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September 12, 2005School Health Programs Department
How to Talk to your Kids about Anything: Tip #3 [Sex & Relationships]
If you feel uncomfortable talking about such sensitive subjects—particularly sex and relationships— with your young child, you’re not alone. Many parents feel awkward and uneasy, especially if they are anxious about the subject. But, for your kid’s sake, try to overcome your nervousness and bring up the issue with your child. After all, our children are hearing about it both through the media and on the playground, and that information may not include the values that we want our kids to have.
Children are exposed to drugs every day. They see adults taking medicine for headaches, classmates using inhalers for asthma, commericals for medications on TV and in magazines, and even people on the news being arrested for drug use. The subject of drugs can be very confusing - and dangerous - for kids.

The younger a child is when he begins to use drugs, the more likely he is to develop problems associated with drug use, such as acts of violence, unplanned or unprotected sex, school failure, or driving accidents.

The average age that a child first experiments with marijuana is 14. And many kids become curious about drugs even sooner. Even children as young as 5 can become involved with drugs. Inhalants, in particular, are abused more often by younger children than older ones. According to the National Institute on Drug Abuse, about 6% of U.S. children have tried inhalants by the time they reach the fourth grade.

If you're concerned that your child may be using drugs, keep reading to find out how you can tell and what you can do about it.

Risk Factors
Young people may use drugs for many reasons that are related to factors such as their self-esteem, how they get along with others, and their environment. No single reason determines who will use drugs and who won't, but there are common risk factors to be aware of:

- low grades or poor school achievement
- hostile, defiant behavior
- tendency to be influenced excessively by peers
- lack of adequate support or supervision
- history of behavior problems
- history of drug use by siblings or friends

Warning Signs
It can be hard to know the difference between normal childhood behavior and behavior caused by drug use. Changes in hairstyle or dress may alarm parents but may be normal behaviors. On the other hand, changes that are extreme or sudden may signal drug use.

It may help to ask yourself the following questions:
1. Does my child seem withdrawn, depressed, or tired?
2. Has my child become hostile or uncooperative?
3. Have my child's relationships with other family members changed?
4. Has my child dropped his old friends?
5. Has my child lost interest in or drastically changed his appearance?
6. Has my child lost interest in hobbies, sports, or other favorite activities?
7. Have my child's eating or sleeping patterns changed?
8. Does my child suffer from headaches, nosebleeds, or other physical problems for no apparent reason?
9. Have I noticed the odor of chemicals or drugs around my child?
10. Do aerosol products at home seem to be used much too quickly?

Positive answers to such questions may indicate drug use. However, these signs may also apply to a child who is not using drugs but who may have other problems, such as depression or an eating disorder.

Be aware of common drug paraphernalia. Possession of items such as pipes, rolling papers, small medicine bottles, cans of whipped cream or other aerosol products, or syringes may signal that your child is using drugs.

What Can a Parent Do?
If you think your child may be using drugs, ask other adults in your child's life if they have noticed changes in your child's behavior. The best place to start is at school - talk with your child's teachers, guidance counselor, school nurse, or coach. Many schools now have prevention specialists on the counseling staff who can help you if you think your child is using drugs.

Communicating with your child at this time is very important. If he is reluctant to talk, enlist the aid of his guidance counselor, doctor, or a local drug treatment referral and assessment center.

Also explore what could be going on in your child's emotional or social life that might prompt drug use. Is there anything going on at home or school that could be responsible for his shift in behavior?

Even when the signs are obvious, parents sometimes have difficulty admitting that their child could have a problem. Anger, guilt, and a sense of failure as a parent are common reactions. If your child is using drugs, it is important to avoid blaming yourself for the problem and to get whatever help is needed as soon as possible.

Be consistent in enforcing whatever punishment your family has chosen for this type of rule violation, such as revoking driving privileges. Do not relent because your child promises never to do it again.

Many young people lie about their drug use. If the evidence suggests that your child is not being truthful, you may wish to have your child evaluated by a health professional, such as an adolescent medicine specialist, experienced in diagnosing children with drug-related problems.

Depending upon the severity of your child's drug use, you will probably need help to intervene. Call your doctor, local hospital, state or local substance abuse agencies, or county mental health society for a referral to a drug treatment program in your area. Your school district should have a substance abuse counselor who can refer you to treatment programs. Parents whose children have been through treatment programs can also provide information and support to help you deal with your feelings.

Although depression is common among children and adolescents, treating it can be problematic, with little in the way of scientific evidence to guide the use of antidepressants, a new report finds.

Recent data about the increased risk of suicidal behavior among children taking antidepressants such as Paxil, Prozac and Zoloft have called their use in children into question. However, experts say the benefits of these drugs outweigh the risks when patients are properly monitored.

The latest research, reported in the Sept. 10 issue of The Lancet, notes that major depressive disorders strike about 1 percent to 2 percent of children aged 6 to 12, and 2 percent to 5 percent of teens. In addition, 14 percent to 25 percent of children and adolescents have at least one episode of major depression before adulthood.

"Depression in children is relativity common, with a lot of impairment that lasts quite awhile," said study author Dr. Neal D. Ryan, a professor of psychiatry at the University of Pittsburgh School of Medicine. "It really deserves treatment. It's not a short or transient phenomena."

In his review article, Ryan looked at the current state of what is known about treating depression in children and teens. "There is a large gap in what is known about treating childhood depression compared with what is known about treating depression in adults," he said.

This knowledge gap exists because there are far fewer studies about depression in children. "It looks like there are a couple of psychotherapeutic approaches that probably work," Ryan said. "But we don't really have the studies to pin down how well they work, compared with medications, to give you a rational basis of what to do first."

In addition, Ryan found that the studies that dealt with using antidepressants showed mixed results. Part of the problem is that there are not enough studies to really tell how well these medications work in children, he said.

Ryan noted that whether these drugs make children suicidal is also an unanswered question. Whether the problem is due to the use of older medications, and is relieved by newer ones, is not clear from the last analysis done by the U.S. Food and Drug Administration, Ryan said. "It's a really mixed picture about the suicidality thing."

"The real question is, 'Is there an increased risk of something related to suicide when you first start taking the medication?' " he said. "Certainly, there is data pointing that way. There is also data that people are better off on medications."

Given the potential problem with antidepressants and the lack of complete knowledge, it is an open question whether to use psychotherapy or medications first with children, Ryan noted. "It's not a straightforward picture," he said.

Ryan believes children with severe depression can benefit from antidepressants, but children using these powerful drugs need careful monitoring. "Anything you can do to monitor for suicidality makes a whole lot of sense," he said.

One expert agreed that both medication and psychotherapy are valuable in treating depressed children.

"When we talk about treating depression, we shouldn't be limited to medication," said Dr. Robert N. Golden, a professor and chairman of psychiatry at the University of North Carolina. "Psychotherapy is also very effective."

But Golden also believes antidepressants are a valuable tool to use with depressed children. "Despite all the public attention that was focused on this finding of increased suicidal ideation in children on antidepressants, we shouldn't lose sight of the fact that there is an overwhelming body of evidence that these medications decrease completed suicide," he said. "That's what it's all about -- saving lives."

Medications have their risks, Ryan said. "But the risk of not giving them is much greater than the risk of giving them under controlled conditions," he added. "You can't give anybody, whether it's a child or adult, a pill and send them on their way. There has to be close supervision, and there has to be a public policy that allows for follow-up services."

More information
To learn more about depression, visit the National Institute of Mental Health.

Wellness Center
Jennifer Kenny-Baum (Wellness Coordinator) is available daily.

Monica Murphy (nurse) is available daily.

Ian Enriquez (Youth Outreach Coordinator) is available daily.

Sheening Lin (psychologist) is available daily.

Ulash Thakore (academic counselor) is available Monday thru Wednesday.

Kory Okun (relationship counselor) is available Tuesdays.

Wayne Hayes (counselor) is yet to be determined.

James Guay (therapist) is available on Wednesdays.

Pauline Ong (Cantonese speaking counselors) is available on Wednesdays.

How to Stay Looking Young
by Kathleen Doheny

Cosmetic surgery might be the quickest way to reclaim a young, healthy look, but it's not the only way. If you focus on correcting the behaviors that add years and harm your health, you can turn back the clock. Here, the 10 unhealthy behaviors mentioned most often by anti-aging experts -- and how to reform yourself.

1- Feeling overwhelmed by stress
Since caveperson times, we've known excess stress lowers our immunity, boosts the risk of heart disease and generally makes us feel crummy. But now Elissa S. Epel, PhD, a professor of psychiatry at the University of California at San Francisco, has cell-level proof that too much stress triggers premature aging of the immune system. Mothers of chronically ill children who felt most stressed, she found, had the most extreme early aging of these cells. To unwind? "The first step is realizing you are stressed and noticing the signs -- you might feel your heart racing, or feel sweaty," Dr. Epel says. "The short-term way to reduce stress is to do deep breathing, what we call diaphragmatic breathing." The longer-term fix: "Make time in your life to do things that reduce stress."
  

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