Did you know screen time is contributing to sleep deprivation in kids? In this Fast Company article, they discuss the links between mental health, sleep, and screen time.
The Centers for Disease Control reported recently that about 1 in 25 teenagers take antidepressant medications, writes the Huffington Post. Depressive episodes in adolescents can look different from adult depression. For one, teens tend to show more irritability than sadness. Another difference is that teens are not as adept as adults in articulating issues associated with depression. Teens who meet criteria for a diagnosis of depression also usually have at least 4 of the following symptoms: (1) loss of interest in activities that used to be pleasurable to them, (2) changes in appetite or weight–either increases or decreases, (3) sleep problems, including troubles falling or staying asleep, or sleeping too much, (4) seeming either physically slowed-down or physically agitated and restless, (5) feeling fatigued or out of energy often, (6) feelings of guilt or worthlessness, (7) problems concentrating or making decisions, (8) recurrent thoughts of death or suicide. Depression is more likely to affect females. It also runs in families. Children who have not yet reached puberty are more likely to have depression in conjunction with other disorders–such as ADHD, Anxiety, or Disruptive Behavior Disorders.
If you suspect a teenager you know may be depressed, you should take action. Schedule an evaluation with a child psychologist. There are evidence-based treatments for depression, most of which are based in cogntive-behavioral therapies. You should notice symptom improvement after 12-16 weeks of treatment. If improvement is slow or nil, consider making an appointment with a child psychiatrist to discuss medication that may be appropriate as an adjunct to therapy.
According to a 2007 Columbia University study, about 1 in 70 preschoolers take psychiatric medications—including stimulants, antidepressants, mood stabilizers, antipsychotics, and antianxiety drugs. It is not possible to say—without knowing these children personally—if medications are appropriate. But we do know that psychiatric drugs are not approved by the FDA for children under 6. There is simply not enough information to know how very young brains and body will respond—over time—to these medications.
As a child psychologist, I have worked with hundreds of children on psychiatric medications. In many cases, medications were necessary for the children’s safety and well-being. Almost every parent I’ve worked with has agreed to their child’s taking medication because they really believed it was the best way to get back on track. Few parents are excited about medications, but look instead to outweigh the downsides of out-of-control behaviors, moods, and urges.
But, here’s the thing. Medication is not the only option. It should never be the first option. The fields of child psychiatry and child psychology have solid, evidence-based research that shows the effectiveness of non-invasive treatments—therapy, sensory integration, parent/teacher education, and coaching.
If you’re wondering if your toddler is “abnormal,” see a child psychologist. This doctor should spend time with your child, you, and get a detailed history of the problem. Child psychologists can conduct standardized measures that have been validated to use on very young children. Mental illness is hard to characterize in preschoolers. You need an expert. There’s a national shortage of child psychologists and child psychiatrists, but it is worth the wait to see one. There is nothing less at stake than the health and welfare of the one you love most—your child.
This CNN article by Kelley King Heyworth is a thorough dialogue about the dilemma of putting toddlers on psychiatric medications.
The Centers for Disease Control reports a rise in the number of children diagnosed with ADHD.
Their report indicates a 10% rise in pediatric ADHD in the Midwest in the past 10 years. The looming question—to which no one can provide a definitive answer—is this: Does the increase mean more kids with “real” ADHD, or just more kids with the ADHD label? The difference is critical.
ADHD is considered a “mental disorder,” and as such is defined by the American Psychiatric Association (APA). It is believed to affect, according to APA’s most recent diagnostic manual, 3%-7% of school-aged children. If prevalence rates are said to be significantly higher (and they are, according to this article by the CDC), it is fair to use the term “epidemic” to describe the rise in ADHD.
ADHD symptoms can be “caused” by numerous triggers: vision problems, hearing problems, spinal misalignments, poor sleep and/or diet, underdeveloped prefrontal lobes in the brain, and structural “abnormalities” in other brain parts. Environmental triggers such as television, video games, and busy schedules can add to a child’s propensity to develop ADHD symptoms.
Are symptoms the same thing as the diagnosis? No. A psychiatric diagnosis confers that that the caues of “problems” are known. It is not simply confirming that a variety of symptoms are present. When a mental health professional diagnoses ADHD, she confirms that she KNOWS, for example, that hearing problems are not the primary cause of a child’s inattention. An ADHD diagnosis confirms that food allergies are not the primary cause of hyperactivity. An ADHD diagnosis proposes that ADHD problems do not stem from an untreated sleep disorder. The problem with the current ways in which children get diagnosed is that many (competent and well-meaning) care providers simply do not have the time, information, or other resources to properly evaluate a child for ADHD. Is it any wonder that ADHD is so easily and so often misdiagnosed and, thus, mistreated?
To get an accurate ADHD diagnosis, Plum Tree evaluates a child with a series of interviews, observations, and tests to determine if ADHD is the appropriate diagnosis. An ADHD diagnosis should only be applied after the mental health provider has:
- Spent lots of time with your child (more than 15 minutes)
- Obtained a detailed and structured history of your child’s health, behavior, and functioning from you AND others, including school professionals, babysitters, etc.
- Administered a computer test (TOVA) to measure objectively your child’s inattention and impulsivity rates
- Ruled out other mental health conditions and the possibilities of other health conditions
The American Psychological Association (APA) posted an article about helping children develop better eating and exercise habits. Below are the benefits of good nutrition and daily exercise, according to the APA.
Good nutrition is essential to healthy brain development in children which is, of course, critical to learning.
Mental and behavioral benefits
– perform better academically
– feel better about themselves, their bodies, and their abilities
– cope with stress and regulate their emotions better
– avoid feelings of low self-esteem, anxiety, and depression.
Establishing healthy eating and exercise habits early in life can lead to long term healthy behavior in adulthood.
Children need a wide variety of nutrients (e.g., protein, complex carbohydrates, healthy fats, minerals, vitamins) to assist in their daily growth and development and to protect them from childhood illnesses.
Daily exercise also helps children to build stronger muscles and bones and limit excess body fat.
Healthy eating also cuts down on risk for cavities, eating disorders and unhealthy weight control behaviors (i.e., fasting, skipping meals, eating very little food, vomiting, using diet pills, laxatives, or diuretics), malnutrition, and iron deficiency.
Healthy eating and consistent physical activity help to prevent chronic illnesses that appear in adulthood associated with obesity, e.g., heart disease, diabetes, high blood pressure, and several forms of cancer.
The relationship between a healthy diet and a healthy mind is perhaps intuitive. But scientists are discovering more every day about how what-children-eat is related to their behaviors. Particularly ADHD research shows how food allergies and sensitivities can mimic ADHD sypmptoms. Before starting any medication, Dr. Weller recommends ruling-out food-related issues. A visit to a Registered Dietician is a good first step.
Today’s parents are usually good at monitoring the content of TV and video games, ensuring that children are not exposed to violence, sexuality, and other adult themes. However, in many households, children may spend hours each day watching TV and playing video games. There is solid evidence that too much TV and video games increase the likelihood of a child developing problems with attention. A good rule of thumb for TV/video game usage is less than 2 hours daily, the less the better.
Limiting time spent with TV and video games is especially important for very young children. According to Dimitri Christakis, MD, MPH, Director of the Child Health Institute and author of The Elephant in the Living Room: Make Television Work For Your Kids, children as young as a few months old are watching too much TV, and may be developing permanent attention problems. In an article on education.com, author Rose Garrett writes, “For every hour of television toddlers watch a day, they are ten percent more likely to develop attention problems at school,” according to Dr. Christakis.
What’s more, according to a recent study about children who watched who watched more than 2 hours of TV per week 40% more likely to have symptoms of ADHD in adolescence than children who watched less TV. The problem is the speed of the frames. Fast-paced electronic media seem to train children’s brains to attend only to faced-paced stimulation (e.g., the opposite of a teacher at a whiteboard). Click for video game and TV time recommendations.
I like this MSN Health article by Rich Maloof: It nicely summarizes medical research and recommendations about TV & ADHD.