Fiction and poetry are doses, medicines. What they heal is the rupture reality makes on the imagination.

(If you’re looking for the manifesto, please scroll down the page and there’ll be more soon)

‘Fiction and poetry are doses, medicines. What they heal is the rupture reality makes on the imagination.’ Jeanette Winterson 

Looking through the newspapers over the last few days, I’ve been overwhelmed by the usual round up of ‘highlights’ of 2011: successes, failures, deaths and revelations. I’m still surprised how little is reported on the on-going crisis resulting from the tsunami in Japan in March.

How is the health and well-being of the displaced people around Fukushima, now that the Japanese government has increased the levels of radiation it is permissible and ‘safe’ for its citizens to be exposed to? Although barely noticeable in the printed media in the UK, counterpunch have provided some compelling detail, exposing the very real and enduring plight of people in Japan. What is particularly poignant, is the focus on women's voices, reminiscent of Greenham Common in the early 80’s, when 30,000 women held hands and formed a human fence around nine miles of the US nuclear missile base, and sung They Shall Not Pass. 

The women of Japan sing a traditional song of remembrance and longing, Furosato:

Someday when I have done what I set out to do,

I will return to where I used to have my home.

Lush and green are the mountains of my homeland.

Pure and clear is the water of my old country home.

This year has also seen societal unrest on a scale unseen in a generation. Whilst focus in the UK media has been on the ‘Arab Spring’ and the unfolding crisis in Syria, the voices of school girls unbalanced the political system across Chile, resulting in a number of government resignations and questioning wider social inequalities. The voices of the young women of Chile cannot be ignored.

Closer to home, and less apparently sensational, the small print in the Guardian on 30th December revealed that antidepressant use in the England has risen by more than a quarter over the last 3 years. Prescriptions for anti-depressants rose from 34m in 2007/08 to 43.4m in 2010/11: an increase of 28%. Furthermore, in the North West we have the highest antidepressant use over 2010/11, with 7.2m prescriptions dispensed.

I have no doubt at all, that antidepressants offer critical respite from serious and debilitating depression, but we mustn't lose sight of some of the factors that impact on our mental health, and the current economic crisis plays a real part in this. Whilst counselling and talking therapies can help turn lives around, it is significant that as the government have increased their support for Cognitive Behavioral Therapy, this apparent treatment of choice is both time-limited and ‘measured’ in part, by the individuals’ ability to find employment/return to work. And we’re told that depression is costing the economy almost £11bn a year. I seem to remember the wonderful Dorothy Rowe telling the Un-Conference here at MMU in October, that guilt, blame and shame are all part of that complex baggage that erodes our well-being and can cause depression. (see Greenberg in recommended books for the big picture)

Doesn’t it seem like we’re in some horrible muddle, measuring our well-being...measuring our ‘happiness’ ad infinitum. The writer Jeanette Winterson sums it up perfectly, ‘...when money becomes the core value, then education drives towards utility...the life of the mind will not be counted as a good unless it produces measurable results.’

In her autobiography, Why Be Happy When You Could Be Normal? Jeanette Winterson paints a picture of her life, originally fictionalised in Oranges Are Not The Only Fruit. It’s an enthralling read and one that I won’t spoil, but one in which we are given some very strong ideas about the potential impact of the arts on our well-being, and how as ‘meaning-seeking creatures’ in an increasingly secular world, we need to find ‘new ways of finding meaning.’ She also succeeds in blowing the myth, that poetry and prose are luxuries for the educated middle classes, suggesting ‘a tough life needs a tough language - and that is what poetry is. That is what literature offers - a language powerful enough to say how it is.’


In his report to HM Treasury, didn’t Derek Wanless suggest that evidence showed that one of the strongest determinants of health impact, wasn’t in fact, the reach of health services, but the female literacy rate?

I wonder how the people of Japan will describe this experience of being; will the actions of the young women of Chile go down in song, and how will we make sense of the here-and-now on our increasingly depressed little island?   C.P

Thanks to Dr Nick Shimmin for sharing counterpunch; Professor Chris Williams of Pace University for his essay; the inspirational young people of Chile and Jeanette Winterson.

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Live 2010 Like You Want To

By Bill Callahan, M.D. 




It’s that time again.  Big balls dropping, toasts given, resolutions given and many broken.  We are on the eve of a New Year. I look at a resolution for change, whether on January 1 or on any anniversary, as a battle between the healthy part of me that is for change and courage, and the destructive part of me that wallows in ruts and familiar patterns.




A careful review of our behavior over the past year allows us to see the thoughts, actions, and fear that causes us to retreat into familiar patterns with known results.  We can predict, if we are honest with ourselves, how we talk ourselves out of change, and perhaps berate ourselves after we get disappointed.  This hopeless pattern does not need to continue.




I find when I set out for my three mile run in the dark at the end of the day, that there is a point just before a mile where my mind and body scream out with every reason to give it up (just for today they tell me) with all kinds of legitimate reasons to postpone, and yet when I make myself persevere there is a powerful euphoria related to the genuine side of me winning over the part that wants to quit and postpone.  We all have the chance to strengthen our healthy side and weaken the self destructive parts of us.

A few ideas that I use to keep resolutions for change, at New Year’s or any anniversary that matters to me:

1.      1. Do set goals.  The focus of our minds makes a huge difference.  Take a look at the movie What the Bleep Do We Know to get a glimpse into the untapped potential of the human mind and spirit.

2.      2.  Catalogue the ways you talk yourself out of change, postpone and procrastinate so that you know the enemy parts of yourself and their maneuvers.  Every time you stop one of them it’s another win for you.

3.     3. Pat yourself on the back for successes, but don’t reward yourself by undoing your gain (spending money if you are reigning that in, eating excessively when you wish to lose weight).  Speak honestly to yourself when you have given in to your destructive side but without berating yourself.

4.     4. Learn to talk in terms of what you want and will do.  Remove the words should, need, have to, can and can’t from your vocabulary.  This language reinforces obligation, which can cause a  knee-jerk stubbornness, and the helpless part of our character.  These parts are not our friends.

5.     5. Remember, when waging war for your independence, there will be many battles.  You simply need to win more than you lose, and you can do that.

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Keeping Your New Year's Resolution with Mindfulness

By Brandon Cornejo M.D., Ph.D.

How many of you are trying to get yourselves back into a regular gym and exercise routine for your New Year's resolution? When it comes to exercise, one of the biggest challenges is staying motivated and consistent. I hope I can help you with this two-part blog post on "Mindfulness."

What is Mindfulness?

• Mindfulness is a nonjudgmental, present-centered awareness in which each thought, feeling, or sensation that arises is acknowledged and accepted.

Mindfulness as a Therapeutic Approach

• Mindfulness based stress reduction means to focus your attention on the "now."

• People practicing mindfulness work on not judging or evaluating the present moment but focus on simply “being” present.

• People in a formal mindfulness class engage in daily meditation along with skill-building homework that ties them to the “here and now.” 

 How Does Mindfulness Work?

• Mindfulness allows a person to pause calmly and reflectively before reacting to things.

• Mindfulness may prevent relapse of clinical depression by allowing a person to have some “space” between who they are and their emotions.

• Mindfulness based cognitive therapy (MBCT), a form of therapy that combines elements of mindfulness with cognitive based approaches to treatment, can be an effective approach for the treatment of anxiety or depressive disorders.

• Mindfulness may enhance mood as well as help eliminate negative thoughts associated with depressive states.

So why is "mindfulness" important to keeping that New Year's resolution of daily exercise? Next week, I will post part two with my tips for staying in the present moment while exercising. Happy New Year's!

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New Routines for the New Year

by R. Scott Benson, M.D.



A reader asked what to do before you get to the doctor asking about medication for a child’s school behavior problems. I thought it appropriate to answer that question and take advantage of the tradition of setting New Year’s resolutions.



In general, the answer is increased structure, not punishment. Set routines that head off trouble before it starts. Families can improve structure with a behavior plan. You will get the best success if you focus on one problem area to address and promote a positive behavior that would prevent the problem. And it will take 2, 3, even 4 weeks to see consistent change.



Let me give an example. I asked a second grader “What time do you get up in the morning?” He gave his mother a puzzled look, hoping she would answer the question. But I pressed a little, “Tell me about getting up in the morning.” Now we get the interesting part. “Well, my mother wakes me up, but I can stay in bed. She calls me a couple of times before she sends my dad in. Then I get up.”



Many families do this kind of complicated dance every school morning. Of course, it adds to the parents’ frustration when the same sleepy-head child bounds out of bed early Saturday if cartoon time is scheduled.



One family faced with this fight every morning decided to send Dad first. And they kept score with punch tickets which could be traded for a treat (a special late movie on Friday, a lunch out with Dad on Saturday). And they practiced their lines, “Good morning, this will be a great day.” Or something similar.



Has you family found a different solution to this problem? What are the other conflicts that repeat every day in your house?

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Healthy Eating

by Felicia K. Wong, M.D.



In my previous blog post, I brought up the importance of exercise as an effective treatment for depression. Today, I’d like to focus on another aspect of lifestyle that you can control to improve how you feel about yourself:



Healthy Eating.



Psychiatric medications and mental illness can pose a double threat to maintaining healthy weight. A common challenge faced by people with mental illness is weight gain. Some psychiatric medications can stimulate appetite and lead to overeating. Others cause sedation, decreasing your energy expenditure and calories burned. Mood disorders have been shown to create carbohydrate cravings because carbs increase serotonin, a chemical that makes us feel better. Eating too many carb-rich foods can lead to repetitive episodes of weight gain or failure to succeed on weight loss regimens.

For people with mental illness, proper nutrition is extremely important to overall health. Weight gain is not only detrimental to emotional health, as it can lead to poor self-esteem and worsening depression - it can also be physically dangerous, increasing the risk for many medical problems including diabetes, heart disease, osteoarthritis, hypertension and gallbladder disease.

Here are some basic tips to jumpstart a healthier diet and promote weight loss:

1. Read the food label.



2. Pay attention to portion size.



3. Eat slowly to give the stomach time to signal the brain when it's full.



4. Eat more frequent small meals and snacks to lower insulin levels, reducing the production of body fat.



5. Differentiate between stomach and psychological hunger. Try not to soothe your negative feelings with food.



6. Reduce fast food intake.



7. Minimize soft drinks with sugar and other high calorie beverages.

8. Eat more fruits, whole grain, vegetables, lean meat, fish, and poultry.



9. Prepare food by broiling or baking more often instead of frying.



10. Keep food/activity diaries.



Start the New Year out with a resolution to eat healthier and lose weight!

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Am I Alone?

by Gariane Phillips Gunter, M.D.

















Am I Alone? by Megan Hance



I get a funny feeling, it comes from deep inside.



I get all mad and angry, wanting to go and hide.



My doctor calls it depression, my dad says it's just me.



But the thoughts and feelings, no one will ever be able to see.



Some say I'm psycho, some say I'm just weird.



It's like I'm a different person, and the old me just disappeared.



I get really edgy, I want to commit suicide real bad.



Then I get a headache, followed by feeling sad.



I wish I could get help, I wish it would go away.



Maybe if I keep praying real hard, it will some day.





I came across this poem and think that the author does a beautiful job of describing the stigma often experienced by those with mental illnesses. The holiday season can be a particularly difficult time as symptoms of depression and anxiety may flare, and feelings of hopelessness creep in.



If you feel yourself slipping away, please contact your doctor or a friend and get help right away. Receive the gift of treatment that everyone deserves. I wish you all a safe and Merry Christmas.

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Thanksgiving – the true spirit of this holiday season.

By Roberto Blanco, M.D.



I love Thanksgiving. It is my favorite holiday of the year. Each year my family gets together to catch up, share quality time and make plans for the future. Leading up to the holiday season this year, however, I had been feeling less than excited about the holidays. Having become accustomed to my daily routine, I found myself searching for a way to escape that monotonous, empty feeling.



So, this year, in celebration of Thanksgiving, I began a list of gratitude: 100 things for which I am thankful. This is not a list of wants or obligations that we create for ourselves - a Christmas wish list, a list of New Year’s Resolutions, or a ‘Bucket List’ (a list of things to do or see before you die). It is a celebration of that with which you have already been blessed. On my list included things like having my health, living in a country with tremendous opportunity, and being able to spend time with family.



Nobody’s family, financial, or personal situations are perfect. For evidence of this, just look at the personal lives of celebrities. And so it’s not surprising that many people can get down during the holiday season because it often reminds us of what we don’t have or didn’t accomplish. This often leads to feelings of emptiness or longing that set the stage for self-destructive situations.



Many individuals take what they have been blessed with for granted and don’t truly appreciate what they have until it’s gone. If you have ever lost something dear to you, you understand this adage all too well. This year, let’s try not to make the same mistake. This year, let’s focus on what we have rather than what we don’t.

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Tips for Talking to Children about the Connecticut School Shooting

By David Fassler, M.D.

Parents and teachers are faced with the challenge of discussing the recent tragic school shooting in Newtown, Connecticut with young children. Although these may be difficult conversations, they are also important.

There are no "right" or "wrong" ways to talk with children about such traumatic events. However, here are some suggestions that may be helpful:

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  Create an open and supportive environment where children know they can ask questions. At the same time, it's best not to force children to talk about things unless and until they're ready.

  
  
  
  


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  Give children honest answers and information. Children will usually know, or eventually find out, if you're “making things up.” It may affect their ability to trust you or your reassurances in the future.

  
  
  
  


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  Use words and concepts children can understand. Gear your explanations to the child's age, language, and developmental level.

  
  
  
  


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  Be prepared to repeat information and explanations several times. Some information may be hard for them to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.

  
  
  
  


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  Acknowledge and validate the child's thoughts, feelings, and reactions. Let them know that you think their questions and concerns are important and appropriate.

  
  
  
  


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  Remember that children tend to personalize situations. For example, they may worry about their own safety or the safety of friends or siblings when going to school.

  
  
  
  


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  Let children know that lots of people are helping the families affected by the recent shooting.

  
  
  
  


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  Don't let children watch too much news coverage with frightening images. The repetition of such scenes can be disturbing and confusing.  

  
  

  
  
  
  

Children learn from watching their parents. They are very interested in how you respond to local and national events. They also learn from listening to your conversations with other adults.

Children who have experienced trauma or losses in the past are particularly vulnerable to prolonged or intense reactions to news or images of violent incidents. These children may need extra support and attention.

Children who are preoccupied with ongoing questions or concerns about safety should be evaluated by a trained and qualified mental health professional. Other signs that a child may need additional help include sleep disturbances, intrusive thoughts or worries, or recurring fears about death, leaving parents or going to school. If these behaviors persist, ask your child's pediatrician, family physician, or school counselor to help arrange an appropriate referral.

Although parents may follow the news with close scrutiny, most children just want to be children. They may not want to think about or discuss violent events. They'd rather play ball, climb trees, or ride bikes.

Senseless, violent crime is not easy for anyone to comprehend or accept. Understandably, some young children may feel frightened or confused. As parents, teachers and caring adults, we can best help by listening and responding in an honest, consistent, and supportive manner.

Fortunately, most children -- even those exposed to trauma -- are quite resilient. However, by creating an open environment where they feel free to ask questions, we can help them cope with stressful events and experiences, and reduce the risk of lasting emotional difficulties.

David Fassler, M.D., is a child and adolescent psychiatrist practicing in Burlington, Vermont. He is also a clinical professor in the Department of Psychiatry at the University of Vermont, College of Medicine.

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Too busy to relax?

By Gina Newsome Duncan, M.D.



For most of us, stress is a part of everyday life—at home, at work, during our commute. Even going on vacation can be stressful. Stress not only has a psychological effect. It also has a physiological effect. That is, it affects us physically, leading to direct changes in our heart rate and blood pressure, and over time, our risk for certain illnesses such as heart attacks and strokes.







Stress also plays a significant role in anxiety, depression and other mental illnesses. This is detailed in the book The Relaxation Response, by Dr. Herbert Benson, a Harvard physician and expert in Mind/Body medicine.



Relaxation, the antidote to stress, can often seem like a luxury. How many of us picture a hot bubble bath complete with scented candles and soothing music, or a long walk on a sun-soaked beach as the perfect way to relax? The problem is that most of us don’t have time to do these things on a regular basis. When you’re in the midst of a crisis, or have a deadline looming at work, it’s not always possible to take an extended break.



The good news is that there are steps we can take psychologically to improve how we feel physically. With practice, you can learn how to relax anywhere and in any situation.



Some of the most common relaxation techniques are:

1. Deep breathing

2. Progressive muscle tension and relaxation

3. Guided Imagery/Visualization

4. Mindfulness



If you have a moment, try this simple exercise right now:



Sit in a comfortable position, either reclining slightly or laying down.

Take a deep breath in while slowly counting “one-thousand-one, one-thousand-two”. Then exhale, while counting “one-thousand-one, one-thousand-two, one-thousand-three, one-thousand-four”. Repeat this for several minutes.



Next, while maintaining a slow, regular pace of breathing, move on to progressive muscle tension and relaxation. This means tensing and relaxing the different muscle groups of your body one at a time. For example, start with your feet, curling your toes under… holding…and then relaxing. Then move on to your legs, stomach, etc, until you have worked your way up to your head.



How did that feel? Don’t worry if you couldn’t relax right away. It takes practice!



Most major bookstores and entertainment stores carry relaxation CDs that incorporate the breathing and muscle relaxation techniques described above. Combined with guided imagery and soothing music, these CDs can be a great way to learn the relaxation response if you don’t feel confident doing it on your own. A quick Google search can also pull up many websites with different types of relaxation exercises, suggestions, and even video.



The best thing is that this can take as little as 5 minutes and can be done anywhere—at your desk or while parked in your car—anytime you need to recharge.



Taking time to relax is not a luxury, it’s a necessity!

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What’s the difference between all these medications?

By Sara Coffey, D.O.





This is a question I am often asked by my patients. Several times a day we see commercials for prescription pills to treat a variety of diseases from high cholesterol to heart disease and treatment for mental illness is no different. Today I would like to talk about one of the most common mental illnesses, Depression and its treatment.

Depression affects roughly 15 million Americans adults, and it is an illness that can be readily treated with antidepressant medications, talk therapy or a combination of medication and talk therapy. Antidepressants have been around for decades and include several classes of medications that work on different chemicals in the brain, but today the first line treatment for depression are medications called, SSRI’s or Selective Serotonin Reuptake Inhibitors. For the most part medications in this class are very similar; they work by increasing the amount of serotonin between nerve cells which is thought to play a role in depression. Unlike a pain pill that works right away, antidepressants can take up to 4 to 6 weeks to have an affect.



Which SSRI a doctor chooses will depend on each individual patient. Just like every other medication, antidepressants can have side effects and interact with the body or other medications in a way that may be dangerous or uncomfortable for patients. Some SSRI’s may be more likely to make a person tired or sedated, while others may have a tendency to give a patient more energy. Depending on an individual’s depressive symptoms, your doctor might prescribe a medicine that would be more likely to help you fall asleep or feel more alert and energetic. Furthermore, certain SSRI’s have been studied more in patients with a particular medical disease, like heart disease for instance and this might leave a physician to try a medication that has research data to show that the medication is safe for their patient. Certainly, some medications work better in some patients than others, and after a period of 4-6 weeks of adequate dosages if no improvement in symptoms occurs your doctor will likely recommend increasing your dose or switching to another antidepressant to treat your depression. In some instances a physician might recommend augmenting your medication by adding another medication that works in a different way to treat your Depression.



Even if the first anti-depressant doesn’t seem to work for you, there are still other options for treatment. Newer medications that work on norepinephrine and dopamine in the brain are also used quite frequently to treat depression, and older medications to treat depression, although they often have more side effects are still effective in treating depression and can be used in refractory cases.



As a patient it is important for your prescribing doctor to know about your symptoms, side effects, and other medical history and current medications that you are taking. And, as always if you have any questions about the medications you are being prescribed don’t hesitate to ask your doctor about your concerns.

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Grief and Loss Never Take a Holiday

By Joshua Reiher, Medical Student

Reviewed by Claudia Reardon, M.D.

The holiday season is in full swing. This time of year is meant to celebrate life, love, family, and friends. However, the holidays can also be difficult, especially if you or someone you know has lost a loved one. Maybe you are grieving the loss of a grandparent, parent, child, sibling, spouse, friend, or pet. Loss is a normal part of being human, and we will all face it at some point. Other causes of grief that you may not have considered:

• A loved one suffering from severe mental illness


• Divorce or breakup after a long term relationship


• Miscarriage during pregnancy

When a person experiences loss, he or she is said to be grieving. Grief is a natural emotional and physical response to any loss.

• People feel a wide range of emotions such as sadness, anger, disbelief, denial, guilt, loneliness, regret, anxiety, acceptance, and many others.


• Physically, people may undergo weight and/or appetite changes, decreased energy, lack of concentration, disturbances in sleep, loss of interest in sex, headaches, and so on.

Grief is a personal and individual experience—no two people grieve the same way. There is no one right or wrong way of grieving as long as it does not lead to behaviors that harm yourself or others. Bereavement is the period of time a person goes through grief following the loss of a loved one. Bereavement varies in duration and intensity, but it can last a year or longer in some cases.

Everyone is different, and reactions to loss are influenced by many factors such as:  

• Cultural beliefs and religious traditions


• Access to support and community resources


• Relationship with the person who left / passed away


• Personality and mental health history  

When to ask for help

While coping after a loss is painful and challenging, most people eventually find effective ways to heal and return to their daily life activities such as school or work. Some people, however, have more difficulty with recovering from a loss, and their emotional and physical symptoms do not improve. They may develop a psychiatric illness called depression. If you are concerned about yourself or someone you know, there are many treatments available including:  

• Talk therapy


• Community support groups with other people who have similar experiences


• Medications such as antidepressants

Additional resources to consider:

• Mental Health America: Coping with bereavement


• Substance Abuse and Mental Health Services Administration: How to deal with grief


• American Cancer Society: Coping with grief during the holidays

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Bipolar in kids? Probably not.

By Scott Benson, M.D.



The 5-year-old little girl had been referred to a therapist by her school because of her severe disruptive behavior. The almost daily tantrums had everyone concerned. She was uncooperative with the assessment and arrangements made for further evaluation. The therapist wrote a diagnosis of bipolar disorder.

The patient was certainly reactive to any limits and her tantrums seemed like they would never end. But she slept well at night; she rarely had behavior problems with her grandparents who provided afterschool care.

After a few parent training sessions with the little girl and her parents her behavior control improved. But continued treatment was threatened when her dad tried to get her on his new health insurance. The diagnosis of bipolar got the application bumped by the computer and it took a lot of calls and several letters to get her on the policy so that her treatment could continue.

At times it seems we are a little too quick to throw a label on a child’s behavior, and bipolar disorder seems to be the most popular current label.

But new research at the October meeting of the American Academy of Child and Adolescent Psychiatry found that children with some symptoms of mania probably do not have bipolar disorder.

Boris Birmaher, M.D., a child and adolescent psychiatrist at the University of Pittsburgh presented his group’s research. More than 2,000 children presenting to 10 different academic centers were included in the Longitudinal Assessment of Manic Symptoms (LAMS) study. 621 were found to have elevated symptoms of mania, but the full evaluation did not find sufficient symptoms for a diagnosis of bipolar disorder. Most had attention deficit hyperactivity disorder (ADHD), others had another disruptive behavior disorder. Children who did have bipolar disorder have poor function and are likely to require treatment in hospitals.

"Kids with manic symptoms don't necessarily have bipolar disorder," he told Reuters Health. On the other hand, "Many children with bipolar disorder are not being correctly diagnosed."

The LAMS study which will follow these children for five years should provide direction for the assessment and treatment of children with severe behavior problems. In the mean time parents should insist on an adequate evaluation for children with severe behaviors.

The Parents' Medication Guide for Bipolar Disorder in Children & Adolescents is a great source of information for understanding the evaluation process and treatment options. Or visit HealthyMinds.org for more information on bipolar disorder or mental health issues in children.

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Holiday Anxiety

By Jeffrey Borenstein, M.D.



As we begin the holiday season, people have hopes and perhaps expectations of an ideal holiday. Time with family and friends, time off from work or school, plans to travel – but the preparation and anticipation is often stressful. While some people may experience feelings of sadness this time of year, often people experience anxiety.



Family gatherings – both large and small may bring up memories and emotions which have been on the back burner but which now result in a higher level of emotions. The holiday season is also a busy time, juggling usual work/school/household activities with holiday preparations. With time off from work and school, our usual routines are interrupted, which is an additional stressor. All this can result in feelings of anxiety. What should you do?



Most importantly – step back and realize what emotions you are feeling. If you are experiencing heightened anxiety, there are steps you can take. I was interviewed for a New York Times article that may be helpful: “Easing Anxiety in All It’s Forms.”



Excessive drinking during the holidays is also a problem for many people. Some use alcohol to help with their stress and anxiety, and those with alcohol problems are particularly vulnerable. Instead of helping, drinking can do the opposite and make you feel worse.



To help you cope during the holidays, make sure you get adequate sleep, make sure you exercise (and walking counts), and share your feelings with friends or family. If you begin to feel overwhelmed and have difficulty functioning, you should seek professional assistance. Most importantly – realize that you are not alone. Many people experience holiday anxiety. Accept support from family, friends, and if need be professionals.

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Parenting in the Internet Age

By Molly McVoy, M.D.

Facebook, blogging, Twitter, email, texting. How is a parent supposed to keep up with all of the technology available to children and teens in today’s world? Many parents and children struggle with safety on the Internet. Although there are no easy answers, some simple steps can help keep you and your child safe.

First, and most important: all of the things that make a good parent in everyday life also make a good parent on the Internet. Spend time with your child in their daily life and spend time with them learning about what they do online. Educate yourself on your child’s school and social life. In the same way, educate yourself about the websites they visit and who they are talking to online.

In addition, keep their access to technology limited and in public settings. Put the computer in the kitchen or the living room – in other words, in a place where secrecy is difficult and monitoring is easy. Online time should only come after homework and other activities are done for the day. Also, talk about what they are doing online, but do not invade their privacy by reading emails unless absolutely necessary. If you suspect dangerous things are happening by or to your child online, then invading their privacy may be necessary. Otherwise, encourage open communication and respect their privacy.

For more information:

http://www.webwisekids.org/

http://www.kids.gov/6_8/6_8_computers_internet.shtml

http://www.attorneygeneral.gov/uploadedFiles/Consumers/cybersafety.pdf

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Hypertexting and risky behaviors: A cautionary tale?

By Tristan Gorrindo, M.D.

Last month, researchers at the American Public Health Association’s annual meeting reported some alarming statistics about the connection between high levels of message texting and risky behaviors. In a study of high school students in the Midwest, the researchers found a relationship between those that send more than 120 texts per school day (20% of the students surveyed fell into this group) and increased experimentation with cigarettes and alcohol, binge drinking, physical fighting, and a high number of sexual partners. These results were widely reported by several major media outlets including CNN and the Associated Press .

While the authors of this research clearly state that they don’t think that “hypertexting” causes students to drink more or engage in risky behaviors, I worry that this fine-point is lost on most people who are just reading the headlines.



Since most of us don’t remember our high school statistics class, I think it’s worth thinking about how two ideas can be related (as they are here) but not necessarily in a causal relationship. An analogy I often use is the finding that yellow teeth and lung cancer are highly connected in research studies. It isn’t that tartar covered teeth cause lung cancer, or that lung cancer causes teeth to yellow. It turns out that there is a common root-cause of both– that is smoking cigarettes causes both yellow teeth and lung cancer.



In a similar manner, there might be an underlying root-cause (or several different causes), which cause kids to use cigarettes and alcohol and to be hypertexters. These root-causes might include poor parental supervision, mental illness, or even a learning disability, just to name a few. But until we conduct more careful studies, we won’t know for sure.



Certainly, parents should know how many texts per day their child is sending. And in the same way that I encourage parents to talk to their kids about alcohol use or sexual activity, they should also be talking to their kids about the ways in which they are using technology.

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