We all know high school is really tough, and for many of us, focusing on work can be quite tough as well. There are many ways to improve your focus and study skills but the three that have been proved to be the most effective are meditating, taking breaks, and developing a plan for working that works well for you.
Meditation can be used for a variety of things and it is most effective when used to combat overwhelming or stressing feelings. When you notice yourself panicking about anything, you should sit down and meditate for 5-10 minutes in order to obtain a calmer mind.
Meditation consists of sitting down and slowing down. You need to focus on your breathing. Inhale through your nose and exhale through your mouth. The goal of meditation is to clear your mind. Don’t think of the test you have tomorrow or the homework you have to do. All you need to focus on while meditating is your breathing. After you sit down and meditate for 5-10 minutes you should feel very relaxed and rejuvenated. Doctors suggest that after you meditate, you should walk into whatever you are doing with a clear mind and relaxed body.
Meditation helps you focus, and focus helps you improve your study skills. One of the main causes of not being able to focus is stressing too much about things that are not worthy of stressing out over. With improved focus and study skills, you will have even less stress which will allow you to focus better, which in turn will improve your study skills. It is a cycle that, over time, brings many positive outcomes.
Another important thing you can do when studying is taking breaks. While these should not interfere with your productivity, they are important. You should take a break, even if it is 10 minutes, every couple or so hours from your work. It can prevent your brain from being fatigued. Additionally, taking breaks can help to lower your stress by giving a few minutes of relaxation, so you can calm down before you get back to work. This can, in turn, improve your creativity, productivity, mental health, and more. Also, having breaks in between your work can make you more motivated to work as you have something to look forward to.
One very popular technique for taking breaks is called the Pomodoro Method. This is a technique in which you study for 25 minutes and take a five-minute break. This helps to keep your mind aware, awake, and active. Some excellent ways to take a break include: going on a quick walk or getting some fresh air, reading a book, talking to someone, or even taking a quick nap. A short, 10-20 minute nap can leave you feeling refreshed and ready to work again.
In high school, it is expected for a student to already have a solid studying plan that works well for them. If a student does not have one of these plans, they will struggle until they find one that works for them. There are many ways to develop a good plan but one of the best ways is to let the homework you get in middle school guide you. You should use this homework to figure out what works for you, so when the homework gets harder, you already have a plan.
I can personally attest that having a work plan increased my ability to study by a factor of 10. Before I developed a study plan that worked well for me, I was struggling. There was a lot of work to manage and I could never seem to find the time that I needed to manage it. This all changed though, when I developed my work plan. My grades improved, I had a lot more leisure time, and my stress levels decreased a lot.
Although the items mentioned above will help you with your passive studying skills, you have to actively improve them as well. There are many things that you can actively do to improve your study skills. These skills include paying attention in class by putting all distractions away, managing your workload by dividing things up, managing time so you don’t procrastinate, making a schedule, paying attention to your homework, and double-checking everything that you have done to make sure that you have not messed it up. Even though these are all study skills that you have to actively think about, if practiced frequently and effectively, these can become passive skills that you would no longer have to think about.
Raise your Words Not your voice It is rain that grows flowers, Not thunder – Rumi
Dr. Daniel Siegal (A psychiatrist and a Clinical Professor at UCLA), in his book ‘Brainstorm – The Power and Purpose of the Teenage Brain,’ talks about the changes in the structure and functioning of the brain during adolescence. In one of his interviews for a teen magazine, Dr. Siegal talks about an architectural restructuring of the teenage brain and an emergence of the adolescent mind that is wonderfully creative, adaptive, and vibrant.
“Adolescence is the golden age for innovation. The adolescent brain is a construction zone: creativity, innovation, the capacity for abstract thinking, and the need to experiment are traits that drive this period. Unfortunately, as adults, we sometimes see the adolescent drive towards experimentation only as a negative, a sign that the teen is being “crazy” or immature.”
Raising kids is tough, and parents are not born with a manual for raising their children. Teens go through social, emotional, and psychological changes between 12 and 18. No two teens are alike, and the values, culture, beliefs, and the environment they grow up in all play a vital role in their wellness and health. The reality is a teen’s brain is in the process of remodeling.
Adolescence can be a challenging time, to say the least, while seeking a secure emotional base or a container where they feel loved and accepted as each teen is going through changes so rapidly. Family can assist in building and supporting a teen’s confidence, help build their identity and be available during their trying times. Our job as parents is to raise a college-bound, portfolio-focused teen with creativity and passion for life.
In India, summer meant playing outside for hours with occasional breaks for food or snacks. We never had many toys, including digital games or social media. Today’s generation of teens, on the other hand, don’t have any time for free play. Their days are packed with structured activities, even in summer, to build up a “portfolio” for the so-called top schools. When my daughters were in high school, they would share how their peers were planning to take many AP courses, online classes, internships over the summer, etc. schedules were packed. Many parents want their teens to go to their chosen top schools only. They have an unrelenting focus on academics at the expense of everything else, including mental health. The physical manifestation of this stress on teens is a growing epidemic – anxiety disorders, migraines, panic attacks, to name a few, and even auto-immune conditions, in some cases.
How can we, as parents, help: Create a stress-free zone: Parents and teens can develop a “zone out” time together. It could be watching their favorite buzz feed videos/TV, cooking/baking, a time of leisure without judgment or life lessons.
Efforts vs. grades: We can counsel them without an obsessive focus on scores. It can be a life lesson that will help them focus on what they need to do and not stress about outcomes beyond their control. Constantly setting stretch expectations, leading to a relentless pressure to meet them, is toxic for your teen’s health.
Sharing your past: Share your college experiences more as an understanding and awareness for your teen, not necessarily to communicate only your (parent) generation’s methods are correct. It would make any teen feel that they never measure up and can damage the child’s long-term self-esteem.
One-on-One: Celebrating your teen’s accomplishments, sharing their disappointments, and supporting their hobbies helps your teen know you’re interested in them. You don’t have to make a big deal of this, sometimes it’s just a matter of showing up to watch your child play a sport or music, reading together, or cooking or baking, and arts and crafts activity or giving them a ride to extracurricular activities.
Treats: Treats worked in elementary school, and they still do, such as a Starbucks drink or a Jamba Juice. Some parents feel that appreciating their teen’s effort or journey would defocus them and stop putting in their efforts. However, research has shown that positive encouragement is vital for teens to succeed in any environment. It is not a bribe but an acknowledgment of their effort. In addition, an encouraging comment along with the reward will help make the message clear to your child how much you appreciated their efforts.
Be Empathetic: Active listening when you are conversing with your teen, without interrupting with our own opinions or judgments, being curious and open-minded about their point of view, and having patience as they solve their problems could be the best thing you offer your teen. You need to increase your capacity to listen actively, be open, and provide a non-judgmental stance.
For example, when a teen comes home heartbroken as they did not get their desired result in their quiz, a parent could respond, “I saw how much you worked on that; I am so sorry to hear that.” This kind of empathy is powerful to hear someone say, soothes them.
Only STEM mindset: There are some misconceptions that only a few majors guarantee a job. Other than STEM majors, there are other majors in Public Health, Global Health, Economics, Nursing, etc., leading to great jobs and careers. Parents should encourage their children to create a career path that brings them joy as well as a paycheck. Holistic outlook.
The Bureau of Labor published in their latest research that there are going to be more non-stem jobs than today over the next decade.With the present Pandemic, more fields are in the making more so in the health care, public health, construction, real estate and other fields.
Chores/Jobs: As parents, we would like to rescue and complete our kids’ activities and chores. However, it is an excellent time for teens to develop and mature and develop independent living skills. Managing simple tasks like laundry, cooking, or running errands for the house once they start driving, teaches them accountability/responsibility and time management. Holistic outlook.
Limit Setting/Boundaries: By setting up rules, boundaries, and standards of behavior, you give a teen a sense of stability and predictability. Regular family meetings and explaining the benefits and consequences of following rules/boundaries would help. It also helps them internalize the concept of delayed gratification. Of course, there will be pushbacks, yet this practice is integral in a time of chaos.
Conclusion: Trust and respect are earned not by doing only heroic, victorious deeds, making significant changes, saving lives around you, but also by paying close attention to your teen’s emotions and feelings. Dr. Siegal reemphasizes the importance of how young adults need to be seen and soothed by their parents. Relationships with our teens provide a template for relating with people when they step outside our homes. Developmental relationships are connections that help young become their best selves.
If you are experiencing going through a difficult time, therapy can help; for more information, contact. Geetha Narayanan – 669-500-5362 OR email@example.com
Bipolar disorder is a mental disorder that causes severe changes in energy, mood, and concentration within a relatively short period of time.
There are three main types of bipolar disorder. All three types of bipolar disorder cause severe changes in mood and energy. There are different types of mood changes that one can go through. There are manic episodes that cause a person to show extremely irritated, elated, and restless behavior (there are less severe manic episodes that are classified as hypomanic episodes). On the contrary, there are depressive episodes that cause people to appear sad, suicidal, energy-ridden, and hopeless.
Types of Bipolar Disorder
There are three types of Bipolar disorder; Cyclothymic Disorder, Bipolar I Disorder, and Bipolar II Disorder.
Cyclothymic Disorder is a rare type of Bipolar disorder whose symptoms are not as severe as those with Bipolar I or II Disorder. If you have this disorder you would experience noticeable mood shifts that go up and down from your normal moods. For some time, you may feel amazing, happy, and motivated, but this changes when you experience a low period which makes you feel sad and depressed. Besides these temporary highs and lows, you may feel completely fine. Although the highs and lows of this disease are less extreme than their bipolar disorder counterparts, it is still imperative to seek help managing these symptoms because they increase your risk of bipolar I and II disorder.
Bipolar I Disorder causes mood swings that include a mixture of emotional highs (mania) and emotional lows (depression). Episodes of having symptoms of depression and mania at the same time are also possible. When your mood shifts to depression you may feel sad and lose pleasure in most of your activities. When your mood shifts to mania you may feel full of energy and irritable. These varying mood swings can affect sleep, energy, and the ability to think clearly.
Bipolar II Disorder causes depressive and hypomanic episodes. It does not cause the full-blown manic episodes that Bipolar I Disorder causes.
Signs and Symptoms
People with bipolar disorder experience distinct periods of emotional changes regarded as mood episodes. Mood episodes are prolonged mood swings where the symptoms last every day for most of the day. These mood episodes may also last for longer amounts of time such as days or weeks.
These symptoms vary from person to person and are not the same with everyone. A person may still have bipolar disorder even if their symptoms are less extreme than those listed above. Some people with bipolar II disorder experience hypomania, which is a less severe form of mania. During a hypomanic episode, a person may feel good, happy, and productive. Even though they may not be able to feel anything irregular, their family and friends may notice changes in their behavior. Without the required treatment, hypomania could turn into severe mania or depression.
Getting a proper diagnosis and good treatment can help people with bipolar disorder have very healthy, active, and fulfilling lives. The first step to getting diagnosed is to talk with a doctor or a licensed health provider. Your doctor might refer you to a psychiatrist, who will help you to open up about your thoughts, feelings, and behavior patterns. You may be asked to complete a self-evaluation about your symptoms and your family members and friends might be asked to provide information about your symptoms.
A person is diagnosed with Bipolar disorder based on their symptoms, experiences, lifetime history, and family history. Bipolar disorder is diagnosed during late adolescence and early adulthood. Bipolar symptoms can appear in children, although this is very rare. Bipolar disorder can also appear during pregnancy or childbirth. Even though the symptoms of Bipolar disorder will vary over time, it still requires lifelong monitoring and treatment. Following a structured treatment plan can lead to a much longer and better life.
Often we mistake them as something uncommon, something that we don’t perpetuate or have applied to us, but stereotypes are apparent in almost every aspect of our lives. It isn’t hard to imagine a world where everyone looks at you through a judgmental filter in order to sort you into different social categories because that is already a part of our reality. These are stereotypes. By textbook definition, a stereotype is “a widely held but fixed and oversimplified image or idea of a particular type of person or thing.” Commonplace labels based on stereotypes, even the seemingly harmless ones like “jock”, and “nerd,” can be problematic because of how deeply they are rooted in society, continuously spreading ignorance and false assumptions.
It is first important to reflect on your life, actions, and experiences regarding stereotypes. To do that, follow these two steps:
Step 1) Take a moment to bring to mind any stereotypes you may have applied to people in your own life and what negative effects that may have had. Acknowledging the issue is the first step to making progress in being mindful about everyday actions and language.
Step 2) Take another moment to think about whether others have applied stereotypes to you, and how that made you feel. You could have been a victim of hate speech, or something about your identity was the target of a “joke” and you might have been told to “chill” about it. Stereotypes are present nearly everywhere in our everyday lives and can manifest as casual assumptions we’ve made about the people around us, both positive and negative, which can accumulate to fuel interpersonal conflicts, bullying or even hate crimes.
And if you have used a stereotype, you might not have done it on purpose! It could have been unintentional, based on what you learned through observing your family’s and friends’ beliefs, and the people stereotyping you might not realize their mistake either! Regardless of intention, people can suffer very serious mental distress as a result of being stereotyped, especially children and teenagers because they are still in the process of developing their own identity all while society is telling them to label themselves. These stereotypes place people into confined boxes that they don’t necessarily fit into in order to label them as “something”. These labels may be wrong, or just don’t show the whole picture. A prominent part of society where stereotypes are used is school. Stereotypes at school are used by teachers, students, sports coaches, parents, and the list goes on. As we said before, the use of stereotypes might be unintentional or purposeful. For starters, gender and dress coding is a huge and widely held stereotype. Female presenting people in the hallways will get dress-coded for “showing too much skin” while biological males can take their shirts off during athletic practices and not get any negative consequences. Another stereotype common at schools is students being unofficially ranked at school based on race. Many of you have heard “asian nerd” or “dumb blonde”. Statements like these are so common and used flippantly. Often, it may not seem insulting in the context it is used, but if you take the time to think about if the context was different, things take a different meaning and effect. It is important to be mindful with your words and avoid stereotypes because while it is not always insulting, someone is always categorized incorrectly, and by being mindful, you can combat this.
In addition, often we hear intentional statements being made, like “you’re good at this sport for a girl” or in other cases “you’re smart for someone who’s pretty”. These are called microaggressions. These little comments are the intentional, negative use of stereotypes. If you catch yourself using a microaggression or catch someone else, take some time to figure out why it can be wrong and how to look at the situation differently in order to not use microaggressions. Scaled up from microaggressions come prejudicial bullying. Some examples of this were crime against East Asians after the spread of COVID-19, or the hate crimes stemming from the rampant Islamophobia after 9/11. These prejudicial stereotypes are rooted in society, are harder to unlearn and are more subtle, which can make them harder to realize they are wrong. They can come from personal upbringing, school social environments, or even the widespread media. And as mentioned before, these can lead to verbal, physical, and even cyber bullying.
People, especially kids, who grow up being bullied based on these stereotypes can struggle with their self-image and self-worth, and they create an overall negative environment to grow up in. At school, when a child is targeted by bullies who based their targets on religion or race because of stereotypes, a person can feel like a piece of their identity is worthless. This is because they are being shown by their surroundings that they are being perceived as an outcast. Mentally, especially in teens who are working to solidify their identity, this can cause social anxiety in the sense that they experience a loss of self-confidence and may end up feeling the need to unnecessarily change themselves for other people or to fit in. This can harm teens’ “self-image,” or the way that they view themselves. Especially nowadays, where more and more teens are feeling insecure about themselves, bullying from others could really damage someone. Within the past couple of years, suicide rates in teens have been rising, so it is important that teens feel comfortable in their own bodies to be who they really are. One example of this outside bullying influence is body shaming people. Social media creates a harmful stereotype saying that people need to have a “perfect body” to be pretty and things like that. This can lead to teens feeling the need to change themselves for others or to “fit in” to the stereotype, which could result in serious conditions such as eating disorders. When someone receives a negative comment based on stereotypes through social media about their physical or mental state, it is harder to deal with. This is because social media provides an outlet that can hide the instigator. Not being able to know who the other person is can leave the victim feeling helpless because they can’t stand up for themselves without taking extreme measures.
Let’s take a look at some other stereotypes that target teens in general. There is a wide-held bias against teens that a lot of adults believe. Usually, adults place teens into a category that says that teens are inherently “up-to-no-good”. And even when an adult has known a teen for a long time and knows they are a good person, the adult trusts the stereotype more than they trust the teen themselves. On top of that, many adults have an expectation that a teen should have their future planned out and should be doing everything they can in school to get good grades, sports, extracurriculars, and the list goes on. This double standard can cause anxiety and cause the individual to feel a lot of pressure. This can lead teens to feel like they aren’t good enough for their parents or other adults, or that they will never meet their expectations. And eventually, even if teens feel comfortable enough to share their feelings, many adults tell them they are being “sensitive”, also perpetuating stereotypes about mental health. And this leads to a never-ending cycle of teens feeling like they aren’t good enough for their parents, and bottling up their feelings. This lack of trust doesn’t let communication happen, which is essential in building a healthy relationship without stereotypes.
In all of these situations, it is important to be aware and informed. Be mindful of your language and actions to create healthy and positive environments for you and people surrounding you. Taking the time to be informed will also help you in the event you need to resolve a situation created by stereotypes. If someone calls you out for using a stereotype, don’t get defensive and try to prove yourself, just own up to it, apologize, and move on. It is essential to be mindful of how big of an impact yours, or someone else’s words could potentially have and to be mindful of others’ feelings on the receiving ends of these types of jokes and bullying situations. By taking others’ feelings into account, it is easier to not use those stereotypes. Overall, stereotypes are prominent in almost every decision in our lives today. Realizing these biases and views on society and making efforts to come together and respect each other’s differences can make a huge impact. As a community, we can work together to unroot any deeply held stereotypes or prejudices that are prominent in our world today.
“The single story creates stereotypes, and the problem with stereotypes is not that they aren’t true, but they are incomplete. They make one story become the only story.”
There’s a common phrase that says, “In a world where you can be anything, be kind.” And for the Taarika Foundation, kindness — in any form through any medium — matters.
This year, Random Acts of Kindness Week is from February 13, 2022, to February 19, 2022, according to the Random Acts of Kindness Foundation — a week to reflect on the positive impact of kindness.
With the period of uncertainty — the Pandemic — we have been and still are facing, it seems appropriate to take any chance we can get to make someone else smile; we do not know what others may be facing in a time like this, and we can only hope that our presence brings a positive aura anywhere we go.
How can we do this?
You guessed it: random acts of kindness! Random acts of kindness provide a way to release positivity into any environment. They bring the community together regardless of background — lifting people’s spirits while making you feel good in the process of helping others.
What’s more, according to UC Berkeley’s Greater Good Magazine, researchers have found that witnessing kindness also inspires people to be kind, a phenomenon referred to as “moral elevation.” Ultimately, random acts of kindness act as a medium for people to offer kindness to others regardless of socioeconomic status, disability, race and more.
Why Random Acts of Kindness?
Kindness is shown frequently in the world we live in — a reality easily overlooked by many. Large or small, these acts of kindness are common, even if we may not always be aware of them nor their positive effects in the community; and while kindness is often covered by the shadows — going missed by many — its beneficiaries are tenfold.
We all should strive to make kindness more noticeable in society; kindness has the power to make a difference — random acts of kindness shown to strangers and friends alike have the influence to bring more smiles to more peoples’ faces.
Why do Random Acts of Kindness Work?
Random acts of kindness have been proven time and time again to make both the recipient and giver of kindness feel an elevated sense of contentment. According to UC Berkeley’s Greater Good Magazine, it has the power to not only make one think more highly of themselves but also become “more aware of positive social interactions.”
According to a research paper published in Oxford Handbooks Online by Kennon M. Sheldon, Julia Boehm and Sonja Lyubomirsky, variation in kindness is the key to happiness. To avoid the feeling of redundancy with kindness, an approach that includes various ways to express kindness to different people can help with enacting positive change in the community. Random Acts of Kindness are one of these methods we can use to help make a change in whatever environment that surrounds us.
Moreover, according to a study conducted by Sheldon et al. published in the Review of General Psychology, a significant increase in happiness was measured in participants who performed five random acts of kindness for six weeks consecutively. Random acts of kindness have the ability to bring change to anyone and everyone’s lives regardless of past history.
How to do Random Acts of Kindness?
It’s time to look outside the box and express your kindness. Kindness matters — it can be as small as a smile and holding the door open for someone or as large as protests, delivering food and raising awareness for mental health.
Random acts of kindness are a venue to show your kindness. Regardless of whether we know the recipient or not, the kindness expressed at random intervals — with no forthcoming — allows for a way to bridge the community together and ultimately make multiple people feel good.
The Random Acts of Kindness Foundation even offers a list of diverse Kindness Ideas to refer to. I hope everyone takes the time to look at the list and express kindness in their communities!
Aesop once said, “No act of kindness, no matter how small, is ever wasted.” I like to think kindness has a ripple effect: your kindness doesn’t just make you feel good, your kindness spreads to others as well. Then their kindness spreads, and so on until we get a communal kindness movement.
Ultimately, kindness is a universal value that will unite people — it is an avenue upon which everyone can agree on. So, whether it be a simple random act of kindness in a community or anything else, we should all start enacting kindness in our communities, looking beyond differences and instead recognizing the underlying humanity in each and every one of us. I’d recommend starting by showing a random act of kindness to someone near you right here and right now; whether you know them or not, kindness can make anyone smile.
A scaly snake slithers slowly around my body, constricting me. With each breath I take, I feel myself slowly, but surely, suffocating. The pallid brown walls of the bathroom stall begin to blur, and the dirty white tiles and stray pieces of toilet paper left on the floor seem to merge. I can’t breathe. I can barely see. The tears that fall from my eyes seem to have no end, as they caress my face in its sticky warmth, leaving trails of wet mascara running down my face. I don’t want to step out of these confines of the tan bathroom stall. Although miserable and pungent, this seems to be the safest option for now; however, I cannot stay here for long – I have to get back to my class.
Bullying – the systematic abuse of power that often happens to many students right under their teacher’s noses. Unfortunately, I am no stranger to being bullied, and neither are the majority of students in America. 1 in every 5 teens in America have reported being bullied in a survey taken by StopBullying.gov, and as bullying continues to gain awareness from the general public, researchers have started to pay closer attention to it as well. An increasing number of studies have proven that there are serious psychological risks associated with being bullied including being put at a greater risk for panic disorder, anxiety disorders, generalized anxiety, depressive disorders, PTSD, and agoraphobia as adults.
One of the most common and overlooked forms of bullying, especially in schools, is name calling. Ranging from small insults to slurs, the impact of a build up of these aggressions is detrimental to a person’s well being. But how can you help and be more aware? One step you can take comes from GLSEN(Gay Lesbian and Straight Education Network), an American education organization against discrimination and bullying based on sexual orientation or gender identity and expression. They started No-Name Calling week, a week during mid-January where students and educators reflect on name calling in schools and the hurtful impacts it causes. Though the week has passed and was from the 17th to the 21st, it is still applicable to our daily lives. How often have you heard common insults thrown around over and over at a person, stifling them and making them feel shame for simply existing?
Taking part in stopping the bullying and harassment done to youth is vital to both their mental and physical health, and is something that you can start working on by reflecting within yourself. By doing so, we can open up a discussion about damaging effects of bullying and help eliminate name-calling in our communities.
My name is Sania, and today I have with me Dr. Vidhya Krishnan, who is a child psychiatrist. We will be talking about the treatment of depression using biopsychosocial interventions.
Before we do that however, would you like to introduce yourself, Dr. Krishnan?
Dr. Krishnan (DK): Sure. Thank you, Sania, for having me today. As you already mentioned, I’m Dr. Krishnan and I’m a child and adolescent psychiatrist. For my day job, I work at the Children’s Health Council in Palo Alto where I’m the head of adolescent mental health services.
What are the different ways you treat depression?
DK: So depression obviously is a mental health condition. It is the language we use for the condition called major depressive disorder, and a few other depressive conditions. Whenever we try to address a mental health condition, we try to come at it from very, very different directions.
So, we try to address the biology of the condition which is what is happening from a chemical, neurocircuitry kind of a standpoint, and psychological, which is the way the brain thinks and processes information, and then we come at it from a social standpoint, but I want to include that to say both social and environmental.
The reason I break it up into these three parts is because [the biological umbrella includes interventions like medication]. The psychological part would be therapy. The various kinds of therapies one might use includes “talk therapy,” one of the more popular kinds.
[However] there are other kinds of therapies people use to treat depression [that address] the social or the environmental factors include things that people do: what’s happening in school, and in a person’s family life, friend circle, even things we do on a daily basis, what we eat, how we sleep, the level of activity we do. So what I would like to say is overall, the treatment of depression includes a wide umbrella of things that basically touches every aspect of a person’s existence.
TF: That’s incredibly interesting to know. I knew that there was therapy and medication, but I didn’t realize that there was such a wide variety of ways that depression was treated. And so that leads me to my next question, which is,
When do you recommend a child’s depression be treated with medication in terms of their age and severity?
DK: So as far as the age goes, there is no particular cutoff. […] There’s not an age below at which we will not treat depression and there is not an age above which we will not treat depression. So I think the question, most importantly, is what presents in front of you. I think of two big categories when I bring up the idea of using medication to treat depression with my clients and their families.
One of them is the severity of the depression. If someone has what we would like to call a moderate to severe level of depression, medications automatically enter the conversation. Just because we talk about it doesn’t mean we always do it, but that definitely shows that things are sever enough that it should be talked about.
The other big factor is functional impairment, right? The way a child goes to the world, they have a family component of their life, a school component of their life, and a social component of their life. If the depression [has progressed] to a point where it’s affecting all or some of these aspects to a big degree where a child’s ability to engage with their school, which is their main job, or their family or their friends is impacted in a big way, we do consider the possibility of medications as one of the things we might want to do to help them get back on a sound footing in their life. So I would say severity and functionality are the two main criteria I use when making medication recommendations.
TF: So that’s very interesting. I didn’t realize that there is no age limit or age range in which it should be treated with medication, so thank you so much for telling us that. And I’ve also seen a lot of people with depression, that see therapists and take medication, but I never really understood how exactly the medication helps with depression.
So can you explain what medications do and why simply going to a therapist isn’t enough in some cases?
DK: For a combination of reasons! Depression, obviously, is a sum of many different factors, right? There is genetic vulnerability, on top of which, there could be medical conditions or life circumstances, which conspire with each other to basically tilt the needle towards the person’s emotional health responding through depression, sometimes in triggered situations where there are negative life situations. Either within someone’s control or not, but sometimes depression can happen for no reason at all. Due respect to why a person becomes depressed at a particular point, there always are neurochemical and neurocircuitry kinds of changes that are observable in the brain, that is easily discernible through PET scan and various other functional metrics of analysis.
Like if you took a picture of someone’s brain who’s depressed, you can see that the various cells in the brain are not talking to each other as well as the like for them to, and the various parts of the brain also, at a bigger level, are not communicating with each other as effectively or efficiently as we’d like to.
And this is obviously a very big challenge because that is a big barrier to being able to experience benefit[s of treatment]; If you think of therapy, [it] is learning new ways of teaching someone new ways for the brain to deal with the world outside of themselves, or even in the way that we talk to ourselves inside of our head as we get prepared to deal with life or life’s circumstances.
The trouble is that when you have therapy alone and the level of depression is extremely significant, these large parts of your mind are not exactly working the way they’re supposed to. Even if the right kind of therapy is available, the barrier because of this lack of appropriate communication between the various parts of the brain is [such a barrier] that therapy alone cannot [provide sufficient support]. It’s almost like asking someone to jump over a wall that’s way too tall—it’s not possible to do no matter how much coaching or training you get. Sometimes you just need that ladder*. (*Note from TF: …and that’s okay!)
Sometimes medicine, if you think about it, is that ladder that you use to be able to climb over taller walls. Someone can coach you on how to climb the ladder, how quickly you can climb it, and how easily you can get over the top. But if you think about it that’s kind of the role it does it makes these parts of the brain have the chemicals necessary in the tank to be able to be available when the right messages come in, so the message is able to go through but also the same time allows for these various parts of the brain to talk to each other a lot more efficiently. It’s almost like it greases the wheels.
TF: That makes a lot of sense, so medicine is kind of like a booster that can really help you get out of your depressive phase or kind of, you know, ease your depression. And so, the next question is,
Once one of your patients starts taking medicine for depression, how long do they need to take it to see results and when would you eventually stop or taper down on the medication?
DK: So the medications, because of what I just explained as what the medications need to do, create this tank of chemicals that needs to be there in your brain so that, you know, […] various parts of the brain are able to communicate with each other more effectively. But eventually, the job of the medicine is to help the body build its own tank of chemicals. And for these effective communication roles that you have developed, almost like information superhighways, to kind of work of their own volition without the aid of medications. What ends up happening though, is this whole process of the brain becoming self-sufficient without the need of this external booster, like you said Sania, […] it takes the brain a while to get into this new habit if you will.
So number one, for the medicine to just start working to build the original time, it can take anywhere from four to six weeks, which is a long period of time and I understand. But given how long [treatment sometimes lasts], six weeks in that scheme of things does not feel like a large amount of time. But once we have found that the medicine is helpful or effective, the treatment of what we call an episode of depression needs to usually last somewhere in the order of about nine months to a year or a year and a half.
The reason for it is it takes that long to shore up the body’s defenses to undo some of the problems that have happened because of the brain being in a depressed place because certain parts of the brain to grow it the way they’re supposed to. It’s almost the same way you think of is you know when a child’s body is malnourished, they don’t grow tall, they don’t put on weight, their body is not able to do the various age-related tasks its due. Similarly a brain that is under the influence of depression doesn’t grow the way it’s supposed to grow and doesn’t do all the tasks and activities that it’s supposed to do for that age and stage of life. So you need to have that regrowth and that catch-up happens before you’re able to get out of that episode of depression. And that takes time, which explains the nine months to a year, year and a half timeline.
One of the things I always talk about is the window of time that we are using medications to address the symptoms of depression. It’s a great period of time to kind of combine that with the therapy because as the brain is growing back, like I said developmentally catching up, right, because depression has almost been like a pause button. What is happening is therapy added in at that particular point can accelerate that process significantly. So to be able to successfully get to that year mark are nine months or a year and a half mark and be at a place of readiness to be able to stop the medicines requires the person to be able to have caught up and keep up with all the things that have happened in that particular time and so I would say three things right?
Giving the brain enough time and space to do the growing it needs and the catching up it needs to do but also modifying the various thinking changes that have happened because of depression by the combination of therapy, is what gets somebody to a place of readiness to see both results and be at a place where you’re ready to stop the medications and kind of move on from that phase of treatment.
Though one other other point it would be useful to add here is that everything that I said right now is valid when you’re looking at someone in their first episode of depression or for the first instance of treatment. But it is important to remember that not everybody responds to the first medicine or the first treatment they take.
And not everybody’s in the first episode of depression. Sometimes this is maybe the second time or the third time someone’s struggling. But in those instances, the answer is a lot more customized and it is something that one should discuss with one’s doctors because once you get into further episodes of depression or more longer duration of illness, other variables start to matter in terms of how long it takes to see results or when a person is ready to stop [treatment].
TF: Yeah, that makes a lot of sense. I like how you said that that it’s, you know, it’s not like a one-size-fits-all type of thing, right? Not all patients will respond to the same medication the same way. And I think it’s really important for people to know that just because the first one didn’t work doesn’t mean the ones after that won’t work, you know?
TF: And so my last question to you is, just to tangent off of that,
How do you deal with suicidal thoughts or tendencies of patients that have depression?
DK: So one way to think about it is, at least as far as people with depression or concern, you want to think of suicidal thoughts or suicidal tendencies as a part of the depressive profile if you will, right. For many kids and including adults, it flows from the symptoms of depression in the sense that “I don’t feel like my life was worth living, I don’t feel like I’m able to help myself or either good enough light that feels meaningful.” And many people without even consciously realizing it slipped into a phase where they start to say, “I don’t matter’ or “My life doesn’t matter.” “What’s the point anyway, I wish I was dead.” “Nobody would be sad if I died.” And sometimes this goes into a place where they start to think that, you know, “I think I’m a burden, I think I am not of value, and what does it matter if I die? Nobody will miss me.”
First things first, I always say that one should not fear asking these kinds of questions if it’s [to] a family or a member or a loved one because it’s a very common thing we see in people with depression, even if they’re not at a point where they’re going to do anything about it. This kind of negative thought pattern is actually very core to just the symptoms of depression themselves, and many of the people who are […] stuck in this thought pattern find that when the depression lifts, these thoughts also get better and go away.
So I think you want to first start by thinking of it as a part and parcel of depression, and not be fearful of asking or checking in [with loved ones] about these thoughts if a person does have them to see hey if you have them because it might be a great sense of relief for someone to share this with somebody and now somebody knows, which means somebody can help, which means somebody can point you in the right direction of what can happen next. And so that is the first thing, asking, checking in, and knowing about it is extremely important.
The other thing that is also important is there are studies out there that show that there may be a very, very small, but nonetheless, important thing where when you start treatment, whether with therapy or whether with medication, there can sometimes be a change or a worsening of these thoughts initially.
That does not mean that the treatment is not working.
Dr. Vidhya Krishnan
Sometimes what ends up happening is treatment makes a person be able to see where their life is a little bit more clearly, and what they see around them may not be something they like because of how much damage depression has done to their life and their circumstances and it can be very disheartening, to begin with. That’s exactly the point where we need to let somebody know that help is on the way, that there is light at the end of the tunnel and holding their hand.
So, instilling a sense of hope and knowing that they have people who are in their corner, people who are rooting for them (who know what they’re doing and who are able to help can preserve that sense of fullness), almost a “substituted hopefulness,” which comes from the outside until the actual treatments for the depression are able to kick in. So there is a period of vulnerability where we might know about these thoughts and feelings but we are not quite in a place where we are able to fully address them, which is when the external help a friend, a colleague or parent or relative, a doctor or a therapist can be so important and so valuable in supporting someone through that particular phase. But most times, as the depression improves, simultaneous to that we also see an improvement in these thoughts and feelings, automatically.
But if that’s not the case, and you’re not seeing those changes, therapy can play a significant role. Because sometimes these suicidal thoughts are almost a, I wouldn’t say a maladaptive coping, it’s felt like “That is the solution to my problems.” And so finding alternative solutions in conjunction with a really good therapist can replace these thoughts and feelings with other, more helpful thoughts and actually have a good chance of being able to help these thoughts and feelings.
So I think you want to think of suicidal thoughts and tendencies almost lockstep with the depression in your treatment of depression, as one of many things we try to address the same way we might try to address sleep or difficulties or appetite difficulties, and this is just one more of those things that we deal with.
TF: Yeah, that’s super helpful to know. I think it’s really nice to know that it’s not something that’s uncommon for people with depression, and it’s, you know, something that happens and it’s something that can be treated and something that can be improved with medication and with therapy. So that is an amazing thing. And thank you so much for joining us today in this interview. I learned a wealth of information, and I’m sure a lot of our listeners did too. So thank you so much.
At the beginning of each new year, January signifies change and turning over a new leaf as many create New Year’s resolutions such as having a balanced diet, dedicating time to hobbies, working out at the gym, or even arriving at school on time. With the prioritization of work and education in many people’s lives, self-care takes a backseat to hustle culture as we are pushed to our limits.
However, with many awareness campaigns promoting January as Mental Wellness Month and National Mentoring Month, the importance of caring for our mental wellbeing while helping others is slowly becoming normalized. Mark the following dates on your calendar so you can follow along and stay updated as well!
Mental Wellness Month
Mental wellness affects all aspects of our lives; from how we act and make decisions to how we are feeling on a certain day, maintaining a healthy mindset is key to living a healthy life.
As the American Mental Wellness Association suggests, health can be improved in four dimensions of our life: the biophysical, social, spiritual, and psychological. For a New Year’s resolution, you can choose any of the following fields to improve upon as there are a myriad of suggestions available.
Improving biophysical health can consist of adopting a healthy diet consisting of correct calorie intake and receiving nutrients from all five food groups to help reduce excessive stress and avoid physical illness.
Other ideas: Regular exercise, Restful sleep, Avoiding illegal substances
Improving psychological health can consist of practicing self-care, which is divided into seven categories: sensory (taking a hot shower), pleasure (watching a movie), spiritual (meditating), emotional (journalling), physical (stretching), social (volunteering), and mastery (cleaning). It is recommended to perform self-care for a minimum of half an hour per day. Self-care will look different for everyone, so engage in an interesting activity you would enjoy!
Other ideas: Avoiding burnout, Avoiding perfectionism, Mindfulness
Improving social awareness can consist of surrounding yourself with an active support system that will provide stability, encouragement, and advice when you are in need of it. Support systems can include anyone, but always remember to reciprocate the support that you receive!
Other ideas: Maintaining a positive environment, Committing to a sensible number of events
Improving spiritual health can look like having a set of healthy, realistic dreams and aspirations that keeps you motivated and encourages you to keep moving forward. Don’t be afraid to re-evaluate your current goals when they feel like they are unrealistic!
Other ideas: Good set of morals, Belief in a higher being
For more ideas, check out The American Mental Wellness Association » Staying Healthy.
Open-Path Collective: Directory of therapists who offer $30-60 per individual session or $30-80 for couples. The client can filter their searches, such as for CBT or daytime availability. There is a one-time membership fee of $50 for the client: