Caffeine and its effects are a very common source of concern in the current day. Through all of the hustle and bustle of the modern world, caffeine has proved itself useful for many people at one point or another in their life. It is the most widely used central nervous system stimulant in the world. As of 2015, approximately 75% of children age 5 or older consume caffeine on a daily basis in the United States. Many people might stop and picture a 5-year-old drinking coffee in the morning before getting on the kindergarten bus– but that’s not the case! Caffeine is added to all kinds of beverages including sodas, teas, sparkling waters, and energy drinks marketed towards the younger generations. How does caffeine affect the body?

Caffeine is a part of a majority of people’s daily routines, especially in the United States. We all know someone (or maybe we are that someone) that cannot be spoken to until they’ve had their coffee! Coffee is commonly referred to as liquid gold or liquid energy, but how does it work?

Caffeine acts on the nervous system as well as the cardiovascular, renal, and respiratory systems. It blocks the uptake of a substance called adenosine. This substance is what builds up causing us to feel tired. For some people, caffeine can increase alertness, stimulate wakefulness, provide a prolonged ability to sustain intellectual activity, and decrease reaction times by blocking the uptake of the adenosine. These are the effects that draw the consumer in, but what if you knew that these effects might only be fleeting and could potentially leave you with some very unfavorable feelings in the future?

Anxiety is a condition affecting approximately 40 million American adults and 4.4 million children aged 3-17. Adults with anxiety disorders have been shown to react negatively to caffeine due to its role in affecting the hypothalamic-pituitary-adrenal axis (HPA axis). This system of the body regulates things like stress hormones and blood pressure, which directly affect how someone is feeling. For someone with an anxiety disorder, this can induce feelings of panic and even a panic attack. Because it blocks the uptake of adenosine and alleviates feelings of being tired, it can cause detrimental issues related to sleep and rest for many people. That crash you might feel after it wears off? That happens due to the rush of the adenosine finally being able to bind to those receptors making you feel very tired very fast. Not everyone experiences this, but many people do.

Sleep is the body’s way of restoring and repairing. This is the way in which we re-charge and perform necessary metabolic functions, especially those that repair and detoxify.  When it comes to anxiety and related conditions such as depression, sleep hygiene is very important. When sleep is off, hormone production can also be dysregulated including the stress hormone cortisol. Caffeine’s stimulatory effects can disturb sleep hygiene making repairing, detoxification, revitalization, and hormone balance difficult for the body to regulate. When these functions and processes are not being performed optimally, this can show up as issues such as brain fog and trouble concentrating, poor detoxification, skin issues, disruptions within the microbiome, hormone dysregulation, weight gain, and more.

Consuming caffeine should be limited to the beginning of the day and an appropriate amount. The full effects of caffeine are typically felt within 1 hour of consumption and can be felt for up to 6 hours following consumption.  This is why it is very important to be mindful of your caffeine consumption in relation to your desired bedtime if you are having trouble falling or staying asleep.

General amounts of caffeine in common beverages:

What is an appropriate amount of caffeine for the average person? The average person can consume up to 400mg per day of caffeine without any harmful side effects. Keep in mind that everyone is different and unique in their other environmental factors as well as their genetics. Children, those with heart conditions or heart disease, women who are pregnant or breastfeeding, those with chronic headaches or migraines, people with peptic ulcers or GERD, and those on certain stimulant medications and even some antibiotics should be very careful in regard to consuming caffeine.

Because children are smaller they are especially sensitive to caffeine compared to adults. Studies have shown that children are especially susceptible to the effects of caffeine in regard to immediate effects as well as how they might be affected as they get older. Because most children consume caffeine through the consumption of sugar-sweetened beverages such as sodas and teas, they are more likely to be overweight or obese into adolescence and adulthood when they consume these beverages on a regular basis. These beverages have empty calories, lack vitamins and minerals, cause inflammation from added sugars, colors, dyes, flavorings, and act as diuretics leading to increased urination and possible dehydration. It’s best for kids and adults alike to stick to water as their main beverage of choice!

What about genetics? The genetic component to how someone might process caffeine relates to what are called single nucleotide polymorphisms (SNPs). These polymorphisms are very common within human DNA. This means that single amino acids are altered in the DNA sequence. These SNPs can be beneficial in some ways, but also harmful depending on the SNP as well as other factors such as diet, lifestyle, stress, etc. The CYP1A2 gene plays a role in the body’s ability to process exogenous substances including aflatoxin B1, acetaminophen, and caffeine. Those who have an SNP in this gene might process caffeine at a much slower rate compared to the general population. This might look like someone feeling the effects of caffeine far beyond the general 6-hour window after consumption.

For those who have this SNP and do not know, this might manifest as anxiety, restlessness, trouble concentrating, insomnia, and other behavioral and psychological issues as well as physical ones. If you or someone you know is struggling with anxiety, sleep issues, trouble concentrating, trouble losing weight, or hormone imbalances consider eliminating caffeine from your diet to see how it might help.

Keep in mind that for those who consume caffeine on a regular basis, caffeine withdrawal might happen after they discontinue consumption of caffeine, typically one or two days after they stop. This might include headaches, drowsiness, irritability, nausea, and trouble concentrating. This typically improves as time goes on and resolves itself after a few days.

If you are looking to learn more about Caffeine and its effects on mental health or nutrition, call us at 201-488-6678!

References

ADAA. (2021, April 21). Facts & Statistics. adaa.org. https://adaa.org/understanding-anxiety/facts-statistics

CDC. (2021, March 22). Anxiety and depression in children: Get the facts. cdc.gov. Anxiety and depression in children: Get the facts

Institute of Medicine (US) Committee on Military Nutrition Research. Caffeine for the Sustainment of Mental Task Performance: Formulations for Military Operations. Washington (DC): National Academies Press (US); 2001. 2, Pharmacology of Caffeine. Available from: https://www.ncbi.nlm.nih.gov/books/NBK223808/

Nemours. (2017, February 1). Caffeine. Nemours Kids Health. https://kidshealth.org/en/parents/child-caffeine.html

O’Neill, C. E., Newsom, R. J., Stafford, J., Scott, T., Archuleta, S., Levis, S. C., Spencer, R. L., Campeau, S., & Bachtell, R. K. (2016). Adolescent caffeine consumption increases adulthood anxiety-related behavior and modifies neuroendocrine signaling. Psychoneuroendocrinology, 67, 40–50. https://doi.org/10.1016/j.psyneuen.2016.01.030U.S. National Library of Medicine. (2021, July 2). Caffeine: Medline Plus. medlineplus.gov. https://medlineplus.gov/caffeine.html

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Clinician Guidelines to Culturally Competent Care

Attention-Deficit/Hyperactivity Disorder is a highly prevalent and pervasive neurodevelopmental disorder. ADHD typically occurs in early development, prior to a child’s school enrollment and is characterized by persistent inattention and/or hyperactivity/impulsivity that affects an individual’s functioning and/or development. Individuals with ADHD can present with symptoms of inattention, hyperactivity/impulsivity, or a combination of both.

Inattention manifests behaviorally as failing to attend to details or making careless mistakes, wandering off task, lacking persistence, difficulty sustaining focus, and being disorganized. Individuals with inattentive features tend to reduce their engagement in tasks or activities that require sustained cognitive effort and may appear forgetful or distracted. Hyperactivity and impulsivity manifest behaviorally as excessive motor activity, restlessness or an inability to sit still when appropriate, appearing as if “driven by a motor”, difficulties waiting for one’s turn in social settings, social intrusiveness, and engagement in actions without recognition of the potential for harm or aversive consequences.

For a diagnosis of ADHD to be met, individuals must exhibit six or more symptoms of inattention or hyperactivity/impulsivity or a combination of both. Symptoms must be present for at least six months, are inconsistent with developmental norms, and directly interfere with an individual’s functioning. Symptoms must be present in at least two settings, such as at home, school, with peers/family, or during leisure activities.

ADHD is highly prevalent among youth and adult populations, with 11% of youth and 8.1% of adults affected during their lifetime. Recent research by London & Landes (2021) has demonstrated a significant increase in estimates of ADHD in adult populations by 24.6% in individuals aged 18-64 and a decrease in gender differences with respect to ADHD prevalence.

While estimates have shown higher rates of ADHD among men and boys, greater diagnostic clarity, symptom recognition, and systematic changes in health care have increased the assessment and recognition of ADHD symptoms in women and girls. However, disparities continue to exist for ADHD prevalence cross-culturally. These disparities in prevalence among diverse cultures may be due to cultural biases inherent in diagnostic assessment and clinical screening tools. Cultural prevalence rates may also differ, due to differences in the ways ADHD manifests in diverse cultures, interpretation of diverse youth behavior by clinicians or caregivers, and bias in rating and screening.

Despite research that demonstrates ADHD occurs in virtually all cultures and countries, the majority of the research on ADHD focuses on Caucasian Americans. However, race, culture, and ethnicity are critical to the assessment, diagnosis, and treatment of ADHD. While, searches for articles that include “ADHD” and “Race” have increased from 1990-2000, as well as reductions in bias in clinical care through diversity training that aim to reduce implicit bias, cultural biases in ADHD diagnosis continue. Furthermore, factors such as racism, stereotyping, trauma, and social disadvantage contribute to the maintenance or exacerbation of ADHD symptoms. These factors can also affect how an individual’s symptoms manifest, the likelihood an individual receives a diagnosis and treatment, and the rate of ADHD detection. Thus, recognizing how ADHD can present across various cultures is significant for clinicians and our communities.

For example, people of Hispanic heritage may be at risk for over-diagnosis, due to expectations within their culture to attend to and perform a variety of tasks during one period of time. This is in contrast to European American cultures who organize tasks and activities in a linear fashion, attending to a singular task or activity, prior to initiating another. Additionally, Hispanic culture deemphasizes structure, routine, and punctuality, whereas European Americans place a higher value on these factors. Therefore, Hispanic children may be at a higher risk of being perceived as impulsive and inattentive, symptomatic of ADHD, rather than behaving in accordance with their culture.

Because ADHD occurs during early, critical periods of an individual’s development, assessment and treatment of ADHD in all cultural groups is critical for the attainment of important skills required for a successful transition into adolescence and adulthood.

Tips for Clinicians in Providing Culturally Competent Care:

1. Identify your own cultural biases and reduce them, through:
   1. Intellectual Engagement (learning about cultural groups through articles, videos, journals)
   2. Emotional Engagement (engaging in personal reflection with own biases, attitudes, and experiences with diverse groups)
   3. Relational Engagement (developing positive relationships with people from different cultural groups)
2. Reflect on your life experiences with people of diverse cultural backgrounds
3. Consider your own experiences of discrimination. Ask yourself: “Are there aspects of your identity that impact the way you perceive others?”
4. Understand and assess key historical events, sociopolitical issues, basic values and beliefs, and cultural practices of your client.
5. Consider cultural explanations in the diagnosis and conceptualization of mental health issues.
6. Assess mental health through the use of a Cultural Formulation Interview*

Cultural Formulation Interviews in the diagnosis of mental disorders aims to identify and clarify key aspects of the presenting problem from the point of the individual and family members within the client’s social world.

A Cultural Formulation Interview:

1. Elicits the individual’s view of core problems and key concerns
2. Focuses on the individual’s way of understanding the problem
3. Uses client language in the description of the problem
4. Asks how the individual talks about their difficulties or symptoms with family and friends
5. Focuses on the aspects of the problem that are most salient to the individual
6. Obtains cultural perceptions of the cause of the problem, as well as factors that contribute to resiliency or the worsening of symptoms.
7. Identifies the role of culture as a protective or promotive factor in healing and wellness.

While little research has been conducted on ADHD in diverse cultures, and racial/ethnic minorities are less likely to be assessed, diagnosed, and treated for ADHD, clinicians can mitigate these disparities in mental health care by utilizing a culturally informed approach to care with all clients.

Specialized Therapy Associates includes staff that is highly skilled in the assessment and treatment of a wide range of mental health issues.  For a free consultation with our intake coordinator who will match you to the best provider and service to fit your needs and goals, call 201-488-6678 or visit https://www.specializedtherapy.com/make-an-appointment/ to schedule an appointment.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Centers for Disease Control (2020, November 16). Attention-Deficit/Hyperactivity Disorder  (ADHD). Data and Statistics About ADHD. https://www.cdc.gov/ncbddd/adhd/data.html

Conrad, P., & Potter, D. (2000). From hyperactive children to ADHD adults: Observations on the expansion of medical categories. Social Problems, 47(4), 559-582. https://doi.org/10.2307/3097135

Danielson, M. L., Bitsko, R. H., Ghandour, R. M., Holbrook, J. R., Kogan, M. D., & Blumberg, J. (2018). Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. children and adolescents, 2016. Null, 47(2), 199 212.         https://doi.org/10.1080/15374416.2017.1417860

Fletcher, J. M. (2014). The effects of childhood ADHD on adult lab market outcomes. Health

Economics, 23(2), 159-181. https://doi.org/https://doi.org/10.1002/hec.2907

Fletcher, J., & Wolfe, B. (2009). Long-term consequences of childhood ADHD on criminal activities. The journal of mental health policy and economics, 12(3), 119–138.

Evans, S. W., Owens, J. S., Wymbs, B. T., & Ray, A. R. (2018). Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Null, 47(2), 157-198. https://doi.org/10.1080/15374416.2017.1390757

Hook, J.N., Davis, D., Owen, J., & DeBlaere, C. (2017). Cultural Humility: Engaging Diverse Identities in Therapy. Washington, D.C., USA: American Psychological Association. ISBN 1-4338-2779-4 (Digital, undefined format) or ISBN 978-1-4338-2779-2 (Digital, undefined format)

Iwamasa, G.Y. & Hays, P.A. (2019). Culturally Responsive Cognitive Behavior Therapy: Practice and Supervision (2^nd edition). Washington, D.C., USA: American Psychological Association. ISBN 1-59147-360-8 (Hardcover)

Lensing, M. B., Zeiner, P., Sandvik, L., & Opjordsmoen, S. (2015). Psychopharmacological treatment of ADHD in adults aged 50+: An empirical study. Journal of attention disorders, 19(5), 380–389. https://doi.org/10.1177/1087054714527342

London, A. S. & Landes, S. D. (2021). Cohort change in the prevalence of ADHD among U.S.  adults: Evidence of a gender-specific historical period effect. Journal of attention disorders, 25(6), 771-781. https://doi.org/10.117/1087054719855689

Richards, P. S & Bergin, A. E. (Ed.). (2014). Handbook of Psychotherapy and Religious

Diversity (2^nd edition). Washington, DC, US: American Psychological Association.

ISBN 1-4338-1736-5 (PDF) or ISBN 978-1-4338-1736-6 (PDF)

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For many children and adolescents who struggle with social anxiety, the thought of returning to school and other in-person interactions has triggered increased anxiety symptoms. Early on in the pandemic many children and adolescents who struggle with social anxiety may have experienced relief. They may have experienced relief from bullying and social anxiety and may have worried less about their performance and how they are perceived by others.  Studies show that some children and adolescents who struggle with social anxiety reported an improvement in their symptoms of anxiety and depression since the start of the pandemic and their ability to attend school and other events remotely. Attending school virtually has decreased unpredictability and uncertainty which is the trigger for anxious symptoms in many children and adolescents. Many children and adolescents have become accustomed to attending school remotely. Therefore, some may be experiencing intensified anxious symptoms as they emotionally prepare to return to in-person school and activities.

What is Social Anxiety?

Social anxiety also referred to as Social Phobia, is a mental health condition where you may suffer from increased anxious symptoms and self-consciousness in social situations. You may experience a persistent fear of social situations and be watched or judged by others. This may affect work, school, and your other everyday activities and functioning. For children the median age of onset is 13-years-old, however, onset can also occur between the ages of 8 and 15-years-old (Psycom.Net).

For children and adolescents who struggle with social anxiety, they may be easily triggered by numerous situations, including engaging in conversations with others, speaking in public, making eye contact, entering rooms, using public restrooms, reading out loud, reading out loud, going to parties, eating in front of other people, starting conversations, and going to school or work. They may experience fearfulness of being judged in social situations or embarrassment, accidentally offending another person, experiencing increased anxious thought processes during conversations, or being the center of attention. Children may experience intensified worries in social situations, including school, play dates, and sports teams.

Those who experience social anxiety may avoid social stimulation and social events engaging in the cycle of avoidance. This can later lead to low self-esteem, poor social skills, depression, and increased negative thought processes.

Social Anxiety can cause many children and adolescents to experience high distress and may harm social relationships, academic performance, self-confidence, and academic performance.

What symptoms do those with Social Anxiety Experience?

Many children who struggle with Social Anxiety experience fear and anxiety manifested as meltdowns/tantrums, clinging, crying, freezing, or refusing to speak (psycom.net).  They may also experience several physical symptoms including:

• Rapid heartbeat
• Dizziness/Lightheadedness
• Stomach distress
• Muscle tension
• Inability to catch a breath
• “Out-of-body” sensation/ Disassociation
• Shakiness/Trembling

How you can support your socially anxious child?

Parents can assist children to cope with their Social Anxiety by helping them understand the nature and meaning of their mental illness and coping with their symptoms. Parents and mental health professionals can assist children to make connections between emotional responses, physical symptoms, and triggers to begin learning how to cope. Providing psychoeducation and providing normalcy in how anxiety impacts thinking and behavior can significantly impact the ability to cope with negative emotional experiences.

Helpful Coping Mechanisms for Children and adolescents who Experience Social Anxiety:

• Relaxation Strategies
  • The first step is to assist your child to understand physical responses to anxiety within their body and relax to utilize adaptive coping strategies.
    • Deep Breathing: Deep breathing has been effectively proven to calm the rapid heart rate and slow down breathing and feelings of dizziness. You can teach your child numerous deep breathing strategies, including ocean breathing, balloon breathing, and deep belly breathing (inhale for 4 seconds, hold, exhale for 6 seconds).
    • Progressive Muscle Relaxation: For those who experience intensified anxious responses they may experience tension and stress within their muscles. Progressive Muscle Relaxation teaches children to relax muscles and release tension throughout the body from arms, neck, and shoulders to feet and legs.
    • Imagery: As our thoughts have a powerful influence on our feelings guided imagery focusing on a calming environment, such as the beach, mountains, or sky, can significantly reduce intensified anxious symptoms.
  • Problem Solving Skills
    • Children and adolescents who struggle with social anxiety tend to engage in the cycle of avoidance. This may provide temporary relief, however, may worsen the anxious symptoms over time. Problems solving techniques can assist children to manage feelings of anxiety. Assisting your child to identify triggers that lead to social anxiety in order to discuss problem-solving skills can assist them to work through these anxiety-provoking themes or situations. For example, assisting your children to develop social skills through role-play and modeling can assist them to gain confidence and reduce anxiety symptoms.
  • Challenging Anxious Thoughts & Cognitive Reframing
    • Children and adolescents who struggle with social anxiety are sometimes overwhelmed with negative core beliefs which magnify anxious thoughts. They may experience anxious thoughts surrounding assuming worst-case scenario, believing that others view them negatively/struggling to differentiate between self-image verse others perceptions, personalization, etc. Therefore, examining evidence of the thoughts can reduce anxious feelings. Teaching children to recognize anxious thoughts, examine the evidence which does not support anxious thoughts, and replacing them with positive thoughts can assist in reducing anxious thoughts and symptoms.

If you would like personalized support and guidance on how you can support your socially anxious child, please call Specialized Therapy Associates at 201-488-6678 to schedule your complimentary consultation.

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This week is National Eating Disorder Awareness Week! Did you know that eating disorders are among the deadliest mental illnesses second only to opioid overdose? 10,200 deaths each year are the direct result of an eating disorder (1).

Some common myths surrounding eating disorders are:

1. “People who have eating disorders must be underweight”. Eating disorders look different for everybody and present themselves in many different ways. Less than 6% of people with eating disorders are actually diagnosed as being underweight (2). Just because someone doesn’t look physically sick, doesn’t mean they aren’t suffering.
2. “Only women can have eating disorders”. Men can have eating disorders, too, and the number of cases has increased in recent years. From 1999 to 2009 the number of men hospitalized for eating disorder-related causes increased by 53% (4). Males account for 25% of individuals with anorexia or bulimia eating disorders. Gay men represent almost half of men with eating disorders and are more likely to fast, vomit, or take laxatives or diet pills to control their weight (5).
3. “Eating disorders are a choice”. Eating disorders are serious mental illnesses, not lifestyle choices.

Click here to fill out our Eating Disorder Self-Assessment checklist.

If you feel like you or someone you know is suffering from an eating disorder, we are here to help! Our staff offers a unique holistic and integrative approach to eating disorder treatment using psychological therapy and a functional medicine approach to regain health.

Call 201-448-6678 to make an appointment or click here to enter your information and learn more about how our team can help!

By Taylor Groff, MS Functional Nutritionist

References:

1. Deloitte Access Economics. The Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders.June 2020. Available at: https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/.
2. Arcelus, Jon et al. “Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.” Archives of general psychiatry68,7 (2011): 724-31. https://doi.org/10.1001/archgenpsychiatry.2011.74
3. Zhao, Y., Encinosa, W. Update on Hospitalizations for Eating Disorders, 1999 to 2009. HCUP Statistical Brief #120. September 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb120.pdf
4. Hudson, J., Hiripi, E., Pope, H., & Kessler, R. (2007) “The prevalence and correlates of eating disorders in the national comorbidity survey replication.” Biological Psychiatry, 61, 348–358.
5. Eating Disorders in LGBTQ+ Populations. (2018, February 21). Retrieved February 22, 2021, from https://www.nationaleatingdisorders.org/learn/general-information/lgbtq

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• Rest & Relaxation: Stress is one of the most prevalent causes of fatigue. We often react to chronic stress with a fight-flight-freeze response. “Fight” may mean increased irritability or reactivity. “Freezing” may look like shutting down or disengagement. And “flight” may entail feeling a need to escape or run away. Day to day threats, whether real or perceived, and the cascade of hormones and neuro-chemicals that follow, can leave your system depleted and in need of serious repair. Implement one new relaxation technique such as meditation, reading, journaling, listening to inspirational music or whatever allows you to feel calm.

• Sleep: Sleep is one of the most underrated tools we have. Clearly, lack of quality sleep can leave you feeling tired, but did you know that over time, being sleep deprived can set you up for mental and physical illness? Sleep is needed for cellular repair, detoxification, brain health, immunity, and balanced mood and hormones. Our non-stop culture and 24/7 access to information and entertainment can trick you into thinking of a full night’s sleep as optional. If you are struggling to fall asleep, waking in the night, or wake up and do not feel rested, start with the basics: eliminate exposure to blue light, have a wind-down routine, make sure your bedroom is sufficiently cool and dark, and avoid working in bed.

• Nutrients: Food is meant to make you feel nourished. But if what you are eating leaves you feeling fatigued, it may be due to a food sensitivity, such as gluten, poor blood sugar balance, or a lack of micro-nutrients such as vitamins, minerals and antioxidants. Beyond avoiding sugar bombs and reading labels, focus on adding in a rainbow of vegetables each day. Eat a combination of fat, fiber and protein from whole-food sources to avoid spikes and crashes in your energy levels. Work with a practitioner to try an elimination diet or get tested to rule out any food sensitivities.

• Movement: Physical activity doesn’t have to mean a grueling workout. In fact, studies show that more moderate exercise is less likely to contribute to inflammation than a more strenuous regimen. Do what you enjoy most, whether that’s walking, biking, tennis, dancing, swimming, yoga or MIIT (moderate- or medium-intensity interval training). Movement is important for your body and mind, supporting detoxification pathways, mood, insulin sensitivity, stress, immunity, longevity, and yes, energy-balance. Speak with your health or medical practitioner prior to starting a new exercise plan, especially if you are recovering from an acute illness, have a chronic condition or suspect adrenal issues.

• Connection: Whether you are still adjusting or have already adapted to life “at home”, this can be a time of significant isolation, even for those with family or friends nearby. Detachment from significant others, withdrawal, or even a feeling of disconnection from yourself, can be read flags. If you don’t feel secure spending time with loved ones even while physically distant, outdoors, with a mask, try spending time in nature. Connection to the natural world can increase perspective, optimism, and take you beyond the four walls of your home, or your mind. Speaking of nature…

• Sunlight: You know how plants need sunlight to thrive? So do we. If you are finding yourself spending days on end indoors, this can definitely contribute to low energy and fatigue. There are plenty of ways to venture out in a safe and secure way. This may mean a walk around the neighborhood. Perhaps a day trip to a botanical garden or beach. Try hiking in a forest, boating on a lake, or even a picnic in a local park. You can even make it a point to have a meal outside on your deck, patio or yard each day. Sunlight is an important source of vitamin D and can help lift your mood, boost immunity and help you get more restful sleep.

• Tech break: More than ever, we are attached to our devices. In addition to excess exposure to blue light and its consequences for sleep, bombardment by media images of danger and suffering, or increased sedentary lifestyles, both the American Academy of Pediatrics and American Heart Association advise dramatically reducing time on tech for both children and adults. This can help combat fatigue. Even if you and your family need to stay connected for work and school, identify certain times each day or places in the home, to have a “screen-free zone” such as the dinner table or between 10pm and 8am. Experiment by staying off media for several hours or even one whole day to sense the difference in how you feel. Focus on what you will gain, such as time or energy, instead of what you will potentially miss out on.

• Functional Medicine: Many illnesses can lead to fatigue, in some cases extreme. Functional medicine uses root-cause assessment and resolution to find out why you are having the symptoms, and provides a more comprehensive plan for how to address them. If you suspect an illness such as autoimmunity, fibromyalgia, anemia, chronic fatigue syndrome, adrenal insufficiency, gut imbalance, infections, or thyroid issues, a functional medicine practitioner can help you combat fatigue and can offer a more lasting solution. Learn more at https://fxmedcenters.com/

• Therapy or coaching: Fatigue and exhaustion can be serious. Don’t ignore the signals. Depression, anxiety, bipolar disorder, alcohol use disorder, and many other conditions can increase fatigue, and if you have fatigue, it can make these conditions harder to manage. If you are struggling with your emotions, mood, relationships, or traumas, consider working with a therapist. If you are interested in implementing some of the above lifestyle suggestions, but aren’t sure how, or would benefit from more support to follow through, a coach can partner with you to work toward your goals and help you make your vision a reality. Call 201-488-6678 to learn more or schedule your first appointment to help combat fatigue.

By Anna Sandbank, LCSW, INHC, CMHIMP, Director of Integrative Mind-Body Health, Specialized Therapy Associates, Fx Med Centers, Xceptional You

Disclaimer: This post is for informational purposes only. It does not constitute medical advice, or replace treatment or intervention by a qualified medical or mental health professional.

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Although kids are home with family, they still struggle with social isolation, feeling lonely and missing their friends. If you think about how children interact at school, they are frequently in physical contact, hugging each other or jostling in line, putting an arm around a buddy’s shoulder. Suddenly everyone is home away from all their friends. Suddenly, in quarantine, the closest we can come is 6 feet.

Self-Isolation

We know that in adults, social isolation and loneliness are correlated with premature death. In infants and toddlers, the lack of social interaction and physical contact can lead to “failure to thrive”, poor weight gain, and delayed development. We clearly all need ‘contact comfort’, a term coined by Harry Harlow in his research during the 1950s and 1960s.

So try to be patient with your children (and yourself!). Kids are home, trying to manage schoolwork without the teacher or only seeing teachers a couple of days each week on a Zoom conference. They feel lonely and keep trying to connect with friends through zoom, texting, or video games. Children can’t go out and play in the parks, get lots of physical activity and social contact. They are quarantined at home, struggling with schoolwork, struggling with parents who are feeling overwhelmed themselves, struggling with feeling lonely. No wonder tempers are short, tantrums are more frequent and whining is on the increase.

So, during this difficult time, take more time to cuddle with your child, give them backrubs, and quiet time together reading books. Encourage them to call friends, have face time visits, and tell jokes. Vary your routine on the weekends. Discover new activities and hobbies. And above all, be patient with your kids. They are suffering and struggling as much as you.

If you would like more information, visit specializedtherapy.com or give us a call at 201-488-6678.

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Apprehension about kids and technology is nothing new. Years ago, when it was first introduced, cable television was considered to be a serious risk to the healthy development of children. Today we don’t think twice about it. Closed-mindedness or even fear about new technology holds us back from developing a balanced view of the benefits and risks associated with it. The truth is that technology allows children access to invaluable resources and learning opportunities but also creates real parenting challenges.

Digital literacy and effective parenting

Digital literacy refers to the set of skills we need to survive in the digital age, including communication and collaboration on social media, the ability to find, select, and evaluate information, cultural and societal understanding, and critical thinking. Parents who spend time to become digitally literate are able to make informed decisions. They know and enforce limits appropriately. Digitally literate parents are able to effectively and fairly  moderate the duration, content, and quality of their child’s digital involvement.

Effective parenting requires a balance between flexibility and firmness. Restricting children builds resistance, while guiding them builds judgement. Several strategies to use in communicating about digital use include:

•Offer information about choices, consequences and responsibility

• Prepare, don’t scare

•Offer problem solving and guidance

•Be firm about your expectations and values. Encourage and support your child’s curiosity by demonstrating how the internet can be used as a tool for learning and self-discovery.

Prepare your children for a healthy digital behavior.

Talk to your child about internet safety and their growing digital literacy before it becomes an issue. It is important for every parent to understand that information in the cyber-universe is permanent and not difficult to retrieve to be used against you given proper motivation.  It is  very important to ask your children who they talk to online or if they have friends they only know online. Find out If they talk to someone who upsets or worries them. Make sure they feel they can come to you if they have any uncomfortable exchanges on the web. Are they sharing pictures of themselves? Make sure your child knows that they can talk to you if they are feeling pressured into sending or receiving personal or sexual images.

Warning signs of problematic digital behavior: What signs to look for.

Secretive behavior, evasive answers, excessive time spent on the internet. Upset during or after use. Late night or all-night texting. Diminished in person social contact.

Remember:
As James Baldwin states “Children have never been very good at listening to their elders, but they have never failed to imitate them.” A parent who is constantly on their phone encourages the same behavior in their children.

At times, we may feel powerless to establish a more effective parenting style that balances between flexibility and firmness and need help of a professional to ease our mind and guide us on a more fruitful path. To get help you want, please call 201-488-6678, click here,  or fill out a form below.

The post Digital Literacy: How can Parents be Prepared first appeared on Specialized Therapy.

The post Digital Literacy: How can Parents be Prepared appeared first on Specialized Therapy.

Does that sound worrisome to actually hear your child may have Autism? You may have been to a parent teacher conference and the teacher mentions that your child has odd behaviors or a certain type of “Quirkiness” which makes them unique. Having Autism is very unique. A person with Autism uses more of their temporal and occipital lobes than the frontal lobes of their brain. What that means  is that they are more adept at following patterns because of their perception and recognition of patterns. They may favor visual experiences because of this as well. By using less of their frontal lobes they may not have as much strength in planning and decision-making as someone without Autism. The result of this is that we have to focus on the strengths of the individual and not to try to have them fit into a preconceived model of learning. We may have to do it their way instead of them doing it the old way.

Your child may not have all of the symptoms to get a diagnosis of Autism but they may have some attributes. Understanding your child and supporting them will help them in their future development.
Here are some common symptoms of someone who may be on the Autism spectrum:

• Difficulty developing friendships

• Selective Mutism

• Lack of empathy

• Unable to make eye contact

• Being socially awkward

• Specific/Focused Interests

• Compliance with routines

• Pattern recognition

• Poor motor skills

The symptoms may sound limiting in today’s society but with awareness and understanding of an individual on the Autism spectrum, these symptoms can be perceived as strengths instead of weaknesses.
Here are some positive attributes that are also seen in someone who may be on the Autism spectrum:

• Honesty – whether they are giving someone positive or negative information their statements will reflect their feelings

• Living in the moment – Instead of distractions such as social cues, individuals on the spectrum depend on sensory input around them. They are practicing mindfulness by being in the present moment without years of studying how to do that!

• Not typically judging others – more accepting of other’s differences

• Less focus on materialism

• Less likely to play mind games with others

• Fewer hidden agendas

If you or your child could benefit from speaking to a therapist about issues associated with Autism, please contact Specialized Therapy Associates at (201) 488-6678 to make an appointment.

The post Could your child be on the Autism Spectrum? first appeared on Specialized Therapy.

The post Could your child be on the Autism Spectrum? appeared first on Specialized Therapy.

Gender identity and expression are key elements to the way a child or teen perceives themselves and the world around them. For transgender children and teens, acceptance and support from family is essential.

Research has shown that support from family can reduce the risk of anxiety, depression, and substance abuse in trans children and teens. Furthermore, family support can prevent suicide and self-injurious behaviors. Familial support can help reduce the impact of bullying that a transgender child or teen may experience socially.

What is Gender Dysphoria?

Gender dysphoria is not considered a mental illness. Gender dysphoria means that a person identifies as a gender that is not the same as the gender they were assigned at birth. Transgender teens and adults often experience a feeling of disconnect between their assigned gender and how they identify themselves. This gender dysphoria can cause emotional pain. This is especially true when their feelings are not understood or validated by others.

5 Ways to Support your Transgender Child or Teen

1. Express unconditional love and support to your child.
2. Advocate for your child to promote a safe and secure environment at home and at school.
3. Encourage your child to advocate for themselves.
4. Educate yourself about supporting your transgender child. Explore resources and support groups.
5. Use the preferred gender pronouns and names for your child (ask them!)

More Resources

The Trevor Project provides multiple resources to support LGBTQ youth.
PFLAG supports the families, friends and allies of LGBTQ people and provides information on support groups around the country.
The Human Rights Campaign provides a transgender children and youth page.

For additional support, consider seeking therapy services for yourself, your family, or your child. For information about therapy services, please contact Specialized Therapy Services Intake department at (201)-488-6678 or contact us online at Specialized Therapy Associates.

The post Why is Familial Support Important for Transgender Youth? first appeared on Specialized Therapy.

The post Why is Familial Support Important for Transgender Youth? appeared first on Specialized Therapy.

Unfortunately, it’s not that simple. However, there are two key factors that have a major impact on building a healthy relationship with your children. The old expression, “Do as I say, not as I do”, no longer cuts it. A child will always do as you do. So, one of the simplest things you can do is be a model for them. Always live your life the way you want them to live theirs. This includes even when they’re not looking because kids always catch on to more than you’ll ever realize.

The second is to do what you can to foster a relationship that they will always feel comfortable going to you about anything. The benefit of this is that when your kids come across something that they haven’t seen you model yet, they know they can go to you so you can help them figure it out.
Now that might be a lot easier said than done. However, there are a few things you can do, within your control as a parent, to create this environment.

The Three R’s

This is where the three R’s come in: Regulate, Relate, and Reason. When your child is small they automatically come to you when they’re upset. So, they present you with this opportunity starting early on. This is when you can help regulate how they feel making them feel calm, safe, comforted and loved. Relating is then validating the way they feel by acknowledging that they’re upset or trying to do something very hard at that moment. Then you can move on to reasoning where you can use logic to redirect a specific behavior or show them another way of doing something.

Whether you’re a new parent or an old pro, sometimes we all can use a little help. Please call STA at (201) 488-6678, because it truly does take a village when it comes to raising a child.

The post Raising a Child: How to Achieve Success first appeared on Specialized Therapy.

The post Raising a Child: How to Achieve Success appeared first on Specialized Therapy.