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Your Teen

Headlines: Another Teen Suicide

On September 6, 2007, the Centers for Disease and Prevention reported suicide rates in American adolescents (especially girls, 10 to 24 years old) increased 8%, the largest increase in 15 years.The sad and desperate story of a college student who killed himself after a roommate secretly videotaped him having sex, and streamed it live on the web has made headlines across the world.

18 year old, Tyler Clementi, was embarrassed and humiliated by the invasion of his privacy. He jumped to his death from the George Washington Bridge. Unfortunately, Tyler is not the only teen who thinks suicide is the only way to end his suffering. On September 6, 2007, the Centers for Disease and Prevention reported suicide rates in American adolescents (especially girls, 10 to 24 years old) increased 8%, the largest increase in 15 years. Amazingly, suicide is the third leading cause of death for 15-to-24-year-olds, and the sixth leading cause of death for 5-to-14-year-olds. The current headlines demonstrate that it is more important than ever that parents are aware of the symptoms of depression and substance abuse.  Suicides increase substantially when the two are combined. What symptoms should I look for? - Change in eating and sleeping habits - Withdrawal from friends, family, and regular activities. - Violent, rebellious behavior, or running away - Drug and alcohol use. - Unusual neglect of personal appearance - Marked personality change - Persistent boredom, difficulty concentrating, or a decline in the quality of     schoolwork - Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc. - Loss of interest in pleasurable activities. - Not tolerating praise or rewards. A teenager who is planning to commit suicide may also: - Complain of being a bad person or feeling rotten inside. - Give verbal hints with statements such as: “I won't be a problem for you much longer,”    “ Nothing matters,” “It's no use, and I won't see you again.” - Put his or her affairs in order, for example, give away favorite possessions, clean his or her room, throw away important belongings, etc. - Become suddenly cheerful after a period of depression - Have signs of psychosis (hallucinations or bizarre thoughts.) What should you do if you notice these symptoms in your child? If a child or adolescent says, "I want to kill myself," or "I'm going to commit suicide,"  always take the statement seriously and immediately seek assistance from a qualified mental health professional. People often feel uncomfortable talking about death. However, asking the child or adolescent whether he or she is depressed or thinking about suicide can be helpful. Rather than putting thoughts in the child's head, such a question will provide assurance that somebody cares and will give the young person the chance to talk about problems. If one or more of these signs occurs, parents need to talk to their child about their concerns and seek professional help from a physician or a qualified mental health professional. With support from family and appropriate treatment, children and teenagers who are suicidal can heal and return to a healthier mental outlook.

Your Child

Kid’s Allergies Linked to Depression and Anxiety


According to the Asthma and Allergy Foundation of America, 40 percent of U.S. children suffer from allergies. It is the third most common chronic disease in kids under the age of 18.

A new study suggests that children who have allergies at an early age are more likely to have problems with anxiety and depression than those that do not.

One reason may be that children with allergies tend to keep their troubles to themselves or  “internalize” them.

“I think the surprising finding for us was that allergic rhinitis has the strongest association with abnormal anxiety/depression/internalizing scores compared to other allergic diseases,” said lead author Dr. Maya K. Nanda of the division of Asthma, Allergy, and Immunology, at Children’s Mercy Hospital in Kansas City, Missouri.

Rhinitis is more commonly called “hay fever” and includes symptoms such as a runny nose, sneezing, and itchy or watery eyes.

The researchers studied 546 children who had skin tests and exams at age one, two, three, four and seven and whose parents completed behavioral assessments at age seven. They looked for signs of sneezing and itchy eyes, wheezing or skin inflammation related to allergies.

Parents answered 160 questions about their child’s behaviors and emotions, including how often they seemed worried, nervous, fearful, or sad.

Researchers found that the four-year–old children with hay fever symptoms or persistent wheezing tended to have higher depressive or anxiety scores than others at age seven.

The more allergies a child had, the higher the anxiety and depression scores.

“This study can't prove causation. It only describes a significant association between these disorders, however we have hypotheses on why these diseases are associated,” Nanda told Reuters Health by email.

Another reason for the association may be that children with allergic diseases may be at increased risk for abnormal internalizing scores due to an underlying biological mechanism, or because they modify their behavior in response to the allergies, she said.

Other studies support the idea that that a biologic mechanism involving allergy antibodies trigger production of other substances that affect the parts of the brain that control emotions.

In a 2005 study, Teodor T. Postolache, MD, associate professor of psychiatry and director of the mood and anxiety program at the University of Maryland School of Medicine in Baltimore found that peaks of tree pollen increased with levels of suicide in women.

Postolache says allergic rhinitis is known to cause specialized cells in the nose to release cytokines, a kind of inflammatory protein. Animal and human studies alike suggest that cytokines can affect brain function, triggering sadness, malaise, poor concentration, and increased sleepiness.

The new study took race, gender and other factors into account, “so the strong association between allergic disease and internalizing disorder we found is definitely present,” Nanda said.

The severity of mental health symptoms varied in this study. Some children had anxiety and depression that needs treatment, while others were at risk and required monitoring, she said.

“We think this study calls for better screening by pediatricians, allergists, and parents of children with allergic disease,” Nanda said. “Too often in my clinic I see allergic children with clinical anxiety (or) depressive symptoms; however, they are receiving no care for these conditions.”

“We don't know how treatment for allergic diseases may effect or change the risk for internalizing disorders and we hope to study this in the future,” Nanda said.

Experts hope that if parents know that allergies may contribute to their child’s mood or behavior, they will be more likely to keep a closer eye on their child for signs of depression or anxiety and seek treatment if necessary.

The study was presented in The Journal of Pediatrics.

Sources: Kathryn Doyle,

David Freeman,


Your Teen

4 in 10 College Students Depressed

A new poll shows that pressure about grades, student loans, relationships and school work is taking a toll on American college students. The Associated Press-mtvU poll shows more than 42 percent of those surveyed at 40 colleges said they had felt down, depressed or hopeless several days during the past two weeks, and 13 percent showed signs of being at risk for at least mild depression, based on the students' answers to a series of questions that medical practitioners use to diagnose depressive illness.

Eighty five percent of those surveyed reported feeling stressed in their daily lives in recent months. The poll looked at over 2,000 undergraduate students ages 18-24 at four-year colleges. It was conducted April 22 to May 4 by Edison Media Research. To protect privacy, the schools where the poll was conducted are not being identified, the students who responded were not asked for their names. The poll has a margin of sampling error of plus or minus 3 percentage points. The TV network mtvU is operated by the MTV Networks division of Viacom and available at many colleges. MtvU's sponsorship of the poll is related to its mental-health campaign "Half of Us," which it runs with the Jed Foundation, a nonprofit group that works to reduce suicide among young people. Many of those coping with feeling depressed complained of trouble sleeping, having little energy or feeling down or hopeless - and most hadn't gotten professional help. Eleven percent had had thoughts that they'd be better off dead or about hurting themselves. Mental health disorders like depression typically begin relatively early in life, doctors say, and college is a natural time for symptoms to emerge. The AP-mtvU poll explored the students' state of mind and the pressures they face, including strains from the tough economy. Among the poll results:

  • Nine percent of students were at risk of moderate to severe depression. That's in line with a recent medical study that found 7 percent of young people had depression.
  • Almost a quarter of those with a parent who had lost a job during the school year showed signs of at least mild depression, more than twice the percentage of those who hadn't had a parent lose a job. More than twice as many students whose parents had lost a job said they had seriously considered ending their own life, 13 percent to 5 percent.
  • Among those who reported serious symptoms of moderate depression or worse, just over a quarter had ever been diagnosed with a mental health condition.
  • More than half of those who reported having seriously considered suicide at some point in the previous year had not received any treatment or counseling.
  • Just a third of those with moderate symptoms of depression or worse had received any support or treatment from a counselor or mental health professional since starting college.
  • Nearly half of those diagnosed with at least moderate symptoms weren't familiar with counseling resources on campus.

Anne Marie Albano, an associate professor of clinical psychology at Columbia University, said college is a "tender age" developmentally, a period when young adults start taking responsibility for their lives. They're selecting careers, moving toward financial independence, establishing long-term relationships, perhaps marrying, and having children. The most troubling thing coming out of the AP-mtvU poll and other studies of young adults dealing with depression, she said, is that "they don't get help" at a time when they're just venturing off on their own. "They have to learn to become their own monitors about their mental health and yet they have no training to do that," she said. The poll also found that 84 percent of students said they'd know where to turn for help if they were in serious emotional distress or thinking about hurting themselves. Most said they'd go first to friends or family. Twenty percent said they'd try school counseling. Dr. Thomas Insel, director of the National Institute for Mental Health, said students need to understand that depression is "a very treatable illness." Campus counseling centers are a good resource, he said, although they're not all set up take care of serious mental illnesses. "There should be somebody there who could at least assess this, and in some cases offer reassurance that 'I'm sure you'll feel better after exams are over,'" he said. Serious cases can be referred for treatment, he said - "and treatment works."

Your Teen

Experts Recommend Screening All Teens for Major Depression


Studies indicate that one-in-five U.S. children have some for of mental, behavioral or emotional problems.  Among teens, one –in- eight may suffer from depression with only about 30 percent receiving any treatment.  Those are troubling statistics for parents, caregivers and health professionals.

The U.S. Preventive Services Task Force (USPSTF), believes more needs to be done to help these children and has recommended that primary care physicians screen all patients between the ages of 12 and 18 for major depression.

Screening tools are available to help primary care doctors accurately identify major depression in adolescent patients, and there are effective treatments for this age group, the task force said.

"Primary care clinicians can play an important role in helping to identify adolescents with major depressive disorder and getting them the care they need. Accordingly, the task force recommends that primary care clinicians screen all adolescents between 12 and 18 years old for this condition," task force member Dr. Alex Krist said in a USPSTF news release.

Currently, there isn’t enough evidence to know whether screening children 11 and younger would be beneficial. The task force noted that more research on depression screening and treatment in this age group is needed.

The consequences of undiagnosed and treated major depression in teens can have serious consequences such as involvement in the criminal justice system, drug or alcohol abuse and in some cases, suicide.

"It is important to take any concern about depression seriously, regardless of age, and any parent who has a concern about their child's mood or behavior should talk with their child's primary care clinician," he said in the news release. Kemper is a professor of pediatrics at Duke University School of Medicine, in Durham, N.C.

The recommendation was published online Feb. 9 in the Annals of Internal Medicine and Pediatrics.

For more information about child and teen depression, one resource is The American Academy of Child and Adolescent Psychiatry at

You can also talk with your family doctor or pediatrician if you feel your child is suffering from depression. They should have resources for you as well.

Source: Robert Preidt,



Daily Dose

Feeling the Holiday Stress

1:15 to read

I can feel the excitement of the holidays in the air. Stress is probably one of the worst things for our health, but we often don't realize how much it affects us. Stress also affects people of all ages so young children may experience stress as well as adults, and everyone in between. Stress may manifest itself in so many ways you can't even count them but in pediatrics the most common things seem to be headaches, tummy aches, difficulty concentrating and sleeping too.

I thought all kids could fall asleep at night, but the longer I practice the more I realize that kids have problems falling asleep, just like adults. They worry about what went on in their day or what they have to do tomorrow just like we parents do. It could be a test they have to take, or a friend they are concerned about, or the things they overheard their parent's discussing that day. Those little ears are listening all of the time. How can they hear whispers behind closed doors when they can't hear "take out the trash"?

Besides trouble sleeping, children will often complain about non-specific headaches and tummy aches. They are always there during the day, but never awaken them at night (at least once they fall asleep).

The other interesting thing is that these tummy aches and headaches will get better over holidays and the summer without doing anything. Why is that? The stress of schedules and school is gone and miraculously those aches and pains vanish too. So during the next week before the holidays and the end of school and the myriad of events that will happen, try to lessen the family stress and enjoy the season. It's always easier said than done. That's your daily dose, we'll chat again tomorrow.

Your Teen

Kid's Poor Sleep Habits and Depression

1.50 to read

A 2010 study of 392 boys and girls published online in the Journal of Psychiatric Research found that those who had trouble sleeping at 12 to 14 years old were more than two times as likely to have suicidal thoughts at ages 15 to 17 as those who didn't have sleep problems at the younger age.Scientists are discovering that children with chronic sleep problems are at increased risk for developing a mental illness later in life.

Recent studies show that children who have persistent sleep problems, such as difficulty falling asleep or staying asleep, or not getting enough night-time shut-eye, are more likely later to suffer from depression and anxiety disorders and to abuse alcohol and drugs than kids without sleep problems. The findings add to previous research that has linked children's sleep problems to a host of issues, including aggressive behavior, learning and memory problems and obesity. A 2010 study of 392 boys and girls published online in the Journal of Psychiatric Research found that those who had trouble sleeping at 12 to 14 years old were more than two times as likely to have suicidal thoughts at ages 15 to 17 as those who didn't have sleep problems at the younger age. In a study published last year in Alcoholism: Clinical and Experimental Research, involving 386 participants, children whose mothers reported that they were overtired when 3 to 8 years old were 2.8 times as likely to binge drink when they were 18 to 20 years old. And a study of 1,037 children revealed that 46% of those who were considered to have a persistent sleep difficulty at age 9 had an anxiety disorder at age 21 or 26. By comparison, of the children who didn't have sleep problems at age 9, 33% had an anxiety disorder as young adults, according to the research, which was published in 2005 in the Journal of Abnormal Child Psychology. Scientists caution that some study-sample sizes are small and research is still in its early stages. Psychiatrists and psychologists say they hope that by addressing sleep problems in childhood, some of the instances of later mental illness can be prevented. Clinicians also have developed effective treatments for poor sleep and are experimenting with some new approaches that teach kids how to reduce the frequency and strength of anxious thoughts that can crop up at night. In general, doctors do not recommend using medication to help kids sleep. "We think that healthy, optimal sleep may be a buffer against developing anxiety and depression in kids," says Ronald E. Dahl, a professor at the University of California, Berkeley and a leading researcher on pediatric sleep. Anxiety disorders and depression are the most common mental illnesses: 28.8% of the general population will have an anxiety disorder in their lifetime and 20.8% will have a mood disorder, according to a 2005 study published in the Archives of General Psychiatry. Anxiety disorders emerge early in life: The median age of onset is 11, according to the study. Rates of depression spike in adolescence, too. And those who develop depression young tend to have a more serious disease, with a higher risk of relapse. Scientists aren't certain as to why poor sleep in childhood increases the risk of anxiety disorders and depression. It could be that sleep problems lead to changes in the brain, which, in turn, contribute to the psychiatric illnesses, they say. Or some underlying issue, partly explained by genetics and early childhood experiences, could be a precursor to both poor sleep and the mental disorders. Researchers say that before puberty—between the ages of about 9 and 13—is a key time to tackle poor sleep. That's before the spike in rates of depression and the upheavals of adolescence and while the brain is still very responsive. "The brains of children are far more plastic and amenable to change," says Candice Alfano, assistant professor of psychology and pediatrics at Children's National Medical Center in Washington, D.C. Sleep changes dramatically after puberty: Circadian rhythms shift so kids naturally stay up later. With schools starting early, kids often don't get enough sleep. Academic and social pressures surge, too. A small study suggested healthy sleep may be able to help protect kids from depression—even those at high-risk because of genetics. (Both anxiety disorders and depression are believed to be partly inherited.) The study, published in 2007 in the journal Development and Psychopathology, found that children who fell asleep quicker and spent more time in the deepest stage of sleep were less likely to develop depression as young adults. A larger body of research shows that improving sleep in kids and adults who already have mental-health problems also leads to a stronger recovery. A Good Night Most parents underestimate the amount of sleep children should get a day. They need: Infants: 14 to 15 hours Toddlers: 12 to 14 hours Preschoolers: 11 to 13 hours School-age kids: 10 to 11 hours Teenagers: 9 to 10 hours Strategies to encourage healthy sleep in kids Set a regular bedtime and wake time, even on weekends. Make the bedroom a dark and quiet oasis for sleep. No homework in bed. Create a calming bedtime routine. For younger kids: a bath and story. For older kids: Reading or listening to mellow music. Limit caffeine consumption, especially after 4 p.m. Ban technology (TV, Web surfing, texting) in the half hour before bed. The activities are stimulating. The light from a computer can interfere with the production of the sleep-promoting hormone, melatonin. Don't send kids to bed as punishment or allow them to stay up late as a reward for good behavior. This delivers a negative message about sleep. Help kids review happy moments from the day. Have them imagine a TV with a 'savoring channel.' Relegate anxious thoughts to 'a worry channel.'

Daily Dose

Post Partum Depression

1:30 to read

If you watch Nashville (which I love), you know that the character Juliet Barnes is dealing with post partum depression. Unfortunately, so is Hayden Panettiere who plays Juliet. Fortunately, she recognized her problems and is seeking professional help in a treatment center.  Post partum depression occurs in up to 10-20% of new mothers and the signs and symptoms may occur from days to months after your baby is born, but unfortunately in up to 50% of cases the symptoms may go unrecognized.  

It is not unusual for a new mother to experience post partum “baby blues” which may cause many differing symptoms including anxiety, sadness, mood swings, crying, difficulty sleeping and a feeling of being overwhelmed. In fact, what new parent doesn’t feel overwhelmed at times (maybe throughout parenting).  But these “baby blues” usually only last a few days to a few weeks and then improve.

At first, post partum depression may mimic “baby blues”, but the signs and symptoms are usually more severe and last longer.  Post partum depression causes not only depression and mood swings, but excessive crying, difficulty bonding with the baby, withdrawal from family and friends, irritability, anger, difficulty concentrating, feelings of inadequacy and severe anxiety and panic attacks. It effects different people in different ways, but in many cases it interferes with a mother’s ability to care for her baby of to even handle daily tasks. In some severe cases it causes suicidal thoughts, or even thoughts of harming the baby.

While it remains unclear as to the cause of post partum depression it seems there are probably multiple factors at work including a drop in hormones (both estrogen and progesterone) after delivery as well as emotional issues (lack of sleep, appetite, anxiety, body image concerns)…and all of these probably play a role. People who have had a past history of depression also seem to be at more risk.

I have had patients with fairly severe post partum depression, and several have required hospitalization.  The most important thing is to recognize the symptoms and to ask for help!! It is not a sign of being an “inadequate or bad mother”, but rather an illness that requires treatment and should never be ignored. It requires not only medical support, but family and friends support.

I am currently seeing a new mother who is dealing with a post partum depression.  She knows the symptoms and had hoped that they would not re-occur after the birth of her second child. She knew that she had “a higher risk” of developing post part depression as she had it after the birth of her first baby ….but she had hoped and prayed that it would not strike twice. As “smart” as she is intellectually, it has still been emotionally difficult for her to give the baby a bottle at night so that she may get more sleep, and to let others help her with her two year she feels “guilty” that she is not available all of the time. She relies on a lot of support from her husband and other family members and is “trying to listen” to her doctors, and she has started medication and is seeing a therapist.  In other words she is being proactive and doing everything she can! Kudos to her. 

If you or any of your friends has symptoms of post partum depression don’t ignore it or “fake it” that you are okay…left untreated the consequences could be serious. GET HELP….it is so important for both you and your child.    

Your Teen

Panel: All Teens Should be Tested for Depression

One of the top government-appointed medical panels is urging doctors to routinely screen all U.S. teenagers for depression. It's a bold stop that acknowledges that nearly 2 million teens are affected by depression. The panel from the U.S. Preventive Services Task Force, which sets guidelines for doctors on a host of health issues, said most are undiagnosed and untreated.

The task is an independent panel of experts convened by the federal government to establish guidelines for treatment in primary-care. The recommendations are published in the April 2009 issue of Pediatrics. They go farther than the current recommendations by the American Academy of Pediatrics for teen depression screening. An estimated 6 percent of American teenagers are clinically depressed. Evidence shows that detailed but simple questionnaires can accurately diagnose depression in primary-care settings such as a pediatrician's office. Because depression is so common, "you will miss a lot if you only screen high-risk groups," said Dr. Ned Calonge, task force chairman and chief medical officer for Colorado's Department of Public Health and Environment. The task force said that when followed by treatment, including psychotherapy, screening can help improve symptoms and help kids cope. Because depression can lead to persistent sadness, social isolation, school problems and even suicide, screening to treat it early is crucial, the panel said. The group recommends research-tested screening tests even for kids without symptoms. It cited two questionnaires that focus on depression tip-offs, such as mood, anxiety, appetite and substance abuse. A separate report, released on the same day in Pediatrics says primary care doctors, including pediatricians and family physicians need to get more involved in mental health care. That report is from the AAP and the American Academy of Child and Adolescent Psychiatry. The group says pediatricians should routinely consult with psychiatrists, including working in the same office when possible. And it says insurers should compensate pediatricians for any mental health services they provide.

Your Teen

Too Much TV Can Make Teens Depressed

A new study reports that greater exposure to TV during the teenage years appears to raise the risk of depression in young adulthood, especially among boys.Parents now have a legitimate reason to be concerned that their teen may be watching too much television. A new study reports that greater exposure to TV during the teenage years appears to raise the risk of depression in young adulthood, especially among boys.

The report appears in the Archives of General Psychiatry. Dr. Brian A. Primack at the University of Pittsburgh School of Medicine and his colleagues studied the media habits over 4-thousand healthy, non-depressed teens. Researchers asked them how many hours they spent during the week watching TV or videos, playing computer games or listening to the radio. The report shows the teens had an average of 5.68 hours of media exposure each day, including 2.3 hours of TV viewing per day. Seven years later, at the average age of 21.8 years old, the study subjects were screened. 308 (7.4 percent) of the subjects had developed symptoms of depression. The report also showed the teens had a statistically significant greater likelihood of developing depression in young adulthood. Young women were given the same amount of media exposure, but the report showed they were less likely to develop symptoms of depression than young men.


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Struggling with feeding your kids healthy (er) meals. Rule of thumb: don't stress over it!


Struggling with feeding your kids healthy (er) meals. Rule of thumb: don't stress over it!

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