The Child Mind BlogBrainstorm
Smart Girls on Anxiety
May 15, 2014 Caroline Miller
We're fans of Amy Poehler's Smart Girls, and last night teamed up with them for a conversation about teenagers and anxiety. Several smart girls who have first-hand experience with anxiety were on hand, and a couple of things they said really jumped out at me.
First, how important your friends are when you're miserable with anxiety. Natasha Lerner, at 15-year-old who's struggled with PTSD and anxiety after witnessing a suicide, talked about how devastating it was for her to have a good friend laugh when she told her she was seeing a therapist.
MTV comedian Shaylah Evans said she had the same experience with the panic attacks that started when she was quite young. "There's not a lot of sympathy for people with panic attacks," Shayla said. "People tell you you're just being a baby, you should just get over it. "
"It can really add to your burden when friends don't appreciate the stress you're under," said the Child Mind Institute's Dr. Jamie Howard, adding that that's why it's so important to speak up about mental illness. "Your friends might need some help knowing how to respond. Empathy doesn't necessarily take place overnight. You may need to educate people."
Since then Natasha has changed schools, and found new friends. "It's hard to tell people and have them react the way you want them to react," she said, 'but if they're really your friends they'll try to understand."
When Franny Condon, now 15, was struggling with anxiety three years ago, her friends were understanding, she said, but the anxiety became more and more extreme. "Anxiety is not something that gets better without being paid attention to, Franny said. "For me it didn't come in one fell swoop. It came little by little and grew, and with everything I avoided I became afraid of something else."
Franny was eloquent about what it takes to fight anxiety in treatment. " You have to change your thinking from using avoidance as a crutch to going through things you are afraid of systematically, until you can face them without irrational fear."
Natasha agreed: "You have to do the opposite of what you want to do."
And Shayla said she went so far as to force herself to start doing improv comedy to teach herself to face down fear. "It's way harder to do an improv comedy show, " she said, "way harder than just going out into the world. Day to day life seems so much less stressful—no waiting for applause or laughter. It reminds you that you can't control anything and that's okay."View Comments | Add Comment
Can Meditation and Mindfulness Cure ADHD?
May 14, 2014 Harry Kimball
This week, an article in the New York Times about the potential for meditation and mindfulness training to ameliorate symptoms of ADHD has been causing some excitement. The author, Daniel Goleman, is a psychologist who has long been interested in meditation, and he suggests the practice helps improve "cognitive control" deficits associated with the disorder. And there are studies, he writes, that show mindfulness training leads to a "decline in impulsive errors," and that meditation appears "to strengthen the neural circuitry for keeping attention on a chosen point of focus."
It should be noted that Goleman's focus on these brain-training strategies is tied to ambivalence about a common treatment for ADHD: drugs. "Meditation, not medication," you might say. He describes a "growing disenchantment" with stimulant meds—familiar to anyone who has read the recent string of anti-stimulant articles in the Times—and then, unfortunately, offers misleading study evidence in support of their unsuitability. For instance, if kids with ADHD in Finland take far less medication than American children, it does not necessarily indict the treatment.
Everyone is entitled to an opinion on medication treatment, however. The real question here is this: Are meditation and mindfulness also good treatments? There is "huge potential" in this research, says Dr. Ron Steingard, associate medical director at the Child Mind Institute. And he is optimistic, but the fact is that the methods "aren't ready for primetime." The studies Goleman cites have limited sample sizes and do not include children. Their authors suggest more robust future research, which is a fantastic idea. As Dr. Steingard points out, high-functioning adults with ADHD who have learned to accommodate certain symptoms may very well use similar mental strategies; understanding this and developing evidence-based treatments would be an amazing help for people who struggle with the disorder.
In the meantime, however, we don't know if these approaches will work in kids, and we don't know if they will help with the hyperactive and impulsive symptoms that pose such a threat to young people with ADHD. Just because we are optimistic does not mean we can cease to be realistic when it comes to the risks of the disorder and the proven treatments we have on hand now.View Comments | Add Comment
Speak Up: A Mother's Story
May 12, 2014 Liza Long
On December 14, 2012, the day that Adam Lanza killed his mother—then walked into an elementary school in Newtown, Connecticut, where he shot and killed 20 first graders, 6 educators, and himself—my then 13-year old son was in an acute care psychiatric hospital.
After years of incorrect diagnoses and medications that didn't work, I still didn't know what was wrong with Michael or how to help him. So I told my story to the world. When I wrote, "I Am Adam Lanza's Mother," millions of families responded and said, "That's our life, too." Today, in 2014, Michael is stable. He has a diagnosis, and medications and therapies that work for him.
But before we could get help—before we could find hope—we had to speak up.
This May, I encourage everyone to speak up for the one in five children in America who struggle with mental disorders. The Child Mind Institute's Speak Up for Kids campaign is making a difference. Together, as we share our stories and speak up for our kids, we move toward making real help, hope, and recovery a reality for our children and our families.View Comments | Add Comment
Facing Down OCD: A Teenager Speaks Up
May 6, 2014 Caroline Miller
Ben Shapiro is a 17-year-old who's written a remarkable piece for Psychology Today about the OCD that took over his life five years ago, and the battle to get that life back.
Ben is candid and articulate about what it felt like to be in the grip of obsessive terrors, and how his compulsive rituals alleviated those fears, giving him what clinicians who treat kids with OCD call a "just-right feeling." As Ben puts it: "It's like a drug for people with OCD; we will do whatever it takes to get that reassurance, no matter how embarrassing our rituals."
Ben also interviewed two anxiety experts about OCD and the treatment for it, which in his case included medication and cognitive behavioral therapy. Ben was helped by both, he writes, but it's the CBT, with Dr. Jerry Bubrick at the Child Mind Institute, that he credits with bringing him down from the ledge. His description of how it works it is the best I've seen.
Ben is also very articulate about his reasons for writing this piece, as part of our annual Speak Up for Kids campaign, aimed at reducing the stigma around mental illness that isolates families struggling with it. His words are more powerful than mine—I hope you'll read the piece.
I decided to step forward and "speak up" on the chance that hearing my story might help even one other kid. OCD made me feel alienated in a world I was sure only I understood. Had I realized how false that was, that there are millions of us out there, I might have felt a little less alone.View Comments | Add Comment
Speak Up: Imagining a Brighter Future for Our Kids
May 2, 2014 Jeremy Richman, PhD, and Jennifer Hensel, MS
Our six year old daughter, Avielle Rose Richman, was one of twenty-six children and educators tragically killed at Sandy Hook Elementary School in Newtown, CT on December 14th, 2012. My wife and I have started a brain science foundation in her honor with the mission of understanding and ultimately preventing violence. This May, the Avielle Foundation joins the Child Mind Institute to Speak Up for Kids because we believe our future depends on our children's imagination.
We speak up because we know that the imagination of a healthy brain can lead to discoveries with the power to change humanity. Every child deserves a chance to imagine a world free of violence, fear, pain, and isolation; a world of empathy, health, beauty, and inclusion. And every child deserves the opportunity to make what they imagine a reality.
We speak up by championing scientific research and education that will bring light to the dark mysteries of the brain, making the invisible complexities visible. When we take the brain out of the shadows, we find understanding and the freedom to create appropriate therapies, bringing hope to kids and families. We see a near future where parents and patients have no fear seeking help, because the brain will be respected and treated like any other organ in the body.
We speak up because every kid deserves a strong, nurturing, and supporting community. Without investment in community we cannot take care of each other; we need a collective solution to provide brain healthcare for everyone.
We speak up with Avielle's voice, because she cannot. We speak up for kids because we imagine a world where all children have the opportunity to live happy and healthy lives that celebrate the beauty of their brains.View Comments | Add Comment
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