Mental Health

This past year, as many individuals sought health care through telemedicine, a question formed in Dr. Gina Sequeira’s mind. As the co-director of the Gender Clinic at Seattle Children’s, her mission is to make gender-affirming care accessible for all youth, and so the capabilities of telehealth are rightfully an exciting new territory to explore. With the growth of telemedicine and its potential to improve access to care, Sequeira wanted to better understand gender diverse youths’ experiences with and satisfaction receiving virtual care during the COVID-19 pandemic.

Published in Transgender Health, Sequeira, the lead author, found the majority of youth who participated in the study were satisfied with telemedicine and would be willing to use it again in the future. Although many said they preferred in-person visits, about 88% of gender diverse adolescents were satisfied with conducting gender clinic visits using telemedicine.

“Telemedicine has been a great way for us to support gender diverse youth and their families during the pandemic. Because of the limited number of pediatric gender-affirming care providers in the region, prior to the pandemic, many families experienced geographic and cost related barriers to receiving this care. We are hopeful that by continuing to offer gender clinic visits over telemedicine we will be able to overcome some of those barriers.” Sequeira said. Read full post »

Hannah Nash suffered a concussion in 2018 and experienced PPCS. Today, she attends the University of Washington.

On Dec. 26, 2018, 18-year-old Hannah Nash, an avid basketball player, was hit in the head while at basketball practice. She initially felt a sharp pain and her head felt foggy. She recalled leaving practice abruptly. The next day, she played in a game, but she didn’t feel like herself.

“I played terribly,” Nash said. “I was just off.”

She went to her pediatrician, and they treated her symptoms like a concussion. She was told to rest. On Jan. 3, 2018, she fainted in her kitchen and hit her head again.

Every year, an estimated 1.1 to 1.9 million youth suffer a sports-related concussion. Common post-concussion symptoms include headache, fatigue, irritability, dizziness and poor academic performance. Depression and anxiety are also commonly reported and have been shown to be associated with prolonged recovery from concussion. For most individuals, symptoms resolve within days or weeks of a concussion, but for youth like Nash, that isn’t always the case. For adolescents who experience persistent post-concussive symptoms (PPCS), the burden on their families, academic achievement and other areas of life can be enormous. Read full post »

Photo Credit: Courtesy of the Miami Dolphins

During the month of December, NFL players sport a different look on their feet with custom designed cleats aimed to represent a cause that they feel most passionate about.

It was only natural for Myles Gaskin, former University of Washington (UW) Huskies football player, now running back with the Miami Dolphins, to choose a cause that hits close to home in more ways than one.

“Growing up in Seattle, I always knew about Seattle Children’s, so when I was playing for UW, teammates and I decided to visit the hospital a few different times to meet some the kids,” said Gaskin. “The whole experience really opened my eyes to see how much you can impact someone by just giving them your time.”

With Seattle Children’s in mind for his cause, Gaskin wanted to zero in on another issue that deeply spoke to him.

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Winter can be a particularly blue time of the year for people. Darker, colder days and the post-holiday letdown often cause a decline in mood and motivation.

It’s normal for all kids to experience emotional ups and downs, including the winter blues. With the COVID-related changes in school and social activities this winter, youth may be especially vulnerable to increased moodiness and irritability. But at least one in five kids will have a diagnosable mental health problem that needs treatment.

Parents can support their child or teen as they cope with seasonal sadness while being alert to the signs and symptoms of mental health problems that require expert care.

Validate feelings

One of the most powerful tools in your parenting toolbox is the ability to acknowledge how your child or teen is feeling. Check in regularly to learn how they’re doing. Listen more than you talk as you give them your full attention. Try to understand their feelings. It can be tempting to offer suggestions to “fix” problems or to force your child to look at the bright side, but it’s better that they feel heard and validated.

Encourage your child to accept and label their emotions. Ask them to think of ideas for how to cope when they start to feel sad, mad, scared or otherwise upset. Let them take the lead as they learn coping skills that work for them.

Focus on healthy habits

Fight the urge to let healthy habits slide this winter. Help your child set up and maintain a predictable schedule to provide a reassuring rhythm to their days, and yours. Work as a family to get enough sleep and exercise, choose healthy foods and drinks, and use positive ways to manage stress, like spending time on a hobby or taking a few minutes for daily meditation. Encourage your child to get outside, even on the rainy days. These habits are important for physical and mental health.

When it’s more than feeling blue: signs and symptoms of a mental health problem

Mental health problems affect thinking, emotions and behavior. They can change your child’s ability to function in school, at home or in social settings. Talk to your child or teen’s doctor if you notice one or more of the signs from this list, or if you have any question about their mental health. Notice if your child:

• Is feeling very sad or withdrawn for two or more weeks.
• Has severe mood swings.
• Shows big changes in behavior.
• Is having many problems in friendships and other relationships.
• Has a sudden overwhelming fear or worry that does not match the situation.
• Seems unusually irritable.
• Displays explosive anger.
• Has trouble sleeping.
• Changes their eating habits.
• Loses weight.
• Spends so much time alone that it gets in the way of doing other activities.
• Starts hanging out (in person or online) with peers who are an unhealthy influence.
• Is taking new risks, like using drugs or alcohol.
• Has lots of stomachaches or headaches.
• Avoids school or stops doing as well as they used to in school.

Ask about suicide

Know that asking your child directly if they are thinking about suicide does not increase the risk of suicide. If they say they are thinking about suicide, stay calm and:

• Call the National Suicide Prevention Lifeline for help: 988.
• Reduce the risk of suicide by removing pills and firearms from your home. If you can’t remove them, place them in a safe, lockbox or other secure place.
• If they are in immediate danger of harming themselves, don’t leave them alone. Call 911 or a local crisis line, or take them to an emergency room.

Get help early

It’s normal to experience some sadness, and this year it’s harder to determine whether the sadness is mild and temporary, due to the change in life from the pandemic, or whether it’s more severe. Don’t wait to get help with mental health. There’s no blame or shame in mental health problems. Effective help is available and can make an important difference in helping your child or teen get back on track with healthy development and life.

Resources

• Mental Health Resource Hub
• Supporting Mental Wellness and Family Life During COVID-19
• Behavioral Health Toolbox for Families: Supporting Children and Teens During the COVID-19 Pandemic
• Washington’s Mental Health Referral Service for Children and Teens

Xander at Meadowdale Beach in Edmonds with Tuft, the family’s dog. Xander began having thoughts of ending his life at age 9, but thanks in large part to the Behavioral Health Crisis Care Clinic, he’s now on the path to recovery.

Xander was just 9 years old when his life took a nightmarish turn.

It started with debilitating headaches, which got so bad that he needed inpatient treatment. The treatment helped, but as the headaches diminished, Xander’s parents noticed a difference in their son.

“He became depressed,” said Stephanie Simpson, Xander’s mother. “He would curl into a ball, was no longer active and couldn’t make it through the school day.”

As if those changes weren’t troubling enough, Xander told his parents something that terrified them: He was having thoughts of ending his life.

Fortunately, Xander was eventually referred to the Behavioral Health Crisis Care Clinic (BHCCC) at Seattle Children’s, where he received a diagnosis and evidence-based treatment that put him on the path to recovery.

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I have worked at Seattle Children’s for 16 years and have been the Chief of Critical Care Medicine since 2013. My son Peter just turned 17. He recently “celebrated” his birthday at a therapeutic boarding school where he is in residential treatment for anxiety and depression. Although he was in and out of outpatient therapy for several years and was hospitalized at the Seattle Children’s Psychiatry and Behavioral Medicine Unit (PBMU) for severe depression at age 13, I rarely discussed his mental health with my colleagues. Most of the people I worked with regularly were unaware that coping with Peter’s anxiety and depression was part of my daily life. I used to think it was something private to keep to myself. However, I now realize it was my inability to address my own fear that kept me silent. I retreated into my job, and, at work, I could be the confident physician and ICU leader rather than the uncertain, anxious parent who didn’t know how to help his struggling son.

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As a teenager, Javi Barria struggled with anxiety, depression and thoughts of suicide, and spent time at Seattle Children’s Psychiatry and Behavioral Medicine Unit. Barria thinks being mindful of language is one simple thing others can do to support those with mental health conditions.

In recognition of Mental Health Month, On the Pulse will be sharing valuable resources and inspiring patient stories each week to guide individuals and families struggling with mental health issues and help destigmatize the topic of mental health in our society.

Talking about mental health can be a challenge for anyone. Though terms like obsessive-compulsive disorder (OCD), depression, and bipolar disorder have made their way into our vocabularies, they’re often used as adjectives to describe behavior, like, “I keep changing my mind about what to wear, I’m so bipolar,” reflecting a lack of understanding of the complexities and challenges facing those living with the condition. Read full post »

In recognition of Mental Health Month, On the Pulse will be sharing valuable resources and inspiring patient stories each week to guide individuals and families struggling with mental health issues and help destigmatize the topic of mental health in our society.

One late afternoon in April, Jessie Early noticed something was wrong her with 7-year-old son, Rohan.

He stopped eating, was withdrawing, and exhibiting suicidal thoughts.

Extremely concerned, Early rushed her son to Seattle Children’s Emergency Department (ED), as recommended by Rohan’s psychiatrist at the time.

Within just a few minutes in the waiting room, Rohan was sent directly to one of the patient rooms for evaluation.

What could have been a stressful and trauma inducing experience for Rohan, Early was pleasantly surprised with the attentiveness and support that the staff provided her son.

“There was always someone there to answer our questions,” Early said. “It made it so we were relaxed and informed. Staff would ask him questions in a respectful and polite way, even though some of questions were difficult for him answer. They were there for us every step of the way.”

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Jessica Carey’s family has received care for her twin sons at the Seattle Children’s Autism Center for about four years. She transitioned to telehealth in February due to the COVID-19 pandemic.

Telehealth refers to a broad spectrum of remote technological healthcare services, which may include non-clinical services, while telemedicine is the practice of delivering clinical care from a distance via technology.

“At first the idea of telehealth seemed daunting because it’s a lot of work for parents, but it’s actually a really nice way to be able to move practice to home from a clinical setting while still receiving support from a professional,” Carey said. “It also saves on travel time and expenses which is really positive.”

Since many appointments were cancelled or postponed, she added, “Being able to at least see our providers at Seattle Children’s helps keep consistency in my boys’ days.”

Carey is just one of thousands of families who have recently experienced Seattle Children’s rapidly expanded telehealth services to ensure children get the medical care they need during an era of travel restrictions and “Stay Home, Stay Healthy” orders to stop the spread of the coronavirus.

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In recognition of Mental Health Month, On the Pulse will be sharing valuable resources and inspiring patient stories each week to guide individuals and families struggling with mental health issues and help destigmatize the topic of mental health in our society.

Alyssa Scott, 17, is a senior in high school. She’s an honor student, participates in her school’s Model United Nations program and is currently taking college-level classes.

By her positive demeanor and ambitious attitude, you would think she’s just like any regular teen.

But there’s more to Alyssa than meets the eye.

Like many individuals, Alyssa lives with mental health issues.

“Even though people might not see it, I struggle every day,” Alyssa said. “Some days are worse than others, but it’s always there.”

For Alyssa, there’s been many obstacles she’s faced in life that have molded her relationship with her mental health. Yet with her strong sense of will and determination, she’s come to a point in her life where she can keep her struggles at bay.

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