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Recovery

Why Is Anxiety So Prevalent In Kids?

By Anxiety, Depression, Ketamine, Mental Illness, OCD, Panic Attacks, Psychotherapy, RecoveryNo Comments

This picture shows anxiety

Session Reflections

 

Why has anxiety become such an integral word in our kids’ vocabulary?

 

            More and more in my office, I am seeing tweens, teens and young adults who describe themselves as anxious.  I have children as young as 10 years old ask their parents to bring them in for their “anxiety”.  College students are requesting face time sessions for anxiety at a concerning rate.  When did our kids become so overwhelmed and stressed that they are using a clinical term for their feelings?

 

            We can definitely thank social media for part of the increased stress and anxiety our kids experience.  It is one thing to be “left out” or not thought of by peers, but when they see it in pictures on Instagram or snapchat, it takes the disappointment to a whole new level.  And the dreaded “group chat” can be another great source of anxiety; are they included and/or are their texts responded to. These social medias issues span from elementary school through college and beyond.

 

            Stress about grades seems to be at an increasingly high level as well.  I see kids in 5th and 6th grade express worry about “what college they will get into”.  The SAT/ACT were not tests designed to be studied for.  Yet, kids are tutored and drilled and pre-tested and pressured to raise their scores.  How about letting our kids get into a school that fits their aptitude and where they can succeed and flourish?  Once in college, I see kids scrambling, cramming, and having great difficulty balancing social life and academics. 

 

            With young adults, I see increasing anxiety about being undecided about a career choice at the outset of their college journeys.  Isn’t it ok and even organic to be unsure of what you want to do with your life when you are 18 years old? 

           

What can we do to help our kids with their anxiety?  Encourage a break from social media.  When I ask teens and young adults to do an “experiment” and shut down Instagram for a day or two, they invariably feel better emotionally. Helping our kids, teens, and young adults with time management when it comes to balancing schoolwork and social outlets, sports, etc. is also a great anxiety reducer.  Encourage them to make lists, use white boards, and calendars; putting to do items into a structured format reduces anxiety and increases a sense of control.  Also, discourage “what if” thinking, which is at the core of much anxiety; help them steer away from this kind of thinking.  Try asking them, “what if……I am fine”. 

 

            When is it time to seek the help of a mental health professional for anxiety?  These are some signs to look for:

            -Isolation

       -Insomnia

            -Increased irritability

            -Restlessness or being keyed up

            -Difficulty relaxing

-Frequent verbalizations about worry

-Grades dropping

-Use of alcohol or weed to self-medicate

 

Stacey Cohen-Meissner, Ph.D.

Synthetic Drugs – Beware…

By Addiction, Mental Illness, RecoveryNo Comments

K2 – “Spice”

K2, Spice, Bath Salts

 Parents and Doctors Beware and Be Prepared!

Over the past several years, there has been increased concern about kids using “synthetic” drugs – substances that are developed in a laboratory and intended to mimic more “familiar” drugs such as marijuana and amphetamines.  Two factors make these compounds particularly frightening: 1) They are packaged as “legal” substances in order to avoid DEA scrutiny, and 2) They are quite difficult to test for using routine drug screens.  

A synthetic form of marijuana known as “K2” or “Spice” which is usually marketed legally as plant food or incense and is obtainable at head shops, gas stations and via the internet, has been a matter of serious concern in recent years.   Emergency rooms nationwide have reported an increase in the number of kids presenting with an array of bizarre symptoms and negative drug screens.  Symptoms usually consist of agitation, hallucinations, panic-like reactions, suicidal ideation, seizures and strange behavior.   Now technically illegal in The United States (http://www.deadiversion.usdoj.gov/fed_regs/rules/2011/fr0301.htm), these compounds are still relatively easy to get a hold of, especially via the internet.  Certain labs can test for the presence of these synthetic cannabinoids, but routine testing will not detect them.  Brand names of these compounds include: Spice, K2, Chill Zone, Sensation, Chaos, Aztec Thunder, Red Merkury, and Zen.

“Bath Salts” are another example of synthetic substances that mimic more familiar drugs of abuse.  The compounds, which are marketed as bath products, mimic amphetamines, which are powerful stimulants.  As with synthetic marijuana, “Bath Salts” are very hard to detect with routine drug testing, and increasing numbers of cases of kids in emergency rooms are popping up.  Kids high on these drugs often have increased blood pressure, rapid heart-beat and even hallucinations and other psychotic symptoms.  Street names for these compounds include: drone, bubbles, meow-meow, MCAT, Ivory Wave, Vanilla Sky, Cloud 9, Red Dove, and White Rush.

It is important for clinicians and parents to be both aware of and educated about these new types of substances that are becoming widely abused by kids.  The DEA is beginning to crack down on these dangerous products, but as one substance becomes illegal, another one is likely to take it’s place.

Scott Bienenfeld, M.D.

Alpine Psych Solutions

 

Video Game Addiction: Is It Real?

By Addiction, Anxiety, Co-Occurring, Gaming, Mental Illness, RecoveryOne Comment

This photo demonstrates how video games are addictiveVideo game addiction

http://www.cnet.com/news/south-korean-government-to-debate-game-addiction-law/

Is it real? Can people actually be addicted to video games? Where does the idea of being “addicted” end, and is it ever used just as an excuse for any bad behavior?  Internationally, “I have a disease” seems to have become a modern day way to relieve people of responsibility. Could the US see a similar problem?

Regarding video games, addictive mechanisms are certainly in play, and technically people can be addicted to anything. Current research focuses on the reward system in the brain. The cultural aspects of it are less clear. We have seen trends in the culture where proclaiming oneself an addict is in fashion, the card to be pulled when someone asks for accountability. The treatment plan for a video game addict may in fact be more than the “off switch” and there have been special programs to treat this behavior. The truth is, though we don’t like to admit it, these addictive behaviors are a “spectrum” phenomenon that range from mild to severe. We all have tendencies, the question is whether or not there is functional impairment, that impacts our lives to the point where we need to do something about it. The policy in South Korea seems extreme. Recovery Spot NY treats a wide swath of addictive behaviors as well as addiction to substances. Often times there are psychiatric underpinnings of these behaviors. Our program, with it’s strong emphasis on psychiatric issues, can help. #video game addiction.

https://www.cnet.com/news/south-korean-government-to-debate-game-addiction-law/

A Final Common Pathway of Addiction:

By Addiction, Alcohol, Alcoholism, Heroin, Mental Illness, Recovery, UncategorizedNo Comments

            Recently, at a clinical conference on addiction, I overheard an intern ask a straightforward question about why a person recovering from a severe cocaine addiction should not consume alcohol, a drug they never really had a problem with.  As it turns out, this is a common question asked by both clients as well as their spouses, families and friends (who often want to be able to drink socially with them).  Seasoned clinicians, long-standing AA members and others who have successfully managed their addictions all seem to understand that a person battling a substance use disorder will be at a serious risk of relapse or “cross-addiction” if they start drinking or using another drug.  The question as to why this is the case is of great interest medically and, as it turns out, has major implications not only for promoting abstinence among those with addictive disorders, but also for one day developing medical treatments that can directly target brain areas that are directly involved in both addiction and recovery. 

            Over the past twenty years, advances in brain imaging and neuroscience have greatly enhanced our understanding of several aspects of addiction.  For a really good and technical overview read the article:  (Nestler EJ. Is there a common molecular pathway for addiction? Nature Neuroscience. 8(11):1445-9, Nov 2005).  One of the most interesting findings has been that when drugs of abuse are absorbed by the brain, certain important areas become activated in a predictable manner.  This is only true for drugs that can be abused and/or cause addiction, and not true for drugs or other substances that cannot.  The areas that “light up” on MRI scans during ingestion of drugs of abuse are located deep in the brain in an area called the ‘mid-brain’ (see fig. 1) which is considered to be responsible for feelings of reward, pleasure, euphoria, compulsion, salience, and  perseveration.  Although different drugs of abuse cause a variety of feelings when ingested (e.g., cocaine, alcohol, marijuana and heroin have very different effects emotionally and physiologically), they all have a very similar effect on these sensitive yet powerful mid-brain areas.  These areas activate very quickly and, frequently unbeknownst to the person.  In fact, it has been clearly demonstrated that these important brain areas become activated even before the addicted individual actually ingests an addictive substance!  So, when an alcoholic walks into a bar, or sees a beer commercial on television, it is quite likely that her mid-brain is firing and activating – a situation that probably accounts for what is known as “cue-induced relapse”.  

            There are three major reasons why this is important.  First, if highly sensitive mid-brain areas can be activated by thoughts, sights, smells, etc…it is a very good reason why those with addiction need to avoid people, places and things associated with drug use.  Second, as it turns out, the mid-brain communicates directly with the frontal part of the brain, the area responsible for decision making, weighing risk vs. reward, and managing impulsivity.   In those suffering from addiction, the frontal brain areas (which by comparison activate slowly), seem to be overwhelmed by the impaired mid-brain areas which continuously fire and dominate the person’s actions and behaviors.  Finally, since all drugs of abuse have a common effect upon sensitive mid-brain areas that are associated with feelings of reward, pleasure, euphoria, compulsion, salience, and perseveration, then it stands to reason that a person who suffers from an addiction to one substance should avoid ALL substances that could cause addiction!

Addiction Center of Brain

Figure 1.

VTA (Ventral Tegmental Area), part of the mid-brain and Nucleus Accumbens, part of the limbic system connect and communicate with the Frontal Cortex.

 

Scott Bienenfeld, M.D. – Alpine Psych Solutions