Mental Health

Disaster & child health in the wake of Hurricane Florence

Hurricane Florence hit the shores of North Carolina, South Carolina, and Virginia a little less than two weeks ago. While the storm has passed, the damages are daunting. Recovery from the disaster will take immense efforts in certain areas, given some homes and businesses experienced massive flooding. But the hurricane didn’t just impact  physical infrastructure—amidst recovery conversations, it’s important to bear in mind the toll natural disaster takes on mental health and emotional well-being as well.

In a recent Atlantic interview, Shannon Self-Brown, the chair of health policy and behavioral science at Georgia State University’s School of Public Health, explained children are particularly at risk of developing lasting emotional trauma from natural disasters because they might not be old enough to understand why the event happened specifically to them. Studying the impacts of Hurricane Katrina, She and her colleagues found that 71% of the 426 children were resilient, showing no signs of Post Traumatic Stress Disorder (PTSD) like hyperarousal or reexperiencing the event in their heads. 25% of kids showed temporary signs of PTSD, meaning the symptoms went away within 2 years, and the remaining 4% of kids studied had signs of chronic PTSD. Unsurprisingly, increased exposure to the hurricane correlated with worse PTSD outcomes. Good social support, on the other hand, correlated with more resiliency.

But establishing good social support—meaning an active and strong peer group—after a natural disaster can prove challenging for families that have been displaced. Often, by encouraging experience-sharing and establishing routines, this is where educators can play a role, even for children who have had to change schools.

In applying other aspects of her research to the present aftermath of Hurricane Florence, Self-Brown recommended opening up a dialogue with kids about the disaster and what happened. This can be done in a number of ways, like coming up with a song, drawing a picture, writing a story, or having a simple conversation. If behavioral changes are occurring in children under the age of 4, Self-Brown notes caretakers should self-evaluate for stress of their own. Toddlers repeatedly acting up can be an indication they sense Mom isn’t doing okay.

The stress of dealing with an unexpected disaster cannot be overstated. Family upheaval affects even the youngest family members, who don’t necessarily understand the nitty gritty of, say, insurance coverage. Other resources for coping with hurricane recovery can be found on the National Child Traumatic Stress Network’s website, and more general information is posted on affected states’ department of human and health services websites.

Prioritizing Well-Being Over Stress

It’s important to motivate children and teens to succeed and do what they love, but a recent newscast in NPR talks about the risks of pushing kids too hard to do well. (The NPR newscast includes a 7-minute talk about this topic which you might find interesting!) It is not a stretch to say that students today feel immense pressure to compete against their classmates and friends to do well, and this stress can be a major contributing factor to anxiety and depression.

 

Some parents admit that they “totally bought into the idea” that their job is to push their kids to succeed and overcome obstacles. But if the pressure is too much, this effort can backfire. One high school in New York invited a psychologist to evaluate the student body using the Youth Self-Report, and found evidence of high levels of stress. This includes internalizing symptoms, or feelings of sadness, anxiety and depression; physical symptoms like headaches and stomachaches, and drug and alcohol use.

 

According to experts, substance abuse is actually something that affluent teenagers may use even more than inner-city kids, as “a form of self-medication” against the stress of high expectations to do as well as peers or parents.  This means that the need for conversation around mental health applies to inner-city and wealthy suburban schools alike.

 

Parents can play a huge role in promoting well-being as a priority that takes precedence over grades. They can have constructive conversations about stresses their families face, which are not likely to be ones they face in isolation. They can also work with schools in order to improve environments at school and at home. Research-based “resilience training programs” that teach “coping and happiness skills” are taking off at school, even for elementary students. Researchers today are finding that “resilience training can help reduce symptoms of depressive or negative thinking among children”

 

Student-directed initiatives also give students an opportunity to talk with each other about topics they might not readily share with parents or teachers, and gives them an active role in their own mental health.

 

All of these efforts should be directed towards valuing well-being and celebrating diverse kinds of passion and success. As a society, we should acknowledge that “a culture shift” is necessary to value all kinds of success instead of prioritizing and zeroing in on certain academic successes or career paths.

 

Mental Health and Social Good: A Partnership?

This week, we would like to continue our focus on discussing ways to actively improve our mindsets and mental health overall. A recent post in NPR discusses a new psychology study that suggests that teenagers benefit from a confidence boost if they help strangers or volunteer. While helping a friend or family member is obviously a positive experience, it is more difficult challenging, and maybe even intimidating, to help someone you do not know - and this is why teens can derive confidence boosts from helping others. Given the diversity of teens’ interests, it’s a wonderful thing that spending time helping strangers - even people one doesn’t meet - can happen in all facets of society.

 

Confidence boosts are always good, but teenagers today may benefit from them the most. Current research tells us that today’s teenagers live in challenging times — both socially and economically — and the numbers show it. The NPR article cites that “by the age of fourteen, 25% of teenage girls and 10% of boys struggle with depression.” Students of all ages seek out help for depression, anxiety, and other difficulties. The idea that they might help themselves and others at the same time by devoting time or energy to social good is wonderful.

 

Altruism has always had a somewhat broad definition, and the way today’s teenagers help others might look differently than the way their parents might envision it from their own experience. For example, teenagers can harness social media to spread awareness and raise funds for campaigns or causes they care about. Parents and teachers can introduce opportunities to get involved or answer questions about navigating ways students can positively contribute to society.

 

At CHIL, we are always trying to link health to many actors: children, parents, teachers, doctors, and officials all play a part in physical, mental, and social health. Linking children’s and teens’ mental well-being to social initiatives, and vice versa, could be very promising!

Being Mindful: Coping with the Stresses of a Student’s Life

Students may face a different kind of stress compared to people who work. Before college, the school day ends at a certain time, but with homework, studying, and projects, there doesn’t really seem to be a definitive end to the school day. After high school, the division between the school day and the rest of the day blurs even further when there is always something we could be studying or reading for.

 

In this kind of environment, it can be easy to feel overwhelmed with work and stress. On top of that, students of all ages might feel competition among their friends, further complicating the school and social life balance. What are some tips for managing these stressors?

 

Get Organized. Juggling all our commitments in our head is unnecessarily stressful. There are many physical planners and productivity apps available to help us manage deadlines and test dates. Choosing one that works for you might take some time, but will definitely pay off in the long-run! The key is not to let the planner/organizer stress you out further. Each day can begin or end with a recap of things to do, and crossing off accomplished tasks can be really satisfying! Planners can also help you avoid overbooking yourself.

 

Get Help, If You Need. This could simply mean asking a friend or teacher for help on understanding a new concept covered in class. This could also mean asking a trusted adult or advisor for help navigating changes difficult to face alone: a parent, a doctor, or a teacher are all great starting points for questions about politics, gender and sexuality, or social phenomena we see everyday. The internet is full of information and can be a tempting go-to but it’s easy to get lost in a sea of opinions out there.

 

Breathe. This is meant both literally and figuratively - we need to relax! In our fast-paced lives, it takes effort and planning to do so. Taking a few minutes each day (such as signing up for the eMindful Challenge) to try some meditation techniques can help us clear our mental clutter, which can make facing the next task easier. If meditation isn’t for you, that’s okay - there are other ways to relax productively such as putting down your smartphone for at least a few minutes. Some of our friends use cooking, baking, exercising, reading, writing, just to name a few, as ways to decompress. The point is to challenge yourself to do something that you might continue to benefit from. For example, if you make a healthy snack now, it means you’re less likely to go grab fast food later. If you read a book by your favorite author now, you can remember it later and enjoy it then too.

 

Sarah is CHIL's lead blogger and currently a student at UPenn with plans to attend medical school in the future. To decompress, Sarah likes to go running or do crossword puzzles.

Why I'm going to CHIL with the Mindful Daily

by Jess Jeavons

Very often, when I chat with a friend who is stressed, overwhelmed, unmoored, or overstimulated by everyday life, I recommend meditation. Meditation changes lives! Individuals who meditate are better able to live in the moment, manage stress, and find time to do the things they've been meaning to do, like eating healthy and exercising. In addition, meditation can improve physical health, including lowering blood pressure, reducing headache frequency, and decreasing risk for heart disease. 

But when it comes to meditating, I haven't been able to make it stick as a healthful habit in my own life. 2018 will be my year for meditation, and I'm starting with eMindful's 1% Challenge to meditate for 1% of each day for 30 days straight. 

Check back in here between now and the end of February, and we'll keep you updated on our progress. We would also love to hear from you! Let us know how you're doing with the challenge in the comments section below, email us at chilinternal@gmail.com, and join us on Facebook, Twitter, and Instagram

 

Weight, Language, and Self-Image

The language we use when talking to a child about their weight is very important. Doctors say that they themselves take great care in the words they choose when they talk to a child or their family member about weight and body mass index, even if their official classification falls under obesity.

 

The New York Times recently published a piece by pediatrician Dr. Perri Klass, who writes that physicians try to take care in order to avoid further hurting a child who may already be unhappy about their weight. A new policy statement jointly issued from the American Academy of Pediatrics and the Obesity society urges pediatricians to use seemingly neutral words instead of words like “overweight” and “fat.”

 

Past and ongoing research into the social and emotional effects of obesity agree that comments on weight can have a large impact on a child’s self esteem. According to Dr. Rebecca Puhl, a clinical psychologist who is one of the lead authors of the policy statement, “Weight is now one of the most frequent reasons kids are teased or bullied.” One of her studies followed more than a thousand teenagers into their early thirties, and found that children who were bullied because of weight were correlated with binge eating, poor body image, and eating to cope with emotions (not to mention other eating disorders). These correlations, in turn, were linked to obesity in adulthood as well. The effect was present for men and women, but more pronounced for women.

 

Dr. Puhl says that healthcare professionals might be some of the few allies overweight children and teenagers can have. After all, they are most likely teased by family members as well as their peers. Another ally that comes to mind is teachers - where appropriate, they can intervene in a bullying situation, as well as promote body positivity and physical activity.

 

We can all be allies if we understand and recognize that making comments about a weight does not encourage positive change; instead, making comments about weight can result in negative, longterm impacts. It is important to make sure that children and teens have access to healthy, positive influences for their physical, mental, and emotional health.

Understanding Toddlers and Tantrums

An interesting piece in the NYTimes this week discusses temper tantrums, and what they do or do not tell us about a young child’s emotional state. Tantrums are most common around ages two or three, and gradually decrease as a child grows older. According to Dr. Egger, chairwoman of child and adolescent psychiatry at NYU, childhood tantrums can be thought of as frustrations from a child who is fearful or angry but is still developing language skills to express these feelings.

 

According to the article, approaching childhood tantrums with adult reasoning or anger might not be productive or helpful. The neuroscientist interviewed in the article, Dr. Potegal, describes the emotions in a tantrum as a combination of anger and distress - anger usually subsides in a tantrum, but distress might remain fairly constant.

 

Dr. Egger said that a parent’s role during a tantrum is not to become stressed or angry herself - a parent should instead act as a container for the child’s feelings, since the child will not feel in control of the situation. Tantrums “typically happen when children are hungry or tired or when there has been some significant change in their routine,” and confusion and frustration can easily manifest themselves in these situations.

 

Experts say the tantrums parents should be concerned about are the ones that occur in public and the ones where children or toddlers become violent and bite or kick. If parents find themselves changing their routines or avoiding triggers in fear of setting off a tantrum, they should seek help instead of struggling on their own. Though this usually isn’t the case, tantrums might be an indication of an underlying developmental problems such as ADHD, or even a medical one.

Mindfulness - Something for Everyone

The timing couldn’t be better - not long after our recent post on ways to be in the present, the New York Times published a piece on “Mindfuless for Children.” The author defines mindfulness as “the simple practice of bringing a gentle, accepting attitude to the present moment,” and argues that even the youngest children can benefit from this approach.

 

The graphics in this article are beautiful and worth checking out, but we’ve condensed some of the main points here:

 

Mindfulness starts young. Even infants can notice the difference between a stressed, distracted parent and a smiling, “present” parent. Mindfulness experts say that eye contact is important to establish a connection between an infant and a parent; unfortunately, smartphones have become a huge distraction in establishing that connection. Experts recommend putting down the phone, however briefly, to interact with infants. The same goes for raising toddlers - as they start to learn to express themselves, helping them identify and describe their feelings is very important.

 

Mindfulness is important throughout childhood, from infancy to early childhood to teenage years. The appearance of mindfulness can evolve. For example, a focus on gratitude and recognizing happy moments for young children evolves to a focus on healthy interpersonal relationships in teenage years. A surprising number of diverse factors are involved in mindfulness. For example, increase in movement and activity relieves stress and improves physical health for guardians and children alike.


Mindfulness can’t be “outsourced.” People who work with children and teens to bring mindfulness into their lives emphasize the key role parents and guardians can have in contributing to children’s health. Mindfulness “isn’t like piano lessons,” where parents can simply drop off their kids to get their weekly lesson. The author of the article concedes that parenting is hard work, and often very stressful, but they are the main figures in their children’s young lives. Caregivers don’t have to be expert meditators; instead, they can focus on things like forgiveness and appreciation of the present along with their children. Having this approach will have positive mental health impacts for everyone involved.

Friends for Life - They're Lifesaving

A quick Google search on friendships and its correlation to health results in many articles concerning the elderly, but a new study has focused on studying teens, for whom the conversation around mental health is especially important. Child Development recently found that close friends among adolescents can have lasting mental health benefits, which can be carried into adulthood, according to NPR.

 

The study, conducted over 10 years, followed 169 15-year-olds until they were 25-years-old. At age 15 and 16, researchers asked participants to record conversations with their friends. Teenage friends discussed the importance and level of trust and communication that was in their relationship at the time. Then, the participants completed annual surveys about their levels of anxiety and self-worth.

 

Researchers found that after 10 years, teenagers with strong, close friendships were more likely to report an improvement in anxiety and self-worth at age 25 than adults who did not have strong emotional links to their friends as teenagers. Stable friendships - especially same pairs of friends who showed up together year after year - seemed to provide participants with the greatest mental health gains.

 

The implications are fairly strong here. Teenagers who find support among each other are more likely to be able to weather challenges that they may face, according to the authors of the study. They also learn how to maintain close, important relationships from a young age, which lays the foundation for future healthy relationships.

 

At CHIL, our projects encourage friends to engage with each other as they participate in activities that can benefit their health. Friendships and teamwork go hand in hand, and a close friendship can be an extra incentive for children and students to invest time in themselves and each other. The importance of friends is a theme that pops up over and over again, but it should not become a cliche - it can really have an impact on a young person’s health in the long-term.

A Home Away from Home: Schools and Students after Trauma

NPR recently discussed some of the challenges and opportunities facing teachers of students who may have been exposed to trauma. In New Orleans, where public schools have largely been replaced by charter schools after Hurricane Katrina, schoolteachers have become accustomed to having students who may have experienced abuse or neglect, have absent or jailed parents, or have witnessed crimes. School discipline policies that previously only focused on a child’s errant behavior are now undergoing an update that takes these environmental factors into account.

 

There are currently five charter schools in New Orleans that are seeking to become “more trauma-informed.” In other words, these schools are starting to incorporate knowledge about their students’ lives outside of school in order to address their social, emotional, behavioral, and development needs. These changes are bound to have an impact, considering the fact that children in New Orleans screen for post-traumatic stress disorder (PTSD) at three times the national rate. Mental health experts and workers have only recently begun to understand that trauma dramatically changes the brain and intensifies the fight-or-flight response in young children.

 

Children with exposure to trauma might be disruptive in school, or they may be withdrawn and inattentive. Teachers are learning to look for signs of both ends of the spectrum and everything in between. They are also engineering new ways to resolve conflict instead of resorting to detention or suspension since sending a child back to a damaging home environment is not the best way to solve problems in the long run.

 

For example, some teachers begin classes with social-emotional learning, and students in disagreement are invited to use group discussion to resolve their problems. Another way teachers are approaching disruptive students is by renaming “time out” as “wellness centers”, and multiple teachers collaborate with each other to work the same students over the course of a day. The article also details the moving stories of students who have seen real change with this type of support that they cannot find at home.

 

Certain statistics aside, this story is not unique to New Orleans. In many urban areas, when children experience poverty and hardship, and there are desperate consequences at home and in their daily lives, teachers everywhere can be heroes that foster a “home away from home” in their classroom. However, these New Orleans teachers and schools have ventured into an unknown space in their mission to understand each of their students, and to address a holistic approach to health. By addressing issues, and not punishing students, a very challenging method, teachers play a vital role in the health and well-being of their students.