Mental Health

In an episode of the popular TV show Big Little Lies, a character’s young daughter has an anxiety attack, prompted by worries about climate change. Though this may seem drastic, Dr. Kendra Read, attending psychologist and director of anxiety programs with Seattle Children’s Psychiatry and Behavioral Medicine team, is having many conversations with families about how to cope with distressing news, such as mass shootings, crime, global politics and natural disasters.

“It’s common for kids to be worried about events that might potentially harm them or their loved ones,” Read said. “Worrying is normal and a typical part of life, but I tend to talk to children whose anxiety over current events impacts their daily functioning. They exaggerate the likelihood of bad things happening and underestimate their ability to cope with things.”

The key is helping kids cope with the worry about these events happening, even though the likelihood is small. With school back in session, Read offers advice to families whose children might experience heightened anxiety after a frightening news event.

“We want to bolster kids’ coping abilities and teach them how they can help themselves,” Read said. Read full post »

Grace Blanchard was just three weeks away from graduating from college when she began feeling like something was off.

“It started with my handwriting,” Blanchard said. “I had always felt like I had good handwriting, so it was strange that it all of a sudden became messy, slanted and unreadable.”

Then there was the slurred speech and dizziness.

“At first I thought I had vertigo,” she said, “so I decided to see a neurologist to get an MRI.”

Once the results of the MRI scan were in, Blanchard received a call.

“They asked me to come into the clinic as quickly as possible, and that I should bring support,” she said. “They knew that after hearing, ‘you have a brain tumor the size of a golf ball on your cerebellum,’ I wouldn’t be able to listen to anything else.”

The following day, Blanchard flew from California, where she had been going to school, to Seattle, her hometown, for surgery to remove the tumor.

“I decided Seattle would be the best option, not only because I wanted to be with my family,” she said, “but also because of the fact that Seattle has the best hospitals for cancer treatment.”

Within 24 hours of flying into Seattle, Blanchard went to Seattle Children’s to get her tumor surgically removed.

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The phrase ‘boys will be boys,’ is often used to describe what some consider are normal masculine tendencies boys might have, such as being rough and reckless.

Dr. Tyler Sasser, a psychologist in Seattle Children’s Psychiatry and Behavioral Medicine clinic believes these characteristics of what society deems as masculine can often reflect unhealthy and sometimes risky behaviors.

“In Western culture, boys and men are expected to be competitive, tough and dominant,” Sasser said. “The term, traditional masculinity, labels these expectations. Meaning, boys and men need to be stoic and suppress emotions they experience, other than anger.”

Recent research shows that these beliefs associated with traditional masculinity often lead to harmful behaviors toward themselves and others.

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I was in middle school when my mental health started deteriorating. Every day I would hide under tables, cover my ears, or hit my head. I would lash out at anyone who tried to help me. I was anxious 24/7. But I kept denying what was happening. I told myself that I was fine, that I was just going through a rough couple of days. Then days turned into weeks, and weeks into months.

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Today, nearly one in five children has a mental, emotional, or behavioral disorder. While some seek relief from their distress using positive coping methods, others may choose methods that are harmful and potentially life-threatening.

Dr. Yolanda Evans, an adolescent medicine specialist at Seattle Children’s, has been seeing a recent increase in teens coming into the clinic with self-injuries done through cutting, burning, pinching and scratching, among others.

“It’s possible that the increase may be partly due to the impact that social media and technology has on the current generation,” Evans said. “Kids might see their peers online engaging in self-harming behavior as a way to cope with their emotions, influencing them to replicate that type of behavior.”

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In honor of Autism Awareness Month, On the Pulse shares a story about a mother with 3-year-old twin daughters who have autism and her showing of gratitude for the relentless care and support that the Seattle Children’s Autism Center staff has provided her family.

Nataly Cuzcueta felt like a proud parent when she witnessed her twin daughters, Kira and Aliya, smile, laugh and walk for the first time.

Seeing them reach these milestones left no doubt in Cuzcueta’s mind that their development was right on track.

However, when her daughters turned 11 months old, everything changed.

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With stories of sexual abuse perpetrated by public figures continuing to be in the spotlight, as well as the rise of the #MeToo movement, there is a growing need for parents and caregivers to educate children and teens about the difficult topic of sexual abuse.

According to RAINN (Rape, Abuse & Incest National Network), every 92 seconds a person in the U.S. is sexually assaulted. Every 9 minutes, that victim is a child.

“Before the age of 18, one in every four girls and one in every six boys will be sexually abused,” said Dr. Lynda Lee Carlisle, a psychiatrist and trauma specialist from Seattle Children’s Psychiatry and Behavioral Medicine clinic. “While it can happen to any child, those most vulnerable are intellectually disabled or identify as LGBTQ+.”

Sexual abuse is rarely committed by a stranger. It is often by someone who the child knows and trusts. While some may think sexual abuse only involves physical contact, it can also be done without contact in the form of inappropriate photos or videos, exposure or other behavior.

“We commonly see children abused by a family member,” said Dr. Carole Jenny, child abuse fellowship director of Seattle Children’s Protection Program (SCAN). “It is also more likely to occur in blended families, with the abuser being a step-parent or a parent’s boyfriend or girlfriend.”

However, adults are not the only perpetrators of abuse towards children. Some children are also prone to committing sexual abuse towards other children, often with those that are younger than them.

“A child who abuses another child typically does it due to a poor understanding of boundaries, lack of parental supervision, and/or drug and alcohol use,” said Carlisle. “Surprisingly these can be children who have not experienced any sort of sexual abuse themselves. Sometimes it can stem from severe behavioral issues where they seek dominance or power over another child, as well as exposure to domestic violence.”

The effects of sexual abuse

The psychological effects of sexual abuse can be extremely damaging on a child and can lead to lifelong psychological problems including post-traumatic stress disorder (PTSD), depression and substance abuse.

Many people often question why sexual abuse victims wait to report the abuse they experienced many years later.

“Studies show that 70% of people who were sexually abused as children don’t report it until they are adults,” said Jenny. “This is often due to the stigma attached to sexual abuse, in which a person may feel embarrassed or guilty that it happened to them.”

This is why Jenny and Carlisle advise parents to start talking to their children as early as possible about sexual abuse.

Tips to help empower your child to speak up about sexual abuse

“While it can be a difficult topic to open up about, it is crucial that children understand the boundaries and what appropriate behavior is,” said Jenny. “Around the age of 3 years old is when I suggest parents begin educating their children, as this is the time when they develop language skills.”

The following are recommendations Jenny and Carlisle have for parents on how they can address the topic of sexual abuse with their children and teens.

• Teach your child the anatomically correct terms, not ‘nicknames,’ for their body parts.“A child needs to learn that they can be open when talking about their body parts and not feel embarrassed or ashamed,” said Jenny. “When children feel uncomfortable talking about certain body parts, they are less likely to tell you if someone is touching them inappropriately.”
• Have your child understand that some of their body parts should be kept private.A child will learn that only certain people, like their own parents or medical professionals, are allowed to see or touch these parts in an appropriate way. “To help a child recognize where these parts are located, you can use the terms, ‘bathing suit area’ or ‘underwear area,’” said Carlisle.
• Help your child practice healthy boundaries.“Teach them they have the option to say ‘no’ if they feel uncomfortable with the way someone touches them,” said Jenny. Carlisle adds, “They should also understand the boundaries of others, and that it is not okay to touch them in an inappropriate way.”
• Be supportive and listen.“If your child feels that they were touched inappropriately or witnessed something that made them uncomfortable, discuss it with them and ask questions,” said Jenny. “Do not dismiss their concerns. It is important you allow your child to speak up and share their experience with you so you can provide them with the help they need.”

“With the stigma that continues to surround the topic of sexual abuse, it is critical that parents have conversations with their children about it often to empower them to talk to you in a situation where they feel like they were sexually harmed,” said Carlisle. “The most important thing they should know is if it happens to them, it is not their fault and their only responsibility is to report it and seek help.”

If your child needs treatment for sexual abuse or sexual aggression, please contact the King County Sexual Assault Center at 888-998-6423 or Harborview Center for Sexual Assault and Traumatic Stress at 206-744-1600.

Resources

• A Safer Family. A Safer World.A resource for parents and caregivers of kids ages 0–12 on preventing child sexual abuse.
• Talking to Your Kids About Sexual Assault, RAINN (Rape, Abuse & Incest National Network)
• Coping with the Sexual Assault of Your Child
• Books about Sexual Assault Prevention and Recovery

Sam Foster, 19, has struggled with obsessive compulsive disorder for most of his life. At first he felt ashamed of it, until he began expressing himself through music and underwent intensive treatment at Seattle Children’s. Photo credit: Christopher Nelson

When Sam Foster steps onstage, guitar in hand, he lights up the room with his confident presence.

Yet behind his poised demeanor is a painful truth that begins to unravel as he lets his lyrics flow through the microphone.

Sam has battled with obsessive compulsive disorder, or OCD, most of his life.

According to the National Institute of Mental Health, OCD is a common, chronic and long-lasting disorder. It occurs when a person has uncontrollable, reoccurring thoughts, known as obsessions, and behaviors that they feel the urge to repeat over and over, known as compulsions.

In response to the social stigma that often surrounds mental health disorders, Sam initially felt ashamed of having OCD. That was, until he began expressing himself through writing music and eventually got the treatment he desperately needed.

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Julie Munko tried to manage her daughter Annie’s anxiety on her own until she found a therapeutic program at Seattle Children’s that dramatically improved their lives.

Imagine if you had a child who cried themselves to sleep at night because they had no friends; who called themselves “horrible” and drew disparaging images of themselves in their journal; who suffered physical pain when they wore clothes or gave you a hug.

This was once the reality for Julie Munko and her daughter Annie, who suffered from an anxiety disorder. But today, their lives are completely different, thanks to skill-based therapy at Seattle Children’s that pushed Annie outside of her comfort zone.

Crawling out of her skin

Munko first noticed Annie’s anxious behavior in fourth grade. Annie desperately avoided the school library and cried at night if she had to go there the following day. She no longer wanted to sleep over with friends or go to parties.

By fifth grade, it began affecting her school life. Annie became distressed if she unexpectedly had a substitute teacher. She ran out of the classroom if her computer was not working properly. Annie was an excellent student but panicked if her teacher’s instructions were unclear or if she was having trouble with an assignment.

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April Merrill is a 6-year-old who loves to sing and dance. Yet, her struggle with an anxiety disorder called selective mutism hinders her ability to do the activities that showcase her vibrant and joyful personality.

“Her voice disappears, as April describes it,” said Kelly Merrill, April’s mother. “She said that she wants to talk but can’t seem to find her voice.”

As April was growing up, Merrill noticed signs in her daughter that indicated something might be wrong.

“When April started to talk, she could only verbalize 20 or so words,” said Merrill. “She was 2 years old at the time and I noticed she couldn’t expand her vocabulary.”

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