The Child Mind BlogBrainstorm
Keeping Anxious Kids From Becoming Anxious Adults
May 2, 2014 Caroline Miller
We kicked off our May Speak Up for Kids campaign this year with a May Day luncheon focusing on anxiety: living with it, treating it, and being the parents of an anxious child. On the program were two experts in the field—Scott Stossel, the author of My Age of Anxiety, who's lived with anxiety for 42 years, and Dr. Jerry Bubrick, who's treated many anxious children at the Child Mind Institute. Moderating the conversation was Ali Wentworth, the actor, comic, TV personality and no stranger to anxiety and depression herself (she noted that she spends more money on Zoloft than Barneys).
If you've read Stossel's book, or the excerpt in the Atlantic, you know that one thing that makes him acutely anxious—along with flying, vomiting, and cheese (long story)—is public speaking. Wentworth opened the conversation by asking Stossel if he'd resorted to his usual cocktail of anti-anxiety meds and vodka, a regimen he described in his book, to steel himself for this event. Stossel responded that the three months of publicity he's done for his book have actually diminished that anxiety. "It's almost like doing protracted exposure therapy," he noted. And he's found that he can get by with less and less medication.
Speaking of exposure therapy—the form of cognitive behavior therapy that Dr. Bubrick described as the gold-standard treatment for anxiety—Stossel also said that when his daughter developed anxiety at age 7, they got her CBT treatment immediately, and it really worked. "It's a joke in my family," Stossel said. "She's now 10, and she's much better than I am." He's become a big believer in early intervention, noting that if he'd been treated as a young child by Dr. Bubrick (who unfortunately was also a young child at that point) he probably would have been a much, much less anxious adult.
Dr. Bubrick explained that parents who want to help kids overcome anxiety need to do the opposite of what seems natural: not reassure them constantly that they'll be fine, or brush off their anxiety, or avoid things that make them anxious. Instead, they need to validate their worried kids' feelings, but express confidence that they can manage the anxiety, and help them think of ways to handle what might happen.
And all three speakers emphasized the importance of not hiding problems with mental illness.
Stossel pointed out that it took him four decades before he was able to "come out," so to speak, by writing his book. Of course, he said, he was quite worried about how the book would be received—how could he not be? "But the incredibly positive response of people coming forward and sharing their stories has been extremely heartening," he said. "There is real benefit to generating conversation about this stuff. And reducing the stigma can really help."View Comments | Add Comment
Offit Schools Colbert on the Anti-Vaccine Threat
April 29, 2014 Caroline Miller
Dr. Paul Offit faced off with Stephen Colbert last night on the anti-vaccine movement, and the result is both funny and telling. Colbert gamely offered up all the usual anti-vaccine arguments, including my favorite: Why should I get my kids vaccinated if everyone around them is vaccinated? They're protected by . . . everyone else.
Dr. Offit, who has written a book about the movement called Deadly Choices, countered that a decline in vaccinations has caused new outbreaks of measles, meningitis and whooping cough. Ten children recently died in a whooping cough outbreak in California, he noted—the worst in more than 50 years. "That isn't fair," Colbert shot back. "You're playing the child dying card!"
On the subject of autism, Dr. Offit said many, many studies have showed that vaccines don't cause autism. How about the argument that we're giving 2 year olds—"kids who can't even handle an unpeeled grape!" Colbert noted—too many vaccines all at once? Offit said the immunological challenge kids get in multiple vaccinations is "a drop in the bucket compared to what kids are exposed to every day in food and water."
Dr. Offit, who heads the Division of Infectious Diseases at the Children's Hospital of Philadelphia, also gave a short talk about the risks of alternative medicines at a recent Autism Science Foundation conference. No Colbert in this one, but it's fun to watch, too.
Dr. Offit notes that of more than 54,000 dietary supplements on the market, only about 50 have research backing their claims of safety and efficacy. "People assume it's all natural, it's all good. You have evil pharmaceutical companies on the one hand. But these products are made by elves and old hippies, on flowering meadows," he said. Wrong, he added. These products are made by the same pharmaceutical companies—have been for a long time. "This is big pharma, but it's an unregulated industry. When you have unregulated industry, you get to make claims of efficacy and safety that you don't have to prove. And that's a problem."View Comments | Add Comment
Rory Culkin and Lou Howe Talk ‘Gabriel’ at Tribeca
April 29, 2014 Harry Kimball
Last Friday night, the Child Mind Institute hosted a screening and discussion of the new film Gabriel at the Tribeca Film Festival. Director Lou Howe and star Rory Culkin were on hand to talk with CMI president Dr. Harold Koplewicz about the movie, an often harrowing look at a young man struggling with psychosis, a troubled family history, and delusions about past relationships. (Warning: spoilers ahead and in the video.)
Howe and Culkin provided thought-provoking interpretations of Gabriel's progress in the film, but their sincere commitment to presenting the truth of the person they bring to the screen is perhaps more notable. Howe described the personal relationship that inspired and informed him, as well the research he and Culkin did with young people with mental illness to prepare. As he got further into the process and saw how deeply the issue affected everyone he spoke to, "I knew I was on to something."
And Culkin emerged as fiercely (if modestly) protective of his character. What did he learn? Dr. Koplewicz asked. For Culkin, the experience remains "private," he said. And what did he hope to convey? "I only had one job, and that was to get into Gabriel's head." He said he couldn't afford to think about the audience, or what other people thought—which is kind of a fitting approach when you think about the intense scrutiny and stigma that confront many people struggling with mental illness.
The questions from the audience that followed were more often personal statements that attested to the power of the film. Whatever their take on the arc of the story, they mostly agreed: it's a must-see. In the words of one audience member: "This movie needs to be shared with people."
You can also read CMI clinical psychologist Rachel Busman's review of the film for the Huffington Post.View Comments | Add Comment
Treating ADHD Like a Piñata
April 28, 2014 Caroline Miller
If you're following the ADHD wars, you might want to check out a blistering response to a recent article in Esquire magazine called "The Drugging of the American Boy." You can pretty much tell where the Esquire story is going from the headline, as Gina Pera, a journalist who focuses on ADHD, writes in the New York Observer: " When a headline features the word 'drugging,' the report about ADHD that follows will not be well-balanced."
Not well-balanced is putting it mildly. The story is classic scare-mongering, suggesting that a cabal of psychiatrists and drug companies is waiting to swoop down and drug your six-year-old boy, turning him manic, aggressive, paranoid, sleepless, starved and possibly psychotic and suicidal. You think I'm exaggerating, but that's the story's opening salvo.
"Esquire joins The New York Times in treating one of the most well-researched and documented conditions in medical history as a piñata," Pera writes. "Bash ADHD and all the goodies fall out. Web traffic soars. The immense anti-psychiatry blogosphere races to showcase the latest proof that they've been right all along." Paul Raeburn, chief media critic at the Knight Science Journalism Tracker, a watchdog site, is similarly outraged.
I didn't write about the Esquire piece when it came out a couple of weeks ago because it couldn't be less helpful to parents. We certainly agree that there are real problems with shotgun ADHD diagnoses and the tendency to treat ADHD as "a default method for dealing with a 'difficult' child"—both things the Esquire story notes. But for this story the red meat is medication bashing, not a serious look at what might be driving overdiagnosis. And as both Pera and Raeburn write, it's not the least bit interested at all in looking at the kids who have been helped by meds—there's decades of documentation on that—or at the kids who aren't getting meds that might help them.View Comments | Add Comment
Lifetime Eating Disorders Guide
April 25, 2014 Caroline Miller
Lifetime tackles a painful issue in a film that's debuting this weekend—the effect of thinspiration and pro-ana web sites on teenagers at risk of eating disorders. "Starving in Suburbia" tells the story of an anxious high school senior, Hannah, who gets drawn in by a kind of virtual Greek chorus of kids in an online forum encouraging her to starve herself in order to be happy, thin, free, energized, confident—everything good you can think of, including perfect.
Hannah is introduced to the site by a friend who finds the whole thing repellent. "You want to see something really sick?" the friend says, showing Hannah a photo gallery of excrutiatingly thin selfies. "It's a freaky cult of anorexics sharing tips. Just watching it makes me nauseous, so I guess it's working."
The film doesn't really make it clear why Hannah would be more vulnerable than her friend to the allure of starving herself, but the reality is that it's often unclear why an otherwise high-functioning girl or boy would develop an eating disorder. And we're happy to report that Lifetime has partnered with the Child Mind Institute and NEDA—the National Eating Disorders Association—to offer an online guide to eating disorders to accompany the film. The guide includes everything from the signs and symptoms to the kinds of treatments available.
Treatment is crucial, because eating disorders are much more dangerous than most girls realize. Kids with dramatically distorted body images just don't perceive how extreme what they're doing is, and, in fact, you don't even have to appear emaciated to be at risk for a fatal heart attack. The longer you starve, the more your brain adapts to it, making treatment harder, too, and the danger of relapse greater. You can see the Lifetime guide here.View Comments | Add Comment
Military Families: Coping With War
April 18, 2014 Suzannah Creech
A recently posted feature on CNN called "The Uncounted" draws attention to the impact of military deployment and mental health on military and veteran families. Among the stories we hear is that of a teenager in a military family, Kristi Anne Raspperry, who describes the development of her own symptoms of depression and anxiety when her father returned from a deployment with post-traumatic stress disorder and her family struggled to cope.
Kristi's painful story is an important reminder to all of us that behind the media coverage on the mental health impact of military deployments are children and families who may also be struggling. In this revealing portrait, Kristi describes some of her most difficult moments, as well as her path to getting treatment. We also see her father respond to Kristi's story in a written statement.
An important takeaway here is that parental mental health can impact children's mental health. And in military or veteran families who experienced a deployment separation, this may create a risky family dynamic. More needs to be done to support military families coping with mental illness, including parenting training.
That's why we are excited about recent developments in this area such as Dr. Ellen DeVoe's work to develop and test the Strong Families Strong Forces intervention for military families with very young children. There is also a new online resiliency training course for military families called FOCUS World that provides support and training around common family challenges after deployment.
Suzannah Creech, PhD, is Assistant Professor of Psychiatry & Human Behavior at Brown University, Providence VA Medical Center. Her research focuses on the mental health of veterans and veteran families.
The contents of this post represents the views of the author and does not necessarily represent the views of Brown University, the Department of Veterans Affairs or the United States Government.
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Jenny McCarthy's Slippery New Vaccine Stance
April 16, 2014 Beth Arky
It's been a super-busy week for Jenny McCarthy. Not only did she announce on The View today that she's engaged to Donnie Wahlberg, she's also facing a backlash after she wrote a Chicago Sun-Times op-ed in which she tried to backtrack from her anti-vaccine stance.
The celebrity mom's 11-year-old son, Evan, was diagnosed with autism in 2005. Since then, McCarthy has often argued that vaccinations are linked to the disorder, fueling the anti-vax movement that has led to preventable diseases like measles, mumps and whooping cough making a comeback.
In the Sun-Times op-ed, she recalls an interview that she says clears up her stance: '"People have the misconception that we want to eliminate vaccines,' I told TIME Magazine science editor Jeffrey Kluger in 2009. 'Please understand that we are not an anti-vaccine group. We are demanding safe vaccines. We want to reduce the schedule and reduce the toxins.'"
Kluger quickly called her out on TIME's website, completing her quote for her: "If you ask a parent of an autistic child if they want the measles or the autism, we will stand in line for the f-cking measles."
He concluded, "It's just too late to play cute with the things you've said. You are either floridly, loudly, uninformedly antivaccine or you are the most grievously misunderstood celebrity of the modern era...Your quote trail is far too long—and you have been far too wrong—for the truth not to be obvious."
Commenters on Facebook agreed. "The damage is done," one wrote. "Families went against everything we've come to know through years of vaccinating our children with proof from data collected, doctors' information, research." And whatever McCarthy says she really meant won't change that.View Comments | Add Comment
Autism Community Split in Four, Says NIMH Chief
April 11, 2014 Beth Arky
The autism community is conflicted in many ways, most obviously between those seeking a cure versus those who see the autism spectrum as a natural state of neurodiversity. Dr. Tom Insel, director of the National Institute of Mental Health, codified those divisions even further in his Autism Science Foundation 5th Anniversary Celebration talk, "From four kingdoms to one community for autism."
Dr. Insel laid out the four "kingdoms," or schools of thought:
Autism as an illness. Those with this view see autism spectrum disorders as a neurodevelopmental disorder. This group is looking for genetic factors, or biomarkers, with a cure as the goal.
Autism as an injury. This camp sees ASD as a "response to an environmental insult of some sort," making autistic children the "canaries in the coal mine" who might just be warning us of the effects of toxins or even climate change. Here, the goal is prevention.
Autism as an insight. This viewpoint sees autism "as a window into the social brain." Here, the goal is comprehending the fundamentals of how the brain grows and functions.
Autism as an identity. Here, autism is seen as a disability. Adults on the spectrum have become self-advocates who focus on functional outcomes. The goal is inclusion, with advocates seeing themselves as part of a civil rights movement with the motto "Nothing about us without us."
Dr. Insel then raised another way of looking at things: "Maybe there really are at least four different disorders involved—we should be talking about 'the autisms.'" From this perspective, he said, "there are people who may be more in this illness kingdom" versus, say, those for whom identity is a better approach.
Dr. Insel noted that the divisions within the autism world mean it's "not the same type of [unified research] community that works on cystic fibrosis or Type 1 Diabetes." He said the problem is so serious, great scientists are saying they have a lot to offer but this is "a community I don't want to deal with. It's too difficult."
The enormous conflict between these four very different groups needs to be overcome if progress is to be made, he continued. He emphasized the need for finding shared interests to unify the community, such as the demand for greater services for—and understanding and recognition of—adults on the spectrum. And scientific efforts that bring together the far-flung kingdoms are crucial, he concluded. "Science has a way of letting us understand."View Comments | Add Comment
An App for Skinnier Selfies
April 8, 2014 Rachel Ehmke
In what feels like an inevitability, there's now an app to make yourself look skinnier in pictures. For the slim price of just 99 cents in the Apple store, you can get the app, take a selfie, and then choose to shave off 5, 10, or 15 pounds from your face. It's called SkinneePix and it only works on faces, which is bad news for bikini season but good news for those of us who are looking for silver linings in this otherwise depressing story.
Of course we're already used to seeing manipulated photos, even if we don't realize it. Page Six recently reported that Lady Gaga made photographers covering an event "smooth out her jaw line and thin her arm" and "smooth out and thin her legs" before she let them release any photos of her. Besides being a disappointing request—Gaga has previously positioned herself as a role model for girls with body image issues—it illustrates how pervasive photoshopping has become. Even the "candids" of celebs have been passed through the digital wringer.
So it makes sense to market a DIY app for us non-celebs. Selfies are addictive, particularly to young girls who are already spending a lot of time crafting the perfect online identity for themselves. An app that makes you skinnier is going to be a no-brainer for a lot of girls.
Which is too bad because when everyone looks fifteen pounds lighter online—or feels like they should—it's going to make it even harder for girls to feel good about who they really are.
Read more about teens, self-esteem, and the impact of social media here.View Comments | Add Comment
Parenting, Lost at Sea
April 8, 2014 Harry Kimball
It seems everyone has an opinion about the actions of the Kaufman family—Charlotte, Eric, and daughters Lyra, 1, and Cora, 3—who were recently rescued by the Navy after their sailboat Rebel Heart floundered in the Pacific 900 miles off the coast of Mexico. We note that their predicament illustrates, on a grand scale, a choice parents make every day and everywhere: to be risky, or not to be risky?
The Kaufmans were headed from Mexico to New Zealand under sail. Charlotte and Lyra had just recovered from salmonella poisoning before they left, and when they were rescued Lyra had a severe rash and a fever. Were they foolhardy, or were they responsibly trying to introduce their young children to a life rich with adventure?
A family's job is "to be prepared and to have a backup plan," a doctor tells the New York Times. "It sounds like they needed their backup plan and executed it." But others wonder if the Kaufmans lost sight of their kids' needs—and even their basic capacity for adventure. "It's not as if a 1-year-old is going to remember an experience, whether it's positive or negative," a parenting author says. We should stress that developmentally, infants and young children need security and attachment; the benefit of taking risks—and learning to be independent and resilient—comes later.
The Kaufmans are sticking by their decision. For the rest of us it's a lesson in being honest about what we do for ourselves, and what we do for—and to—our children. At some point, kids take risks; but parents shouldn't ever take risks with kids.View Comments | Add Comment