Category: Anxiety, Depression & More

Managing Uncertainty With Your Family During COVID-19: More than deep breathing

Mother resting her forehead on his daughter with ADHD's forehead, both wearing blue shirts and masks, trying to manage uncertainty with her family.This new “normal” isn’t anything we’re accustomed to. With school closures, social distancing, working from home, job lay-offs and 24/7 family time, everybody is making huge adjustments to the massive disruption wrought by COVID-19. While we adults struggle to wrap our brains around these changes, it’s even harder for children and teens who may or may not understand why they are home. Managing uncertainty with your family during COVID-19 will likely be a continuous process for quite some time. Take time to get familiar with anxiety-reducing practices, and make a habit of family check-ins so you all can feel the support from one another during this difficult experience. Kids and teens are now separated from friends, family and familiar activities like school, sports, music, drama, etc. They feel ripped off and, frankly, lack a sense of control about their lives. And then there’s the worry. Daily news reports increase our anxiety. We’re concerned for our loved ones while simultaneously feeling helpless to protect them and ourselves. Many of us are living more anxiety than we are accustomed to and it’s not a particularly pretty picture. And yet, human beings have built-in hope and fortitude. We have all been through challenging times in our lives (perhaps not to this extent) and survived. I’m convinced we will survive this too–although the timeline may take longer than any of us anticipated. How can we apply our resilience from the past struggles to help us in this moment? How can we assist our family in managing their uncertainty along with their disappointment, frustration and loneliness?

Getting to the root of anxiety, and how best to approach it.

Teen holding his hands up to his head and looking anxiously at the camera while trying to manage uncerainty.Anxiety comes from wanting safety and security and being unsure that they will occur. It wants to make uncomfortable feelings go away and, right now, that’s not really possible. When it comes to managing uncertainty with your family, you don’t want to dismiss your children’s anxiety. Instead, you want to respond to it in ways that are healthy, while managing your own worries, too.

Avoiding anxiety, or pushing it aside, only makes it stronger. Attempting to resolve each worry is like playing a game of Whack-a-mole: once one worry is gone, another will pop up in its place. Instead, this is the time to take a step back and examine how your child’s anxiety operates by focusing on the way it works—the process and not the content.

Managing uncertainty and anxiety with your family by using the 3 R’s:

Reflect, Recognize & Reset.

Instead of minimizing your kids’ feelings, or trying to get rid of them by saying things like, “Don’t worry, we’ll be fine” or, “You can still talk to your friends on social media,” acknowledge how they are feeling. Offer them tools to tolerate the discomfort of their emotions.

Offer these words instead: “Of course you’re disappointed and angry that graduation may be cancelled. It’s terribly sad.”  Or, “Of course you’re missing your friends and hanging out. It’s lonely not seeing them in person.”

You are listening compassionately and reflecting back what you hear. Since you can’t make this situation go away, you acknowledge its reality and how your son or daughter is affected by it. You validate their issues and recognize any patterns.

Then, you figure out together what is the next right thing to do to move forward. This is a collaborative process based on brainstorming and, if the well runs dry, a few suggestions based on their interests. You help them reset in a moment when they’re lost or overwhelmed or frustrated.

Building resiliency: The other crucial piece to dealing successfully with uncertainty.

Child in the middle of rock wall climbing.

Anxiety is very skilled at causing amnesia about memories of past successes—times when your child or teens faced a fear and overcame the obstacle. To build confidence in the ability to tackle and survive tough times, and the unknown, kids need reminders of their previous achievements. You’re accessing and fostering their inner resilience as you recall together those moments when you’ve seen them recover from obstacles. Write some of these down and post them in the kitchen. Consider doing this for yourself, too.

5 steps for managing uncertainty and anxiety with your family during COVID-19:

When we are worried, we are tense. Kids feel our stress and it increases their own anxiety. Follow these steps to reduce your family’s stress and anxiety.

1. Name the anxiety.

It’s easier to band together to fight the worry monsters that are invading our homes if we identify them. “Oh, there’s Donald Downer, making everyone feel scared again” or, “Here’s Fantasy Fred, imagining the worst.” Consider making a family drawing or writing a funny song about the effect of anxiety in your lives. Enlist your teen’s assistance. Managing uncertainty with your family takes teamwork, and your kids are likely to have some creative ideas and insights, regardless of their protesting.

2. Be honest, without over-sharing.

It’s okay to share a sanitized version of some of your concerns without going into the details. There’s a big difference between, “Yes, I think about Grandma and Grandpa too and wish we could visit them,” and, “I’m so worried about my parents and how they are managing. I don’t want them to get sick and die.”

Be careful about how you discuss your own anxiety within your child’s earshot: little pitchers do have big ears. Try to avoid talking about how much you want an extra glass of wine to soothe your nerves. While that may well be true, you’re also conveying to your kids that self-medicating is a coping tool. That’s not the message we want them to learn.

3. Offer daily kindnesses.

Mother tickling her son while he's laughing joyously.

Make a family agreement to do something nice for one person each day. Brainstorm some suggestions together and write these down as reminders. This creates positive plans that are helpful when managing uncertainty with your family. If someone can’t think of anything, you can refer them to the list. Before bed, ask your kids what they did that day or perhaps share these at dinner.

4. Catch them doing something positive.

People are getting on each other’s nerves with each day of confinement. Start a wall of being good. Get some Post-It’s or a large sheet of paper and tape it to a wall. Whenever you catch your kids doing something positive—their schoolwork, chores, playing a game, etc.—write it down. At the end of the week, call a short family meeting and read what’s on it. This turns the attention away from what’s not working to what is.

5. Use bedtime to check in:

Once they’re under the covers, sit or lie down with them for a few moments. Ask them about a highlight of their day—anything. Whether it’s small—“I liked the pancakes this morning” or something bigger—“My teacher liked my essay,” celebrating whatever happiness occurred in the day will shift the negative focus and decrease anxiety. These moments help manage uncertainty with your family by focusing on today. It also counters the fears, disappointments and frustrations by offering a fresh perspective.

Mother and daughter with their dog looking at a book with a flashlight under sheets.

While you can’t make uncertainty go away, you can reduce its influence on your family.

Use a daily schedule to bring structure to your days so kids know generally what to expect during their waking hours. Take a daily walk outside and notice your environment: identify new flowers or leaves emerging, pick a color and name things with that hue or count dogs, bicycles, squirrels, etc. This is the time to help your kids learn how to manage their upsets by listening to their concerns, validating what you hear and figuring out together how to move forward.

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AttentionTalk Radio: ADHD & COVID-19––Managing Work and Kids at Home

It’s a unique time in world and American history. For the first time we’re basically putting the world on hold to combat the Coronavirus. Schools are closed and many are having to work from home. This is a challenge for everyone but especially for those who have an ADHD family. In this episode of Attention Talk Radio, ADHD coach Jeff Copper (www.digcoaching.com) interviews Dr. Sharon Saline (www.drsharonsaline.com) around thoughts and insights of how to manage work and kids at home as best you can. There is no perfect solution, but with the right strategies, relief can come. Listen to this interview to manage things and not let them manage you. Click the logo below to listen!

Kids and Mental Health Days

Mental health days can be very beneficial to kids for a much-needed break from the stress of school, particularly with kids who have ADHD, learning disabilities or high functioning ASD for whom school can be their hardest area of functioning.

When kids are particularly overwhelmed, exhausted, anxious and fed up with school, a planned day off can be very helpful. These are days for rest, recovery and regrouping. Perhaps some time outside is in order: a walk, hike, or doing something athletic with you. Or maybe it’s a day with you a day in pajamas with limited screen time, playing board games, creating art projects, baking, reading or making music. I’ve worked with a number of kids with ADHD, LD or ASD who needed a break from the social and academic demands every 6-8 weeks. School was emotionally and physically draining for them. For adolescents who face increasing pressure to excel at everything, having a planned day off can be a lifesaver. Other kids benefit from a general agreement that they can have X number of days off per semester and you can choose these on an emergency basis (e.g. “I can’t take it anymore. I need a break”) or with certain dates set in mind. If a child doesn’t seem to rebound after this day and their symptoms of anxiety, sadness, depression or social difficulties persist, then I highly recommend finding a therapist to assist you in figuring out what is going on.

To be honest, I used mental health days with my daughter when she was a teenager. About twice a semester, she would hit a wall: she needed sleep and some down time to get her head back in the game.  So, we periodically gave her a “Sick-and-Tired” day off from school. It wasn’t planned but we had agreed as a family in advance that she could have 2 such days per semester. It was a successful collaboration: she felt that she got the mental health day she needed and we saw a positive difference when she returned to school.

Read more about the habits that hurt mental health

Rewire: Don’t Google Your Symptoms – Why We Get Medical Anxiety

I woke up in the middle of the night with pain in my chest. I rolled over and grabbed my phone, googling my symptoms. It didn’t look good. “Think you’re having a heart attack? Call 911 immediately,” Google advised me. “Chest pain has many causes — most of them are serious,” read a Web MD page. Was it coronary artery disease? Myocarditis? Mitral valve prolapse? Hypertrophic cardiomyopathy? Or maybe it was my lungs? My liver? Pneumonia? Undiagnosed asthma? A broken rib? Shingles? Spoiler alert: I wasn’t dying, and it wasn’t a heart attack, or any of those serious conditions. Not even close. Click logo below to read more.

Why did you post THAT? Smart Screen Parenting for Kids with ADHD

It’s the question I hear from almost every parent I meet: How do I make sure my son or daughter is using technology appropriately? Research has shown that managing technology in families is the greatest sources of arguments in the home according to both kids and parents. Many parents forget that screen time is a privilege–not a right, although most kids and especially teens will tell you differently. To create a health media diet in your family, start by looking at your values and your goals related to technology. Consider how and when you use your phone. Ask yourself “What role do I want the phone or computer to play in my daughter’s life? What are the conditions and expectations I’ve already set up about using the computer? What does it mean to use devices safely and how can I teach these skills?” These reflections are the first step in smart screen parenting. 

Families meet problems with technology because they haven’t set up clear terms and/or contracts about using screens from the beginning. It’s never too late to have honest, forthright conversations about how to use phones and computers (including texting, apps and email  appropriately) and what safety looks like. Have you discussed digital footprints and the longevity of online activity? College admission counselors, coaches and future employers can look up your history and see what you’ve said and to whom. Kids with ADHD lack of cause and effect thinking. They struggle with impulse control and self-regulation. They often believe that consequences just won’t happen to them. It’s especially hard to stop themselves from texting or posting something inappropriate if other kids are doing it too.

Discuss how to make good choices about appropriate material to post and which sites to visit. If you wouldn’t say to someone’s face, then don’t send it online. Follow the WWGS rule: “What would Grandma say?” If you don’t want your Grandma to read something, should you really post it? Expect your son or daughter to treat others with respect, and to never post hurtful or embarrassing messages. Encourage them to think twice before hitting ‘Enter.’ Being mean isn’t okay at any time. Of course, ask them to always tell you about any harassing or bullying messages that others post.

We are responsible for teaching kids how to be a digital citizens just like we are teaching them to be a member of our communities. All families, especially those with ADHD, need guidelines about living successfully with technology–guidelines that are enforced consistently. You don’t have to reinvent the wheel: websites like http://www.commonsensemedia.org offer great sample contracts and other ideas for how family’s can establish plans about technology. Here are my suggestions to help you practice cyber safety and teach NET-etiquette:

  1.  Get informed about digital media and technology so you are not acting out of fear or ignorance. Nobody wants to be a watchdog. Remind kids that what they post can be used against them. For example, letting the world know that you’re off on vacation or posting your home address gives would-be robbers a chance to strike.  Teens should also avoid posting specific locations of parties or events. If you don’t know know people or people who know them, don’t friend those folks.
  2. Go through privacy settings together to make sure your kids understand each one. Also, explain that passwords are there to protect them against things like identity theft. They should never share them.
  3. Live in a household with trust that goes both ways. Remember that your kids can go online and get all kinds of information that would often be better learned from you. We want kids to turn to us when they struggle with making good choices about where to go and what to do with friends. Tracking locations or reading their texts shows them that you don’t trust them or the decisions they are making.  Unless you learn that your child or teen has been lying to you about where they are going, what they are doing or texting or posting inappropriate material, stick with direct conversations with them about their activities and friends.
  4. After you get home from work, plan to spend the first hour reconnecting with your family. Limit your screen use to times when your kids are absent, asleep or occupied with friends or their own screen time.
  5. Stay connected with the parents of their friends so you can know what’s going on with your son or daughter and the kids around you. This helped me tremendously when my children were teens. Several parents agreed that we would support each other as our kids became more independent. We didn’t hesitate to call or text folks about social or school issues. The kids knew that we talked with each other and professed to disliking it but they also knew that they couldn’t stray too far because someone would see it and then share it.

Habits that Hurt Mental Health

I see a few major habits in my clients that hurt their mental health more than help them.

  1. Spending too much time on social media: Social media not only seems to suck up time faster than you notice but it also is built to so that people compare themselves to others. These comparisons are rarely favorable and people walk away with not feeling positive about themselves. As one adolescent girl told me, “No one ever posts pictures of their face mid-menstrual break-out or of their bombed test grade.” People feel pressured to keep up with friends, stay in touch and maintain an image that they’ve created. This creates more stress in their lives which interrupts their  ability to reflect on themselves, what they think and create a sturdy sense of self.

  2. Eating fast food on the run instead of preparing healthy meals and sitting down to eat them: We are so much of what we eat and we eat non-nutrutious food quickly, we’re not providing our brains or bodies with the appropriate fuel needed to think and function well. Sharing a meal is not only good for our physiology but it also provides an opportunity to connect with people face-to-face and talk about our lives. During a sit down meal, our bodies slow down and properly digest our food so we can absorbe the nutrients and simultaneously take a much-needed break from the chaos of our lives.

  3. Having arguments via texting or emailing: You can’t take an emotional weather report via electronic communication. If you say something difficult or sensitive this way, there’s no way for you see how your words affected the other person or perceive whatever feelings are brewing inside them. It’s easier to disengage and avoid accountability for your words and actions. People need to learn and practice interactional skills not only for healthy personal relationships but also for work and life situations where they have to deal with others.

Forget Freaking Out: How to parent panic attacks in kids with ADHD

Does your child or teen ever tell you that they are having a panic attack? Or, do they describe symptoms such as shortness of breath, a pounding heart and the sudden feeling like the world is closing in on them? Panic attacks are awful for everyone who experiences them. Kids can feel terrified, unsure about what is happening to them. Parents, desperate to assist their kids can be freaked out themselves and confused about what to do. Kids who live with ADHD typically struggle managing their big feelings anyway. In these moments of acute anxiety, they told me  that it’s like flailing around in rough waves with no raft. Since there’s no rational thinking in the midst of a panic attack, it doesn’t work to trying to talk to your child reasonably in these moments. Yelling at them to calm down is equally ineffective. Panic attacks are best managed by having a concrete set of steps to follow that you and your child or teen have figured out beforehand. When you work together to name the triggers and notice the warning signs, it’s easier to create an effective strategy to use in a panicked moment.

The goal isn’t to eliminate panic attacks: that may be unrealistic for now. Instead, the immediate goal should be to teach your son or daughter techniques for self-soothing in uncomfortable moments. Focus on becoming familiar with the clues that anxiety is rising and how to respond to those signals to lessen their intensity. We want to turn down the volume on the anxiety so it doesn’t mushroom into a panic attack. 

Following the plan that you’ve previously created and practiced together instead of trying to find a solution in the middle of a heated, emotional moment keeps things from escalating even further. Over time, by learning how to use tools to reduce anxiety, kids become more confident about what to do to soothe themselves when they start to feel agitated. The frequency of panic attacks goes down. 

While the following suggestions are meant to be helpful, they do not substitute in any way for taking your child to see their physician to rule out any physiological issues that could be causing panic. Please check out other causes too, such as bullying, learning disabilities, problematic teacher dynamics or other environmental factors. Here’s what you can do: In a quiet moment, sit down with your son or daughter and talk about how you can work together as a team to cut down panic attacks and reduce anxiety. Ask them what internal changes signal that they are feeling anxious and later panicked. Share some of your own too. Increased heart rate, shortness of breath, perspiration, a knot in the stomach or sudden headache are common signs that anxiety is rising. Write these insights down.    Next, show them the list of tools below and customize each option for them. Put the final document on both of your phones, computers, iPads, etc. and make a copy for the kitchen, the car and their room so everybody can refer to it when necessary. Consider sharing this with your child’s school counselor or teacher as well so you are all on the same page. 

  1. Breathing exercises: Alternate nostril yoga breathing calms you down quickly. Put your index finger on your right nostril: breathe in and out of your left nostril. Now switch and breathe in and out of your right nostril. Do this on both sides for 4-6 times until you start to settle down. 
  2. Make a playlist of songs that you love, soothe you or just make you smile. Give the playlist a fun title like “Cooling down tunes.”
  3. Change your environment: If you are inside, go to a different room or step outside. Notice what’s happening around you as you are inhaling in for 4 counts and exhaling for 4 counts. 
  4. Go to the bathroom and wash your face and hands. Tell yourself something encouraging such as: “You’ve got this.” “This has happened before and you’ve survived.” “It’s just your fears trying to run the show. Slow down so you can calm down.” 
  5. Physical movement:  Walk, run, ride a stationary bike, jump on a trampoline, etc. Get the body moving so kids move their attention from out of their heads and into what’s happening around them.
  6. Comfort activity: Reading, drawing, coloring, Soduku, playing with a pet, Lego’s, listening to a story, receiving a hug–these can also quiet the system until the storm passes.

Impact of Watching Scary Shows

Stranger Things is back on Thursdays.
Should you let your child watch it or other scary shows?
How to judge if they are ready.

Watching anything scary on television or at the movies before a child is cognitively, psychologically and emotionally ready to understand and process the visual information can lead to increased fears, phobias and nightmares. Adult themes, violence, inexplicable events and cruelty are simply not appropriate for many kids.

It’s important that parents examine why they are allowing their children to watch such shows and if their kids are really ready for it. Kids will show by their behavior, words and facial expressions how they respond to information that is overwhelming them and unpleasant to watch.

If kids need to verbally discuss the themes for reassurance about their safety and the fabricated nature of the show, then they aren’t ready for it. I personally think there is NO rush to expose kids to frightening shows. Kids today are more anxious than ever so why exacerbate the possibility for unnecessary worries.

Are You Giving Feedback or Criticism? Recognize the Difference and Change What You’re Doing

Sad girl with ADHD resting her face on her hand while enduring criticism from her angry mom in the background

As a parent, your motivations and intentions behind a statement might greatly differ from how your child interprets it. How do you know when you are giving feedback or criticism, and who is to decide? For example: Your 16 year-old daughter, Layla, agrees to clean her room and picks things up nicely except for the balled up pair of socks and crumpled tee shirt she leaves on her bed. Instead of simply saying, “Wow. Great job!” you want her to notice what she’s missed. You say, “That’s pretty good, but to be fully clean you missed the socks and tee shirt on your bed.” Your daughter loses her cool and starts screaming at you about how she’s never good enough and demands that you leave her alone. What happened?

How your child might view feedback or criticism:

Teen with ADHD upset on his bed, resting his head on his hands after listening to feedback that seemed like criticism

You may think that you’re making an innocent comment aimed to teach your teen what a cleaned room really looks like. But, in reality, what she heard was only the negative part: what she missed on the bed erased the value of the rest of her good work.

When I was doing interviews with kids for my book, they told me repeatedly that there’s no such thing as positive feedback: it all feels negative to them. Fed up and frustrated with consistently missing the mark, despite well-meaning efforts to do things, kids with ADHD blow their tops- just like Layla.

There is a big difference between feedback and criticism. Ideally, feedback takes into account intention, effort and progress. It’s a teaching tool. Criticism just looks at what isn’t right and often adds a mixture of blame, anger and disapproval. Nobody feels good after criticism, no matter how carefully it is worded.

How to use the ADHD Adapted Sandwich Feedback Method to formulate feedback instead of criticism

To make the shift from veiled or direct criticism to feedback that works more effectively, reframe your thinking. Use the ADHD Adapted Sandwich Feedback Method to prepare your statement like you would make a delicious sandwich. When you are hungry, you consider what might be tasty and which foods you want to place between the slices of bread. It’s a thoughtful, deliberate process with a yummy, anticipated outcome. Giving feedback can be similar. You start with positive observations as doughy top and bottom pieces, throw in an encouraging condiment, place a neutral piece of observed information in the middle and top it off with a piece of compassionate cheese.

An image of a person making a sandwich to represent the ADHD Adapted Sandwich Feedback Method

Here’s how this approach could go with Layla: “Nice job cleaning your room, Layla. I like how you arranged your books and notebooks by color on your desk. Although it’s no big deal, I see that you missed a few pieces of clothing on your bed. Great work on picking up all of the items from the floor so I can vacuum your rug. Thanks!

My guess is that Layla will have a very different attitude about the socks and tee shirt with this “sandwich of feedback.” She’ll feel appreciated more for her efforts and respond to that validation, rather than focusing on the one thing she overlooked. It will be more likely to be interpreted as feedback than criticism.

The influence of the negativity bias on the value and memory of criticism.

Mother bending down at her child's level to happily hug her son with ADHD who is also smiling with joy

We’ve got to remember that the negativity bias in human brains naturally overshadows positive information. For neurodivergent kids with ADHD, LD or ASD, they hear so many more negative statements in a day than positive ones. We’ve got to make concerted efforts to give them feedback they can actually absorb and use. That’s why we have to add extra validation and encouragement when we are responding to kids’s efforts for change, following through on tasks or taking risks.

I encourage you to try the ADHD Adapted Sandwich Feedback Method this week and see what happens. For an extra boost, ask them to repeat back one of the positive things they heard you say. This will help their working memory encode it and send it down the memory line for long-term storage. Be kind to yourself as you try to make this shift. It’s easier to blurt out something critical (even if you don’t mean to) than it is to thoughtfully generate useful feedback.

 

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Feeling Holiday Stress? Start caring for your mental health today!

Happiness during the holiday season for your family really depends on your ability to stay sane and stable in the midst of all of the shopping, planning and parties. When you are able to manage yourself with as much calm and clarity as possible, your son or daughter with ADHD will regulate better too. You are not only modeling for them how to regulate but why it’s helpful during busy times like these.

Good mental health during the holiday season starts NOW for the best results. The goal is to establish do-able routines for self-care now, so you will be in the habit when the stress intensifies later. Our brains need time to process the myriad of stimulating activities during this time so we don’t feel perpetually stressed, overwhelmed or burned out. Follow these tips for better self-care and, if you can, expand them to your kids too. Everyone will benefit from some time to slow down, plan ahead and focus on the important stuff. 

Follow these steps:

  1. Create a daily routine for connecting with yourself: Whether it’s going to the gym, stretching before bed, meditating, taking a hot bath, listening to favorite music or walking outside, set up a plan for doing something at least twice a week. You need this time for integration and letting go throughout the year but, during the holidays, when the emotional, physical and psychological demands are greater, it’s more important than ever. Make this activity achievable by starting off with something small that you can actually accomplish. You’ll feel nourished in a way that only you can give yourself.
  2. Take a moment and set goals for the holidays:  Instead of trying to be everywhere and everything for all of the people in your life, take a few quiet moments to reflect on what you would like to get out of this holiday season. What are your goals? What are your limits? What happened last year that worked and you’d like to repeat? What do you want to avoid?
  3. Write these down: Look at them when you’re feeling frenzied, overwhelmed or discouraged. Ask your children and partners the same questions, identify shared intentions, add those to your list and focus on making these things happen.
  4. Plan for what’s most important before shopping: You are only one person and you can’t do it all. Most people become overwhelmed because they’re not able to formulate a strategy for getting things done. Sit down with your partner and/or kids and make a list of who you want to make or purchase gifts for and what those items are. Ask your children to assist you in ways that are appropriate for their age and capability. Then assign days and blocks of time for shopping or creating.  When you have an action plan, you’ll feel more empowered and less freaked out.  

Good luck on your holiday escapades!