Parenting a Child with Special Needs Has Its Challenges

as seen on nytimes.com

If you are a parent of a child with special needs, your everyday challenges will undoubtedly be much greater than the average parent.  There may be times where you feel isolated and alone.  The challenges are great, but know that you are not alone and with help and guidance you can help your child become a successful and productive adult.

The term “special needs” can refer to a range of developmental disabilities. This can be a variation of different things such as impacting a person’s ability to move, learn, communicate, care for him/herself, and become independent.  The conditions include, attention deficit hyperactivity disorder, cerebral palsy, autism, seizures, stuttering or stammering, hearing loss, blindness, learning disorders and other developmental delays.  It is believed as many as fifteen percent of children have some sort of “special need”.

A Sense of Grief

It is normal when you are a parent of a child with special needs to feel a sense of grief and is actually more common than you would think.  It is natural as parents to develop hopes and dreams about what their child can become in the world.  There is never the expectation that the baby will be born with, or develop, a disability or special need.  When it happens, much of what was imagined and planned is forever changed.

A Parent Will Experience Different Emotions

Parenting a child with special needs can be quite overwhelming at times.  When the parent first learns about the child’s condition, the parent will no doubt experience a whirlwind of emotion:

• It is not uncommon to feel a sense of anger toward your child.
• Many parents will have an immediate sense of fear about their child’s future.
• Feelings of isolation and depression are common as well.
• Guilt for being unable to protect your child.
• A sense of resentment towards those whose children do not have developmental disability.

Whatever emotions you may initially feel remember, there is support for both you and your child.

The process is long but there are steps you can take to cope with these emotions of isolation or depression.  Remember that this is your child, and that he or she loves you and that you love them.  This process is more about understanding yourself, than your child’s condition and that you still have the ability to be a great parent and that your child can still achieve his or her goals with love and support.

Portraits of summer camp showcase sun-splashed children playing sports, swimming, and getting freckles. Not pictured is any sign of anxiety, a natural reaction to a new adventure and a several-week separation. All children experience a mixture of excitement and nervousness when summer camp approaches. For most, excitement trumps nerves, but some children develop anxiety serious enough to get in the way of what should be a fun, formative experience.

Summer camps hone many skills useful for future success: resilience, self-reliance, and social adaptability. The camp experience—being away from home among peers as much as crafts, sports, and theater—can aid a child in crucial socialization and in completing necessary developmental tasks, which include separating from parents, cultivating independence, and demonstrating mastery. Children are often ready for sleep-away camp around ages 10 to 12, although preparedness varies depending on age, experience, and temperament.

How do you know if your child’s case of pre-camp nerves is in the typical range, or something problematic? You might be concerned if she demonstrates physical symptoms of fear: cold or clammy hands, butterflies, faintness, headache, or nausea. Excessive tearfulness and hiding are also signs that something out-of-the-ordinary is going on. A child might have nightmares about separation, or ask questions like, “What if something happens to me or you when I’m away?” If a child’s reaction is so severe that it interferes with normal functioning, it might be time to consult a mental health professional. Otherwise, the key to helping your child get over anxiety is to acknowledge it and give her tools to help her tame it.

13 tips to get your child ready for summer

1) Let your child feel a sense of ownership over the experience. Involve him in picking the summer camp; familiarize him with the camp environment and teach him about camp activities so he can formulate expectations.

2) Help your child get excited about camp: Take her shopping for new gear and focus her on fun things about camp that she can anticipate.

3) Avoid focusing on what makes children anxious. Instead of asking leading questions like, “Are you nervous about horseback riding?” ask open-ended questions like, “How are you feeling about the horses?”

4) Don’t trivialize her concerns or offer glib reassurances. Constantly insisting, “There’s nothing to worry about!” or “Everyone loves camp!” may discourage your child; show that you have empathy and acknowledge her concerns.

5) Focus on concrete details in conversations leading up to and during summer camp. Avoid abstract issues like what it it’s like to be away from home in favor of cabin details, meals in the lodge, or campfire rituals to keep their heads in the game.

6) Reflect on your own formative experiences away from home and share positive aspects of them with your child. Show that you are willing to talk about the new things he’ll be doing, whether it’s sharing a bathroom, getting along with cabin-mates, or choosing a partner at a square dance.

7) Go through “rehearsals.” A shorter-term sleepover or a night at Grandma’s will make it easier for your child to be away from home.

8) Don’t linger at the bus stop. Keep the goodbyes short, as delaying just causes more mixed feelings.

9) Make communication easy and accessible: Pack envelopes and stamps, outline a schedule for phone calls or emails if they’re part of the camp’s routine, and make sure your child understands how easy it will be.

10) Have goals for each letter or conversation, so your child will come away focused on how she is adjusting, rather than on how much she wants to come home.

11) Try not to communicate your own anxiety; your child can pick up on your feelings even if you don’t verbalize them. What you want to share is your confidence in your child and the summer experience.

12) Help your child formulate realistic, goal-oriented plans for making friends or toasting the perfect marshmallow or passing a swimming test. The thrill of completing these plans can give your child a feeling of success and take his mind off his anxiety.

13) If your child has psychiatric or learning issues, don’t keep them a secret. Make sure the staff and counselors know anything they need to know to head off problems and maximize her experience. Does she wet the bed? Is she anxious about water? And let your child know that counselors are there to support her, whether she has a simple question or a larger problem.

Are you ready for your child to go to summer camp?

For parents who are anxious about sending kids to summer camp, remember that the cost of a good camp covers more than the arts and crafts; it includes a team of professionals and counselors committed to fostering social learning in your child

Summer camp is a unique situation where your child engages with a large community of peers and learns how to interact socially in a less-structured environment than school. This is a time for him to actively make decisions for himself and develop a sense of self-reliance. Though you may be concerned and wish to intervene, an attitude of “back-up” supportiveness will give your child room to take ownership over the experience himself.

On Monday, May 20th, a massive tornado ripped through the Oklahoma suburb of Moore, leveling entire neighborhoods, setting buildings on fire and landing a direct hit to an elementary school.

For me, the cruelty of this natural disaster is how innocent children, packing up their backpacks and planning afterschool play dates, were harmed, traumatized, and killed. My immediate thoughts and concerns went to parents, teachers, and other loved ones impacted by this horrific event, identical to how many of us were feeling when 20 first-graders were killed in Newtown, CT in November 2012.

The circumstances are indeed dissimilar but that doesn’t lessen feelings of loss, anguish, sadness, and disbelief that parents and other adults share when such tragedies befall us.

In the aftermath of the Oklahoma tornado tragedy if you’re wondering how to talk to your children about tragedy and natural disasters, you’re not alone. It’s  completely normal to feel overwhelmed by such catastrophe. The key, however, is including children in the dialogue.

It is vital that adults talk with children and keep lines of communication open. Children are being exposed to stories and photos of dislocated families, destroyed homes and a rising death toll.

When children are left alone with information, they have the capacity to imagine far worse than reality. For example, young children often confuse facts with fantasy and may not realize that the same images are shown over and over again on television. Rather they may think that the disasters are happening over and over again.

There are concrete tools for talking with and helping children cope with the tornado in Oklahoma and other tragedies:

• Encourage ongoing dialogue. The more communication the better. One conversation is not enough. Children are better able to take in and cope with small amounts of information at a time.
• Be honest.  Use developmentally appropriate words and concepts that children can understand.
• Encourage children to ask questions. Make sure that you listen to the questions being asked and concerns being expressed. Don’t assume and don’t project your fears onto your children. Answer the questions that children ask. Keep it to that. Do not volunteer more information than asked because children may not be ready to handle that information. Unconsciously, they know what they can handle and when.
• Know the facts. Be able to explain what a natural disaster is as well as how and why they happen. Use simple, clear facts and avoid opinions.
• Normalize feelings – especially fear. It is important that a child not be left with distressing feelings. A child may demonstrate their distressing feelings by throwing temper tantrums, an inability to sleep or having meltdowns. Pay attention to unusual behavior and address behaviors head on.
• Turn OFF the television. Watching the devastation over and over and over again only heightens a child’s worry and fear. Research has shown that watching media coverage, especially repeated viewing, can create stress for children even when they are not directly exposed to disaster.
• Reassure children that they will be taken care of and that you will do everything that you can do to protect them. DO NOT tell them that “this will never happen to you” because as we know all too well, a natural disaster can happen anytime, anywhere.
• Use the conversation as an opportunity for learning.Talk about what you and your family would do in the event of a natural disaster. Make a plan. The reassurance will provide comfort.
• Encourage children to relax. Some options include: coloring, reading poetry, singing songs, and yoga.
• Maintain a consistent routine because children equate a routine with stability and security.

The important thing to know is that children take their coping cues from us, the trusted adults in their lives. This isn’t to say that we should cover up our emotions. Rather, we need to model healthy coping mechanisms for our children, including talking, moderating news intake, self-care (eating, sleeping, bathing), and expressing our wide range of feelings.

Including children in the dialogue about a natural disaster is essential because it demonstrates that parents are trustworthy and that honesty is a core family value.

About Sibling Rivalry
While many kids are lucky enough to become the best of friends with their siblings, it’s common for brothers and sisters to fight. (It’s also common for them to swing back and forth between adoring and detesting one other!)

Often, sibling rivalry starts even before the second child is born, and continues as the kids grow and compete for everything from toys to attention. As kids reach different stages of development, their evolving needs can significantly affect how they relate to one another.

It can be frustrating and upsetting to watch — and hear — your kids fight with one another. A household that’s full of conflict is stressful for everyone. Yet often it’s hard to know how to stop the fighting, and or even whether you should get involved at all. But you can take steps to promote peace in your household and help your kids get along.

Why Kids Fight
Many different things can cause siblings to fight. Most brothers and sisters experience some degree of jealousy or competition, and this can flare into squabbles and bickering. But other factors also might influence how often kids fight and how severe the fighting gets. These include:

• Evolving needs. It’s natural for kids’ changing needs, anxieties, and identities to affect how they relate to one another. For example, toddlers are naturally protective of their toys and belongings, and are learning to assert their will, which they’ll do at every turn. So if a baby brother or sister picks up the toddler’s toy, the older child may react aggressively. School-age kids often have a strong concept of fairness and equality, so might not understand why siblings of other ages are treated differently or feel like one child gets preferential treatment. Teenagers, on the other hand, are developing a sense of individuality and independence, and might resent helping with household responsibilities, taking care of younger siblings, or even having to spend time together. All of these differences can influence the way kids fight with one another.
• Individual temperaments. Your kids’ individual temperaments — including mood, disposition, and adaptability — and their unique personalities play a large role in how well they get along. For example, if one child is laid back and another is easily rattled, they may often get into it. Similarly, a child who is especially clingy and drawn to parents for comfort and love might be resented by siblings who see this and want the same amount of attention.
• Special needs/sick kids. Sometimes, a child’s special needs due to illness or learning/emotional issues may require more parental time. Other kids may pick up on this disparity and act out to get attention or out of fear of what’s happening to the other child.
• Role models. The way that parents resolve problems and disagreements sets a strong example for kids. So if you and your spouse work through conflicts in a way that’s respectful, productive, and not aggressive, you increase the chances that your children will adopt those tactics when they run into problems with one another. If your kids see you routinely shout, slam doors, and loudly argue when you have problems, they’re likely to pick up those bad habits themselves.

What to Do When the Fighting Starts
While it may be common for brothers and sisters to fight, it’s certainly not pleasant for anyone in the house. And a family can only tolerate a certain amount of conflict. So what should you do when the fighting starts?

Whenever possible, don’t get involved. Step in only if there’s a danger of physical harm. If you always intervene, you risk creating other problems. The kids may start expecting your help and wait for you to come to the rescue rather than learning to work out the problems on their own. There’s also the risk that you — inadvertently — make it appear to one child that another is always being “protected,” which could foster even more resentment. By the same token, rescued kids may feel that they can get away with more because they’re always being “saved” by a parent.

If you’re concerned by the language used or name-calling, it’s appropriate to “coach” kids through what they’re feeling by using appropriate words. This is different from intervening or stepping in and separating the kids.

Even then, encourage them to resolve the crisis themselves. If you do step in, try to resolve problems with your kids, not for them.

When getting involved, here are some steps to consider:

• Separate kids until they’re calm. Sometimes it’s best just to give them space for a little while and not immediately rehash the conflict. Otherwise, the fight can escalate again. If you want to make this a learning experience, wait until the emotions have died down.
• Don’t put too much focus on figuring out which child is to blame. It takes two to fight — anyone who is involved is partly responsible.
• Next, try to set up a “win-win” situation so that each child gains something. When they both want the same toy, perhaps there’s a game they could play together instead.

Remember, as kids cope with disputes, they also learn important skills that will serve them for life — like how to value another person’s perspective, how to compromise and negotiate, and how to control aggressive impulses.

Helping Kids Get Along
Simple things you can do every day to prevent fighting include:

• Set ground rules for acceptable behavior. Tell the kids to keep their hands to themselves and that there’s no cursing, no name-calling, no yelling, no door slamming. Solicit their input on the rules — as well as the consequences when they break them. This teaches kids that they’re responsible for their own actions, regardless of the situation or how provoked they felt, and discourages any attempts to negotiate regarding who was “right” or “wrong.”
• Don’t let kids make you think that everything always has to be “fair” and “equal” — sometimes one kid needs more than the other.
• Be proactive in giving your kids one-on-one attention directed to their interests and needs. For example, if one likes to go outdoors, take a walk or go to the park. If another child likes to sit and read, make time for that too.
• Make sure kids have their own space and time to do their own thing — to play with toys by themselves, to play with friends without a sibling tagging along, or to enjoy activities without having to share 50-50.
• Show and tell your kids that, for you, love is not something that comes with limits.
• Let them know that they are safe, important, and loved, and that their needs will be met.
• Have fun together as a family. Whether you’re watching a movie, throwing a ball, or playing a board game, you’re establishing a peaceful way for your kids to spend time together and relate to each other. This can help ease tensions between them and also keeps you involved. Since parental attention is something many kids fight over, fun family activities can help reduce conflict.
• If your children frequently squabble over the same things (such as video games or dibs on the TV remote), post a schedule showing which child “owns” that item at what times during the week. (But if they keep fighting about it, take the “prize” away altogether.)
• If fights between your school-age kids are frequent, hold weekly family meetings in which you repeat the rules about fighting and review past successes in reducing conflicts. Consider establishing a program where the kids earn points toward a fun family-oriented activity when they work together to stop battling.
• Recognize when kids just need time apart from each other and the family dynamics. Try arranging separate play dates or activities for each kid occasionally. And when one child is on a play date, you can spend one-on-one time with another.

Keep in mind that sometimes kids fight to get a parent’s attention. In that case, consider taking a time-out of your own. When you leave, the incentive for fighting is gone. Also, when your own fuse is getting short, consider handing the reins over to the other parent, whose patience may be greater at that moment.

Getting Professional Help
In a small percentage of families, the conflict between brothers and sisters is so severe that it disrupts daily functioning, or particularly affects kids emotionally or psychologically. In those cases, it’s wise to get help from a mental health professional, such as a Licensed Clinical Social Worker (LCSW). Seek help for sibling conflict if it:

• is so severe that it’s leading to marital problems
• creates a real danger of physical harm to any family member
• is damaging to the self-esteem or psychological well-being of any family member
• may be related to other significant concerns, such as depression

Mindful parenting can be defined as when “parents intentionally bring moment-to-moment awareness to the parent-child relationship” or “acting with awareness.” There are certain qualities and skills that must be developed in order to accomplish this, but it is worth it.

Mindfulness in general has been associated with:

• More positive emotion
• Less anxiety and depression
• Greater relationship satisfaction
• Less relationship stress
• Brain activity associated with greater emotion regulation.

There are five dimensions of mindful parenting:

1. Listening with full attention – “Goes beyond simply hearing words that are said….You should be sensitive to the content of the conversations as well as your child’s tone of voice, facial expressions, and body language, effectively using these cues to successfully detect your child’s needs or intended meanings.” This becomes especially important during adolescence when parents cannot physically monitor their children most of the time.
2. Nonjudgmental acceptance of self and child – Through your behavior and what you say you communicate what you think about your child’s competencies. We need to be careful with our attributions and expectations. This does not mean however that we relinquish responsibility for enacting discipline and guidance when necessary. Rather, it means “an acceptance of what is happening in the present moment that is based on clear awareness…It also means acceptance that there will be struggles in parent-child relationships.” As a mindful parent, you should convey your acceptance of your child while also providing clear standards. We need to drop our “cognitive filters” as they are called. For example, we have a whole array of past experiences that we usually use to judge the current interaction with our child; however, this may produce a biased view of our child, where we inherently view him or her negatively no matter what is going on.
3. Emotional awareness of self and child – How aware are you of your own emotions during interactions with your children? “Strong emotions can trigger automatic [responses and behaviors]” that are not always successful. Emotional awareness is key. Without awareness of your emotions, you may undermine your own parenting! With awareness, you can consciously choose how to respond instead of reacting.
4. Self-regulation in the parenting relationship – Mindful parenting requires self-regulation in your relationship with your child. This “does not imply that the impulse to display negative [emotion], anger, or hostility is not felt, but mindful parenting involves pausing before reacting.” Sometimes, you may need to stop during an interaction with your child and tell yourself, “Stop, Be Calm, Be Present.”
5. Compassion for self and child – You should meet your child’s needs and comfort any distress. As you do this, your children will feel a positive connection with you. As parents, we also need to be less harsh on ourselves and our parenting efforts. The way you evaluate your parenting influences your parenting! For instance, if you believe you are a competent parent this generally will result in better parenting overall.

If you are able to master mindful parenting, you will find that it contributes to:

• a more positive parent-child relationship
• greater flexibility and responsiveness inside the dynamics of your home
• a decreased level of parenting stress
• a wider use of parenting strategies
• greater youth well-being
• It will also help to disrupt destructive cycles that may be working in your family right now.

What Is A Mindful Parent? (A Summary)

“Parents who bring a mindful parenting approach to [situations] may listen intently with nonjudgmental acceptance, not focus on memories and/or future expectations to interpret what is happening in the moment, show low emotional reactivity and thereby maintain parent-youth closeness, support parental monitoring and use the situation to help socialize appropriate behavior. This kind of interaction is likely to yield strong adolescent-parent connections that contribute to a mutually responsive orientation.”

Citation:
Duncan, L., Coatsworth, J., and Greenberg, M. (2009). A Model of Mindful Parenting: Implications for Parent–Child Relationships and Prevention Research Clinical Child and Family Psychology Review, 12 (3), 255-270 DOI: 10.1007/s10567-009-0046-3

Approximately half of U.S. students are impacted by traditional bullying each school day. It happens on buses, in the cafeteria, gym, hallways, playground, and in classrooms. The most frequent form bullying takes is words (teasing, taunting, ridiculing, name-calling, and gossip – not blows). This type of bullying happens in the “physical” world and that world has time and space limits. Cyber-bullying is making school days even more painful for many children and some school staff. Bullying in cyberspace is not bound by school hours, school days, or facing the intended bully victim. Unfortunately, the perceived anonymous nature of the internet often insulates the bully from the consequences of their damaging behavior.

As the number of households with Internet access approaches saturation and cell phone ownership expands to the 100 million mark, so do the ways kids bully each other. Cyber-bullying in the form of text messages, emails, photos, website postings can go school-wide in minutes and global in days. Slanderous information sent out into cyberspace is difficult, if not impossible, to expunge. Cyber-bullying often takes the form of cyber gossip, where damaging content is based on whim; not facts, and is posted on social networking sites such as Twitter and Facebook.

Incidents of Cyber Bullying are Rising

Studies indicate that cyber-bullying incidents have quadrupled in five years. A 2000 survey by the Crimes Against Children Research center at the University of New Hampshire reported 6 % of young people had experienced some form of cyber-bullying. In 2005, studies of 1500 Internet-using adolescents found that over one-third had been cyber bulled and half of those admitted to cyber-bullying others (Hinduja and Patchin, In Review.) A 2005 study by National Children’s Home Charity revealed that 20% had been cyber-bullying victims. A 2004 survey conducted by i-Safe America of 1556 adolescents found that 42 % had been bullied online.

How Cyber-Bulling Messages Are Communicated

• Text or digital imaging messages sent on cell phones
• e-mails
• instant messaging
• web pages
• web logs (blogs),
• chat rooms or discussion groups, and
• other information communication technologies

Cyber-bullying Perpetrators – It Is A Cycle:

Middle School and High School girls were about twice as likely as boys to display cyber-bullying behaviors in the form of email, text, and chat*

Middle School and High School girls were twice as likely as boys to report receiving email, text messages or chat room messages that teased, taunted, and ridiculed. *
62% said that they had been cyber-bullied by another student at school, and 46% had been cyber-bullied by a friend. **
55% didn’t know who had cyber-bullied them.
Only 20% cyber-bullying victims tell their parents about the incident. Victims are most likely to tell a friend (42%).

**(2005, Kowalski et al., Electronic bullying among school-aged children and youth.)

* (2007-2009, Kamaron Institute, School Surveys)

Ten Tips: Parents Cyber-Bullying Preemption

1. Consider installing filtering and blocking software, but understand clearly that proactive parents are the only real deterrent and the best resource for bullying preemption.

2. Keep your home computer(s) in easily viewable places, such as a family room or kitchen.

3. Model the behavior you want to see in your child.

4. Talk regularly with your child about on-line activities he or she is involved in.

5. Set firm guidelines for cell phone use and monitor that behavior.

6. Talk specifically about cyber-bullying. Explain that that it is harmful and unacceptable behavior.

7. Outline your expectations for responsible online behavior and clearly explain the consequences for inappropriate behavior.

8. Encourage your child to tell you immediately if he or she is a victim of cyber-bullying. Tell your child not to respond to the bully.

9. Stay calm. Plan in advance how you will calmly receive the news that your child is being bullied and the solution steps you will take. You will want the evidence. Tell your child to save the bullying messages or photo.

10. Call your child’s school; ask the principal what measurable, bullying preemption, activity-based programs they have in place today. Offer to serve on the group that expands the school’s behavior policy to include cyber bullying behavior that disrupts the schools teaching and learning environment. Ask about results.

I have been treating a 37 year old woman for about six months.  She is married with three young children.  She came to me for treatment of depression and anxiety precipitated by her husband’s layoff from his lucrative job in the financial industry.  She and her husband were facing significant financial difficulties which have contributed to her depressed mood, difficulty sleeping, overeating, and feelings of hopelessness. They had been arguing in front of the kids and she was concerned how all this tension was  affecting them.

After referring her to a psychiatrist for an evaluation, she had responded quite well to her prescription for Zoloft, a medication to treat depression.  Things had been improving with her husband after he secured another banking job and they were barely arguing with each other.

However, about a month ago, my patient began to slip back into even a worse depression, not being to get out of bed in the morning and having frequent crying spells.  She told me that she has suffered from this “different” type of depression for the past two years, usually coming on during the month of December.  Her psychiatrist increased her dose of Zoloft and surmised that this “different” type of depression was Seasonal Affective Disorder or SAD.

What is SAD?

Seasonal affective disorder (SAD) is a kind of depression that occurs at a certain time of the year, usually in the winter.

Causes, incidence, and risk factors

SAD may begin during the teen years or in adulthood. Like other forms of depression, it occurs more often in women than in men.

People who live in places with long winter nights are at greater risk for SAD. A less common form of the disorder involves depression during the summer months.

Symptoms

Symptoms usually build up slowly in the late autumn and winter months. Symptoms are usually the same as with other forms of depression:

• Hopelessness
• Increased appetite with weight gain (weight loss is more common with other forms of depression)
• Increased sleep (too little sleep is more common with other forms of depression)
• Less energy and ability to concentrate
• Loss of interest in work or other activities
• Sluggish movements
• Social withdrawal
• Unhappiness and irritability

SAD can sometimes become long-term depression. Bipolar disorder or thoughts of suicide are also possible.

Signs and tests

There is no test for SAD. Your health care provider can make a diagnosis by asking about your history of symptoms.

Treatment

As with other types of depression, antidepressant medications and talk therapy can be effective.

Managing Your Depression At Home

To manage your symptoms at home:

• Get enough sleep.
• Eat a healthy diet.
• Take medicines the right way. Learn how to manage side effects.
• Learn to watch for early signs that your depression is getting worse. Have a plan if it does get worse.
• Try to exercise more often. Look for activities that make you happy.
• Practice good sleep habits.

Avoid alcohol and illegal drugs. These can make depression worse over time. They may also affect your judgment about suicide.

Nutrition Recommendations

It is important to consume a lot of foods and/or supplements with B Vitamins.  These vitamins found in chicken, meat, and eggs are improve mood symptoms and energy. Vitamin D is often very important because it too effects mood and energy.  People in the Northeast are often very low in this necessary vitamin because of limited sun exposure during the winter months.  Vitamin D can be found in yogurts, milk, and liver oil.  Tryptophan is also important because it is a building block of serotonin, a brain chemical implicated in depression.

Light Therapy

Light therapy using a special lamp with a very bright light (10,000 lux) that mimics light from the sun may also be helpful.

• Start treatment during the fall or early winter, before the symptoms of SAD begin.
• Follow your health care provider’s instructions about how to use light therapy. A common practice is to sit a couple of feet away from the light box for about 30 minutes every day. This is usually done in the early morning, to mimic sunrise.
• Keep your eyes open, but do not look straight into the light source.

Symptoms of depression should improve within 3 – 4 weeks if light therapy is going to help.

Side effects of light therapy include:

• Eye strain and headache
• Mania, less often (see: Bipolar disorder)

People who take drugs that make them more sensitive to light, such as certain psoriasis drugs, antibiotics, or antipsychotics, should avoid light therapy.

A check-up with your eye doctor is recommended before starting treatment.

With no treatment, symptoms usually get better on their own with the change of seasons. However, symptoms can improve more quickly with treatment.

The outcome is usually good with treatment. However, some people have SAD throughout their lives.

Calling your health care provider

Get help right away if you have thoughts of hurting yourself or anyone else.

My patient has greatly improved since taking her increased dose of Zoloft, working out at the gym four times a week, and continuing to see me on a weekly basis.  Moreover, she reports that using a light box every day for thirty minutes has really helped as well.

References

American Psychiatric Asosciation. Practice guideline for the treatment of patients with major depressive disorder. 3rd ed. October 2010.
Tesar GE. Psychiatry and psychology. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine 2010. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2010:section 11.

Trevor’s mother sat down in my office last week exasperated that her 10 year old son was refusing to do his homework every night for the past three weeks.  He was getting good grades, sleeping his typical nine hours during the night, and generally loved going to school.  She had tried everything including letting him do his homework at the dining room table after dinner, allowing him to relax when he got home from school, and even bribing him with promises of a new Xbox game if he did his homework. Also, Trevor wanted to wait until 9:00 pm when his father returned from work to help him with his math homework; his mother acquiesced to this as well. Nothing was working.

The problem that Trevor’s mom presented is fairly typical in my clinical work with parents and their children.

Parents get stuck in homework battles with their kids all the time. Either their children get distracted halfway through and want to give up, or they resist doing the work in the first place. As many parents know all too well, this resistance can often take the form of acting out behavior: kids will yell, start fights with you, or even throw a tantrum to avoid doing their work. Sometimes they start their homework and then throw their hands up in the air and say, “This is too hard,” or “I’m bored,” or “Why do I have to do this stupid stuff anyway?” As hard as it can be to not take that bait, avoid getting sucked into power struggles with your child at all costs. You will end up frustrated, angry and exhausted, while your child will have found yet another way to push your buttons. And wind up hating school and hating learning—exactly what you don’t want to have happen.

So why is homework time often so difficult? One of the major reasons is because it can be hard for kids to focus at home. Look at it this way: when your child is in school, he’s in a classroom where there aren’t a lot of distractions. The learning is structured and organized, and all the students are focusing on the same thing. But when your child comes home, his brain clicks over to “free time” mode. In his mind, home is a place to relax, have a snack, listen to music, and maybe watch TV and play video games. So for better or worse, kids often simply don’t view home as the place to do schoolwork.

The good news is that there are effective techniques you can use to end the nightly battle over homework.

Start Early

I always tell parents that the earlier they can begin to indoctrinate their children with the idea that schoolwork is a part of home life—just as chores are—the more their kids will internalize the concept of homework as being a regular part of life. If your child is older and you haven’t done this, that does not mean there isn’t hope for him. It simply means you will initially have to work a lot harder to get him on track with his schoolwork.

Make Night time Structured Time

When your kids come home, there should be a structure and a schedule set up each night. I recommend that you write this up and post it on the refrigerator or in some central location in the house. Kids need to know that there is a time to eat, a time to do homework and also that there is free time. And remember, free time starts after homework is done.

Don’t Fight with Your Child

Make it very clear that if they don’t do their homework, then the next part of their night does not begin. And don’t get sucked into arguments with them. Just keep it simple: “Right now is homework time. The sooner you get it done, the sooner you can have free time.”

Say this in a supportive way with a smile on your face. Again, it’s really important not to get sucked into your child’s fight. And when you establish a nightly structure, it will be easier to avoid power struggles over homework.

Know Your Child’s Homework List

It’s very important to know what your child’s homework is — parents need to make sure it doesn’t get lost in the shuffle. Having good communication with your child’s teachers is key, because your child will have homework every night as he or she gets older. If your child is not handing in their work on time, you can set it up so the teacher will send you any assignments that your child didn’t get done each week.  Many schools have a parent portal where your child’s teachers post each night’s homework assignment; take the time to go through this each evening.

Establish a Token Economy in Your Home

Don’t forget, we want to pay kids in a currency that they desire. Extra carrots are not going to get much out of your child, but an extra fifteen minutes before bedtime or extending their curfew by half-an-hour on Friday night will.

This kind of system is called a “token economy”. The “tokens” become the currency, and in this case, the extra time playing video games, watching TV, and using the computer is the money. You want to withhold it or give it out according to how your child is earning it.

Map out a List of Rewards and Consequences

Parents should have a list of rewards and consequences mapped out for all their kids. It should be a pretty big list, and might include things like going to the park, going to the movies, and going bowling. Have a section that lists the video games your child likes to play and the TV shows he likes to watch, because this is what he will be rewarded with.

I have parents sit down with their kids and say, “All right, when you do well and I want to reward you, what kinds of things would you like to do?” Be sure to include activities that don’t cost money, too, like going to the beach, taking a ride in the car, or playing board games. Then, if your child is able to finish his homework on time for a whole week, at the end of the week he gets rewarded from the list you’ve compiled.

Keep in mind that our job as parents is to help guide and coach our children with their schoolwork, but it’s also our job to let them experience the natural consequences when they don’t get it done. That might mean that they get a poor grade, which is the result of not following through on their responsibilities.

It’s so important to let your child experience the disappointment that comes with that, because that will help motivate them to try harder next time. And as a parent, when the report card comes along, if your child is not at some baseline that you’ve determined, (it might be that they should get nothing lower than a B, for example) then they should lose some of their privileges at home. That might mean they can’t study alone in their room until they bring their grades up, and you might have to watch them more closely when they do their work.

Remember, a major part of ending power struggles over homework lies in establishing structure, giving consequences and rewards, and getting your child to see that schoolwork is a regular part of home life. Once they accept that, you’ve already won half the battle.

Change is hard for emotionally healthy and mature adults in divorced situations. Moving from what was a normal daily life to a new normal always takes adjustment and compromise for the whole family. It also takes time and effort and a willingness to adapt. Is “nesting” a better solution for all involved?

Kids don’t have the luxury of time to adjust or often a voice in the decisions that affect them. Their emotions are raw and their life skills are limited. They like their own house. They know their friends in the neighborhood. They know the way to school. They don’t have to worry about whether their backpack is at Mom’s house or Dad’s house. They need the structure of the known when the unknown is occurring all around them daily.
The hardest time in the day is transition time. It is the time when the kids are dropped off at day-care, go from dad’s house to mom’s house, when schedules are interrupted or changed. Some divorced couples have come up with a parenting plan that puts the needs of the children above their own. They recognize that while they may not be able to live together, they are still a family and they work to find ways to make this transition easier on the kids.

Kids Stay in the Nest
To reduce the trauma and transition of the divorce on the children, the parents shuttle back and forth and the kids stay put. This allows the kids to feel that they have some stability in their lives while the parents make major life changes. They maintain their own environment with their things in familiar places as they adjust to the idea that the parents are no longer a unit, but they are still a family.
As I have the opportunity to talk to children who are shuffled from one school, house, neighborhood and group of friends during a divorce, I feel their very real pain and anguish. There has to be a better way. It is not the children who decided to change the family dynamics…so why should they uproot from everything that is familiar?
Divorced or Separated Adults Visit the Nest
A shared custody, nesting arrangement indicates that there is always a loving adult in charge. Many of the parents who are trying it are doing so to lessen the harmful effects of uprooting the kids and also because they can’t sell the house in this economy. As parents shuttle or fly back and forth to the nest of children, they are also going through some transition times. It gives them an opportunity to take some time to spend one-on-one bonding with the children, often for the first time in their lives.

This arrangement helps the kids feel more stable and secure, but often involves problems for the parents. It means that three rents or mortgages must be paid, rather than one. It means a civial working relationship and communication between the parents because all sorts of practical considerations come up.

Indeed, one may ask: Why are the parents getting divorced, if they seem to have a good, partnered relationship during and after the divorce?

After spending a wonderful holiday over the Christmas and New Year period, some people feel blue and find that it’s difficult to function normally in their daily rhythm. Holiday blues, holiday depression, or post-Christmas blues, these commonly used terms depict the mental distress occurring after the winter holidays and festival season. This article is focused on experiencing the “blues” since this term suggests mild mental distress, a commonly occurring phenomenon when dealing with daily life stress and change. Below are some suggested steps to get rid of your post winter festive season holiday blues.

1. Expect some letdown. The holiday season is both joyful and stressful at once. There is family to get along with, gifts to buy and return, people to visit, activities to throw yourself into, plenty of festive food to eat, sales to rush to, and parties to plan and attend. Topped off with the excitement of New Year’s Eve, your adrenaline has probably been pumping a lot of the time during the Christmas and New Year’s period. Returning to the usual routine and probably quieter workplace than normal can dampen your spirits just by the absence of exciting things to do and look forward to. Equally, if your Christmas and New Year’s Eve period wasn’t as enjoyable as you had hoped, you can be left feeling down about the lack of enjoyment you’d expected and this can sour your mood. Expecting to feel a little low is a way of telling yourself that this is a normal feeling and that it will soon pass once the routine re-establishes itself. Look at your past experiences to enlighten you as to your normal post-holiday feelings. Do you always fall into a slump after the holiday season? If you have spent period of time after last two holidays in despair, then the chances of this post holiday period continuing in despair are high. Look carefully about what you did last time and what relaxed you. And realize that generally this is a phase that is easily fixed.

2. Choose to see the benefits of post-holiday time. The good side to the end of the holidays is that you’ve had a chance to rest, to relax, and to enjoy yourself. The craziness prior to Christmas has ended both at the workplace and in the home, and the restful time after Christmas and New Year’s Eve has hopefully given you the opportunity to do things that are different from your usual routine. And any break in the routine is good for the spirit, providing you with the chance to rejuvenate. Take it easy when you’re settling back down into your usual routine. Your more rested self is a good thing and gives you an opportunity to take a renewed perspective on your work, routine, study, or home life pace. Perhaps the break has given you perspective on your life, job, relationships etc. If so, this is a good time to consider making changes to improve your situation, especially because not making the changes can prolong your blues.

3. Take it easy and be gentle on yourself with respect to your New Year’s Resolutions. If you set the bar too high and you already feel as if you’re slipping, don’t berate yourself. Instead, look at your resolutions realistically and assess whether they need some tweaking to ensure that they’re achievable. Discard the resolutions that required you to be too harsh on yourself and reform them into ones that can be met now that the heady atmosphere of New Year’s Eve is behind you. Think of it as a double checking of the details, and simply fiddle with the fine print! Taking weight loss as an example, targeting for a size zero is unrealistic, but looking for 1 pound loss in a span of a week or two seems to be more achievable.

4. Keep being around people. Some of the post-holiday season blues might be related to having been around many people over the Christmas break and then suddenly finding yourself surrounded by people you don’t know that well, or even not by many people at all. Lift your spirits by continuing to stay connected with friends and family, and getting out and about to do activities where other people interact with you.

5. Do things that give you cause to look forward to something. Revive the excitement of anticipation by arranging fun things, such as having dinner with friends, starting a new class for a hobby or interest, attending a sporting event regularly, going to the movies, etc. Choose activities that meet your budget and interests, and that you know will give you a thrill.

6. Make healthy choices. After the many indulgences over the holiday period, it can leave you feeling a little out of shape and worse for wear in the nutrition department. Aim to return to eating healthy food, drinking healthy drinks, and ensuring that you keep getting a good amount of exercise. Eating well and keeping up regular exercise will enhance your mood and help you return to good shape and fitness levels. If you’re worried about not keeping warm enough during the colder weather, have more healthy chunky, warming soups that will both warm and fill you up without carrying lots of calories. Warm salads are also an excellent choice during winter. Eat foods that boost your serotonin (feel good) neurotransmitters. Suitable foods containing tryptophan (the building block for serotonin) include bananas, poultry, dairy produce, and peas. Keep exercising no matter the weather. Exercise will give you the mood-boost you need and gets you moving again. If you’re living in a cold climate, there are plenty of winter exercising options such as walking, skiing, and gym workouts, and for those in a hot climate, swimming, hiking, and water sports are ideal mood lifters.

7. Make this a time for getting professional help and turning around things that have been bothering you. The holiday season tends to put a hold on pressing issues at work and in your personal life because the celebrations, meet-ups, and preparations require your foremost attention. Once this busyness dies down, you’re returned to thinking about your general life issues and this might just be a good time to get help from the professionals, be it for anything from sorting out your finances or dealing with the unhappy feelings you’re experiencing. If you didn’t plan so well for the holidays and find yourself deep down in the debt rack, get financial advice immediately and start to sort out the finances sooner rather than later. It might reduce the indulgences for now but this is probably the best time to feel the least deprived about indulgences!

8. Make plans for the year ahead. Expect to enjoy the year ahead. Trying to keep a positive frame of mind and planning for interesting and fulfilling events throughout the year is a good way to calm your current blues. Think ahead to the changing seasons and the sorts of things you’d like to be doing as the year moves on, and the sorts of activities and events you’d like to be a part of. Doing something about the things you’d like to happen is the first step and once you’re immersed in planning and doing, you’ll be too busy to fret. If you want to travel, start planning the trip and budget now. If you’ve got big plans ahead like your own or someone else’s wedding, having a baby, renovating a home, taking your parents on a cruise, etc., throw yourself into planning.

9. Sometimes a person suffering from post holiday syndrome or post-Christmas blues can behave in erratic fashion for the initial weeks after the holiday, doing things like waking at night and sleeping during the day. This type of behavior can be attributed to heavy responsibilities which people experience during holidays. Realize that the change back to a normal routine is disruptive and ease yourself back into it. Before heading back to work, study, or your daily home life routine, it can be helpful to ensure that you have dealt with the vestiges of the season. Pack up the Christmas tree and decorations, take down the cards and recycle or box them, finish the leftovers, etc. Leaving these reminders around can bring on anxiety because they remain tasks to be done and can also bring on a sense of sadness. Get other members of the family or household to help you clear this up in a busy afternoon and share a delicious meal afterward.

10. The more severe form of post holiday syndrome or post-Christmas blues is referred to as depression. This is an illness of persistent sadness, and is not attributed to normal holiday reaction. Seek professional help if you’re concerned that you might be suffering from depression. A mental health professional, such as a Licensed Clinical Social Worker, can help you discuss and explore with you, your possible family history of depression, alcohol and substance abuse, and other life stresses that may be contributing to ongoing depression.