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Do I call a psychiatrist?

A psychiatrist prescribes medication to help with your psychological struggles.  There are some certified to work with teens and children.

A psychiatrist prescribes medication to help with your psychological struggles. There are some certified to work with teens and children.

First of all, a lot of people do not know the difference between a psychologist, psychiatrist, counselor and therapist.  Let me start by clarifying what those terms mean.  Counselor is the most general term.  It can refer to a therapist, psychologist or psychiatrist.  Counselor is also the term used for a person with an associate degree or certification in addiction counseling.  A therapist refers to either a psychologist or a master’s level person with a license.  A therapist is someone who will spend an hour with you on a regular basis talking about ways to work through your struggles, and can also do psychological testing.  A psychologist has a doctorate (either a Ph.D. or a Psy.D.), can do psychological testing, and can do therapy.  A psychiatrist is a medical doctor, who completed medical school and a residency.  The psychiatrist can do therapy, but typically chooses to refer out for therapy.  The psychiatrist evaluates patients to determine whether medicine can help a psychological condition, and if so, prescribes that medication.

 

Sometimes people hesitate to take medicine for a psychological condition, preferring to address the problem in therapy.  Usually your therapist will let you know when it is time to seek a psychiatric evaluation.  It is also a good idea to see a psychiatrist if you feel extremely depressed, are considering suicide, have been hallucinating, or have extreme anxiety like panic attacks.  There are other conditions where seeing a psychiatrist is advisable as well.  For example, if you suspect your child has ADHD, then you can get a diagnosis and treatment from a psychiatrist.  Use your therapist or primary care doctor as a guide in terms of when to contact a psychiatrist, and often they will have good referrals to give you.

 

When you go to your psychiatry appointment, come prepared.  Keep a list of your symptoms, what caused them, and what time of day they occurred.  Be extremely honest about any drugs or alcohol you use.  Your psychiatrist is required to keep everything confidential, so don’t be afraid to tell him or her.  If you smoke marijuana every so often, your psychiatrist NEEDS to know this.  The reason it is so important to give your psychiatrist this information is that you are being given medication.  Alcohol and illegal drugs interact with legal medication, affecting how well the medicine works.  In some cases you actually are putting yourself in danger by mixing certain medications with certain drugs or with alcohol.  Your psychiatrist isn’t going to be judgmental of you, believe me.  Your psychiatrist has heard it all, and I mean ALL.  You will not shock your psychiatrist.  He or she has seen some of the seemingly most normal looking people take drugs, have an alcohol problem, lose touch with reality, make poor decisions, participate in extremely risky behavior, and anything else you can think of.  Just keep in mind that your psychiatrist can only help you to the extent that you share everything about what is going on with you.

 

Also come to your appointments with a list of any physical symptoms you might be dealing with.  Remember, this is a medical doctor.  Sometimes psychological problems are caused by a physical problem or a disease.  Your psychiatrist is trained to look for signs of physical disease and help you connect the dots.  They are also trained to look for the opposite (physical problems caused by psychological impairment).

 

So, is it time to call a psychiatrist?  Perhaps, and especially if you’re considering taking medication to deal with a psychological struggle.  Consult with your therapist or primary care doctor to find out.  If you don’t have a therapist or primary care doctor, you can call a psychiatrist directly for an evaluation in most cases.

 

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

Sports: Good for Teen Girls

Adolescent females have been shown to benefit from being athletes for a number of reasons. Some of my favorites include the development of fortitude, and work ethic. I also love the stat showing teen female athletes become sexually active later than their non-athletic peers.

Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT

Good morals or fitting in…A teenager’s dilemma

Are you the same person with your family and with your friends?  Consistency lowers anxiety.   Image courtesy of freedigitalphotos.net

Are you the same person with your family and with your friends? Consistency lowers anxiety.
Image courtesy of freedigitalphotos.net

What do you do if your family is raising you to be a certain way, but your peers want you to be something else?  Your family has taught you to be responsible, kind, caring, respectful, avoid curse words, tell the truth, be honorable, try hard in school, etc.  Your peers are encouraging you to experiment with alcohol, marijuana, sex, and irresponsible behavior.  Your peers think it’s fine to lie to your parents, use the f-word in every sentence, and complain about school.  How do you reconcile these two very different environments when it’s no longer cool to stick with the morals your parents have instilled in you?

 

Living in this tension is a source of immense anxiety for some teens.  They kind of go with the flow at school and around their friends, but in their hearts they’d rather be the person they are around their families.  They feel guilt and sometimes shame.  It’s very difficult to keep up an appearance of being a great kid in front of certain people, and the appearance of being an edgy kid in front of other people.  After a while it is confusing and stressful.

 

It’s very normal for adolescents to try and discover their own identity until their mid-twenties.  A teenager may come home with blue hair or a piercing; parents, don’t make this the end of the world.  They’re trying on a new identity.  Usually, as they get older they settle more into what they’ve always been taught.

 

In the meanwhile though, teenagers please remember that “normal” isn’t that great.  Fitting in with kids who are going against what you believe is only going to cause internal angst.  It takes a lot of emotional strength and fortitude to remain grounded in what is right, even for adults.  As a teenager it is much more challenging.  Teens are quick to give their peers a dirty look or a few harsh words when one of their friends doesn’t go along with everyone else.  If you prefer not to drink at a party, you probably have to deal with a few condescending comments.  Keep on track and don’t worry about what some drunk kid says about you; conformity doesn’t breed greatness.

 

Your overall anxiety will be lower if you are the same person in every situation.  Here’s where parents can make a huge impact: model having integrity in every area of life, and stick with good morals.  Parents, be the same person at work, home, in the dark and in the light.  Your children will benefit immensely from watching your consistency.

 

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

Porn Addiction In Teenagers

Sexual addiction affects adults and teens alike. Image courtesy of photostock / FreeDigitalPhotos.net

Sexual addiction affects adults and teens alike.
Image courtesy of photostock / FreeDigitalPhotos.net

More and more teens are engaging in pornography use.  The majority of the use seems to be on their phones.  Adolescents are very private about their cell phones.  It is harder for parents to monitor what they search than when there was a family computer.

 

According to Covenant Eyes, a company that sells a way to block certain web content from either accidentally coming up, or from coming up as the result of a search, the statistics are unsettling.  For teens, a 2010 national study indicated that about 25% of teenagers have viewed nudity online by accident.  Over 1/4 of 17 year olds have received a “sext” at some point.  9 out of 10 teenage boys have been exposed to pornography by time they reach college.  The same is true in almost 6 out of 10 teen girls.

 

Recently in my private practice I have been receiving desperate calls from parents whose teen children are addicted to internet porn.  The parents feel helpless and frustrated.  For starters, there is more shame in admitting you need help to stop a sexual addiction than even a drug addiction.  It seems easier for a parent to call me and say their teenager is addicted to marijuana, alcohol, or even methamphetamine than to online pornography.

 

If your child is struggling with this, or you are struggling with this, the first thing to do is set aside your shame.  Shame makes us hide.  We feel mortified about something we are doing, or some part of who we are.  When we feel ashamed of something, it is very difficult to talk about it.  However, getting it out in the open is how healing begins.  Think about when you have a wound, it needs to be cleaned out and it needs air to heal.  If you hide away your wound then it just begins to spread infection to other parts of the body.  Sexual addiction is like that (as are any other addictions).  If you don’t discuss it, even if that is incredibly difficult to do, it starts to affect other areas of life; addiction makes the most honest people into liars, the most responsible people into schemers, and emotionally closes off the most open and loving people.

 

Therapy is one of the best places to talk about sexual addiction.  It is confidential and free of judgment.  You will not shock your therapist.  Your therapist should be able to help you pick a path back to health.  This is not easy.  Many people assume if you want to stop a sexual addiction then just stop looking at the porn.  If it were that simple I doubt anyone would have the addiction.  Whether or not the images are viewed, they still exist in your teen’s mind’s eye.  It takes a lot of work and time to get to the place where those images don’t pop up each time your teenager thinks about sex.

 

Patrick Carnes is one of the leaders on treating sexual addiction.  He wrote a book called Out of the Shadows that is very helpful for those with addiction, and the people that love them.  If you’re reading this because you want help, but you’re afraid to say that out loud, then I recommend you start with this book.

 

If you or your child is struggling with sexual addiction and you are ready to say that out loud, don’t wait any longer.  Go and get the help you or your teenager needs.

 

Helping teens grow and families improve connection,

Lauren Goodman, MFT