Q.Please comment on ways to help children relieve stress during tests. With all the New York State requirements I’m worried my teenager will not do well because of the stress level.
A. Your question indicates that parents also often have stress about how well their children perform on tests. It is important not to convey your anxiety to your child by making it seem that any one grade or test result is a make or break point in his or her life. Some anxiety about tests can be a good thing because it can serve as a motivator to do the pre-test work that will make your child become a good test taker.
The best way to approach a test is by looking at it as part of the learning process. Weeks and
months are usually spent by classroom teachers preparing their students for the Regents
Exams. A child who has worked to the best of his ability all along, ie. attended class, done his
homework in an organized, purposeful and comprehensive way will have more confidence as
the test approaches. Working on Regent’s preparatory books and taking sample tests will also
be helpful. Hard work and good preparation are the best defense against test-taking anxiety.
Then, when the test is presented to your child he must remind himself not to panic, take a
moment to look the test over, understand the directions, breathe slowly and remember that he
has worked hard and is now well prepared.
Q. My wife’s general practitioner & psychiatrist believe that she is manic depressive, but her sister has talked her out of taking any medications as she does not believe in doctors or medication. She now refuses to see her doctors and I am having great difficulty in coping with her wild mood swings & neglect of our children. I would appreciate your assistance.
A. Medication non-compliance is a relatively common problem in people with bi-polar disorder for a variety of reasons. People may find the side effects of their medication intolerable or, they may discontinue taking medications as soon as they start to feel better. They might not be convinced that they have bi-polar disorder, believing that it is someone else’s fault that they are so unhappy and angry. Many people believe that it is a weakness to need medication or that there will be long term harmful physical consequences to taking the medications. Treatment of bi-polar disorder must address all of these issues in the initial stages of the diagnosis in order to insure better compliance. Treatment of bi-polar disorder with medication (usually lithium carbonate) is 80% successful and can return the person with the diagnosis to a normal life.
Medication alone is not the answer, however, for people with bi-polar disorder. Treatment should also include learning new coping skills and finding out ways to predict their mood swings and what triggers them. Also, spouses, parents ( in the case of children with the disorder) and other key family members might be brought into a patients’ therapy sessions to insure that a consistent and accurate amount of information is provided and to allow the patient to work out with them ways for the family to help. This allows everyone to be on the same page and thus more skilled in efforts to support the patient. Regular and frequent psychotherapy sessions increase the compliance rate in people with the disorder once they have formed a trusting relationship with their therapist. Untreated, bi-polar disorder is a roller-coaster ride for the person with it and for their family. It is the responsibility of anyone who is given this diagnosis to take it seriously and learn as much as they can about it so that they can prevent the often disastrous consequences of the disorder for themselves and their loved ones.
Q.Attachment Disorder, What is it? What to expect?
A. An Attachment Disorder has its origins in infancy. It is the result of physical separation from parents due to inconsistent parenting, separations for long periods, legal removal as a result of neglect, physical abuse or alcohol and drug abuse.
The trauma to the infant is not due to these things alone, although they create their own set of problems, but rather to the separation itself. The sound of the parents’ voice or even his or her smell and touch become familiar to the infant and are associated with comforting, nurturing, warmth and above all security. The loss of these things or the unpredictability of these things is extraordinarily disruptive to the child’s ability to develop trusting relationships and the damage can be life-long, preventing any successful relationship formation in the person’s life.
Children who are adopted from orphanages, at the moment primarily from China, or who have had several foster placements from infancy may have had adequate physical care but no primary attachment to a consistent care-giver. Studies show that good physical care in the absence of a consistent, nurturing relationship with a parent or primary caregiver is not enough to prevent the development of an Attachment Disorder.
Children with this condition may appear distant, make poor eye contact and resist hugs or other emotional involvements. They often don’t experience normal separation anxiety. They may cry or fuss and seem inconsolable when there is no physical reason for their distress. On the other hand, these children may be extremely gregarious and treat everyone they meet as a long lost loved one. They can be overly and inappropriately affectionate.
Children with Attachment Disorder can develop the trust necessary to build relationships but it takes time. Often lots of time. The treatment is time, patience, dedication and love from caregivers who don’t go away. Consistency, solid routines as they grow, loving limits and discipline are what it takes to reverse an Attachment Disorder.
A good relationship with the child’s Pediatrician and a Developmental Psychologist can also help parents and the child through difficult times. Ideally, all the helping professionals in the child’s life should remain the same. Residential moves, changes of school or any lengthy separations from parents must be prepared for well in advance and perhaps avoided altogether in the early stages of the relationship.
Q.Does my child have an Auditory Processing Disorder?
A.Auditory processing is simply what your brain does when you ears hear sound. Your brain interprets that sound so that you can react accurately to it. As a child develops language, he is not just learning new words but he is also categorizing them, developing sentence structure, syntax and subtle nuances of meaning. A person who has normal verbal processing skills develops language that is fluid and in harmony with his thinking. Proper language development results in the child’s ability to learn, understand his world, receive and interpret social cues and develop behavioral controls.
People with an Auditory Processing Disorder have difficulty understanding what they hear not because they can’t hear but because they can’t make sense out of what they hear. A child with Auditory Processing Disorder often looks like he or she is not paying attention but it is more than simple distractibility or ADHD; memory, concentration, carrying on a conversation, and learning are monumental tasks for a person who cannot make sense out of words or key phrases. They also often have behavioral problems because proper language allows us to internalize verbal directions and rules of everyday life. Although these children typically have normal intelligence they have difficulty with reading, reading comprehension, sequencing and math. They often require more time to process information and complete tasks. Vocabulary building and spelling ability also lag behind. Social skills suffer and these children frequently have trouble making friends because they don’t understand or have misunderstood what their peers are saying to them. Anger, frustration and depression can result from these deficits. These children often feel lonely and like they just don’t fit in.
If you suspect that your child may be suffering from an Auditory Processing Disorder he or she should have a comprehensive speech and language evaluation, audiology exam to evaluate your child’s hearing and psychological evaluation to determine affected cognitive areas. Once a diagnosis is made, your child’s school will become involved to assure proper teaching techniques are used and to make special programming available. Often these children require speech and language tutors or extra time to finish their work, preferential classroom seating to reduce distractions and improve concentration as well as strategies to improve your child’ organizational and sequencing skills.
Q.How does daily organization and structure contribute to ADHD therapy?
A.Once a valid diagnosis has been made with the help of a psychologist, the child’s teachers, pediatrician and family, several treatment methodologies will come into play. First of all medication, is often recommended because it has been found to be the most effective treatment for ADHD. However, a pill alone will not advance a child’s academic progress or social controls without a behavioral program that is consistently administered both at home and at school. The child must begin to take responsibility for improving his attention span,organization planning, judgement, academic performance and social interaction.
Cognitive behavioral therapy and the use of positive reinforcement can greatly improve a child’s academic motivation and judgement. By using “thinking techniques” learned through cognitive behavioral therapy and “words” rather than impulsive actions the child can learn to delay his demands for instant gratification and reduce impulsive behavior. Cognitive behavioral therapy teaches a child to slow down and think things through calmly before acting. Positive reinforcement for meeting goals and a place to go both at home and in school where a child can sort things out for himself and take a time out from the imminent stress can improve confidence and eliminate “meltdowns”.Parents must be taught the value of creating a schedule, even if the child spends time between two parental households, with consistent expectations for doing homework,going to bed and getting up at the same time every day, keeping the backpack and bedroom well organized, having the things necessary for school ie paper, pens and pencils in good order and readily at hand go a long way toward decreasing the frustrations of ADHD. Parents must be willing to take a hands -on approach to their child’s academic, social and organizational tasks. Do home work together, clean his room together and organize his backpack together. This helps the child to feel less overwhelmed and more supported as he begins to reverse the effects of ADHD. Have some fun each night taking turns reading a story together. This will help your child value reading because it becomes a positive experience with his parent and makes reading fun.
Often tutoring in reading and math are recommended to help the ADHD child catch up, speech and occupational therapy may also be helpful. Sometimes a child with ADHD may require special services ie. an aide or other accommodations to help him through his day.
Q.Is it possible for a person to be diagnosed Bipolar & with a personality disorder in their 50’s? I have always had a problem with relationships and wondered if it was a result of this disorder.
A.Often bi-polar disorder, especially bi-polar II the less serious form, can unfortunately be undiscovered or misdiagnosed for years. The nature of these disorders is that people with them can go for long periods of time in a depressed and irritable state and are often treated simply for depression. The manic phase of bi-polar disorder may be characterized by irritability and poor judgement but also with feelings of elation, overconfidence, high energy etc. People with the disorder are often not troubled by their symptoms during this phase although people around them may be. The diagnosis of a Personality disorder can encompass many types of behavior and shares symptomatology with bi-polar disorder especially in the manic stage. People with either or both can act impulsively, self-destructively, exhibt poor judgement , have trouble sleeping and seem to have blind spots as to how their behavior affects others. Consequently, people with these problems often have difficulty with trust , believing that they need help and fail to develop close ties with family and friends. There is often a lack of insight with both conditions which makes it hard for the sufferer to see their role in their own difficulties with keeping jobs, friends or good family relationships. It is possible for people to have both conditions ar the same time.
Therapy with such individuals is to help them to understand their problem, its effect on them and others and develop new ways of thinking so they become capable of improving their lives. Medication is also used in the case of the bi-polar disorders to help people avoid their extremes of mood fluctuation.
Q.I am a 37 year old female with four kids. I have recently had a lot of stress in my life - my father passed away due to cancer. I am on anti-depression medication but recently my hair started falling out as well as my joints are painful. Should I be worried?
A.Alopecia or hair loss and painful joints can be stress related symptoms. Alopecia may be an auto-immune disorder with genetic underpinnings brought on by stress. Symptoms such as these should always be brought to the attention of your medical doctor for further diagnosis and treatment. However, the combination of grieving plus the raising of four children are presenting you with a great source of stress. The anti-depressant medication can be very helpful but brief, grief-focused psychotherapy could be beneficial as well in providing a trained professional who can objectively guide and support you and give you strategies for successfully navigating yourself and your family through it.
Q.I have trouble making eye contact with other people. Why is that and what can I do about it?
A.An ancient proverb says that the eyes are the window to the soul. We instinctively know that meeting someone’s gaze provides an instantaneous but none the less special connection to another human being. Many factors may be involved in your difficulty making eye contact. Among them are shyness, social phobia, social avoidance and even Asperger’s syndrome. Many individuals feel nervous when meeting new people. We want to make a good impression and we want people to like and admire us. All of the above mentioned problems have their start in childhood and probably have a genetic origin. Help comes in the form of learning desensitization and relaxation techniques as well as getting to the root cause, that is, an individual’s belief system. If a person believes that they are being judged and criticized in social settings they well may never feel comfortable and will find socializing difficult. They may avoid social or family gatherings and begin to feel isolated and alone. Techniques can be learned to confront this faulty thinking and replace negative self evaluations with positive ones. Over time the individual learns ways of thinking which allow positive social connections to develop.
As a start make an effort to hold someone’s gaze to the silent count of five. Practice this and with guidance from a therapist who understands social phobias and shyness great improvement can be achieved.
Dr. Woods' Roll in Wellness
Dr. Susan Woods, a licensed psychologist, has been in private practice in Schenectady since 1983. Dr. Woods received her masters degree from Columbia University and her Doctorate in Psychology from the University of Michigan. Her doctoral research concentrated on Attention Deficit and Hyperactivity Disorder. This research was one of the first studies to show that ADD/ADHD affected children who were medicated with Ritalin type medications were less likely to use illegal drugs, commit crimes or drop out of school than children who were not medicated. Her training included internships at children’s psychiatric hospitals, mental health clinics, family court and public schools.
Dr. Woods has a special interest in working with children, adolescents, and adults with ADD/ADHD, Eating Disorders, Bipolar Disorder, Depression and Anxiety, along with their families. Couples counseling is an important part of Dr. Woods’ practice as well. Separation and divorce can be destructive to every member of a family. Therapy aims to preserve the marriage if possible but if not to guide the couple and their children through this painful process in order to minimize its negative effects.
Dr. Woods provides a homey, comfortable office where children and adults alike can feel safe and secure in discussing their problems and goals in life.
Dr. Woods encourages an atmosphere where realistic change can occur while people regain the ability to take charge of their lives by thinking clearly through to reasonable and rational solutions to their problems.
This general Information is not intended to provide individual advice. Please make an appointment with a physician to discuss you particular situation and needs.
