Blog Archives - ADHD, Mood and; Behavior Center

October is ADHD Awareness Month

October 1, 2023/in ADHD, Blog /by Katherine Shaw

What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children (8.4 percent), though it also affects many adults (2.5 percent). General or common symptoms of ADHD include:

Inability to stay focused, which can lead to not paying attention
Hyperactivity, which means the person is moving their body too much and/or inappropriately for their setting (for example, bouncing up and down during quiet reading time in school)
Acting on impulse in any given moment without thought

ADHD is most often initially identified in school-aged children because the symptoms lead to disruption in the classroom or problems performing schoolwork. ADHD is more common among boys than girls, though the cause of that factor is unknown.

No specific causes of ADHD have been identified, though some evidence suggests that genetics contribute to ADHD. In approximately 75 percent of cases, a relative of someone with ADHD also has the disorder. Other factors that may be linked to ADHD include premature birth; brain injury; or the mother smoking, drinking alcohol or experiencing extreme stress during pregnancy.

What are ADHD symptoms?

Many ADHD symptoms, such as short attention spans, sitting still for extended periods and high activity levels, are common in most younger children. In children with ADHD, though, their heightened activity level and inability to focus are much more noticeable and greater than expected for their age. Their symptoms also cause distress and problems with daily functioning, whether at home, school or with friends.

ADHD symptoms are not due to the child being defiant or hostile or unable to understand and follow instructions or complete a task.

A diagnosis is typically based on symptoms experienced during the previous six months. ADHD is diagnosed as one of three types:

Inattentive: six (or five for people >17 years old) of these symptoms occur often:
- Has a hard time staying focused with activities or tasks, such as listening to lectures, participating in conversations or completing long reading
- May start tasks, but does not follow through or quickly loses focus
- Seems to not be listening when spoken to (inattentive)
- Doesn’t pay close attention to details; makes seemingly careless mistakes in school or at work
- Is easily distracted
- Difficulty with organizing and managing time; may miss deadlines and turn in messy work
- Forgets to do regular daily tasks, such as chores or errands; for older teens and adults, examples include grocery shopping, returning phone calls, going to appointments, paying bills
- Often loses commonly needed daily items or tools, such as a cell phone, car keys, wallet, schoolbooks
- Avoids or dislikes (more than average) anything requiring a sustained mental effort
Hyperactive/impulsive type – six (or five for people >17 years) of the following symptoms occur often:
- Always go, go, go
- Fidgets, taps hands or feet, squirms in a seat
- Unable to stay seated in the classroom or at work
- Runs around or even climbs when and where it is inappropriate
- Has difficulty waiting for their turn
- Unable to play or do leisure activities quietly
- Talks too much (others may not get a word in)
- Interrupts conversations or in class; may not wait to answer before a question has been finished or is not directed at them; may finish other’s sentences
- Intrudes into other’s activities without being invited; may even take over a task (a symptom more of older teens and adults)
- Uses other people’s things without asking permission
Combined type

How is ADHD Diagnosed?

No laboratory tests can diagnose ADHD. Diagnosis involves a medical evaluation to rule out other possible medical problems. Information is gathered from parents, teachers, the patient and possibly others. Checklists also help make a diagnosis.

What do I do if I notice symptoms in my child?

Though teachers and school staff can provide information about resources or tools to help evaluate behavior and learning problems, they cannot diagnose ADHD or make decisions about treatment or administer medication at school without an official diagnosis. If you are noticing symptoms and/or your child’s teacher brings up behavioral issues, you should start with making an appointment with your child’s pediatrician.

Students diagnosed with ADHD that impairs their learning may qualify for special education under the Individuals with Disabilities Education Act or for a Section 504 plan (for children who do not require special education) under the Rehabilitation Act of 1973. These benefits allow children with ADHD to receive instruction on study skills, behavioral modification techniques, changes to their classroom setup (for example, a yoga ball “chair” they can bounce on), alternative teaching techniques and a modified curriculum.

What should I do if I notice symptoms in myself or my adult partner?

Many adults with ADHD are unaware they have the disorder. Often, an adult partner or other close person who starts to recognize symptoms. If you recognize symptoms in either yourself or your partner, make an appointment with your primary care physician. They will be able to help begin the diagnosis process and provide you with referrals and resources.

The diagnosis procedure is the same as for children, but with the use of adult rating scales or checklists. Adults with ADHD are typically treated with medication, psychotherapy or a combination of both. Behavioral modification strategies can also help, such as finding ways to minimize distractions and increase your daily structure and organizational skills. Involving immediate family members can also be helpful.

What can I do to raise awareness about ADHD?

The Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) organization recommends the following to raise awareness.

Print out the NRC fact sheets on ADHD and share them with your friends and community.
Find additional resources on how you can increase awareness about ADHD and share them with others.
Host an event promoting ADHD Awareness Month or local resources for ADHD and mental health. You may want to partner with a local organization. During the COVID-19 pandemic, a virtual event is the safest choice.
Use your social media platforms to help dispel myths about ADHD and provide facts and other helpful information.
Speak out. Whether commenting on a social media post, having a conversation with family or friends, volunteering at your child’s school, contacting your local news media, or even your elected officials—use your voice to foster positive education and change. Let everyone know what it is like to live with ADHD and refer them to evidence-based information they can use to help spread awareness.

Awareness is education. The more you educate others, the more benefit you promote to those living with ADHD, especially for those who are unaware they or their child might have the disorder.

ADHD is a serious health condition that can create much adversity in a person’s life. With identification, proper treatment and support, they can be successful and have fulfilling lives. The ADHD, Mood & Behavior Center is always available to help you, whether providing resources or telepsychiatry visits with an online psychiatrist or online therapist. Contact us with questions and concerns or to make an appointment.

9 Tips on How to Take Control of Your Mental Health

November 16, 2020/in Blog /by Katherine Shaw

Think of your mental health as if it were part of the outside of your body, like an arm or leg. If you had an open wound, bruises, broken bone or a bad burn, you would get your injury treated. People would see your injury and know you were in pain.

Your mental health IS part of your body. The wounds don’t look like broken bones, but they still need to be treated. And preventing those mental broken bones is just as important as maintaining your physical health, yet it often gets overlooked.

Recognizing a Decline in Your Mental Health

We’re in the worst of a pandemic that is approaching the one year mark. The holidays are upon us with the extra stress of the pandemic. Daily life stressors are greater and your regular responsibilities can easily create a barrier to taking care of yourself when you need it most if you’re not watchful.

Recognizing when you are experiencing a decline in your mental health can be difficult. A bruised, bleeding and throbbing knee will send you running to the medicine cabinet for a bandage and a pain reliever. This is your body’s way of flashing neon lights and screaming that something is wrong. The signs of injury to our mental health are much more subtle and can also build over a longer period of time.

There is also the stigma that still exists around mental health. When faced with the happy highlight reels on social media and the persistence of society to ignore the importance of mental health, speaking up when you have a problem may be uncomfortable or embarrassing for some people.

Tips to Improve Daily Mental Health

Making your mental health a priority is the best way to help prevent a problem before it starts or get treatment when you need it because you’ll be able to recognize when something is wrong. You’re always going to have ups and downs emotionally, and that’s okay and normal.

However, there’s only so much stress a person can mentally handle before experiencing a decline that does not go away. Even with the limitations the COVID-19 pandemic presents, you still have many ways of keeping your mental well-being a priority.

1. Exercise

Time and motivation are two barriers to this excellent way to keep your mental health in top form. The benefits of exercise extend well beyond the physical, making this one of the most important ways to stay healthy. Exercise helps your brain release endorphins, which are hormones that create a pleasurable feeling, minimize pain sensations and promote healing.

Your exercise routine doesn’t have to be similar to intense training for a triathlon. Find something you love – gardening, walking the dog, a dance class, yoga – and mix it up! When you like a physical activity, finding your motivation will be much easier. During the pandemic, many classes are offered in an online format, so you can stay safe at home while exercising.

If lack of motivation is still hard to overcome, start with just a small amount and add a little each day. Getting started is the hard part, but once you get going and start to feel better, getting exercise will become a healthy habit you enjoy.

2. Eat well / get the proper nutrition

The healthier your body is, the better you feel mentally and emotionally. If you need help finding the right foods, talk to your healthcare professional or a nutritionist. Or, check out ChooseMyPlate.org. This government guide to foods and healthy eating is excellent and comes in app form as well, so you can go mobile. They have also added a section on food planning during the COVID-19 pandemic.

3. Get outside

The benefits of being outside are well documented and have been prescribed by physicians throughout history. Even in winter, take some time to enjoy being outdoors. The sun provides much-needed vitamin D for our bodies, which also plays a role in our mental well-being. Vitamin D deficiency is an issue for many people.

Nature is soothing and slows everything down, allowing a mental break in a stressful day. If the weather permits, take your work outside for a while. Do a phone call outside. Take a 10-minute walk. Or just sit and focus on the sights and sounds around you. The stimulation for your brain may be just the thing to give you a mental boost for the day.

4. Volunteer

Volunteering feels good emotionally because you know you are helping others. When we make positive changes in others’ lives, it has a great impact on our own. This is also an opportunity to connect with others in your community.

Being able to change a life, even in the smallest of ways, provides purpose. There are plenty of volunteer opportunities from the local to worldwide level. If you have trouble deciding, make a list of issues you are passionate about and start there. Something as simple as writing a note to someone each day to lift their spirits will lift your own as well.

5. Be kind to yourself

We all have a running mental chatter going on in our brain. Pay attention to the chatter. Is it negative in tone? Are you being hard on yourself? You may be surprised at what you “hear” when you are more mindful of your ongoing mental chatter. Change negative thoughts about yourself with purposeful positive ones. And give yourself a break!

6. Practice mindfulness and meditation

Mindfulness is the practice of being fully aware of what’s going on around us, our senses, and being present in any moment. Being mindful takes practice, especially to not be too reactive or overwhelmed by what’s going on around us.

Research is proving that mindfulness and meditation bring many benefits to all ages. Whenever you focus on awareness of what you’re experiencing via your senses, your thoughts and your emotions, you’re being mindful. For example, you sit down to relax with a cup of tea. Feel the warmth of the mug in your hand. Feel the shape of the mug. Smell the tea. Focus on the taste as it hits your tongue.

Meditation provides many long-term benefits, including lower stress levels, coping with pain, improved mental focus, making stronger connections with others, and being kinder to ourselves. Mindful.org provides a basic beginner’s guide to meditation. However, there are many videos and apps that also walk you through meditation and mindfulness exercises. A quick Internet search will provide a wealth of resources to help you.

7. Try something new

Trying new things creates opportunities for our brain to make new pathways and stimulates our thinking. New things also create a sense of anticipation and excitement. Try a new recipe, a new hobby, art, writing, reading a new book or new magazine, the practice of bonsai, puzzles, games.

8. Be wary of social media

Although social media can provide a way of connecting with friends and family, especially during times of isolation, it can also create negative feelings. People tend to post only happy moments or staged pictures or what looks like a good time (they may be miserable, but smiling perfectly in that selfie). In teens, they may see friends hanging out and wonder why they weren’t invited. Other posts may incite anger or fear due to false information or just general arguing. Don’t mistake the world of social media for what you gain through true social time with friends and family.

9. Ask for help.

If none of these tips are helping and your mood is consistently low, you may be experiencing signs and symptoms of a mental health disorder. Asking for professional help is the first step to regaining your mental health. All serious mental health problems should be discussed with your doctor, who may refer you to a specialist. There is nothing shameful about needing help for a medical problem.

If you are experiencing a mental health crisis, call 911 immediately or visit your local emergency services.

The ADHD, Mood & Behavior Center is always available to help you, whether providing resources or visits with an online psychiatrist or online therapist. Contact us with questions and concerns or to make an appointment.

The Benefits of Telepsychiatry

November 6, 2020/in Blog /by Katherine Shaw

What is Telepsychiatry?

Telepsychiatry is a subset of telemedicine, which is a way of providing healthcare communication other than in-person visits, such as videoconference or telephone. Telepsychiatry provides a range of services including psychiatric evaluations, patient education, therapy and management of medications.

Benefits of Telepsychiatry

Video-based telepsychiatry in particular meets important needs that may not be possible in-person, especially now during a global pandemic. Patients have needs for convenient, easily accessible and sometimes quick mental health services. Many other benefits of telepsychiatry, which include the following:

Bringing care to the patient’s location instead of them traveling*
- For adults, this means they can have a telepsychiatry appointment on their lunch hour or from home in the middle of a busy day.
- For adolescents and children, they can log on in the safety and comfort of their own home, whether in their bedroom or even a playroom. This personal environment will help them feel more relaxed and open up while speaking with an online psychiatrist or therapist.
Improving access to more mental healthcare services that might not otherwise be available due to a patient’s distant location
Improving continuity of care and follow-up
Filling prescriptions
Reducing need for time off work, childcare services and travel time and costs required to attend in person visit
Reducing transportation barriers, such as lack of transport to and from appointments
Reducing trips to the emergency room for emergency mental healthcare
Reducing delays in care with faster and easier access
Reducing barrier of mental health stigma

Some people may feel odd talking to an online therapist through a screen or monitor; however, research has shown that most people are comfortable with telepsychiatry, and the practice of online meetings is becoming more commonplace in all areas of life.

Although telepsychiatry has the perceived disadvantage of the patient and psychiatrist not being in the same room, it can create enhanced feelings of safety, security and privacy for many patients. Once a connection and trust is established, the possibility of moving to in-office visit (for local NJ residents) is a possibility, if preferred.

*Online psychiatrists and other clinicians must be licensed in the state(s) where the patient is living. State licensing boards and legislatures view the location of the patient as the place where “the practice of medicine” occurs.

Is Telepsychiatry Effective?

There is a large amount of evidence supporting the effectiveness of telepsychiatry. Patients satisfaction has been found to be high, as well as psychiatrist and other mental healthcare professionals. Research has also shown good overall experiences among all age groups. Telepsychiatry has been found to equal in-person care in these areas:

Privacy
Confidentiality
Quality of Care
Patient satisfaction
Diagnostic accuracy
Treatment effectiveness

APA Position Statement on Telemedicine in Psychiatry

Telemedicine in psychiatry, using video conferencing, is a validated and effective practice of medicine that increases access to care. The American Psychiatric Association supports the use of telemedicine as a legitimate component of a mental health delivery system to the extent that its use is for the benefit of the patient, protects patient autonomy, confidentiality, and privacy; and when used consistent with APA policies on medical ethics and applicable governing law (APA Committee on Telepsychiatry, Approved February 2018).

How to Prepare Your Child to Go Back to School Online

August 26, 2020/in ADHD, Blog, Learning Disorders /by Katherine Shaw

As the COVID-19 pandemic continues to spread, many schools have opted to function completely online or in a hybrid format, with some days of in-person learning and the rest online. This format is new to most schools, parents and children. This new way of educating children is daunting enough for parents, but especially challenging for parents of children with attention-deficit/hyperactivity disorder (ADHD).

Now, children must face an extended period of no socialization with their friends and peers, canceled sports, clubs and other activities, and being stuck at home for months without any assurance of a date that they can get back to “normal.” They may be having to face a new normal that looks different than the comfort of their past routines, except that no vision of what this new normal will be is available.

Impact of COVID-19 on Children’s Lives

Having our regular routine disrupted unsettles all of us. Anxiety, mood, ability to learn and more are all affected. When a scary pandemic is the cause, our emotional and mental reactions are even more heightened. Frustration and confusion are common. Just having the news on can cause anxiety in an adult, but for children, it may cause even more confusion and fear.

Take care of your family and your community. Stopping the spread of COVID-19 is the bottom line. Follow whatever guidelines are being made, from reputable sources like the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC). In those areas of COVID-19 “hot spots,” stay home if you can and keep your children at home unless necessary to leave. If you have to go out, wear a mask, be sure your children properly wear a mask, and stay at least six feet away from other people. For most kids, unfortunately, that means not getting together in person with friends for now as well as canceled sports, clubs and other social activities.

Challenges of Uncertainty for Children, Especially Children with ADHD

Children mentally process things differently than adults. Uncertainty is abstract for kids. Be realistic but also reassuring about the pandemic and how it personally affects them and your family. Encourage discussion often and questions. Children often need straightforward answers to their questions first. Avoid oversharing and flooding with facts. Then wait and see what further questions your responses elicit. Answer those in the same way—brief and to the point, honest, and reassuring.

Using Mindfulness to Normalize Mood

Though you can’t change the pandemic and school situation, you can work on keeping your children mentally settled. Trying mindfulness may help normalize their daily lives. Mindfulness builds resilience during stressful and difficult times by giving deliberate attention to how we relate to what is happening in our lives each moment.

The level to which you can employ mindfulness with children depends on age. Teenagers are likely to be able to fully grasp the concept and practice on their own. Younger children may need more planting of seeds of mindfulness, where you normalize the experience of awareness. Then the practice of mindfulness grows over time.

If your child is receptive to the idea, set aside a few minutes a day to start for a mindfulness practice. Don’t force it as this may make your child resist the idea completely. Find a guided practice online if needed, or a book or app. Make it a family activity and schedule mindfulness “breaks” during the day and evening.

For kids (and parents), focus on keeping mood or emotions close to neutral. Think of mood on a scale of one to 10. A settled, calm, “normalized” mood is a five. You and your child will slide a bit over and a bit under and that’s normal. What you want to avoid is a huge swing one way or the other, closer or at a one or a 10. Big swings can lead to heightened emotions and distraction.

There is nothing you need to expect to happen. The purpose is to gently guide children back to their present awareness when they get distracted. Keep mindfulness breaks unforced and fun, and let the practice develop at its own pace.

Schedule, Schedule, Schedule

Create structure and routine. Both adults and children are happier with a daily schedule. For families, post it somewhere for everyone to see, whether on a piece of paper or using an online family calendar. Posting a hard copy will be easier for younger children who do not have access to an online calendar or know how to use one.

Exercise. Our mental health is connected to our physical routines. Exercise daily, even if your children complain. Regular exercise has a positive outcome on mood, energy level, learning and more.
Sleep. A consistent routine of wake up and bedtimes encourages better sleep.
Eat healthy. Don’t use food as bribes or to keep kids happy. Stick with a balanced diet.
Limit screen time. The more screen time kids have the more wound up and agitated children get. No limits lead to arguing with you over putting a device away. Set a total amount of time or a set time period during the day and stick to it.
Keep up with relationships. One place screen time is very useful and helpful is in sustaining relationships with friends and family. Support is there for you and children when you reach out regularly during this challenging time.
Create a chore schedule to keep to reduce the stress of a messy home, keep a routine and teach responsibility.
Schedule and prioritize everything else if you wish, like family time, outdoor time, hobbies, art, etc.

Adjusting to Virtual School

Almost all kids can get off-track or miss details without strong adult supervision and guidance. Expect your child will need additional home supervision and guidance while working online. The success of online learning in previously in-person learning environments is unknown, and some to many teachers have little experience in this area. There will be a learning curve for students, parents and teachers. Try not to form preconceived ideas of how much progress will be made during this initial learning curve.

If your child has ADHD, remember he or she has difficulty with self-management and lag behind the non-ADHD norm. Children with ADHD need more structure and direct involvement than their peers to complete online work. Inform your child’s teacher and work with your child’s teachers and administrators and counselors to keep an open line of communication. Your child may have an Individual Education Plan (IEP). Contact the school to see how this will impact your child with online learning. Ask for support early and often, and if your child is still struggling, ask your school’s counselor or administrator for advice on what to try next or additional resources.

Your school will likely send out a supply list. If you don’t receive one, ask the teacher. Even though they are learning at home, your child will need many items for the virtual learning to support his or her learning and classroom lessons.

Find out what virtual classroom platform your school will be using. Get comfortable with using it so you can help your child when needed. If your school is not offering tutorials and your child needs one, you can find many online. Many schools are using Zoom, which can record class sessions for students who are unable to attend due to family obligations or other scheduling conflicts or who wish or need to review the material again at a later time.

Ideally, students should have access to learning anytime, anywhere. Teachers of younger students may also work with families to determine the specific needs of their children, including built-in time for completing assignments away from the computer that may differ from what is given in the daily schedules.

Synchronous and Asynchronous Learning

Synchronous learning takes place in real-time with a group and the teacher either live in person or live via videoconferencing, such as Zoom meetings.

Positives:

Frequent live interaction with teachers and peers
Questions can be answered quickly
Feedback is immediate
Closest format achievable in a virtual setting to replicate in-person learning

Challenges:

Less flexible schedule; students need to be online at specific times to learn
Feedback given in a large group setting may not be specific to each child

Asynchronous learning is anytime, anywhere learning that provides students with structured and engaging independent practice and possibly pre-recorded lessons. Examples include independent reading, video lessons, online assignments and discussion boards.

Positives:

Students choose the time and place that they learn
Students have more time to review and reflect on their learning
Students can follow the learning pathway in whatever way meets their personal learning needs
Many traditional learning strategies such as group discussions, individual student conferences and assessments are accessible in an online format

Challenges:

Students need a degree of self-motivation or adult support to stay on task
Presents additional challenges for ADHD children and their parents
Lack of live interaction with others

Setting up Your Home School Environment

Set aside a time for school. This may be dictated by your school except for offline learning activities (asynchronous learning), which you will have to schedule.
Create a dedicated school work area for your child with a minimum of distraction. Take away phones, turn off TVs and music and shut down anything else that is distracting.
At the start of the day, check school assignments posted online. Make a to-do list from it. Play time must wait until that list is complete.
Supervise schoolwork. You are a parent, not a teacher, but most kids need an adult around to stay efficient. Kids have immature self-management skills by definition and ADHD kids have even less self-management skills and computers are distracting to even adults.
Use timers if necessary. Children may find it easier to focus and behave if they know when a break is due. If not already defined by the teacher, define for your child what he or she is to do at the start of each work period. For example, for the next 20 minutes, do only this math sheet. Make the timer visible to them.
End each school day by having your child clean and organize his or her work space, just as it would be in school.
Emphasize “recess” daily. Remember the benefits of exercise, as this will help your child learn.
Encourage reading to promote academic success. Read with your kids and have them read alone. They can even read aloud to pets. Schedule it each day.
Limit non-school screen time, as mentioned earlier.

For middle school and high school students:

Focus on behavior management instead of “brain breaks.” When it comes to middle and high schoolers with ADHD, they need help sustaining their motivation and attention versus preventing learning burnout (which is where “brain breaks” come into play in the classroom or live online environment). Getting these students engaged to start with may be the most challenging aspect at home.
Choose the best time and place to remove distractions from their environment. Though having a dedicated work space is very helpful, a change of scenery may be useful if they are having trouble staying focused. If it’s nice outside, perhaps a school day outside in fresh air is an option.
Allow teens to use electronics (usually their phone) for fun only if they have completed all of their academic tasks for the day. Parents will need to develop a strategy of how they can monitor student performance consistently. Some schools have academic parent “portals” and even text and email reminders of assignments that are due, what is outstanding, what has been turned in and grades. Check if your school uses this extremely helpful tool and sign up.
Help your teens plan out their work in advance and use time management strategies.
Dividing their work into smaller chunks is helpful while being sure they are aware of expectations. Then monitor whether it’s completed.
Recognize and praise your teens for staying on-task and getting work done.
Refrain from micromanaging or taking over for them. This behavior is tempting for many parents, especially when they become impatient and have their own work to get done.
Do not give in to attempts to get out of work.

This school year is going to be challenging for everyone, with extra challenges for children with ADHD and their parents. The ADHD, Mood & Behavior Center is always available to help you, whether providing resources or visits with an online psychiatrist or online therapist. Contact us with questions and concerns or to make an appointment.

Productivity versus Procrastination in the Remote Work Environment

August 11, 2020/in ADHD, Blog /by Katherine Shaw

Working from Home

Working from home sounded great at first. The idea of not having to get up early (in theory), wear uncomfortable clothes and shoes, and drink horrible breakroom coffee all day sounded appealing to many former office workers. Now that some – or a lot – of weeks have passed, it hasn’t turned out to be the pajama party you thought it would be. With those perks come distractions: television, your personal phone, social media, kids, errands that are easier to run during the day, household chores to get done. And let’s not forget that fridge and pantry full of snacks.

If you are struggling to maintain productivity while working remotely, you are not alone. These easy, but effective tips may help:

Make a list. Start your day by making a to-do list. Write down everything you need to get done each day or use an electronic list or app. Put everything in order from most important to least important. Checking them off as you finish will also provide you with a sense of accomplishment, which helps fuel motivation to keep working.
Reward yourself. Sometimes it helps to keep yourself accountable by putting a reward system in place for yourself. For example, after you complete five tasks from your list, you get to treat yourself to a snack break, one (short) episode of your favorite show on Netflix, reading a chapter of a book, taking a quick power nap, or anything that will keep you motivated to keep going.
Switch it up. Many people recommend having one designated space for your home office. You’ve probably heard not to work in the same room you sleep or watch TV. However, sometimes switching to a more comfortable chair with your laptop and getting a change of scenery is just what your brain needs to stay productive. Weather permitting, take that laptop outside for a bit while you soak up some energy boosting Vitamin D.
Get dressed. It doesn’t have to be a suit and tie or a skirt and heels. It doesn’t even necessarily need to be jeans. Just don’t wear what you wore to bed last night when you work. The routine of grooming and getting out of sleepwear is needed to switch your brain from sleep mode to work productivity mode.
Take breaks. It’s important to get up and stretch your legs every once in a while. Stand up, drink some water, walk around, grab a snack. It can even be helpful to go outside for a couple minutes and get some fresh air. While there may not be time to take a walk around the whole block, exercise is very beneficial to a brain with ADHD. Also, sitting for extended periods is harmful to your health in many ways.
Take your medication. Adult ADHD medication works best when taken regularly. Just because you’re working from home in a familiar and comfortable environment does not mean you can skip a day of taking your medication.
Stick to a routine. Set your alarm and get up at the same time each day and go to bed at the same time each night. Set your work hours. Eat meals and snacks at roughly the same times. Do not perform any chores or errands you would not be able to perform if you were working in an office, which will throw off your entire work routine.

Learning from Home

Online learning for children is another big adjustment many people have had to make. It can seem overwhelming to parents who had to transition from working in an office, uninterrupted by the needs of school and childcare, to working at home while facilitating a learning environment and being constantly interrupted for snack demands to needing help getting back on Zoom.

To help lighten the load, many of the steps listed above for working from home also apply to learning from home. Also, remember that even though your child is usually spending around seven to eight hours at school, they really don’t need to spend that much time hitting the books at home. They had lots of breaks at school, too. These guidelines can help provide a structure for your day:

Kindergarten through second grade only need a maximum of 90 minutes of active curriculum learning per day
Grades three through five only need a maximum of 120 minutes per day
Grades six through eight need a maximum of 180 minutes per day (30 minutes per class)
Grades nine through 12 need a maximum of 270 minutes per day (45 minutes per class)

These timeframes can even be broken down into smaller chunks throughout the day.

Getting your child involved by giving them new age-appropriate responsibilities will help both you and your child. Some ideas include:

On the weekend, make up breakfasts and lunches together for the week and refrigerate or freeze them
Teach your child how to safely use the microwave
Keep healthy snacks within their reach in the pantry or fridge and set a timer for snack times or limits on the number of snacks
Set a reading time for each day. Have your child read out loud to you or a pet if they are younger and need supervision.
Plan physical activities in advance and offer a choice to your child to avoid them sitting in front of a screen all day.
Keep art supplies on hand and an area set up where your child can get their art on.
Give them an age-appropriate chore list. When they are bored, have them pick a chore. This won’t be their favorite activity, but it will help you keep them occupied while getting housework done. Chores also teach responsibility, even though their standards are likely going to be a lot lower than yours.
Bless the mess. Most children are messy. Art is messy. Snacks are messy. Having them dance in the background of your work Zoom meeting is messy. As you watch the mess expand like the blob throughout the day, your frustration level will likely rise in accordance. Instead of yelling, ask your children to behave as if they were at school – would their teacher allow them to leave a mess? Learning to accept some degree of messiness is also key. You’ll need to find the balance that works for your home. Just remember to keep your expectations reasonable for your child’s age and development level.
Set boundaries (like no dancing during meetings), but remember kids aren’t always going to follow the rules. They don’t at school either. Talk with your pediatrician or look online for ways to keep them engaged so they have less of a chance to break the rules, and a discipline structure for when they do.

If you are still feeling overwhelmed and having difficulty coping with the new arrangements, schedule a session with a therapist here. Online psychiatrists are also available when needed for your convenience. We are here to help.

Daily Life and Coping with Coronavirus

April 12, 2020/in Anxiety, Blog /by Robert Adamo

Life has drastically changed for all of us as a result of the outbreak of coronavirus disease 2019 (COVID-19). At times, all of these changes can result in overwhelming feelings of fear, anxiety, sadness, and also grief. Many of us have experienced many losses over these past four weeks – from the loss of our ability to see our loved ones whenever we wish and the loss of seeing our co-workers in person, to the loss of jobs and the loss of loved ones. Some of us are struggling with the fear of having to go to work at grocery stores, pharmacies, gas stations, hospitals, banks, post offices, etc etc. Those of us who are not essential workers might be struggling with feelings of guilt – of feeling like we’re not doing enough. For parents working from home, it can also be very difficult having to balance your own work responsibilities with your child’s/children’s teaching responsibilities. IT’S A LOT. We, at the ADHD, Mood, & Behavior Center, would like to provide our patients, and anyone else looking for some guidance at this difficult time, with some tips on how to cope with these feelings and how to differentiate between a normal stress response and a response that may require professional help. We are currently offering video appointments with our psychiatrists and therapists for our current patients, as well as anyone else who is looking to initiate care at this time. Please do not hesitate to reach out for help if you need it.

Ways for adults to cope:
• Make sure to take breaks from COVID-19 related news stories or social media stories.
• Try to maintain a daily schedule if your day is now significantly less structured. Have a consistent bedtime and waking time. Have well-balanced and regularly scheduled meals. Exercise regularly.
• Make time to relax and engage in activities you enjoy. Try to get some fresh air when you can, while maintaining social distancing practices.
• Try to maintain social connections using video chats and phone calls. There are many apps now that allow you to have group video chats with friends and family.
• Take space when you feel you need it. Sheltering in place could sometimes result in some of us feeling overstimulated by always having to be around those in our household. It’s important that we all take breaks and get space when we need it.
• Avoid unhelpful coping strategies, like substance use and high-risk behaviors.
• Seek out help from a professional if you are struggling.

Ways for parents to help their children cope:
• Limit the amount of television or news children watch as the news can be frightening and disturbing to them. Instead, find accurate and age-appropriate information and have an honest discussion with them using language they can understand. Answer any of their questions honestly.
• Try to maintain a regular routine, as children feel more secure when there is structure to their day.
• Help facilitate video chats and/or phone calls with their friends and family.
• Make sure children get some fresh air whenever they can, while maintaining social distancing practices. Try to implement some sort of daily physical activity.
• It can be very difficult for children to be stuck inside, especially when the weather is beginning to get nicer. Try to come up with fun activities for the family to engage in. Have game nights. Have children help in meal preparation or menu planning. Encourage them to learn a new skill. There are many free online classes available now.
• Give children choices when possible, as this will give them a sense of control during a time when there is little they can control.
• Give them space when they need it. Sheltering in place could sometimes result in some of us feeling overstimulated by always having to be around those in our household. It’s important that we all take a break and get space when we need it.

Common stress responses in adults:
• Changes in sleep or eating patterns
• Difficulty concentrating
• Changes in energy levels
• Avoidance of activities previously enjoyed

Common stress responses in children and teens:
• Excessive crying, irritability, or acting out
• Regressive behaviors or returning to behaviors they have outgrown such as bedwetting
• Changes in sleep or eating habits
• Poor school performance or avoidance of school related tasks
• Difficulty concentrating
• Avoidance of activities previously enjoyed

When to seek out help:
• If any of these responses persist for longer than 1-2 weeks and/or start to get in the way of an individual’s function, it is likely time to seek out professional help from a psychiatrist or therapist.
• If you or your child becomes preoccupied with or has intrusive thoughts or worries surrounding COVID-19 or death.

How to Talk to Your Child About Disasters & When to Seek Help

November 19, 2018/in Anxiety, Blog, Depression, Obsessive-Compulsive Disorder, Teens /by Angela Corsetto

Recent disasters, such as the wildfires in California, the Thousand Oaks shooting, and the shooting at a Pittsburgh Synagogue, can be very frightening for children. Since children often see or hear about these events either through the different news outlets that are accessible to them or through their interactions outside the home, it can be helpful to talk about the event with them in language they can understand.

The following guidelines can be useful when having these conversations:

Try to set aside adequate time and a quiet space.
Use a tone that’s calm and language that’s not overwhelming.
Ask the child what he/she already knows and what questions he/she has.
Be honest as children are very aware of their parents’ concerns and know more than we think.
Talk about your worries as well as your abilities to keep your child safe.

In addition to having these conversations, it is also important to look for signs that your child might be struggling after a disaster. There are different factors that can affect a child’s response to a disaster that can include:

The way they experience their parents’ response.
How close they are to the disaster/whether there was direct involvement
Whether they know anyone that was directly affected.
The child’s age.

Behavioral changes that might indicate your child is struggling and may benefit from being evaluated by a mental health professional include:

Acting out or misbehaving in school or at home that is atypical for the child.
Refusing to go to school or other places the child typically attended without a parent.
Fears that persist long after the disaster, jumpiness, nervousness, and a much heightened sensitivity or alertness to danger.
Avoidance of people, places, and things that remind the child of the incident.
Sleep disturbances or changes that were not occurring prior to the disaster, such as nightmares or bed-wetting.
Depressive symptoms that can include low or irritable mood, appetite changes, fatigue, withdrawal from friends and family, decreased interest in activities, feelings of hopelessness, and in some cases suicidal thoughts.
Physical symptoms in the absence of a physical injury or illness, such as headaches and stomachaches.

How to Talk to Your Child About Suicide

August 20, 2018/in Blog /by Angela Corsetto

Recent celebrity suicides have shed more media light on the issue of depression and suicide. Any time someone commits suicide, family, friends and acquaintances are left in shock and sadness. There is often an overwhelming question of why and why didn’t we know? These questions are also followed by feelings of guilt and regret for not having known how badly a loved one was suffering.

It can be a difficult and awkward topic for parents to discuss with their children, however it’s important to be direct and as honest as possible when speaking to children about depression and thoughts of self-harm.

Be direct and provide age appropriate information. Provide an explanation of mental illness that makes sense for your child’s age, maturity and level of understanding. For example, for a younger child you may say that ‘people’s thoughts and feeling are controlled by their brain and sometimes their brain gets sick the same way a body can get sick. When someone’s brain gets very sick, it sometimes makes them want to stop their body from working. For an adolescent or teenager, you may use more direct language.

Encourage your child to ask questions. Providing the opportunity to have a conversation about mental health opens the doors to further conversations and it also normalizes discussion about mental health in general. While it may be uncomfortable, try to remain present and listen to your child as much as possible. Practice reflective listening and ask open ended questions such as, ‘How do you feel about what happened?’ ‘What are your thoughts about what happened?’ ‘What questions do you have?’

Talk about the signs and symptoms of depression. If your child is a young adolescent or teenager, it’s a good opportunity to talk about how anxiety and depression affect someone’s behavior. This is the age where kids start sharing less with their parents and more with their peer group, so give your child helpful information so that if they or a friend is feeling depressed, they know what to do.

Finally, emphasize the importance of maintaining good mental health. Just as going to the gym regularly can help keep your body healthy, talking to a licensed therapist or counselor helps keep our minds healthy. Encourage your child to speak and use outlets for their feelings. Let them know who the counselor is in their school, discuss the value of therapy. Consider making an appointment for your child with a therapist if you have any concerns that they may be depressed or anxious.

*If you or your child is feeling suicidal, call 911 or go to your nearest emergency room or contact the National Suicide Prevention Lifeline at 1-800-273-8255 or https://suicidepreventionlifeline.org/. *

What to Do if Your Child is Being Bullied

May 30, 2018/in Anxiety, Blog, Teens /by Angela Corsetto

It can be very difficult as a parent to watch your child come home from school in tears, withdrawn, or moody only to find out that they are being teased or bullied at school. Here are some key tips to support your child and help resolve the situation as effectively as possible.

Listen to your child without judgement. Allow your child to tell you the full story in their own words without interruptions and minimal reactions. It is already difficult for a child to recount what has happened so they may minimize what happened if they feel you are getting upset. Use open ended questions and phrases such as: tell more about that, how so?
Find out the facts. When appropriate make sure you get the who, what, when, and where of what occurred so that you can record it and let your child’s teacher know. Keep a record of an future incidents.
Problem solve. Engage in problem solving with your child so that they know how to self-advocate if the situation occurs again. Come up with several strategies (including finding a safe teacher or administrator that your child can go to) with whom your child feels comfortable. Practice using the strategies with role play.
Reach out. Talk to your child’s teacher as soon as possible. Keep in mind that teachers don’t always and can’t always know when bullying occurs. Kids are smart and know when to tease/make cruel remarks when the teacher is occupied or out of earshot.
Ask for a copy of your school district’s bullying policy. This will send the message that you know how to advocate for your child. Also, every school should make this available to parents upon request by law.
Take your concerns up the chain of command. If the problem persists, meet with your child’s school principal and ask for documentation of how the problem will be resolved. Familiarize yourself with the state law and pursue that the school do a full investigation and document a case of HIB (Harrassment, Intimidation, or Bullying) if you feel like you are not getting results.

Find out more here:

http://www.nj.gov/education/students/safety/behavior/hib/ParentGuide.pdf

http://www.stompoutbullying.org/information-and-resources/parents-page/what-do-if-your-child-being-bullied-and-resources/

Watch for signs of serious stress, anxiety or depression. Having your child talk to a professional can be particularly helpful especially if you see emotional or behavioral signs of stress such as social withdrawal, sleep issues, changes in appetite, or mood swings.