Counselor ToolBox News Live

Your audio is already live. Looks like it connected up fine. Hey there, everybody, and welcome to Counselor Toolbox News. I AM your host, Dr. Donnellice Snipes. It is Children's Mental Health Week in the UK and any week is a good time to focus on children's mental health in the US So guess what we're talking about today? The first study we're going to start talking about is the fact or a study that found that depression impacts up to 10% of children and adolescents each year and is associated with a significantly increased risk in suicide. Neither one of those things is good, but 10%, that's 1 in 10. Look around any classroom, look around any. Anytime your friend kids have friends come over, you know, there's probably five, but if 10 come over, one of them is probably going to experience a depressive episode sometime in that year. That, that's, you know, kind of shocking and kind of sad. However, we don't want to get too caught up in. Does it meet the criteria of clinical depression? The research has found that regardless of the exact diagnosis, whether it's major depressive disorder or persistent depressive disorder or disruptive behavior disorder, there's a lot of different labels we can put on it, but it doesn't really matter. We really want to look at the symptoms. And it's important for us as parents, clinicians and teachers to be alert to the symptoms of depression in children, which aren't always the. The same as the symptoms of depression in adults. They have some overlap, of course, but children tend to present a little bit differently. Remember that depression in children can be caused by a variety of things. It's not necessarily cognitive, it's not necessarily their thinking. It can be caused by organic issues. You know, they were born and, and have a certain organic problem, if you will, in the functioning of some of their neurotransmitter systems. That's possible. We do see some genetic components to mood disorders. Exposure to trauma also contributes to the development of depression. Diabetes and thyroid dysfunction both also contribute to the development of depression. And sleep deprivation is another one. We don't think about a lot, and a lot of kids, actually, most children and adolescents don't get enough sleep, and that can contribute greatly to their mood issues. Additionally, especially in adolescence is a time of huge hormone fluctuations. Those can contribute to depressive symptoms. What we really want to look at in those depressive symptoms is how long they last and how intense they are. People, adults and children, are going to have days occasionally when they're just, they're feeling kind of rotten for some reason, and that's not necessarily what we're talking about here. What we're talking about is depressive symptoms that persist for two weeks or, you know, at least a week and are causing significant impairment in the child's quality of life or ability to function. So what? Some symptoms that we want to look for in children more so than we do in adults. I mean, look for them in adults too. But children generally present as more irritable and angry. They may withdraw socially. They may have increased sensitivity to rejection, especially well children and especially adolescents. They may have a lot of vocal outbursts or crying, difficulty concentrating, physical complaints like stomach aches and headaches, and reduced ability to just function. In general, they are slowed down quite a bit and impaired thinking or concentration, which makes school even more difficult. If children start displaying these symptoms, it's important to get them screened for depression and other issues. If it is hypothyroid or hyperthyroid, that's something that can be treated with medication and that may resolve those symptoms. If it is diabetes or prediabetes, that early intervention is really important to prevent the development of actual major depressive disorder later on. So we want to really look at becoming more aware of the symptoms of depression in children. Insulin resistance. You know, I just mentioned diabetes. Insulin resistance is also associated with depression, regardless of adiposity, which basically means regardless of people's fat percentage. Insulin resistance is associated with the development of depression and is on the rise in children and adolescents. We've heard over the past five years a lot about insulin resistance, so I think you're probably somewhat familiar with it. But it is important to continually be cognizant of that. It could be a early warning sign of the development of diabetes and or the development of depression. This underscores the importance of screening for insulin resistance in all patients, not just those who are overweight. You don't have to be overweight. I know I've said that like three times now, but I want to drive home that message that you don't have to be overweight to have insulin resistance. This, this study actually also corresponds to other studies that have highlighted that the high comorbidity or co occurrence between diabetes and mood disorders. Insulin sensitivity and regulation problems are key features in diabetes, but they're also seen and quite strongly associated with depression. Depression and diabetes have two other physical similarities. So there's a lot of overlap here. Hyperaction, sorry, hyperactivation of the HPA axis. And if you've watched my other videos, then you're familiar with the HPA axis, that's our threat response system. So people who have depression or diabetes tend to have an overtaxed stress response system and increased levels of pro inflammatory substances, which means in our body we have these substances circulating through that increase inflammation. And those substances have been independently correlated with both depression and diabetes. Sometimes it's hard to differentiate without having a medical evaluation whether the person is presenting with symptoms of a mood disorder or symptoms of diabetes. We need to make sure we rule this out. Screen for it. Risk factors for the development of diabetes include obesity, lack of physical activity, having first or second degree relatives with diabetes, hypertension, high cholesterol or polycystic ovarian syndrome. Now, you're probably not going to see polycystic ovarian syndrome in adolescents, but if you see adolescents or children and they report having hypertension or high cholesterol or any of these other risk factors, we really want to consider sending them for a screening for diabetes just to make sure that it's not there. Especially if they have any of the following risk factors, which include excessive fatigue. Now if they're experiencing clinical depression, they may have that excessive fatigue. But if you add that in addition to sudden increases in hunger, thirst or urination, slow healing of wounds and or darkened skin, especially around areas that rub, like the folds of where your arm bends or your neck or the armpits, those are places that if the person reports that they're having darkening of the skin, that could indicate signs of diabetes, which may be only mildly symptomatic. Millions of people go through a lot of their life having diabetes or pre diabetes and aren't getting diagnosed early enough. It's getting missed. And the earlier we intervene, the better our chances are for preventing depression, as well as any of the other associated complications that go along with diabetes. Another study looked at siblings of children who have a developmental disability. We've talked a lot about autism and I'm going to do an episode specifically on autism. But in general, siblings of children who have a developmental disability have higher odds of developing depression or other mental health issues. And there are a lot of reasons for that, and they're not exactly sure which ones are the most critical, but they found that there are complex, complex interactions which contribute to the development of depression, including the characteristics of the child with a developmental disability. Is this child largely independent or is this child requiring a whole lot of mom and dad's attention? So the siblings feel jealous, feel rejected, feel ignored, whatever. Is this child's developmental disability causing other changes in the structure of the family or how things operate. And there are a lot of other characteristics, but those are two of the big ones. It also depends on the characteristics of the children who are siblings of the child with a developmental disability. Some children are extremely resilient and not may not need as much attention and reinforcement and reinsurance from the parents as other children. And children who typically are high needs children or who have issues with emotional dysregulation may not thrive as well if parental attention is focused on significantly on the child with a developmental disability, trying to keep him or her safe, etc. And characteristics of the family also impact whether siblings are negatively impacted by having a brother or sister with a developmental disability. If there is family support and good communication skills and lots of consistency, then that typically mitigates some of the negative impact of having a special needs sibling. What we can do we can educate families about the impact of having a child with a physical or mental developmental disorder and the impact of that disorder on siblings. And we can educate families about effective skills to prevent the siblings that don't have developmental disabilities from developing a mental health disorder. This can include other things we can do Regularly inquire with the caregivers about the presence of any behavioral changes in the non developmentally delayed siblings. In children who have mental health issues that come into your office, it's wise to inquire about the status of siblings. Do you have brothers and sisters? And if there are any developmental disorders that may be contributing to the family stress and the presenting child's mood. We know that autism, for example, is becoming increasingly prevalent, so it wouldn't be uncommon for a child to present in our office that has a sibling with some level of developmental disorder. Another really interesting finding. We have heard for years and years and years that people with a lower socioeconomic status have a higher risk for the development of mental health issues. This study did not show anything different than that. However, one thing it did show was that parental education and the number of stressful life situations were the biggest predictors of the persistence and severity of children's mental health problems. So the lower socioeconomic status puts people at risk for the development of mental health issues, but how intense those are and how long they go on can be mitigated significantly by parental education and, you know, life stressful life events. One theory is that caregivers with higher education, and I'm not talking about necessarily college, but I'm talking about some sort of advanced education, have different cognitive and analytical abilities which they're able to use to help children mitigate mental health problems in a Stressful life situation, regardless of household income and parental employment, which they found were pretty much unrelated. What types of skills do we develop in advanced education? When you get past, you know, middle school, you know, later into high school and maybe trade school or college, what types of skills do we develop? Well, we typically develop skills in accessing resources. We learn how to do research, we learn how to find things that we need. We typically are become more skilled in advanced problem solving and we have a sense of enhanced self efficacy. We are encouraged to some, some would say forced to step outside of the box and to really challenge ourselves. I remember in my first couple of years of college, you know, I went to college and it was a whole different ball game and all of a sudden I'm writing four page papers and 10 page papers and I was just could never have dreamed of doing that before. And once I had done it, I like okay, I can do that. These are the things that we actually learn, you know, some of the useful things that we actually learn in higher education. And we can teach parents these things. We can teach them how to access resources and effectively problem solve in order to develop more psychological flexibility to help reduce their stress as well as model effective problem solving for their children. Another fabulous article that I came across and all of these are from 2019 or 2020. Children whose fathers had poor physical or mental health were approximately three times more likely to have poor physical or mental health themselves. This really underscores the importance of paternal or father's mental health. Nearly 10% of the children in the study were found to have poor mental or physical health issues and that was directly correlated to their fathers having poor mental or physical health. Programs that foster the health and well being of fathers are essential to the prevention of mental health issues in children. Unfortunately, in many cultures, men's mental health issues are vastly under diagnosed as a result of stigma associated with diagnoses like depression and anxiety and a different presentation of these disorders in men than women. Women tend to be more emotive, men tend to be a little bit more stoic, they be maybe more irritable. They may tend more towards substance use or aggression than not, not violence, but you know, doing things like weightlifting to try to deal with their feelings instead of emoting. They may have more somatic or physical complaints and a lot of times these go unnoticed as depression in men. Caregivers should regularly be screened for depression and anxiety and provided resources to assist them in coping with adversity and increasing resilience. Now one of the things that seems to be pretty Common among at least the men in my family is a resistance not only to go to counseling, but a resistance to go to the doctor, period. So one of the challenges comes up is how do we reach these men who may be experiencing poor physical or mental health, and how do we help them? And a lot of that is going to be creative outreach through programs, handouts from the school, pro health and wellness programs at work, anything that can encourage health and wellness in men, and doing our best as clinicians, especially to destigmatize mental health issues in men. It's not a sign of weakness, it's a sign of an issue. Just like when you have the flu, you wouldn't think twice about going to the doctor with the flu. Why do we avoid going to the doctor if we are experiencing ongoing major depression? When children are brought in with symptoms of a mental health issue, it's also important that we screen for the presence of mental health issues in the home environment, which may impact the effectiveness of treatment. If we have a caregiver in the home who has mental health issues, we know from the Adverse Childhood Experiences Survey, this isn't new news that mental health conditions in one or both of the caregivers can contribute to childhood mental health issues. So if the child comes in and they've got mental health issues, yes, we need to work with the child, but we also need to make sure that the environment they're in is not contributing to their mental health issues. And so we need to screen for mental health issues in those caregivers. We also want to screen for strengths, though. I don't want to always be looking for the negative. I want to screen for strengths that families have when they bring junior in for counseling. You know, what do they have going for them that we can build upon to help that family be happier and healthier? Another associated article, and I've talked about this one before, but this article recently came out. Paternal postpartum depression. Try saying that three times fast is associated with delays in behavioral, emotional, and social development in children up through the ages of at least four and five years old. You know, they stopped at four and five years old for this particular study. It's not just the moms. Postpartum depression in either parent can contribute to delays in behavioral, emotional and social development. We need to remember that. I have talked to so many people. Well, actually, I've never met another clinician that I have talked to, and we started talking about postpartum depression who realized that men and adoptive parents can get postpartum depression. But we really we're focusing here on men. Since that's a follow on from the Men's Mental health article, it's important to recognize that men can get it too. Risk factors for postpartum depression include a history of depression in either parent. So if the dad has had a history of depression, then that's a risk factor for postpartum depression. If the other partner, other parent has had depression or currently has depression, that's a risk factor for the dad developing postpartum depression. If there's significant sleep deprivation that's associated with the development of postpartum depression. And I've done other videos on the All CEU's education channel about the importance of sleep and how that activates when we're sleep deprived. It activates our threat response system, prevents quality sleep, prevents us from clearing out the adenosine in our brain, makes it harder to concentrate lots of really bad mojo when we don't get enough sleep. And it's hard with an infant in the house to get enough sleep. That's one of the things that we're going to talk about in a second that we need to prepare people for. Poverty is another risk factor for postpartum depression because that increases stress, that increases or reduces, I guess you could say, access to resources, feelings of parental inadequacy, perceived lack of partner support and testosterone changes. Now, obviously this is for the mental. Testosterone change actually does change dramatically between the pregnancy period and the postpartum period. And I need to go back and find where it was. But the article that I did some months ago on the impact of hormones on mood, I found an article that discussed the fact that after a man becomes a father in that immediate postpartum period, their testosterone levels actually go down because it's not the time to procreate anymore. Now's the time to focus all their energy on protecting their little youngling. So we do see testosterone changes and we know that lower testosterone can be associated with the development of depressive symptoms. These are things that are. Some of these things are easy to screen for in the doctor's office. We want to regularly screen for the risk factors for postpartum depression or symptoms of depression or anxiety, which could eventually lead to something more serious. Connect caregivers to resources for parenting education, both self directed and consultation. A lot of people are not going to want to go to parent education groups. They're not going to want to participate in classes. If we can give them access to self directed resources, a lot of people will gobble that up. However, we also want them to know where they can go in order to get consultation, if they're having difficulty with their child, if they're not sure what's going on. I know when I had my son, when he came home from the hospital, he had gastric reflux and we didn't know what it was. We just knew he wasn't sleeping at all and it was causing a lot of stress and we didn't know what to do. And it broke my heart to see my little Wookiee feeling in, in so much pain and I didn't know what to do. Thankfully, we had a, a good pediatrician at that point. But parents need to know who they can call if they need a little bit of assistance. Not everybody has a mom that they can call and go, hey Ma, what do I do in this situation? We want to connect caregivers to peer support. Sometimes it's helpful to be in a new mom's group or a new dad's group. And yes, I am separating the genders here. There are some differences in, in roles, so to speak. And what stresses out particular caregivers that they found. We want to make sure people are aware of community resources to mitigate any financial burdens. Formula Pampers, those can get really expensive. If you have to rent a breast pump, that can get really expensive. Respite care if you need it can also be exp. You see where we're going. We want to also encourage the caregivers to develop a plan for ensuring that both people can get sufficient sleep. I was really lucky when my children were infants, my husband was on midnight shift, so he took the night shift and I took the day shift. And you know, when he was on, on duty with the kids, then they would get a bottle of pre pumped breast milk and then when I was awake, I would nurse when he was at work, Obviously I would have to get up during the night, but it did allow both of us to get at least two or three good night's sleep during the week. Once we got Sean's reflux under control, we also want to explore ways to enhance the perception of partner support. What does it look like if your partner supports you in raising this newborn? What is it that you want or you need them to do for you? With Sean, for example, when he was little and he was going through the gastric reflux, I could carry him around for so long and then after a certain point I would start to get so frustrated and feel so helpless that my stress levels would go up, which he would sense and his stress levels would go up anymore so he'd cry even harder. So my husband was really good at stepping in and helping out when, you know, my stress was going up or if I needed to sleep. He was very good at doing things that were supportive of me to be as healthy and functional as I could possibly be with an infant in the house. And we want to also encourage both partners, both caregivers, to examine any concerns about parenthood. They may have had a great childhood, they may have had a crappy childhood, but it's important that they look at any concerns they have about their personal effectiveness as a parent and start addressing those in order to help them address and prevent those feelings of parental in adequacy and address any or head off any perceptions of lack of partner support. 14% of children report feeling persistently lonely, which impacts current well being, future physical health, academic achievement, and contributes to depression. Wow. So again with this depression thing. But now we're talking about loneliness. The current study investigated whether emotional intelligence, we've heard a lot about that lately, can explain the maintenance of internalizing problems. That is, you know, children who are distressed and they are take all that and they hold it inside, they don't act out, they sort of act in. Emotional intelligence is a idea that indicates how we perceive, communicate, regulate and understand our own emotions as well as the emotions of others. And it's characterized by self awareness of our emotions, self regulation of our emotions, motivation, empathy, and social skills. Interestingly, high levels of emotional awareness. So really sensitive adolescents and children have increased association with internalizing disorder. It can almost get overwhelming to feel those emotions so intently, especially if you don't have this skills or you don't feel like you have the skills to deal with them. So high levels of emotional awareness is associated with social withdrawal and even loneliness. Part of this is because people may be unable to label their complex emotions and understand how they're working and what they're there for. And they just, they feel out of control or they may feel incompetent to handle those feelings. So they don't want to put themselves in social situations. They feel kind of out of control of what's going on in their own body, so they withdraw and they feel lonely. They feel like they don't fit in. What can we do? Help adolescents who are highly emotionally aware and most adolescents tend to be highly sensitive, help them identify feelings and associated complex reactions in themselves and others. Help them develop confidence in their skills for self regulation and enhance their social skills. These are things we normally talk about doing anyway, but now we're seeing how social skills and emotion regulation relates to the development of healthy social support systems, the mitigation of loneliness, and the prevention of depression. As always in these episodes I talk about a book and today we're going to talk about ACT Made simple or Acceptance and Commitment Therapy Made Simple. This book is a helpful basic introduction to acceptance and commitment therapy. There is a lot in ACT just like there's a lot in Dialectical Behavior Therapy. But this book will help you learn the basic concepts of ACT and it help you explore how to modify your assessment instruments to better fit within the solution focused ACT framework. Instead of looking for problems all the time, we're looking for solutions. We're looking how to improve the next moment and use it. Help the person use their energies to move towards what they envision as a rich and meaningful life. There are plenty of exercises and activities that clinicians can use to help teach clients basic ACT principles and translate them to daily life. And there's also tons of vignettes to give examples of how exactly to apply acceptance and commitment therapy. Now is this a book that I would recommend for clients? No. I think it's a little bit too intense and too heavy on theory for a lot of clients, but it is a great primer for clinicians and it does give you a lot of information and tools you can use for with clients. If you are interested in checking this book out, you can find it@newharbinger.com if you choose to buy it, you can use promo code 1168 snipeswharbinger.com to save 25% off your entire order. If this broadcast was helpful to you, subscribe by clicking the link below if you're watching YouTube and click the bell to be notified when we publish new videos and go live each Monday. Again, this is applies to YouTube. A CEU course based on this broadcast is also available right now at allce. Com so you can get credit just for watching today. Have a great day and I will see you next week.