As with all partnerships in your life, finding a psychotherapist that’s the right fit for you can take some trial and error. Sometimes you may be lucky enough to find someone you click with right off the bat, but other times you may need to dig a little deeper to find a good match. Here are our tips to help you find a psychotherapist that’s good for you.
Evaluate Your Needs
The first thing to do is evaluate what you would need out of a mental health provider. Some people might find that talk therapy is sufficient, while others may feel that they need medication. Yet others are simply looking for a comprehensive initial assessment to help them determine their diagnosis. Some do not know exactly what they are looking for, but are feeling distressed and are looking for some relief.
If medication is required, you would do best with a psychiatrist or psychiatric nurse practitioner. If you are seeking psychotherapy, you can look for counseling, clinical social workers, marriage and family therapists, clinical psychologists, or certified drug and alcohol counselors.
Consider Your Finances
Therapy comes with a multitude of life-changing benefits, but it is also an investment. The most affordable option would be to find a psychotherapist who is on your insurance plan. However, certain therapists either are not included in your insurance plan or do not accept insurance. If the full fee is too costly for you, you can find lower-cost options at a community mental health center or clinics affiliated with local universities. The latter will provide therapists-in-training, who are often graduate students. Lower fees do not necessarily mean that you will receive a lower quality of service. If you are comfortable, your workplace or school may even offer free short-term counseling services.
Do Your Research
Sometimes, the best place to start is with a simple internet search for mental health providers in your area. If you live in a city, chances are that you will have your pick of choices. Unfortunately, a rural area might yield fewer results, although there should still be options that you can choose from. Getting personal recommendations from people in your life that you can trust can also be a helpful starting point. Your family doctor may be familiar with therapists in the area, and community leaders at places of worship can also provide help if necessary.
Meet the Therapist
Once you find your top candidates, call them up to schedule an appointment. On your first meeting, you will complete some paperwork and discuss your concerns, health status, and life history with your potential psychotherapist. This is a chance for both of you to see whether you will be able to work well together. You should have a list of questions ready for the therapist, which can revolve around:
Their experience, license, training, and education
If they have any experience with the issues you are currently facing
The type of therapy they provide, and evidence of its effectiveness
Their office hours, availability, any after-hours emergency services they provide, and their fees
Not all psychotherapists provide the same services. Still, taking the first step in reaching out for help is always a good start.
Anxiety, depression – are they both the same thing? Both are generally distressing emotional states to deal with, but there are key differences between them, and they are different conditions. Depression prompts feelings of reduced energy, sadness, and despair. Anxiety engenders feelings of worry, dread, and nervousness. It is possible to have both conditions at the same time and while it is normal to feel depressed and anxious every now and then, persistently experiencing these emotions could be a sign that you may need treatment. Here, we go through the symptoms of depression and anxiety and discuss how they may be treated.
Understanding Depression
When you are depressed, your symptoms could include:
Apathy
A loss of interest in things that you used to enjoy doing
Sadness, anxiety, hopelessness
Sleeping either too much or too little
Eating more or less than you once did
Trouble concentrating
Generally, for depression to be diagnosed, you would need to experience symptoms throughout the day, and nearly every day over two weeks. These symptoms, however, can be prompted by physical issues, such as thyroid problems. If that is the case, you would benefit from visiting a doctor who could treat the issue instead. This should relieve your symptoms.
Understanding Anxiety
Like depression, it is normal to experience anxious feelings now and then. If you notice that these feelings are persistent and interfering in your daily life, however, you should seek help. The symptoms of anxiety include:
Feeling constantly on edge
Feeling sweaty or shaky
Feeling out of control
Overwhelming feelings of worry
The Relationship Between Anxiety and Depression
Both depression and anxiety are differentiated primarily by their symptoms. However, these conditions can often be concurrent, with about 60% of those who experience depression also reporting symptoms of anxiety, and vice versa. Symptoms of depression can also be aggravated by symptoms of anxiety, and the reverse also holds. Both anxiety and depression could be genetic or triggered by stress and trauma experienced early in life.
Treating Depression and Anxiety
It can be harder for both depression and anxiety to be diagnosed and treated if they are concurrent. This is why it is essential that you reveal all your symptoms to your doctor so that they can make an accurate and comprehensive initial evaluation. Depression and anxiety treatments involve medication or talk therapy, and sometimes a combination of both. The main form of talk therapy is cognitive behavioral therapy, which teaches you how to restructure your thought patterns and behaviors so that you can stop triggering your depression and anxiety. Meanwhile, antidepressants are medical treatments for depression. They alter the chemical balance of your brain to improve your mood. Anxiety medication includes antidepressants, beta-blockers, and anti-anxiety drugs.
If you have noticed symptoms of anxiety and depression in your life, it is time to seek help. You no longer have to live in fear, sadness, or hopelessness. Instead, there are treatments available for you to be able to experience a better quality of life. Take the first step to regaining your mental health today by reaching out to a mental health provider.
Life is a complex thing. We cycle through a variety of circumstances – and emotions – through the years. Sometimes, everything seems to be going well, and other times it seems as though we are in a rut. We may experience feelings of sadness, anxiety, agitation, or emotional disturbance in general. While these feelings are normal from time to time, especially if precipitated by particular events, there may come a time when you need extra help to manage them. Here, we discuss 6 signs that you need to find a psychologist in New York to help you through tough times.
You are Undergoing a Transitional Stage
If you are experiencing feelings of stress (or are feeling low in general) while undergoing a transitional stage, you may want to consult a psychologist. Big life changes, such as a move to another city or job, can prompt negative emotions that may point to other, underlying issues. Perhaps you do not cope well with change or instability. A psychologist could help you get relief from these issues and help you understand why you feel the way that you do.
You have Low-self Esteem
We don’t always feel on top of the world. Most of us go through life with insecurities, but when feelings of low confidence, worthlessness, and sadness are persistent and debilitating, it may be time to seek help. If you feel that your low self-esteem has been causing you distress or is preventing you from living life to the fullest, you may need some help to overcome it.
Thoughts of Self-harm
If you feel worthless, or that life in general is not worth living, you might have accompanying thoughts of self-harm. This persistent sense of dread and apathy can be difficult to handle, and it can often seem as though you will never overcome it. This is not true, and seeing a psychologist or any mental health expert can give you the resources you need to overcome these feelings.
You are Having Relationship Issues
Relationships are delicate things that require care and attention. Some relationships are more fraught than others. If you are having issues in some of your important relationships, be they with your spouse or partner, parent or child, you may benefit from therapy. An individual therapist can help you through the effects that these relationship troubles may have on you, but couple and family therapy can provide a conducive, meditative environment for you and the other person to talk through your issues.
You are Withdrawing Socially
People are social creatures. Even the introverts among us have activities they enjoy, places they love to go to, and people that they enjoy spending time with. If you do not feel any impulse to do the things that you used to love and find yourself withdrawing socially, it could be a sign of deeper issues in your life.
Seeking Help
There is no shame in seeking help for your mental health if you need it. You can try a neuropsychological assessment to help you get started. We provide comprehensive initial assessments and can even offer second opinions if you are currently seeing a therapist but want a fresh perspective on your treatment.
There are various social anxiety disorder treatments available, but which would be the best for you? How much your social anxiety disorder affects your ability to function on a daily basis will determine the kind of treatment you need. Typically, social anxiety disorder treatment includes medication, psychotherapy, or a mixture of both.
Psychotherapy
Psychotherapy refers to talk therapy or psychological counseling. This improves the symptoms of most people who have been diagnosed with social anxiety disorder. Therapy can help you recognize and modify any intrusive negative thoughts you may have and develop the skills to help you take part in life activities more confidently.
The most effective type of psychotherapy for anxiety is cognitive behavioral therapy (CBT), which can be conducted with equal effectiveness in individual or group settings. During CBT sessions, you face situations that cause you to fear. This helps you improve your ability to cope with stressful situations. You may participate in role-playing where you practice your social skills, honing your levels of comfort and confidence in social situations. Repeated exposure to situations that cause you to stress will help you become comfortable in dealing with them on your own.
Medication
Several types of medication are available for social anxiety disorder. The go-to medication is selective serotonin reuptake inhibitors (SSRIs). Health care providers will most likely prescribe Zoloft or Paxil. A serotonin and norepinephrine reuptake inhibitor (SNRI) known as Effexor XR is also a helpful option.
You will often start with a low dosage to reduce the risks of side effects. Your health care provider will then gradually increase your prescription until you reach the full dose. It can take a few weeks to months of medication for you to notice a significant improvement in your symptoms.
Other medications that you may be provided include beta-blockers, which help reduce heart rate, pounding of the heart, blood pressure, and shaky voice and limbs. These are often prescribed right before a big event that triggers your anxiety so that you can navigate it more calmly. Also commonly prescribed are antidepressants and anti-anxiety medications such as benzodiazepines. It is important to take these medications only when they are prescribed and to do so with care. These medications are not usually recommended for long-term use or general treatment of social anxiety disorder, as unrestrained use can lead to dependency.
Keep at It
In therapy, you are equipped with skills that will last you a long time, so don’t be discouraged if it takes you time to see noticeable results. Changes to the way your thought and behavioral patterns are structured take time to manifest, so be patient with yourself. Finding the right medication for your particular situation is also a process of trial and error.
For some people, the symptoms of social anxiety disorder will gradually fade with anxiety treatment, and medication can be discontinued. Others might need years of anxiety treatment to prevent relapses. Anxiety in children is also quite common, so if you think that your child might need help, it is best to seek it earlier rather than later.
Everyone deserves good healthcare. Wonder Years was founded on the principle to provide high quality care while keeping the costs of care fair to both the patients and the healthcare providers. In keeping with this vision, Wonder Years has followed a ‘hybrid model’ i.e. we offer services both via insurance and private pay. After being in existence for four years we are now ready to take the next step to make this vision even more accessible and affordable. Starting July 4th 2020, I have decided to offer my services to Veteran families who are not in network with Aetna or Cigna for a token fee of $1. For the Veteran families who are in network with Aetna and Cigna, I will waive off all co-pays & any unmet deductibles. I am calling this initiative ‘Wonderful Veterans’.
My vision is to make ‘Wonderful Veterans’ a collaborative initiative i.e. to have as many healthcare providers in every domain be a part of this program. I value the time of the various providers that will eventually participate in this program and so would request each provider to take up only one family at a time. Your work would be independent of Wonder Years and you can continue to function independently in ways you feel best works for you. Even though ‘Wonderful Veterans’ is Trademarked to Wonder Years, healthcare providers are free to use it on their website without any permission.
Wonder Years has compiled an extensive list of resources and referral options for our patients during this pandemic.
Stay safe and Healthy.
Coronavirus Info Hotline: 1-888-364-3065
• NYS Coronavirus response updates: https://coronavirus.health.ny.gov/home
• CDC, updates/information: https://www.cdc.gov/coronavirus/2019-ncov/index.html
• CDC, What to do if you think you have been exposed to COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html
Crisis Situations:
• Suicide Prevention Lifeline: 1-800-273-TALK (8255) for English; 1-888-628-9454 for Spanish
• National Domestic Violence Hotline: 1-800-799-7233
• NYS Coalition Against Domestic Violence 1-800-942-6906
• Child Abuse Hotline: 800-342-3720
• SAMHSA’s Disaster Distress Helpline: 1-800-985-5990 (English/Spanish); TTY: 1-800-846-8517
• Veterans mental health/suicide hotline: 1-800-273-8255, or text 838-25
COVID-19 Volunteering:
• Health care workers: https://coronavirus.health.ny.gov/get-involved-how-you-can-help
• General Public, NYC: https://www.newyorkcares.org/projects/support-covid-19-relief-efforts
• General Public, NYS: https://www.volunteernewyork.org/
• Blood Donation site locator: https://donate.nybc.org/donor/schedules/zip
Peer Support:
• Veterans Peer Support Call – DAILY at 1p.m. EST: 1-800-767-1750 x99873
• NAMI-NYS helpline: 518-248-7634
• Mental Health Empowerment Project warm line for people with mental illness: 1-800-643-7462
• Alcoholics Anonymous online: http://aa-intergroup.org/directory.php
Accessing Treatment and Services:
Medicaid / Food Stamps / Cash Benefits Online Application
• Identifying Supports:
If they are in NYC, 1-888-NYC-WELL or text “WELL” to 65173
NY Connects, statewide social services finder: https://www.nyconnects.ny.gov/welcome
The website Aunt Bertha (www.auntbertha.com) allows you to locate supports by zip code. Click here for instructions on using the site.
NYS and nationwide health and human services information and referral: dial 2-1-1
• Employment-related:
Unemployment: 1-888-209-8124
COVID Emergency Paid Sick Leave: https://www.governor.ny.gov/paid-sick-leave-covid-19-impacted-new-yorkers/emergency-covid-19-paid-sick-leave, Hotline = 1-888-364-3065
NYC Small Business Financial Relief: https://www1.nyc.gov/site/sbs/businesses/covid19-business-outreach.page
Remote Jobs As Contact Tracers
Search for Medical Care / Food / Job Trainings / Work / Legal Assistance
• Income Related:
NYC Cash Assistance: https://access.nyc.gov/programs/cash-assistance/, Infoline 718-557-1399
Social Security and COVID: https://www.ssa.gov/coronavirus/
• Health/Mental Health/Substance Use:
Mental Health Treatment: OMH Customer Relations: 1-800-597-8481
Substance Use Treatment: OASAS Treatment finder https://findaddictiontreatment.ny.gov/
County Health Office finder: https://www.nysacho.org/directory/
• Call assistance for persons with hearing and speech disabilities: dial 7-1-1
• Discounted internet service:
Spectrum: https://www.spectrum.com/browse/content/spectrum-internet-assist.html
Comcast: 1-855-8-INTERNET (1-855- 846-8376)
• Seniors/Elderly:
Senior service (senior centers, meals on wheels, etc) locator for NYC: https://www1.nyc.gov/site/dfta/services/find-help.page
NYC Grocery Delivery for Elderly, Disabled: https://www.invisiblehandsdeliver.com/about-us
County Offices for the Aging locator (scroll down for filters): https://aging.ny.gov/local-offices
NY Connects, statewide social services finder: https://www.nyconnects.ny.gov/welcome
US Administration on Aging Eldercare Locator: https://eldercare.acl.gov/Public/Index.aspx or 1-800-677-1116
Dementia Support: Alzheimer’s Association web-page, “Coronavirus (COVID-19): Tips for Dementia Caregivers,” https://www.alz.org/help-support/caregiving/coronavirus-(covid-19)-tips-for-dementia-care
• Children:
Talking with children about Coronavirus: CDC Guidelines
Helping Children Cope With Changes Resulting From COVID-19: NASP guidance
How To Ease Children’s Anxiety About COVID-19: NAMI guidance
Young Children and COVID – what to say, tips on home time: https://www.zerotothree.org/resources/3210-tips-for-families-coronavirus
Family Readiness and Child/Teen Anxiety: https://www.nctsn.org/sites/default/files/resources/fact-sheet/outbreak_factsheet_1.pdf
Taking Care of Your Family During Coronavirus: https://www.cstsonline.org/assets/media/documents/CSTS_FS_Corona_Taking_Care_of_Your_Family.pdf.pdf
Free Pick-up Meals for NYC children locator: https://www.opt-osfns.org/schoolfoodny/meals/default.aspx
Digital learning resources: http://www.nysed.gov/edtech/digital-content-resources
Brooklyn Public Library, virtual storytime: https://www.bklynlibrary.org/calendar/list?age%5B0%5D=12986
Virtual field trips: https://adventuresinfamilyhood.com/20-virtual-field-trips-to-take-with-your-kids.html
• Veterans:
VA facility locator: VA locator
Veterans metal health/suicide hotline: 1-800-273-8255, or text 838-25
• First Responders/Essential Workers:
CDC Self-care Guidance: https://emergency.cdc.gov/coping/responders.asp
• Social Distancing, Quarantine, Isolation:
SAMHSA Tip Sheet: https://www.samhsa.gov/sites/default/files/tips-social-distancing-quarantine-isolation-031620.pdf
• Mental Health:
Anxiety management, various populations: https://omh.ny.gov/omhweb/guidance/covid-19-managing-stress-anxiety.pdf
Mental health strategies: AFSP, Mental Health and COVID
12 Strategies for Anxiety Management during COVID: https://www.popsugar.com/fitness/how-do-i-manage-coronavirus-anxiety-47313611?stream_view=1#photo-47313715
• Meditation:
Headspace is offering free meditations on their website and on their app
The Insight Timer app has free guided meditations
NYAPRS will offer a daily meditation at 8am M-F on YouTube, access via their site: https://www.nyaprs.org/
• Online Yoga:
Yoga with Adriene on Youtube – always free online
YogaWorks – free online classes during this time
• Online Exercise:
Planet Fitness free live workout sessions – during this time
Les Mills Free Workouts – during this time
Pamela Reif on Youtube – always free
Popsugar Fitness – always free
Fitness Blender – selection of free workouts
• Online Classes:
Free courses online for adults: https://www.classcentral.com/collection/ivy-league-moocs
Free classes in variety of subjects: Khan Academy – https://www.khanacademy.
According to WHO, Depression is a common illness worldwide, with more than 300 million people affected. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Close to 800 000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds.
While there are many effective treatments for depression, first-line approaches such as antidepressants and psychotherapy do not work for everyone. In fact, approximately two-thirds of people with depression don’t get adequate relief from the first antidepressant they try. After two months of treatment, at least some symptoms will remain for these individuals, and each subsequent medication tried is actually less likely to help than the one prior.
What can people with depression do when they do not respond to first-line treatments? For those individuals and the many others who have had an inadequate response to medications and therapy alone, there is a newer treatment option called transcranial magnetic stimulation (TMS).
What is TMS?
Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven’t been effective.
This treatment for depression involves delivering repetitive magnetic pulses, so it’s called repetitive TMS or rTMS.
How does it work?
During an rTMS session, an electromagnetic coil is placed against your scalp near your forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates the nerve cells in the region of your brain involved in mood control and depression. It’s thought to activate regions of the brain that have decreased activity in depression.
What are the different types of TMS treatments available?
Repetitive transcranial magnetic stimulation (rTMS)
rTMS is used to treat patients with unipolar depression.
In rTMS an electromagnetic coil is held against the patient’s left side of the scalp while short electromagnetic pulses are administered through the coil. The magnetic and repeating pulses cause small electrical currents that stimulate nerve cells in the targeted region of the brain.
Deep transcranial magnetic stimulation (dTMS)
The procedure uses specialized coils, called H coils, which reach about 2 inches beneath the surface of the skull and are designed to target different brain areas.
During a dTMS session, a person wears a cushioned helmet, which generates brief magnetic fields.
dTMS is used to treat patients with unipolar depression and obsessive compulsive disorder.
Risks
Repetitive TMS is a noninvasive form of brain stimulation used for depression. Unlike vagus nerve stimulation or deep brain stimulation, rTMS does not require surgery or implantation of electrodes. And, unlike electroconvulsive therapy (ECT), rTMS doesn’t cause seizures or require sedation with anesthesia.
Generally, rTMS is considered safe and well-tolerated. However, it can cause some side effects.
Common side effects
Side effects are generally mild to moderate and improve shortly after an individual session and decrease over time with additional sessions. They may include headache, scalp discomfort at the site of stimulation, tingling, spasms or twitching of facial muscles, lightheadedness
Your doctor can adjust the level of stimulation to reduce symptoms or may recommend that you take an over-the-counter pain medication before the procedure.
Uncommon side effects
Serious side effects are rare. They may include Seizures, Mania, particularly in people with bipolar disorder, Hearing loss if there is inadequate ear protection during treatment
Preparation
Before having rTMS, you may need a physical exam and possibly lab tests or other tests and a Psychiatric evaluation to discuss your depression. These evaluations help make sure that rTMS is safe and a good option for you.
Tell your doctor or mental health provider if you are pregnant or thinking of becoming pregnant, if you have any metal or implanted medical devices in your body. In some cases, people with metal implants or devices can have rTMS. However, due to the strong magnetic field produced during rTMS, the procedure is not recommended for some people who have the following devices such as Aneurysm clips or coils, Stents, implanted vagus nerve or deep brain stimulators, implanted electrical devices, such as pacemakers or medication pumps, electrodes for monitoring brain activity, Cochlear implants for hearing, any magnetic implants, bullet fragments or any other metal device or object implanted in your body. Also let your doctor know if you are taking any medications, if you have a history of seizures or a family history of epilepsy, if you have other mental health disorders, if you have brain damage from illness or injury, such as a brain tumor, a stroke or traumatic brain injury, if you have frequent or severe headaches, you have any other medical conditions, or you have had prior treatment with TMS, and whether it was helpful in treating your depression.
Repetitive TMS isn’t invasive, doesn’t require anesthesia and can be performed on an outpatient basis. You don’t need to arrange for someone to drive you home after treatment — unless, for the first treatment, you prefer a driver until you get a sense of how you’ll feel afterward.
Before considering treatment, check with your health insurance company to see whether rTMS is covered. Your policy may not cover it.
Repetitive TMS is usually done in a doctor’s office or clinic. It requires a series of treatment sessions to be effective. Generally, sessions are carried out daily, five times a week for four to six weeks.
After each treatment you can return to your normal daily activities after your treatment. Typically, between treatments, you can expect to work and drive.
Does TMS work?
Approximately 50% to 60% of people with depression who have tried and failed to receive benefit from medications experience a clinically meaningful response with TMS. About one-third of these individuals experience a full remission, meaning that their symptoms go away completely. It is important to acknowledge that these results, while encouraging, are not permanent. Like most other treatments for mood disorders, there is a high recurrence rate. However, most TMS patients feel better for many months after treatment stops, with the average length of response being a little more than a year. Some will opt to come back for subsequent rounds of treatment. For individuals who do not respond to TMS, ECT may still be effective and is often worth considering.
Can TMS help with other conditions?
TMS is being studied extensively across disorders and even disciplines with the hope that it will evolve into new treatments for neurological disorders, pain management, and physical rehabilitation in addition to psychiatry. There are currently large clinical trials looking at the effectiveness of TMS in conditions such as pediatric depression, bipolar disorder, smoking cessation, and post-traumatic stress disorder. While promising avenues for research, TMS for these conditions is not yet approved and would be considered “off-label.”
Wonder Years is delighted to announce that we now accept Bitcoin as a payment method in addition to conventional modes of payment.
Bitcoin makes use of peer-to-peer technology to function with no banks or central authority; managing transactions, and bitcoin issuance. Bitcoin’s open-source; the design of it is public, no one controls or owns Bitcoin and everyone can partake.
How to pay for your visit using Bitcoin:
Wonder Years generates a QR code that has the Bitcoin amount and address embedded in it
Scan the QR code with your Bitcoin wallet application on your tablet, Android, or iOS device
Press send
That’s it! You’ve now paid for your care with Bitcoin!
Any parent who has a teenage son or a daughter has either heard or witnessed ‘self-harm’ first hand. For parents not only is self harm very concerning but it also leads to significant conflict. They question if they are ‘good enough’ parents. Are they doing the ‘best’ for their children.
So what is self-harm? Self harm is when a teenager hurts herself physically. Clinically, the most common forms of self harm I see are cutting, scratching, picking skin, pulling out one’s hair, burning one’s own skin and ingesting pills.
Why would my son or daughter want to self harm? Many reasons. But the most common I see is anxiety and stress either from school or home. At school stress could happen due to being bullied, not fitting socially, not achieving academic excellence, poor self esteem, relationship issues & gender identity issues. At home, stress could happen due to parental conflicts, conflicts with siblings, financial problems, coming out for kids who identify themselves as gay, lesbian or transgender, abuse and not meeting parental expectations.
Teenagers often report to me that self harm takes away the emotional pain they are suffering and replace it with physical pain which is more tolerable. Some teenagers are venting our anger and frustration towards themselves or others by hurting themselves. For some self harm is ritualistic and for some self harming can make them feel a sense of heightened emotion or experience.
As a parent what should I do or not do? Most importantly, Do Not consider Self harm as merely an ‘attention seeking behavior’. It is a genuine problem and a very strong predictor for future suicide. It is often difficult for parents to comprehend the problem. It is better to be concerned, confused and conflicted than ignoring the problem. Do not ignore it. Take Action.
I just saw my child who has self harmed. What do I do?
If injuries are serious, call your child’s pediatrician. If it is after hours or doctor’s office is not responding, call 911 or take your child to the the nearest emergency room.
If the wounds are fresh, provide appropriate first aid like dressing fresh wound.
Do not over react. It can make matters worse.
While waiting for the ambulance or on your way to the hospital, ask questions like
How did it happen?
Go through the events step by step.
How did they harm themselves?
Where did they do it?
Their feelings at the time of harming themselves
Is it their first time harming themselves or have they hurt them selves before?
Have they ingested anything as well like alcohol, pills, drugs?
At the ER, your child will be evaluated physically and then by a mental health clinician as well.
Upon discharge from the hospital, they will put into place a plan like having to see a therapist and a psychiatrist.
Follow the discharge plan as recommended
At home, implement a safety plan like removing dangerous objects, Ensuring the child is not left alone and Check in with them regularly.
Inform the school about the recent ER visit or hospitalization and develop a safety plan with the school guidance counselor or psychologist.
Anxiety is common in Children. Much of it is normal developmentally, meaning age appropriate. For example, Infants can be anxious about strangers or startled by sudden and loud sounds. Toddlers can be fearful of darkness, imaginary creatures and fear separation from parents or significant care providers. Elementary school children are often fearful of injury, storms or death. As kids move to middle school, school performance and social status becomes increasingly important which can lead to anxiety around these issues.
When does anxiety become problematic?
If developmentally appropriate anxiety does not subside with time or starts impairing a child’s everyday functioning like missing school days or not able to keep friends, then intervention is required.
WHAT CAUSES ANXIETY IN MY CHILDREN?
No single cause. Anxiety is multi-factorial and results from interaction between biological and environmental risk factor. Biological factors include genetics, family history of anxiety or presence of any other psychiatric condition increases the risk of having anxiety. Environmental risk factors include bullying, parenting styles and trauma.
TREATMENT OPTIONS
I don’t want my child to be on medications. That is the first comment I hear from numerous parents even before my first evaluation is complete. Well, as per American Association of Child & Adolescent Psychiatry (AACAP), the first line of treatment for anxiety disorders, especially if it is mild, is Psychotherapy.
So how does psychotherapy help? Psychotherapy lets children talk about underlying feelings and problems. They receive emotional support, learn to resolve conflicts with peers and family members, perceiving comments as they are and not ‘overthinking’ them.
How long? Some forms of therapy are time bound like CBT (Cognitive Behavioral Therapy). CBT can last 12-16 weeks. Some centers offer time bound group therapy sessions. Individual therapy which is readily available in the community could last many months to many years depending on the complexity of the child’s condition and progress.
What about medications? If the anxiety is severe or psychotherapy has failed completely or has shown partial response, adding medication to treatment may be helpful. In my recommendation, the child should not be taken off therapy when on medication. It should go hand in hand.
How long would my child be on medications? If the child is being prescribed for the first time, I try to taper the medications off after 6 months to 1 year. The child should be in remission on medications for significant period before this decision is made. During the course of taper, I recommend that child should continue to be on therapy. Some children do very well after the taper and might not require medications again. But for many children, especially with significant genetic load, they might need medications again. The length of treatment will then depend on individual case.
