Dr. Henry Paul, MD

Psychiatrist, Author and Educator

THE BRUCE JENNER INTERVIEW

April 24th, 2015

There is a lot of speculation and curiosity about the highly promoted interview between Diane Sawyer and Bruce Jenner that is running tonight on ABC.  I am sure that after the interview there will be a lot of questions.  Many Americans do not understand what a life-changing decision it is for a person to struggle with gender identity.  The lack of understanding leads to confusion, paranoia, and discrimination.  What I hope will come from the Jenner interview is a national dialog that will change the stigma surrounding transgender people in the United States.

Elliot Fukui, TransJustice Coordinator at the Audre Lorde Project,  a community organization in New York City, spoke with CBS News recently about some of the common issues and misperceptions facing transgender people today.  He says that it is important to support a person’s right to choose their identity, and he suggests a number of ways to do just that.  Click here to read the CBS story and Fukui’s recommendations.

I just wrote last week in my blog about the great job that the media is doing bringing transgender characters and actors to television. It is evident that the diversification of today’s TV characters has certainly opened up plenty of discussions.  Tonight Jenner will only add to the discussion, and that’s a good thing.  I hope tomorrow to wake up and find the national dialog has exploded on this issue.  It will only help people to understand gender identity and the need to embrace those who choose to make a change.

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.

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.

GETTING CHILDREN BACK TO SLEEP AS SCHOOL STARTS

September 5th, 2014

School Daze: Getting Kids Sleep Habits Back on Track (CBS News) offers suggestions for getting children back into a normal sleep routine after the lazy days of summer. Staying up late and sleeping until noon, no longer works when you have to get up for school.

Make sure that your children get enough sleep – at least eight hours. Talk to them about the importance of sleep on their overall health and their performance in school, both academically and on the athletic field.

If you suspect more serious sleep issues make sure to contact your pediatrician. Here are some blogs that I recently wrote that look more closely at sleep disorders and how to treat them.

Email me if you have further questions. I hope this is a safe and happy school year for all of you and your children.

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.

 

SCREENING PRESCHOOLERS FOR DEPRESSION IS A GOOD IDEA

August 22nd, 2014

Depression can strike at any age, even among preschoolers, researchers report. CBS News

A very interesting study came out this month that looked at depression in preschoolers. The study found that preschoolers who are depressed are two and a half times more likely to continue to experience symptoms in elementary and middle school.

The study, published recently in the American Journal of Psychiatry, was done at Washington University by a team headed by Dr. Joan Luby, who directs the university’s Early Emotional Development Program. It included 246 preschool children, ranging from three to five years of age. Luby’s team evaluated the children for depression and other psychiatric conditions over time.

At the onset of the study, 74 of the children were diagnosed with depression. Six years later, 79 of the children met the criteria for clinical depression, including about half of the 74 children diagnosed with depression when the study began. Of the 172 children who were not depressed as preschoolers just 24 percent of them went on to develop depression later.

The study identified a higher risk of depression for children whose mothers had suffered from depression, and those who were diagnosed with a conduct disorder while in preschool.

When I was in training, we were taught that young children could not suffer from depression because they were not old enough to have a superego — a mental structure described by Sigmund Freud that develops at about eight years old. This theory, which denied the obvious, which was that we often saw depressed young children, flew in the face of reality and caused depressed children to be left untreated up until the last few decades.

Today, we know that people of all ages can suffer from depression, especially young children who grow up in stressful circumstances. If untreated, this depression can lead to severe consequences including further depression, educational slowing, behavior disorders and other syndromes.

I agree with the researchers that children as early as three years old should be screened. Childhood depression can be treated, and there are a host of interventions that help including psychotherapy, family therapy, and medication.

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.