Monthly Archives: September 2013

The Drama of the Anxious Child

The Drama of the Anxious Child

2013-09-30

Childhood anxiety is on the rise at every level, from fear of monsters under the bed to severe anxiety disorders

When I was first studying psychology, thirty years ago, I learned that about 10-20% of children are born with a temperament that is highly reactive to anything new and unfamiliar. Some of these children go on in life to be anxious, timid, or shy (or, as we shy people like to say, “slow to warm up.”) A much smaller number of children, about 1-5%, were diagnosed at that time with a full-fledged anxiety disorder.

Nowadays, there are still 10-20% with that reactive temperament, but the number of children with a diagnosable anxiety disorder has skyrocketed, up to 25% according to the National Institute of Mental Health. A report from the National Institutes of Health adds, “There is persuasive evidence from a range of studies that anxiety disorders are the most frequent mental disorders in children and adolescents….” These new numbers must be viewed skeptically, of course, because of the trend towards looser and broader definitions of mental illness. Many commentators have linked this trend to the influence of pharmaceutical companies on diagnosis and prescription patterns.

Despite these caveats, however, I believe that childhood anxiety is indeed on the rise at every level, from fears of monsters under the bed to phobias and panic attacks to severe anxiety disorders.

Last year I gave a lecture on childhood anxiety to parents at a public elementary school. I heard about children who couldn’t be in a different room from their parents, even to use the bathroom, children who were too afraid of the water to swim or even take a shower, and children who were too afraid of making a mistake to function well in the classroom.

Of course, these were parents who chose to attend a lecture on childhood anxiety, but many teachers have told me that they now have a number of highly anxious children in every class. What struck me most in this group was that none of these children was in therapy, and none had received an “official” diagnosis of an anxiety disorder (though I did give out a few business cards).

In my practice I have seen more and more children who have too much social anxiety to go to school, too much stress about grades to enjoy life, and too much separation anxiety to achieve independence as they grow older. My colleagues report the same rise in fears, worries, and anxieties.

What’s going on?

Anxiety is an alarm system—we need a little jolt of it so we will look both ways before crossing the street, but we also need an all-clear signal when the danger has passed. I think our constantly wired world has drowned out the all-clear signal. We hear instantly about every disaster, and we are bombarded with graphic images that repeat on a loop—first onscreen and then in our minds.

Another way to think of anxiety is as a simple formula: Add up all the things that cause us stress, and then subtract all of our abilities to cope. The net result is our anxiety level. This formula makes it clear why childhood anxiety is on the rise. Schools are more competitive and stressful, children are more overscheduled, parents are worried about finances and safety, and our society is based on a win-lose model, where only a few children will be able to succeed. Meanwhile, coping mechanisms are disappearing: Children don’t get enough time outside, either experiencing nature or running around in their neighborhoods. Children don’t spend nearly enough time doing “nothing,” enjoying the downtime necessary to process all their new experiences. Instead, they are desperately engaged in a drive to never be bored. I think many parents have put themselves—and their children—into an anxiety-producing corner. They want their children to be academically successful and always happy and creative and socially/emotionally intelligent. It’s an impossible demand, and the inevitable result is anxiety and burnout.

In order to change this, we first need to look to ourselves. What are we doing to manage our own anxiety? I have lost count of the number of parents who tell me they don’t pressure their high-strung children. Let’s get real. I’ve been observing a strange mix of avoidance and pressure in today’s parents. They say things like, “You don’t have to swim (or go to birthday parties, or play soccer) if you don’t want to,” but at the same time they are distraught about their child not having a best friend or the right playdates in kindergarten.

As parents, we need to focus on the opposite of worry, anxiety, and fear. In terms of the body, that means relaxation, physical activity, roughhousing, and outdoor time. In terms of overprotectiveness, that means letting children have adventures that are scary, fun, and safe. In terms of specific phobias, the opposite is a gentle nudge towards facing the feelings and overcoming the fears. And for us parents, the opposite of worry is trust: trust in the power of development, trust in the resilience of children, and trust that the world is a good and safe place for our children to grow up.

Why you shouldn’t go to work sick

Why you shouldn’t go to work sick

2013-09-26

By Dr. Jennifer Shu, Special to CNN

he average adult gets a cold about two or three times a year, with each one lasting up to a week, or sometimes longer.

Staying home from work every time you are sick could add up to a lot of missed days. In fact, it has been reported that up to 40% of lost time from work is due to the common cold, totaling about 23 million missed days per year.

Even though it can be tempting to go to work while you’re sick, here are some reasons why you are better off staying home:

You’ll get other people sick

Germs can spread from direct contact with a sick person or his or her secretions (such as from handshakes or touching shared objects like doorknobs). Some viruses can live on the skin or other surfaces for at least a few hours and continue to infect others.

In addition, viruses can spray a few feet following a cough or sneeze. Especially in the earliest part of illness, when you are most contagious, stay home if you work in close quarters with other people or if you handle food.

It’s also important not to go to work if you work with young children, the elderly or people with weak immune systems. The relatively minor illness you experience may cause more severe symptoms in these groups of people.

You’ll be less productive

It is hard to know the exact financial and physical toll that an illness takes on an individual or employer. Sure, you’ll be more productive than if you stayed home and didn’t do any work at all, but you may not be as sharp or efficient when suffering from a cold.

It may take longer to recover

Pushing yourself and working too much in the early stages of illness may actually prolong your recovery time. Studies have shown that lack of sleep can weaken your immune system and make you more susceptible to colds.

Conversely, getting enough sleep can boost infection-fighting cells and antibodies so you can get well faster. Do yourself a favor and stay home and rest.

Ideally, we would all be able to rest and recuperate during a cold. If that’s not possible, see if you can work from home so at least you won’t spread your germs.

If you must go to work, try to keep your distance from others, wash or sanitize your hands often, and cover coughs and sneezes with a sleeve or elbow. You can also cover with a tissue but be sure to throw it away immediately and then wash your hands.

Disinfect touched objects such as phones, doorknobs, and computer keyboards, and consider avoiding sharing items such as pens.

Why Videos Aren’t the Best Way for Kids to Learn

Why Videos Aren’t the Best Way for Kids to Learn

DVDs and educational programs on TV have a growing place in helping young children to learn. But there’s new evidence that they may not be as effective as old fashioned conversation.

Even before birth, children hear sounds and words and can babble a variety of noises that will eventually coalesce into into language. “Before nine months of age, a baby produces a babble made up of hundreds of phonemes from hundreds of languages,” Elisabeth Cros, a speech therapist with the Ecole Internationale de New York told TIME in April. “Parents will react to the phonemes they recognize from their native tongues, which reinforces the baby’s use of those selected ones.”

It’s that dynamic interaction between the infant and her caregiver — a back-and-forth that static videos and television programs can’t provide — that is critical for efficient language learning. And a group of researchers from the University of Washington, Temple University and the University of Delaware explain why.

The scientists studied 36 two-year-olds who were randomly assigned to learn verbs in three different ways. A third of the group trained with a live person, another third learned through video chat technology like Skype, and the final third learned by watching a pre-recorded video of a language lesson from the same person.

Their results, published in the journal Child Development, showed that kids learned well in person and in the live video chat, likely because both scenarios allowed for an interaction between the child and the teacher, allowing the youngsters to be more responsive and therefore retain more from their experience. The children using the recorded videos, by contrast, did not learn new vocabulary words by the end of the 10 minute learning and testing task.

The findings confirm previous work that connected live conversations with better vocabularies among young children, but add another layer of understanding about why one-on-one interactions are so important to a developing brain. Nerve connections responsible for language building requires repetition and reinforcement, which can help to strengthen the correct and appropriate words or sounds and discard extraneous or inappropriate ones. It’s not that educational programming or DVDs are harming young minds; it’s more that they aren’t maximizing the infants’ ability to absorb and learn and pick up words and verbal skills more efficiently. So parking a child in front of screen for a few minutes isn’t going to hamper his ability to talk, but interspersing those videos with some one-on-one time engaging  in conversation could help to speed along the learning process.

@acsifferlin

Alexandra Sifferlin is a writer and producer for TIME Healthland. She is a graduate from the Northwestern University Medill School of Journalism.

Why New Mothers Stop Breast-Feeding

Why New Mothers Stop Breast-Feeding

2013-09-24

While nearly all mothers start breast-feeding their newborns, about half stop after a few weeks. The latest study explains why.

A team of researchers conducted over 2,700 interviews with 532 first-time mothers multiple times after they gave birth, starting 24 hours after delivery and ending at 60 days postpartum, about their breast-feeding choices. They report in the journal Pediatrics that women who worried from the start about their ability to nurse their infants were more likely to switch to formula sooner than those who didn’t have these concerns.

By the third day after delivering, over half of these women were worried about their babies’ ability to latch on, while 44% were concerned about breast-feeding pain, and 40% about their capacity to produce enough milk to nourish their infants.

Continue reading Why New Mothers Stop Breast-Feeding

5 tips for recovering from emotional pain

5 tips for recovering from emotional pain

2013-09-19

By Guy Winch, Special to CNN

Editor’s note: Guy Winch holds a doctorate in clinical psychology and has a private practice in Manhattan. He is the author of “Emotional First Aid: Practical Strategies for Treating Failure, Rejection, Guilt, and Other Everyday Psychological Injuries.”

We sustain psychological injuries such as rejection and failure as we go through life just as often as we do physical injuries. But while we have access to ointments and bandages to treat cuts and sprains, we have no such tools to treat emotional pain.

In my book, I discuss the impact of seven common psychological injuries on our emotional well-being — rejection, failure, guilt, loneliness, rumination, loss and bouts of low self-esteem — and offer science-based treatments that ease the pain, accelerate healing and minimize long-term risks to our mental health.

Continue reading 5 tips for recovering from emotional pain

Eat Better and Stress Less: It’ll Make Your Cells (and Maybe You) Live Longer

Eat Better and Stress Less: It’ll Make Your Cells (and Maybe You) Live Longer

For the first time, researchers show how a plant-based diet, stress management and other lifestyle changes may lead to longevity.

It’s not quite the Fountain of Youth, but it may be the river that leads to it. In a paper published in the journal Lancet Oncology, scientists found that a small group of men who made changes in the way they ate and handled their emotional needs showed longer telomeres in their cells.

That’s exciting because previous research suggested that telomeres, which are protein and DNA-based complexes that cap the ends of chromosomes, regulate the aging of cells. Each time a cell divides, a section of telomeres erodes, and, like a burning candle wick, when telomeres are exhausted, so is the life of the cell.

Continue reading Eat Better and Stress Less: It’ll Make Your Cells (and Maybe You) Live Longer

How much sex is considered exercise?

How much sex is considered exercise?

2013-09-18

By Jay Williams, upwave.com

Editor’s note: upwave is Turner Broadcasting’s new lifestyle brand designed to entertain the health into you! Visit upwave.com for more information and follow upwave on Twitter, Facebook, YouTube, Pinterest and Instagram @upwaveofficial.

(upwave.com) — When I think of the ultimate sex workout, I picture the scene from “Mr. and Mrs. Smith” where Brad Pitt and Angelina Jolie throw each other around their kitchen for an hour. Unfortunately, not every sexual experience is quite that… well, high-intensity. But how many calories do we really burn in the act?

The rumor: A bout of sexual activity can burn between 100 and 300 calories

Continue reading How much sex is considered exercise?

Teens gaining healthy habits, but not enough

Teens gaining healthy habits, but not enough

Efforts to increase healthy habits in American teens may be making an impact, according to a new study. Adolescents are moving more, eating better and watching less TV than they used to, and researchers say obesity rates in this group may finally be stabilizing.

The study results come a little more than a month after the Centers for Disease Control and Prevention announced it was seeing signs of progress in the fight against childhood obesity, especially in low-income families.

Continue reading Teens gaining healthy habits, but not enough

Erectile dysfunction? Try losing weight

Erectile dysfunction? Try losing weight

2013-09-16

By Anne Harding, Health.com

Viagra gets the job done, but it’s a quick fix. For many men, weaning themselves off the little blue pill and finding a longer-lasting solution to their sexual dysfunction may require hitting the gym and putting down the doughnuts.

A new Australian study, published Friday in the “Journal of Sexual Medicine,” found that losing just 5% to 10% of body weight over a two-month period improved the erectile function — and revved up the sex drives — of obese men with diabetes.

The study was very small (it included just 31 men), so the results should be taken with a grain of salt. But the findings are yet another reminder that obesity and erectile dysfunction (ED) often go hand in hand.

Excess weight — especially excess belly fat — can affect sexual function in many ways; it can interfere with the body’s ability to supply blood to the penis, for instance, and it can cause testosterone production to plummet.

And though the research on weight loss and sexual dysfunction is still emerging, there’s growing evidence that men who get active, eat healthier foods, and pare a few pounds will see their sex lives improve — not to mention their overall health.

In fact, doctors express hope that the promise of an improved sex life will finally get through to all the overweight and obese men who haven’t responded to dire warnings about heart disease, diabetes and stroke.

“You talk all the prevention you want,” says Kevin Billups, M.D., an associate professor of urology at the University of Minnesota, in Minneapolis. “When I talk about restoring penile health, I have their attention.”

When a patient comes to see him about ED, one of the first things Billups tells him to do is to stand up and look at his belly. “If you can’t see your penis,” he says, “that’s a problem.”

How obesity hits below the belt

The most important way that excess weight drags down a man’s sex life is by affecting the health of his blood vessels.

An erection occurs when the blood vessels leading to the penis dilate, causing it to fill with blood. This process begins when the inner lining of the vessels (known as the endothelium) releases nitric oxide, a molecule that signals the surrounding muscles to relax. (Viagra and similar drugs work by increasing the amount of nitric oxide in the endothelium.)

Although experts aren’t exactly sure why, obesity appears to damage the endothelium. And when the endothelium doesn’t work properly, the penis may not get enough blood to produce or sustain an erection.

“An erection is basically a cardiovascular event,” says Robert A. Kloner, M.D., a cardiologist and professor of medicine at the University of Southern California’s Keck School of Medicine, in Los Angeles. “If blood flow cannot increase because the blood vessels can’t dilate normally, then there’s a decrease in erectile function.”

Sure enough, in the new study, endothelial function improved in the men who lost weight. (Function was measured using two different laboratory tests.)

Poor heart health can cause ED in another way. The fatty foods and lack of exercise that cause weight gain also contribute to the narrowing and hardening of arteries (atherosclerosis), in which cholesterol and other substances build up in the artery wall.

Atherosclerosis, which can lead to heart attacks if it occurs in major arteries near the heart, can happen just as easily in the small blood vessels leading to the penis.

In fact, atherosclerosis may hit those small blood vessels first, which is why ED is increasingly seen as an early warning sign of heart disease, Kloner says.

The role of testosterone

Blood vessel problems are responsible for the vast majority of ED cases in obese men over 40, experts say, but another common culprit is low testosterone, which is also linked to obesity. Adequate levels of this male sex hormone are necessary to maintain sex drive and get erections.

Low testosterone is “very much underdiagnosed,” says Ronald Tamler, M.D., co-director of the men’s health program at the Mount Sinai Medical Center, in New York. “And as we are all getting fatter, it’s becoming an increasing problem.”

Those big bellies Billups warns his patients about are especially worrisome when it comes to testosterone. Belly fat, a strong predictor of heart risk, seems to have a greater effect on the hormone than excess fat distributed in other parts of the body.

“That’s the bad actor that causes all sorts of inflammatory mediators and different substances to be emitted into the body that will lower testosterone,” says Billups, who studies the relationship between heart health and sexual dysfunction.

Losing even a little weight can improve blood vessel function (as the new study shows), but the effect of weight loss on testosterone levels may not be as rapid or as direct. Men who have persistently low testosterone levels and ED despite losing weight may need to consider testosterone gels, shots or patches, Tamler says.

Weight loss can turn things around

Being overweight doesn’t seem to affect a man’s self-esteem as much as it does a woman’s, says Joel Block, Ph.D., a psychologist on Long Island who specializes in couples therapy and sex therapy. ED, on the other hand, can trigger a cycle of shame and doubt in even the most confident men.

“Once [ED] happens it becomes self-perpetuating,” says Block, an assistant clinical professor at the Albert Einstein College of Medicine, in New York City. “The more he fails, the more difficulty he has.”

Eventually, Block says, a man will begin to avoid sex. And his condition may plunge him into depression.

“Even if you have clear cut medical reasons — diabetes, obesity — when you’re having erectile dysfunction…it is depressing,” Billups says. “A lot of these men [are] down in the dumps.”

Losing weight can help with the plumbing aspect of ED, but it can also provide an ego boost that carries over into the bedroom, says Stephen Josephson, Ph.D., a psychologist at New York-Presbyterian Hospital.

“People need to feel good about themselves [to] overcome performance anxiety and other things in the sex arena, and sometimes it’s as simple as getting into shape,” Josephson says.

Some men who have relied on pills like Viagra or Cialis to get erections can toss them once they start exercising, eating right and losing weight, Billups says.

These men may see their morning erections return, he adds, and their wives have been known to say they’re acting “friskier.”

“They’ll come in and tell me, ‘Wow, doc, things are really turned around,'” he says.

Smarter Kids Are Smart Enough to Avoid Alcohol and Drugs, Right?

Smarter Kids Are Smart Enough to Avoid Alcohol and Drugs, Right?

2013-09-15

Maybe not. The latest study of twins shows that early bloomers may become heavier drinkers who start chugging earlier in life.

The research is part of an emerging but counterintuitive body of work that suggests kids who develop language and intellectual skills earlier are more likely to drink and take other drugs than their less intelligent peers.  In 2011, for example, British researchers found that women who were in the top third of the IQ range when tested in elementary school were more than twice as likely as those scoring in the bottom third to have used marijuana or cocaine by age 30; for men, the top ranked boys were almost 50% more likely to have taken amphetamine and 65% more likely to have used ecstasy (MDMA) by adulthood.

For decades, scientists had documented that those with lower IQ and less education were more likely to become addicted to alcohol or other drugs, probably because lower levels of education and lower IQ are associated with the damaging effects of poverty and because having less intelligence offers fewer mental resources to allow users to moderate and avoid problems.

The latest data, published in Alcoholism: Clinical and Experimental Research, doesn’t contradict those findings. Drug use is not the same as drug addiction— and a great deal of earlier research shows that higher intelligence is a protective factor against alcoholism and addictions, even though smarter people are more likely to drink or try drugs.

The researchers followed 3000 healthy identical or fraternal twins in Finland, focusing on the group who had significant differences in verbal development as children and who also turned out to have varied drinking behavior as adults. The twin who spoke her first words earlier or began reading earlier was nearly twice as likely as her co-twin to be drinking more at age 18. And twins who spoke first were four times as likely to get drunk once a month or more often than their later-speaking twins, who either hadn’t been drunk at all or did so less than once a month. Overwhelmingly, this drinking was not out of control and did not qualify them for a diagnosis of having an alcohol disorder.

Social drinking in many countries and non-problematic drinking is more frequent and common among people with higher education,” says Antti Latvala, a postdoctoral researcher at the University of Helsinki in Finland and lead author of the study. Why? What protects them from sliding into addiction?

Intelligence can serve as a vehicle for moderation when it comes to alcohol or drug use — the more educated people are, the more they internalize and appreciate the dangers and risks of overindulging. The higher education that’s correlated with greater intellect also puts more at stake for those who indulge in alcohol or drug abuse.

Intelligence can also spur more curiosity and openness to new experiences. And that includes experimenting with alcohol and drugs. “People have this impression that intelligence is somehow related to being introverted and bookwormish,” says Latvala, “But if you look at these large studies they definitely find this association with sensation-seeking and seeking different kind of experiences. [They’re] trying to learn new things  It could be related to the nature of intelligence.” Such experimentation doesn’t always lead to addiction or problematic behavior because this type of exposure often involves a few experiences before the person moves on to the next novelty.

Verbal intelligence may also often allow kids to better negotiate the social world, and since most social teenagers in Western societies drink, being social inevitably exposes them to alcohol. The study found that the more verbally skilled twins did have more friends who drank than their co-twins, so the connection might be reinforced culturally as well.

Although the study did not find that the early exposure to alcohol and drugs made the smarter twins more vulnerable to addiction, these twins weren’t entirely safe from the harms — including overdoses, drunk driving, sexual assaults and injuries — that can result from drinking or abusing drugs. Being smart doesn’t mean you are immune from drug-related dangers.