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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

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

Marijuana Addiction in Teens

Marijuana addiction in teens is a growing problem

Marijuana addiction in teens is a growing problem

People have a hard time believing marijuana is addictive.  Indeed, for many people it is not.  It is similar to alcohol in that most people who use it do not become dependent.  Most can use it in a social, recreational situation.  However, like alcohol, there are some who cannot control their use.

 

Someone who is addicted to marijuana always says that other people do not understand it.  They say it has health benefits, and that it is not an addictive drug.  They say of course they could stop if they wanted to.  They ignore the irritation of their loved ones, and they ignore the signs that it is a problem.  Their productivity is lowered, and their emotional range is blunted.  They tend to use it several times per day.  It is often the center of their social group.

 

Heavy marijuana users tend to need it to fall asleep.  Their anxiety becomes so high that it is hard to quiet their minds before falling asleep.  What is ironic about this is that the majority of people who abuse marijuana claim it isn’t addictive.  However, if your teenager needs it in order to get to sleep, their body is dependent on it.

 

According to drugabuse.gov, 1 in 6 teens who use cannabis end up addicted to it during their lifetime.  For those who use it daily, the number skyrockets to 1 in 4.  Nearly 1 in 5 teenagers who enter a drug rehab facility go to treatment because they can’t quit using marijuana.

 

As a therapist who works with teens that have drug problems, I find that the teens who abuse marijuana are initially resistant to the idea they are addicted.  This is much more true than the teens who abuse other drugs.  I have yet to sit down with an opiate, meth, cocaine, or anxiolytic (such as Xanax) addict who thinks there is absolutely no problem with their drug use.  Yes, some of these drug users are in denial about how intense their addiction might be, but they all agree that it would be better to be sober.  This is not true with adolescents abusing marijuana.  Most of them maintain a moderate level of functioning, so they argue that they’re completely fine.  It takes a lot of work to break through a marijuana addict’s denial wall because addiction to marijuana is more subtle.

 

If this describes your teenager, my heart goes out to you.  You might even feel torn about whether marijuana is addictive yourself.  One thing that may help you understand is according to http://adai.uw.edu/marijuana/factsheets/potency.pdf, marijuana is 2 to 7 times more potent than in the 1970s.  Also, teens tend to smoke the flower buds of the cannabis plant, which is stronger than the leaves previous generations tended to smoke.  Many now use “dabs,” which is concentrated THC inhaled through a vape pen.  According to justthinktwice.gov, dabs are approximately four times as strong as the highest grade marijuana; they are absolutely addictive.  Previous generations also were more likely to begin use in their 20s, but now that is starting 5-10 years sooner.

 

If this blog is hitting home a little too closely, your teen has possibly begun to have a marijuana dependence.  They will argue with you that they feel fine, but it is still a problem behavior.  If you want your teen to be engaged, present and productive, then encourage them to quit.  If they cannot or will not quit, get them help.

 

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

Teen sobriety requires a change in friends

Making new, sober friends helps a teen stop using drugs.  Image courtesy of photostock at FreeDigitalPhotos.net

Making new, sober friends helps a teen stop using drugs.
Image courtesy of photostock at FreeDigitalPhotos.net

While this is not California, the statistics from this article are still very interesting to think about.  http://eastwindsor.patch.com/articles/christie-courts-mandatory-treatment-for-drug-offenders-26a17aed

 

In the state of New Jersey it has been found that mandating arrested drug offenders to treatment programs instead of jail-time has greatly reduced the repeat offense rate.  When a drug-offender simply does jail time the rearrest rate is 54% with a 43% re-conviction rate.  When mandated to treatment, the rearrest rate is 16% with an 8% re-conviction rate.

 

One thing that is rumored to happen in jail or prison is that an addict learns even more about how to be an addict.  There are a lot of drug users and dealers in prison/jail, and they educate one another in further delinquent behavior.  It is also rumored that there is a pretty significant amount of illegal drugs dealt within the prison system, sometimes making an addiction worse.

 

Whether you believe our justice system should or should not offer treatment centers as an alternative to jail/prison time, this article is a good example that treatment for addiction can be very helpful.  It also demonstrates that who you spend your time around is who you become.

 

While there’s a good chance your teenager isn’t serving jail time for a drug-related arrest, this article still applies to you.  The two important things to get from this is that 1) prisoners who spend time in the main prison population often commit drug-related crimes again and 2) prisoners who spend time around recovering addicts tend to get better.

 

If your child is acting out and participating in drug use, the most important thing you can do is change their peer group.  This is extremely challenging as a parent.  How many times have you told Junior, “I don’t like you being around those kids.  What about hanging out with so and so instead?”  Then you’re rewarded with a dirty look and an accusation that you “hate all my friends.”  This is when you need to start thinking outside the box.

 

If your kid isn’t working, help them find a job.  Teens who work develop friendships with their co-workers.  A job also takes up time that could otherwise be used to smoke a joint.

 

Your child might be farther into their drug use than just getting a job to change their peer group.  In that case, you’ll have to be more forceful and drastic.  Sending your teen to a relative’s house for about 3 months can be extremely helpful.  Do you notice that while your teen talks back towards you, they don’t talk back to your sister?  They aren’t familiar enough with your sister to do that.  It might just work to have them stay with her for a little while.  This is only effective if your relative lives far enough away that your teen cannot see the same friends.

 

If the case is more severe, you’ll have to strongly consider either rehab or teen boot camp.  Both of these methods are effective and helpful.  I’ve found that teens who go to boot camp tend to come back a little bit stronger than rehab.  However, in no way am I claiming to have completed a study on the matter.  Each rehab and each boot camp are different.  What works well with one type of teen may not be the ideal fit for another type of teen.

 

The bottom line is, teenagers begin to act like the people they are around.  Getting your struggling teen around successful teens tends to improve the decisions your teenager makes.  Just like the prisoners in this article, everyone needs someone who will show them an alternative, positive way out.  For teens the most important thing is that they think it is their idea.  This is your chance to be a creative parent and covertly help your teenager come up with a good idea for how they can start making changes.

 

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

Entertainment Streaming Addiction

Entertainment streaming addiction is so prevalent among teens (and people across the United States for that matter) that it’s almost hard to recognize.  Most people are watching hours of Youtube videos, Netflix, or Hulu each day. Because a great number of people are doing it, it starts to seem acceptable.  However, I challenge you to think about how any “addiction” is defined.  This will help you decide if your adolescent might have streaming addiction.

Addiction means needing more and more of something to feel satisfied, while feeling some form of withdrawal when it is taken away.  Has your teenager spent increasing amounts of time watching videos of some sort?  If you took all devices from them so they could not stream anything, would they be irritable?  Would it go beyond irritability?  Would they become despondent?

Many people thinl addiction is only possible if drugs or alcohol are involved.  They assume you need to go through physical withdrawals for something to qualify as “addiction.”  While the withdrawals from substances add danger to the withdrawal process, my experience tells me people get addicted to all kinds of things ranging from gambling to pornography to entertainment streaming.

The other element of addiction is whether it is leading to atrophy in other areas of life.  Is your teenager spending an inordinate amount of time sitting or lying down in order to watch a screen?  Is your teen struggling to get enough sleep because of hours lost to binge watching?  Has your teenager socialized less and less frequently with friends, preferring the company of a series they are watching?  Is your teenager’s favorite activity with you to watch a certain TV series together?  If you answered yes to these questions, then their life is out of balance because of entertainment streaming overload.

I encourage you to begin limiting your adolescent’s time in front of a screen.  According to Common Sense Media, teenagers are in front of a screen an average of nine hours per day.  Think about that!  Nine hours per day!  I PROMISE you they don’t have nine hours of homework per day, which means a lot of that screen time is unproductive.  Try putting a monitor on their devices just to make them aware of it at first.  Most people don’t want to be someone who does nothing but watch shows, they just don’t realize how much they’re doing it.  If they are made aware of how much screen time they accumulate each day, that might be enough for them to pare back.

If this doesn’t impact their screen use, then you will have to consider cutting the cord.  A lot of parents are hesitant to end a Netflix subscription because they also enjoy streaming.  But, being a parent has always meant doing things you don’t feel like doing.  When your kids were little you probably didn’t want to watch The Little Mermaid for the 100th time, yet you did it because it made them smile.  You may not want to give up Netflix in the house, but you can do it because it’s best for your kids’ growth and development.

Once your teenager is through the initial withdrawal period they will suddenly reappear around the house.  You will see your teen in the family room more often.  They will reengage with other activities.  It’s hard to imagine anything past their initial anger at first.  After a week or two though they usually start to enjoy things again.

Helping teens grow and families improve connection,

Cameron Munholland, MMFT, Associate MFT