse did a 2012 study that said that nationwide, only 11 per cent of substance abusers get help from treatment centers.  According to the study the primary reason that number is so low is because the wait time is too long.

The NBC story references another study that says “Even when people sign up for wait lists, they will only tolerate one month on average. 40 per cent of people on a wait list will drop off in two weeks, according to a 2008 study.” Click here for the full NBC Story “As Heroin Epidemic Grows, So Does Rehab Wait” by Charlie Giles, September 6, 2015.

If you have questions about rehab placement in the New York area please email me at drpaul@henrypaulmd.com.

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.

HOW HEALTHY ANGER CAN LEAD TO ANXIETY, HOSTILITY AND RAGE

September 9th, 2015

12029187_sThe anger metamorphosis is an insidious process that develops over years. Fortunately, there are many opportunities along the way that can alert us that this process is underway. This is important to remember because the process can be reversed – more easily at the beginning. The anger metamorphosis leads to what I call legacies of mishandled anger that include many of the common psychiatric problems of the childhood and teenage years.

Anger metamorphosis starts after healthy anger, a normal, warm, healthy communicative feeling has been repeatedly mishandled by important people in a child’s environment. It is the long-term mishandling that initiates this anger process and not the occasional mishandling that happens in normal households from time to time.

The anger metamorphosis consists of five stages:

Stage 1: A child will exhibit heightened signs of anger or exaggerated expressions of normal anger.

Stage 2: A child will begin to try and curtail or hide their anger. This is an attempt to control the anger.

Stage 3: Since direct anger has not gotten the right response the child now tries other behaviors. Some examples of the behaviors include trying extra hard to please, becoming cunningly manipulative, or silently complying with whatever a parent asks. In this stage, you begin to see early signs of a more serious psychiatric disturbance.

Stage 4: The child will begin to bury the anger by repressing it. Repression is a way of dealing with feelings that are considered dangerous or unacceptable. These dangerous or unacceptable feelings actually are banished from the conscious awareness. This doesn’t mean that the feelings no longer exist. They continue to lead an active subterranean life, affecting the child in all sorts of ways, even know they are beyond awareness.

Stage 5: The final stage sees the transition of the original anger – appropriate, natural communicative – that the child has controlled, repressed, and externalized become fuel for anxiety, hostility, rage and eventually the production of psychiatric symptoms and pathological character traits.

Sadly, the end products of the anger metamorphosis bear no resemblance to the original anger. A healthy anger that is constructive, doesn’t leave scars, is transient and enhances a child’s relations with other. Understanding anger is an important part of parenting. I encourage parents who have questions about their child’s anger to contact their pediatrician or a specialist in child behavior. I am happy to field your questions, too. Details about normal anger and its metamorphosis can be found in my first book, When Kids are Mad Not Bad.  Please email me at drpaul@henrypaulmd.com.

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.