Schizophrenia in Children

By Erika Krull, MS, LMHP

Schizophrenia in Children

When you think of someone hallucinating and hearing voices from schizophrenia, you probably imagine an adult or older teenager. It’s not common, but schizophrenia does affect about 1 in every 10,000-30,000 children.

While it’s common for children to have imaginary friends or think about fantasy worlds, they also understand that these friends and places are not real. These thoughts and images do not interfere with a child’s ability to interact socially or do daily activities.

For a child with schizophrenia, these hallucinations seem like a normal part of life. However, the characters may not all be friendly. They may tell the child to do bad things to other people or to themselves. Hallucinations can be frightening and disruptive, leading to episodes of anxiety, paranoia, and some violent behavior.

Researchers are looking into various systems within the brain that make normal thought processes possible. It seems that the foundation of schizophrenia may lie in a person’s genetics, leading to certain problems with brain structure and chemistry.

But even with the right genetic package, a person may or may not develop a particular disorder. Environmental factors and chance may play a role in the final outcome.

Unfortunately, many questions about childhood schizophrenia remain unanswered. Medication can help, but side effects can be a challenge. And because of its rarity, families need to remain persistent when seeking assessment and treatment.

Childhood schizophrenia is not a common disorder, but it can only help for more people to understand it. Compassion and support are essential for families dealing with this difficult disorder.

If you have experience with childhood schizophrenia, please add your own comments below. Or pose a question in the comment section.

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Is Competition Harmful or Helpful for Kids?

By Erika Krull, MS, LMHP

Three high school girls, as part of a larger group, run up and down the beach

If you have kids, you probably have a good idea how they handle competition. One child may embrace challenges without blinking, and another may approach competitive situations with more caution.

But let’s face it. Competition is something humans have faced for as long as we have existed. We have had to compete for food, for shelter, for mates, and for power in our societies. Even as the many human cultures of the world have developed and advanced, competition has remained a predictable part of life.

So you may be wondering, is all this competition good or bad for your kids? I went to the internet to find out the latest word on this topic and found two interesting articles with very different perspectives on the issue.

If you remember an earlier set of posts on postpartum depression, I presented two viewpoints on the same topic so you could see both sides of the story. I’ll do a similar service here. Both articles are somewhat long but are very much worth reading in their entirety.

According to the first article from the New York Times, many scholars understand that competition is unavoidable in life. However, many also agree that the kind of competition our kids face today can promote anxiety and damage performance.

The author includes segments from several expert interviews as he pursues the truth about kids and competition. Each expert lays out a different viewpoint on competition, and some offer ways to redefine competition for kids.

While the article doesn’t come off as completely anti-competition, it does suggest that parents will help their children by modifying the way they perceive competition.

The second article from the New York Times focuses on how a person’s temperament equips them to handle competition. Some people are built to handle the challenges of competition, and some worry and perform poorly when competition arises. While I can’t go into the details here, the article describes these variances in terms of genetics and neurochemicals.

The article also explains how stress and anxiety can have a positive role in competitive situations. It’s also possible to train a person to handle competitive pressure in one area of their life, even if this goes against their general temperament.

Overall, this article redefines stress and competition more positively. It suggesting that people can learn how to manage the stress that comes with competition, even if it goes against their natural tendencies.

So did we answer the question about competition being good or bad for kids? I think you need to decide. Both articles quote viewpoints from professionals and experts, and both cite research studies.

Even if you agree more strongly with one article, you can value important information from the viewpoints presented in the other article. Readers, what are your thoughts on this?

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Postpartum Depression – Answering Important Questions

By Erika Krull, MS, LMHP

Postpartum Depression Questions

I did a talk recently about postpartum depression and used a really resource to help answer some questions. Katherine Stone’s blog postpartumprogress.com is a tremendous resource for all things related to mental health and pregnancy. Several members of the audience I spoke to had some great questions. I thought I’d share some of these topics with you in case you had similar concerns.

One question was about telling the difference between the common “baby blues” and true postpartum depression. This distinction is so important to make at the beginning. The more aware you are of the signs and symptoms of postpartum depression, the better you can determine whether you need to get help.

Here’s a blog post from postpartumprogress.com that goes into such great detail. The big takeaway for this: any symptom or problem that can’t be alleviated or seems to last a long time (at least two weeks straight, most of the time) is reason for concern. Read the lists and you can compare how much more severe and pervassive the postpartum depression symptoms are.

Other questions were raised about a number of mental health problems related to pregnancy that are NOT postpartum depression. Obsessive-compulsive disorder, depression during pregnancy, and anxiety are problems some moms have but don’t hear much about.

Since their symptoms occur during pregnancy or don’t involve depression, these moms may have no idea what to do or believe anyone can help them. Thankfully, postpartumprogress also covers all of these different disorders here on this page. Mental health symptoms can occur during or after pregnancy, and can include depression, anxiety, OCD, PTSD, and other disorders.

In mild cases, formal treatment may not be needed. Or, only a brief course of treatment may be necessary if the symptoms are caught early. But no matter how mild the symptoms, awareness is a huge part of identifying the problem and recovering. If you are watchful of yourself and keep a good support system around you, any symptoms you experience will likely be handled pretty well.

There is absolutely no need to suffer for years like I did. I didn’t tell anyone for nearly 2 1/2 years. That’s also why I took
medication for two years and had a short course of therapy. Had I said something the first time, or even when problems started after my second child was born, my recovery would have almost certainly been shorter. Hard to know if I would have needed medication, but it probably would have been a shorter course.

I hope that if you are pregnant, might be pregnant soon, have recently had a baby, or know someone in these situations, you will keep this information in mind. Please check out the links and bookmark them for your use. You never know if you could be that caring person that helps a mom pull away from pregnancy-related mental illness.

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Calming Your Nerves Helps Your Child Cope During Hospital Stays

By Erika Krull, MS, LMHP

Calm Nerves Child Anxiety Hospital

Has your child had to stay in the hospital or have an outpatient procedure? Hopefully not, but many families have had at least one child go through this experience. Many hospitals aren’t the monochromatic sterile places they used to be. Hospitals that serve children have done a lot to make the experience as positive as possible.

Our family has had some experience with this because of my daughter’s cleft palate surgeries. When she was very young, the toy room was a fun place to hang out. Later on, the child life specialist gave us our first chance to play Fruit Ninja on an iPad. No matter what the form, positive distractions were everywhere to help her through the toughest moments.

This recent study gives more insight into how a mother’s coping skills can affect the anxiety level of her child while in the hospital. As a mom who’s been through this process, I can assure you that feeling stress is nearly unavoidable. You know what you are doing is best for your child, but you hate to see them in pain or feeling anxious about being in the hospital.

It can be a tough balance, trying to look calm and confident while your palms feel clammy and your heart races just a bit. But the more you can distract yourself from worry, the easier it gets.

This particular study looked at children’s drawings, and at questionnaires that asked about the mother’s coping behaviors and her satisfaction with the hospital. The results were similar to what I suggested above. The more coping skills the mother used, the less the drawings showed signs of anxiety.

The coping behaviors examined in this study including leaning on family members to help with non-hospitalized children, keeping social support around, and gaining knowledge about the hospital experience. I did all three of these and found the combination to be really helpful.

The goal isn’t to be a perfect smiling parent. It’s to have a calm responsive presence for the benefit of your child as much as possible. There may be times when your child is doing fine and other times when they really need you.

More than likely, the normal healthy things you do at home are the very things that will help you in the hospital. You don’t have to learn how to do a lot of new stress management techniques. Just do a few good strategies that you know will help.

And when you’re child doesn’t feel good and seems reassured by your presence anyway, you’re doing the right things. Many hospitals now have specialists trained to help kids feel better about their stay in the hospital. Find out as much as possible about what your hospital has to offer before you go.

Here’s the link to that study again.  (It has not been published yet, but has been accepted for publication soon.)

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Untreated Depression During Pregnancy – Part 2

By Erika Krull, MS, LMHP

Untreated Depression Pregnancy

This week I’m highlighting recent expert opinions on untreated depression during pregnancy. My post a few days ago highlighted a research paper stating that anti-depressants generally “do not provide clinically meaningful benefit to women with depression.”

While a strongly disagree with that position, I am impressed by the number of non-medication therapies that are being researched or have already shown benefits for women with depression.

And now we get to “the rest of the story”.

A letter of response was submitted in the same research journal not long after the first paper was published. The letter’s authors disagreed with the conclusions made in the paper, especially that anti-depressants were so ineffective for women. They stated that while research studies doing random medication trials with pregnant women are unethical, that didn’t mean there was no useful data.

According to these experts, the research paper’s authors may have had the wrong assumptions about pregnant women with mental health issues. Because of the complexities of depression in pregnant women, medication can be a critical part of their care.

More than anything else, the authors of this letter thought the researchers minimized the seriousness of depression during pregnancy. They feel that a research paper with these conclusions creates “harmful hype” for a problem that is already challenging to address.

So why have I summarized two papers that seem to show such opposite view of the same problem? To show you that not all research is the same. It’s important to see how experts come to the conclusions they publicize in papers, articles, and interviews. Also, some issues are complex and the available information can be controversial or conflicting.

Consider that even though I didn’t agree with the some of the conclusions in the first research paper, I still found something valuable from it. The list of alternative therapies looks like a promising direction for future research.

There is much research to be done about depression during pregnancy. Hopefully, more questions will be answered and research results will become more consistent. Until then, be sure you get information from all sides of an issue to make your own conclusions.

Here’s a link to the letter of response again.



Untreated Depression in Pregnant Women – Hot Discussion Among Researchers

By Erika Krull, MS, LMHP

Untreated Depression Pregnancy

Untreated depression during pregnancy is not well-recognized and is certainly under-treated. The risks of letting perinatal depression go untreated can extend beyond pregnancy itself. While there is no gold standard treatment that most experts endorse, there is certainly a lot of discussion going on.

A research article was published in the scholarly journal Human Reproduction in January, 2013. It is a detailed examination of potential risks for infertile women taking SSRI antidepressants. The article also discusses SSRI use in pregnant women.

Whether you agree with their conclusions or not, this is a fascinating read. Each potential risk is described in detail with research citations. Perhaps the most practically useful part of the article is the discussion on alternative treatments for depression during pregnancy.

These treatments could be done with or without also taking medication. The list includes cognitive behavioral therapy with a counselor, yoga, relaxation training, and more. Not every therapy has solid research results behind them, but it’s a good list for further study at the least.

There is one part I completely disagree with, mostly because it is done in such a broad sweeping way as to appear almost not-believable. The authors state that “the best meaningful evidence suggests that antidepressants do not provide clinically meaningful benefit for most women with depression.”

I was a depressed mom that finally came out of the deep hole of depression with the help of medication. I am a counselor who has seen many people of both genders benefit from counseling and medication. I have also been connected with the postpartum depression community for a number of years. I’ve heard countless stories of women who were so grateful for the change they experienced after taking medication. Having seen all of this, I cannot believe such a broad- brush statement refuting the effectiveness of antidepressants for “most women with depression”. I just can’t.

You now know my personal opinion, but I do invite you to form your own. This article is full of many interesting nuggets. And even if you do believe antidepressants can be helpful for women with depression (pregnant or not), this is a good thought-provoking article showing the opposite position. It is long with some scientific jargon here and there. But it is primarily a review of many studies, which makes it fairly readable.

Also, note that this is a rare fully-published article made available to read at no charge. Many full studies or research articles are only visible through a paid service. Here is that link again from the Human Reproduction scholarly journal.

Remember way back at the beginning of this article when I said there was a discussion going on among the experts? As Paul Harvey always said, you’ll hear “the rest of the story” in a few days on my next blog post.

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Mom, I Don’t Know How to Study – What Should I Do?

By Erika Krull, MS, LMHP

Mom I Don't Know How To Study
I paused for a moment when I heard this statement from my daughter the other night: “I don’t know how to study”. What? For a girl who gets good grades and stays on track with her homework, I couldn’t figure out why she wouldn’t know.

Then I realized something important about what she was asking. She was challenged in a way she hadn’t been before and she needed help. Her usual methods of learning and retaining information weren’t going to be enough this time.

As a parent who has been through seemingly endless years of school, I had to think back for a minute. I know how I would study if I were preparing for a test, but when did I do that. How did I figure it out? What did I learn about myself?

After so many years, I had almost forgotten that it was a long process of making mistakes and experiencing triumph. I had to have started somewhere and so did she.

I gave her a few ideas about what has helped me, but I reminded her that she has used her own tricks in the past to remember things. She has used rote memorization unless the amount of information was simply too difficult or massive to retain. In some cases, she has used quirky memory associations to learn state capitols and Canadian province capitols.

As she gets older and is given harder material, she may have to develop broad skills like good note taking and time management. Perhaps the most important thing to remember is that no single study method or habit is best for everyone.

What’s Your Learning Style?

The three basic learning styles are auditory (listening), visual (seeing), and kinesthetic (moving). Everyone uses the three learning styles, but each person has a preference. You may say your a “visual person”, or you feel like you’re a real “hands-on person”. That’s most likely your strongest learning style.

Ask your child what they prefer. Or help them take this quiz to figure it out. You may be surprised at what you find out about your child.

When you figure this out, you can help them tailor their studying habits around these strengths. If they are an auditory learner, they may like to be verbally quizzed by someone, talk over the topics with a friend, or repeat words to themselves out loud.

A visual learner will like looking through notes, slide shows, maps, and videos. A kinesthetic learner will like to thumb through books, tap their feet to music while they study, and write or type things out by hand.

In the age of the internet, there are also about a million different tutorials on nearly every subject imaginable. Videos, articles, mp3 audio clips, slide shows, quizzes, and interactive tutorials can be easily found. Many elementary students are encouraged to use school-approved online learning websites. These can also help you understand the ways your child learns best.

This is a neat website about how to study. It has lots of tips, articles, and good base knowledge on various subjects. It looks like they do sell some of their own guides as books, but there is plenty of free information available.

Readers, what have you done to help your child study? How does your child’s style differ or compare to the ways you’ve learned to study and remember information?

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Obsessive-Compulsive Disorder in Kids and Teens

By Erika Krull, MS, LMHP

obsessive compulsive disorder kids teens

Obsessive-Compulsive Disorder is a serious mental health condition that often goes undiagnosed in children for years. Many kids suffer in silence because they can’t always control their thoughts and behaviors. If OCD develops while a child is in elementary school, they will do a lot to conceal their rituals so no one discovers their secret.

You may think of Obsessive-Compulsive Disorder (OCD) as something that happens mostly with adults, but nearly 1 in 200 kids and teens have OCD. Following the example given by the OC Foundation , a K-5 elementary school with 300 children could have at least one or two kids with Obsessive-Compulsive Disorder. These kids may or may not be diagnosed at that age, depending on their symptoms and how they are addressed.

Mental health disorders can be tricky to diagnose in children sometimes. Symptoms don’t always appear the same as they do with adults. Also, it’s important to consider that they are always growing and maturing. That’s why it’s crucial to make sure symptoms appear as a pattern. Just having one sign of OCD could be explained by a stage of development.

If you are concerned about your child or another child you know, the OCD section at KidsHealth.org  has an long but excellent article describing the condition. This page highlights possible symptoms of  obsessive-compulsive disorder in children and teens. Be sure to read the entire 5-page article to get a better understanding of this condition.

These is another thorough resource for parents if children with OCD. The main page shows a long list of helpful articles with highlighted links that lead to more resources. Topics range from diagnosis to treatment to managing school issues. The bottom of the page has links to several books.

Parents of kids with OCD need help and support, too. This website lists several online groups as well as a few in-person support organizations. NAMI is a mental illness support organization that has groups in many communities across the U.S. Anyone who is a family member of someone with a mental illness can join and be part of a unique support community. To find your local NAMI affiliate group, search for your state on this NAMI web page.

Despite the serious nature of OCD, many people learn how to manage and even overcome their symptoms in time. Your child’s life doesn’t have to be defined by OCD. The websites listed here offer a lot of solutions and an abundance of hope. If you want more information about OCD, please don’t hesitate to check out these resources. Get in touch with someone to ask more questions if necessary.

If you have any personal stories of recovery or other messages of support, please add your comment below. Questions are great, too. I’m not a specialist in OCD by any means, but I’ll do what I can to find good solid information if you need help.

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Parenting Trends – Are You In or Are You Out?

By Erika Krull, MS, LMHP

Parenting Trends 2013

I’m not a really trendy person in general. In fact, you might call me pretty square. As a parent, trends have certainly surrounded me. However, I often found myself falling into the same rut. Or, perhaps I just followed my own trend with great consistency?

I’m sure many of you have found yourself in a parenting rut, I mean “your own parenting trend”. Sometimes it’s interesting to stick your head up above the surface and see what other people do, or what they think you should be doing. It is very enlightening at times, though not always in a good way.

I find that when I take a closer look at parenting trends, I see three main things: choices I already make, choices I have purposely avoided, and choices that would never occur to me (good or bad). So in the spirit of self-discovery and some fun, I invite you to peruse these lists of parenting trends.

Your place in the  “in” crowd or the “out” crowd may come down to which list you read. No matter what any single list says about itself, there is no definitive list. Even the lists are trendy, it seems.

Ultimately, trends will come and go. When you do what feels right for you and your child, all the other stuff doesn’t matter too much.

Biggest Parenting Trends 2013 – iVillage

This is what you are supposed to look for in 2013. If you have babies or really little kids, some of these ideas are really cute and even useful. I like the nail polish one because I have girls 13 and younger. Other trends are a little more controversial. It’s an interesting mix to say the least.

Parenting News Predictions – Huffington Post

These trends are more about events and ways of thinking. Again, some of these may really strike you, others may seen controversial. They aren’t based on a product or socially popular item, so the odds of these things coming true are uncertain. However, they are likely to make you think a bit.

Current Parenting Trends – Everyday Family

The four trends listed here are more like parenting styles or choices. I think these are actually bigger than trends. More than likely, if you are a so-called “helicopter parent”, you aren’t going to just drop your watchfulness and involvement all of the sudden. Also, I think parents have been putting their kids in front of TVs for a while now – not all that new.

No matter what you call this list, it is your job as a parent to decide how your parenting style fits with the way you want your child to end up once you have raised them. This list has some interesting things to consider.

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Whose Behavior Carries the Most Weight At The Dinner Table – Mom or Dad?

By Erika Krull, MS, LMHP

Dinner Table Parent Influence Child Obesity

You may have read a very recently released article highlighting the influence moms have on their children’s’ eating habits. An undergraduate wrote a thesis paper about this connection. She studied over 200 low-income preschool children in the Head Start program. Her focus on African-American and Latino children matches the group of kids with the highest obesity levels.

According to her research, the mothers’ behaviors shaped their children’s eating habits. When moms show higher levels of control around food, their kids tended to be picky eaters. When moms were emotional or impulsive eaters, their kids tended to be more tempted by food.

While the results of the study showed some possibly negative outcomes of parental influence, it also means that a positive influence could be powerful. If parental behaviors carried that much weight at the dinner table, then healthy goals could also be reached with the right kind of information and motivation.

And just when you thought you knew it all…

Dads apparently have some pretty strong influence when the family eats out. According to this study by researchers at Texas A&M, kids followed their father’s lead when going to fast food restaurants. When dad spent more time going out for fast food, the kids had an increased likelihood of going for fast food as well.

The article states that we’ve grown accustomed to that moms had the influence when it came to food. But with dads doing more hands-on care for their kids, it shouldn’t be a big surprise that their behaviors would be a strong example, too.

Keep in mind that these are each individual studies. That doesn’t mean their information is invalid, it just means more will need to be done to make their findings look more meaningful. In the meantime, it wouldn’t hurt to take a closer look at the example you are setting for your kids at the dinner table.

Who do you think has the most influence at your house at the dinner table? Mom or Dad?

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