4 Tools to Manage Panic Attacks

Panic attacks are best managed by having a concrete set of steps to follow that you’ve figured out beforehand. When you can identify the triggers and notice the warning signs, you can ground yourself more effectively and won’t be thrown off course as much. In a calm moment, think about what internal changes signal that you are feeling panicked and write these down.  Increased heart-rate, shortness of breath, perspiration, knot in the stomach are common signs that anxiety is rising.

Next, create a list of the following tools and put it on your phone, computer or post-its so you can easily refer to it.

1. Breathing exercises: Alternate nostril yoga breathing calms you down quickly. Put your index finger on your right nostril: breathe in and out of your left nostril. Now switch and breathe in and out of your right nostril. Do this on both sides until you start to settle down. It might be as many as 10-20 times.
2. Make a playlist of songs that you love, soothe you or just make you smile. Give the playlist a fun title like “Cooling down tunes.”
3. Change your environment: If you are inside, go to a different room or step outside. Notice what’s happening around you as you are inhaling in for 4 counts and exhaling for 4 counts. 
4. Go to the bathroom and wash your face and hands. Tell yourself something encouraging such as: “You’ve got this.” “This has happened before and you’ve survived.” “It’s just your fears trying to run the show. Slow down so you can calm down.” 

Read More about Anxiety Purchase handout: You Can’t Stop Anxiety. You Change Your Relationship with It

Depression Myths

What people get wrong about depression:

1. You could make it go away if you tried harder.
2. An incident must have happened to make you depressed. Otherwise you wouldn’t be sad.
3. If you practiced more gratitude, you’d feel better.
4. Anxiety and depression are unrelated.

Depression is not a matter of will. People who are depressed would strongly prefer not to feel this way. Depression is usually a combination of several factors: biological, environmental and psychological. People may be biologically pre-disposed (it runs in their family) or their brains lack sufficient neurotransmitters (Serotonin, Dopamine, Norepinephrine) to help them regulate their mood. They may have persistent stressors in their lives which don’t resolve (poverty, trauma, unhappy home or work situations). They may suffer from low self-esteem and lack confidence. While a single event can lead to feeling depressed (loss of a loved one, prolonged unemployment, etc), some people simply become depressed without a ‘cause.’

When you’re struggling with depression, you often don’t see any options for yourself and the depression itself prevents you from seeking assistance from others, including therapy or medication. It can be hard to manage daily living, take care of yourself or appreciate anything. Changing your perspective on things would be great but usually it’s out of reach because everything seems difficult and dark. Sure, more gratitude is always a good thing but a depressed person has to start noticing a few positives in their lives first. They’ve lost a sense of agency and getting back is a top priority.

Untreated anxiety has been found to lead to depression. When people feel worried and powerless over time, they can develop an anxious depression.  They’re preoccupied with things that might go wrong or they can’t control and feel discouraged about their alternatives. It can be overwhelming to act on anything.

More Resources: Why do I cry so easily Anxiety and other conditions Handout: Anxiety

How To Make Family Dinner, Family Connection Time

Do you rush to get a healthy dinner on the table and find your hopes for a nice meal dashed immediately? Arguments between kids, trouble staying at the table, inadvertent spills can transform a lovely opportunity for connection into a battle zone. Instead of positivity, you can’t wait until everybody’s eaten and you can sit for a minute alone. Family dinners are not only an important way to come together as a family but also a time to teach social skills. Eating together, no matter how briefly, offers a chance to pay attention to each other. You practice listening, making eye contact and the ritual of sharing food. The trick is how to do this with less conflict and more enjoyment. Dinner time needs to be a tech-free time. Instead of checking with your phones, check in with each other. Try the ritual of asking for a high and low from the day. This gives each person a chance to share something that went well and something that didn’t. To keep the focus positive, you can follow up on the high note with a related question. Or ask a specific question about a class, lunch or recess related to who they sat next to or played with. Try to avoid general questions such as “How was your day?” or discussing potentially upsetting topics such as homework. You can discuss these after the meal. Many kids with ADHD have trouble sitting at the dinner table or even focusing on eating their food. If this is the case in your house, I’d recommend against turning on the television or iPad to distract them so they’ll eat and try these activities instead:listen to an engaging audio book, play a card game and offer small meals. Sometimes kids prefer grazing: eating a little bit, taking a break and coming back to the table. Work with your son or daughter to create a plan that makes sense to them and satisfies your goals of being sure they consume nutritious food. Bon Appetit!

Habits that Hurt Mental Health

I see a few major habits in my clients that hurt their mental health more than help them.

1. Spending too much time on social media: Social media not only seems to suck up time faster than you notice but it also is built to so that people compare themselves to others. These comparisons are rarely favorable and people walk away with not feeling positive about themselves. As one adolescent girl told me, “No one ever posts pictures of their face mid-menstrual break-out or of their bombed test grade.” People feel pressured to keep up with friends, stay in touch and maintain an image that they’ve created. This creates more stress in their lives which interrupts their  ability to reflect on themselves, what they think and create a sturdy sense of self. 
2. Eating fast food on the run instead of preparing healthy meals and sitting down to eat them: We are so much of what we eat and we eat non-nutritious food quickly, we’re not providing our brains or bodies with the appropriate fuel needed to think and function well. Sharing a meal is not only good for our physiology but it also provides an opportunity to connect with people face-to-face and talk about our lives. During a sit down meal, our bodies slow down and properly digest our food so we can absorb the nutrients and simultaneously take a much-needed break from the chaos of our lives.
3. Having arguments via texting or emailing: You can’t take an emotional weather report via electronic communication. If you say something difficult or sensitive this way, there’s no way for you see how your words affected the other person or perceive whatever feelings are brewing inside them. It’s easier to disengage and avoid accountability for your words and actions. People need to learn and practice interactional skills not only for healthy personal relationships but also for work and life situations where they have to deal with others. 

Frustrated by Inconsistent Progress? Change Your Expectations and Nurture Efforting

It happened again. Tonight when you went to take your daughter's phone for the evening, she argued with you. Even though, you've had this conversation for the millionth time yesterday, she pushed back again today. Exasperated by her lack of recall and self-control and expecting a different outcome, you lost it. The evening ended in a collective meltdown.

 Expectations, whether they're reasonable or unrealistic, often lead to frustration, disappointment and anger. When you wish your child was acting differently, when you notice that they're unable to consistently perform a task or when you inadvertently set a goal that they can't achieve, it's not only discouraging but also demoralizing. Like Goldilocks and the three bears, it can be tough sometimes to know what task levels are just right for your child's growing capabilities.

Ideally, you want your child or teen with ADHD to have a variety of tasks in their lives. These include things that they can do easily and independently, some things are challenging that require some adult support and a few things that are reach items. Reach items are tasks or chores that kids can't do without your help and you'd like them to learn. It's really important that you assess their abilities in relation to these different levels of tasks so that you can express support rather than judgment. Instead of expressing your frustration with their inability to put their clothes in the hamper today when they did it for the past three days, your goal is to notice their efforting--their attempts to work on a desired goal. Is three days in a row better than one day last week? Neutral expectations--ones in which you expect progress amidst inevitable setbacks--are what matters most. You acknowledge when your daughter clears the table without asking tonight but you don't expect that this is the new normal immediately until you see it unfolding more often than not. It takes extra time, repetition and cueing for the ADHD brain to learn routines and life skills. Paying attention to the positive helps encode these behaviors more effectively.

Life with a child or teen with ADHD is filled with periods of two steps forward and one step back. Rather that being surprised and disappointed by this pattern, expect the stumbles. Remember that your son or daughter is doing the best they can with the resources available to them in a given moment. If they can't follow through, it's because they can't access the right thing to do right then due to their executive functioning skill challenges. These abilities takes more time, repetition and patience to develop than for neurotypical brains.

By reframing your expectations, not abandoning them, you acknowledge your child's progress and nurture their self-esteem.

Negative Assumptions about Students with Disabilities

Yes, we are all more than our diagnosis, but negative assumptions about students with disabilities run rampant in our culture.

Often kids with learning disabilities are seen as less intelligent or competent by peers or adults.  Sadly, they may begin to believe that they are ‘less than,’ lower their expectations for themselves and isolate from friends. 

The current trend in US education is towards the integration of different types of learners in elementary and secondary school classrooms, not creating homogeneous learning situations. These diverse environments help break down barriers between young people and offer valuable opportunities for them to connect. They reduce the stigma associated with having a learning disability and being seen as ‘different’ in a judgmental light.  A child who may be dyslexic but quick with math will see other students who also juggle their own strengths and weaknesses. Perhaps someone writes well but spells poorly or another student excels at algebra but struggles with geometry. Maybe the kickball game at recess levels the academic playing field and what happens in the classroom is long forgotten with a winning home run. 

In my book, “What your ADHD child wishes you knew: Working together to empower kids for success in school and life,” I interviewed dozens of kids with ADHD who told me, overwhelmingly, that they do not like being singled out because they have ADHD. They consider it a part of who they are—not the whole story—and they are trying their best to figure out how to accept the brains they have and spend time doing what they love. Often, they turn to non-ADHD friends for feedback, guidance and support. One high school senior told me that she really benefits from doing homework with her non-ADHD boyfriend because he notices when she’s spacing out and calls her back to the task at hand. Another boy is grateful to his group of friends who patiently repeat something in a group conversation if he misses it as they all laugh together. These kids want to do well and fit in as much as any teen. 

Inclusion programs provide essential interactions and relationships between kids, replacing feelings of isolation with normalcy. Ultimately what matters is who a person is, not what they can or can’t do. Kids are much more likely to take this perspective when they have natural, unforced contact with each other.

Teen Hormones and the ADHD brain? Helping Kids in Transition

As they enter adolescence, boys and girls with ADHD may not be able to articulate what is swirling around inside of them. Quick to react and then make inappropriate choices, they may not be aware of what triggers them or how to manage themselves differently. When the floodgates release, their feelings overwhelm them. Sometimes the intensity of these moments reflects their changing hormones; other times, it's connected to their frustration of living with ADHD. It's hard to tell the difference. 

The onset of puberty in boys and girls, especially those with ADHD, can also increase their reactivity and sensitivity to anxiety, anger and later, shame about how they've behaved. Both estrogen and testosterone have a direct effect on the brain’s neurotransmitters. Their outbursts are showing you that they need help developing skills for self-regulation and understanding what's happening in their bodies and brains. 

Here are a few things you can do to assist them:

1. Arrange an appointment with his or her pediatrician to discuss the behavioral changes you’ve been seeing at home and talk about how and why hormones contribute to them. It’s important that the doctor knows what is happening and may have some suggestions for both of you. 
2. Collaborate with your son or daughter to find ways to deal with their agitation. Given fluctuating hormones and the challenges of living with ADHD, you can’t expect to stop big feelings from happening. What you can do is create a plan to deal with them before they actually erupt. Sit down together and talk about the triggers that you both notice lead up to these explosions. Look for the patterns and focus on them instead of the content. Review any signs that indicate something’s changing. What does he notice is occurring in his body? What behaviors does she start to display? Make a list of these observations.
3. When things heat up, you've got to slow them down. Talk about what has helped in the past when intense feeling arose. Which of these could be used now?  Ask what you can do (and what you can avoid) that would support him or her in developing self-control in those moments? Connect these ideas to your previous observations. Write a list of  these options and post them in your kitchen.

If your son or daughter continues to struggle, consider going to see a therapist. Counseling can be extremely useful in assisting kids with ADHD and their parents to understand triggers that set them off, improve their ability to talk about what’s happening and reduce anxiety and anger and create options when emotions run high. 

Manage big feelings better: Reduce triggers by noticing bodily signals

For kids with ADHD, managing intense emotions can be extra tough. In the heat of the moment, it’s hard for any of us to hold it together and act the way we’d like to. Breathing techniques, calming phrases or taking a walk are great options that tend to go out the window when you're angry, frustrated or afraid. Instead, we yell, cry or say inappropriate things.  When confronted by a tidal wave of big feelings, kids with ADHD especially struggle to access the parts of themselves that know how to make effective, positive choices. Their weaker executive functioning skills aren't yet developed enough to exert emotional and verbal control and they often can't recall how they should be responding. Instead of trying to stop these strong emotions or argue with your son or daughter about their irrational reaction, we have to help kids notice and respond to what's happening inside of them.  Practicing and teaching self-regulation requires acting like the GPS in your car: you neutrally observe that you’re off course, stop going in that direction and  choose a new route. You notice the physiological signs that you are activated (increased heart rate, perspiration, louder voice), you pause (take a deep breath, change your location and consider what's most important right now) and you re-direct (make a choice that's different than a typical reaction).  Since most children and teens with ADHD are still cultivating self-awareness, they'll need your help to detect the signs that a tidal wave is building inside of them. By identifying the pattern of what triggers them and the bodily signs that something is off, you work as a team to reduce their reactivity and decrease their triggers. They'll feel start to feel a greater sense of self-control and you'll feel less frustrated with their outbursts.  Follow these steps:

1. In a calm moment, talk with your son or daughter about things that set them off.  What are the bodily responses that signal something is escalating? Usually people have a physical reaction when something bothers them, but they can’t catch their reaction fast enough to make a calmer choice. Share a few ways that you can tell when you are agitated. 
2. What would they like to do differently and how could you assist them? How could you cue them to respond differently without being provocative? Offer a few of your observations of their behavior and some ideas for alternative choices. Make a list of these and post it in a space that you can all refer to for support in a tough moment. 
3. Acknowledge all attempts to follow a suggestion on the list as well as successes. Efforting in this area matters a great deal even if it's not consistent because practice makes progress. Tell them specific ways that you notice this progress and how you appreciate it. 

When you work together to identify triggers and manage the big feelings that accompany them, you're helping your child or teen build those critical executive functioning skills of self-regulation and self-awareness. It may seem like one slow step at a time but you're still moving forward!

Academic Support for Teens & College Students

School-based interventions improve academic performance and social relationships.

For high school students with ADHD who already run a higher risk for underachievement and dropping out than neurotypical kids, having support services can make all the difference. This recent study also showed that whatever services kids receive in elementary school are often discontinued as they mature. It’s a sad irony I’ve seen too many times: when kids with ADHD have useful scaffolding and are doing better, the services are later withdrawn because of their success. Instead, these interventions need to remain in place to help with the increasing executive functioning demands for independence in middle and high school. When students receive appropriate levels of support during these years, it makes the transition to college or trade school more successful.

For high school and college students who have a diagnosis of ADHD but have never received psychological testing, I highly recommend that you get this because these assessments will identify your cognitive strengths and challenges..... Read More of my advice in Psychology Today.

Anxiety and Food

Q: What foods might spike anxiety ... and why?

A: Although I am not a medical doctor, I've observed that especially sugary foods or those with a lot of caffeine can increase someone's agitation and then make them more prone to anxiety. Sometimes ginseng can do this as well. 

Q: Are there foods we should turn to instead to reduce anxiety?

A: I think herbal teas such as chamomile or those with other calming properties can be extremely useful. 

Q: How much should people be eating?

A: Everyone is different, but we should all eat slowly and mindfully! Often when people eat quickly or standing up, their bodies don't have a chance to metabolize the food and recognized that they are sated Often overeating happens with rushing. u

Q: Are there any links between how much you eat and your anxiety or when you eat and anxiety?

A: Yes, some people eat when they feel anxious; others can't eat. It's really an individual response.  

Q: Is all of this true for people with diagnosed anxiety disorder only or just regular folks who sometimes feel anxious?

Whether or not you have an anxiety disorder or 'just feel anxious sometimes,' the feeling of anxiety is the same. The difference is one of frequency and intensity. So yes, it's true for both sets of folks.

Read more advice from Dr. Saline on anxiety Purchase Anxiety Worksheet

Strategize Now to Set up a Successful School Year

Gather your strength--it's time to set the alarms, make the lunches and buy the supplies. School is starting again. How can you avoid frustration and arguments to create the smooth transition that everybody wants? By relying on Compassion, Collaboration and Consistency, you can work with your child or teen to set a positive tone for the year.

Many kids with ADHD feel mixed about the return to school. While they may be excited to see their friends, they often dread the return to academics, waking up early and the responsibility of homework. If they struggled last year, they may worry about repeating the same challenges or facing new, unexpected ones.

1. Before talking with them, take a few moments to summon your Compassion. Reflect on some of the highs and lows for your son or daughter from last year. How did they meet those challenges? What types of support from you or their teachers was helpful? Jot down some of your ideas. Before moving forward, remember that kids with ADHD are doing the best they can with the limited resources available to them in a given moment. They need you to understand this before approaching any plan for this year.2. Make a time to talk with your child or teen about this upcoming year so you can Collaborate on a plan for success. Ask them to recall successes and challenges and, if they can't think of anything, offer some reminders from your notes. Together, make a list of useful supports--anything from setting several alarms in the morning to emailing a copy of homework in case they forget to turn it in to breaking up study periods with timed breaks. Then, make a list of common distractions or obstacles you both anticipate could arise this year.

3. Evaluate both your expectations for the year and theirs. Consistency relies on regular efforting, not perfection. We want to nurture resiliency by acknowledging how kids with ADHD are trying to do stuff and improve themselves. You're looking for progress, not perfection. There are three types of goals to consider: easily attainable (things they can definitely achieve or have already been doing),  working on/within reach (things they accomplish but require supervision or help) and mostly reach goals (things that are sporadically achieved). For now focus on one easily attainable goal and one working on/within reach goal. You can expand this list as the year progresses. By  keeping things simple, you increase the chance for success and we want children and teens to feel as positive as possible right now. Feeling successful early in the year has a snowball effect: they notice their competence and want to build on it. Using Compassion, Collaboration and Consistency, you'll create a strong foundation for a great year!

Recent College Grads: Adjustments, Parents' Role, Jobs and Adult Life

What are some of the adjustments that recent college grad kids will be making?

Recent college grads have many adjustments to make. Not only are they saying good-bye to many of their friends, a familiar surrounding and a student lifestyle, but they are also facing the uncertainty of what comes next. Even if someone has a job and an apartment lined up (these are huge things to swing for many recent college grads), they are leaving behind a structure of  going to school and an identity of being a student. Friends disperse, they are responsible for paying their own bills, and self-sufficient adulthood, while longed for, can be overwhelming. Many new college grads aren’t accustomed to creating and living on a budget, shopping for and cooking meals and making plans to spend time with friends instead of bumping into them at the cafeteria. It’s a huge shift in many areas simultaneously. 

How can parents and loved ones can help ease the transition?

It’s important that parents and loved ones acknowledge the enormity of this transition and don’t compare their own experiences with those of their children. Things have changed a lot and many young adults struggle under the burden of huge financial debt, a high cost of living and a tight job market. Staying compassionate, offering to assist them and collaborate on tasks and being available to talk through emotions related to this change is most helpful. Don’t solve issues: offer your suggestions and avoid getting hurt if they aren’t taken. Young adults often like to figure things out for themselves, which means trial-and-error learning. Sometimes the best support you can give is managing your own frustrations, sharing your feelings without blame or guilt and validating their successes. 

What are some tips for applying to jobs, moving home, and how to adapt a healthy routine in adult life?

Having a daily routine offers structure and freedom. It’s critical to set aside a specific period of time for applying to jobs each day so this activity has boundaries. Looking for job can be exciting but it’s also tedious and sometimes deflating. It can spread into all aspects of your life as the list of things you should be doing keeps growing. Avoidance accompanies discouragement and overwhelm. Talk with your son or daughter about marking off a few hours each day (preferably in the morning to get it over with) for job hunting online, responding to emails or dropping off resumes. This will assist them in feeling accomplished each day and competent as well because they’ve done something in a time frame that they laid out. Then they can do whatever they want. Help young adults limit screen time: advocate for doing other things that interest them and make them feel good. Exercise, time with friends, shopping and cooking with you--these are all activities that contribute to healthy living. Teach them how to shop, balance their bank account, make a budget and understand their health/car insurances. These skills are not necessarily second-nature and it’s very common for recent college grads to need extra support in learning them.

Anxiety and Resilience

Anxiety is a physiological response related to a perceived danger and worried, negative thinking. Basic fight or flight responses are triggered from worries and these reactions are usually disproportionate to the concern at hand.

Worry can be productive or poisonous. Productive worry is worry about doing things--completing homework or getting to work on time --and can be helpful in getting things done. Poisonous worry is worry about things you can’t control--the ultimate demise of the planet or whether people like you--and can be debilitating. The first step to dealing effectively with anxiety is to determine which type of worry you are dealing with. Then, engage the thinking brain to slow down the tidal wave of anxiety and emotion volcano by doing two things:

1. Rely on past experiences of successfully overcoming anxiety and applying those skills to this moment.
2. Engage in a worse-case scenario by asking “And then what?” repeatedly until you land at the illogical end.

This process works with kids and adults.  I give you more specifics in this Youtube video and in this handout.

Got an anxious high schooler with ADHD? Help is here.

Many teens today feel extremely overwhelmed and anxious, especially those who are out-of-the-box thinkers. Life seems constantly demanding and stressful. With the executive functioning challenges that are typical of ADHD brains, it's even harder for them to regulate intense feelings.  Routine concerns can quickly balloon into outright panic.  Approximately 35% of kids with ADHD have also been diagnosed with an anxiety disorder. In my clinical experience, this number seems higher. After hearing over the years about about the ways that they miss the mark, don't measure up and differ from other kids, these kids develop an internal vigilance--a nervousness--about the next time they will inadvertently stumble, what people will think of them and how to deal with the inevitable consequences. These worries fosters overt or covert anxiety. I've asked teens with ADHD to describe the two things that cause them the most anxiety. Here's what they’ve told me that they wish adults knew:

1. 1. They can’t keep up with 24/7 demands of their lives--whether it's in real time or on social media. They struggle to regulate themselves regarding technology, understand social nuances and keep track of events and responsibilities. Their parents don’t see or understand all of the nuances they are dealing with.

Solution: Despite their words or actions to the contrary, teens actually want their parents to set limits on technology and help them manage. Parents, befriend your children on all social media outlets and help them manage FOMO. Talk with your teens about appropriate responses to relationship challenges both online and in person. Help them distinguish when to engage and how. Create screen-free family time at meals. Ask them to share an online, Youtube or musical interest or hobby with you so you can understand and participate in their world 

1. 2. They feel enormous pressure about school, the college process and what to do after high school. Some teens with ADHD drive themselves too hard, over-focus on achieving good grades and keeping up with their friends. Going to the ‘right’ college becomes more important than pursuing what best fits their interests. Other kids, in the face of repeated academic difficulties, adopt a "why bother even trying" attitude. They've lost the interest and impetus to make efforts. Too often, in all of these scenarios, parents will push their children based on their expectations of who they think their teen should be. Arguments and disappointment abound.  

Solution: Meet your teen where they are, not where you want them to be or think they should be. Development is an organic process that doesn’t necessarily unfold in a linear fashion. This is especially true for kids with ADHD, learning differences or high functioning autism. Their brains need more time to mature and they may benefit from an alternative path for a while until things fall more into place. Be open to thinking about alternatives. Maybe your son who likes video games and art might be better suited for a vocational program in computer design than conventional academics. Perhaps your daughter who excels at soccer but hates writing might benefit from being an assistant coach for a gap year. Offer guidance and support with an open mind.  Of course, you can't erase your teen's anxiety. But, you can help them reduce it by monitoring their overwhelm, showing interest in their on-screen activities and keeping perspective on post-high school options.

Screens, Summer and Sanity

You are the parent! Repeat. Screens are NOT a right! You are the parent! Repeat. Screens are NOT a right, they are to be earned. Write what you will accept, and then work with your child - now, at the start of summer, to collaborate on a plan that you both agree to. Learn more about my screens and summer advice in this Youtube video.

Want better conversations with your child or teen with ADHD? Use the WAIT-Now Method

Do you ever say something to your son with ADHD, or daughter with ADHD, and wish you could take it back? Most parents feel this way at one time or another. Sometimes, especially when raising teens, I've imagined a cartoon bubble of my words and wish I could suck them back into my mouth just a few seconds after it's already too late. That's why I created the WAIT-Now Method to help take that needed pause when you're triggered. Instead of blowing your cool and regretting it later, you'll say something appropriate and feel good about yourself too.

The WAIT-Now Method stands for "Why Am I Talking Now?" Rather than give into your automatic response in a tense or uncomfortable situation with your kids, you PAUSE by actively telling yourself to WAIT. This is part of the STOP in my STOP, THINK, ACT technique, but it's geared directly to what you say. Notice what you are saying to your child or teen, how are they responding and where the conversation is headed. If it's going downhill, pause your talking and ask yourself these questions:

WAIT-Now Method: "Why Am I Talking Now?

1. What am I saying?

   Ask yourself if you are actually communicating what you want to be. If you are, great--keep going. If you aren't, then stop. Take a few deep breaths and pause. Reflect on what you really want to saying, edit your words and try again.

2. How are my words being received? 

   Notice how your son or daughter is responding. Their body language and their comments are giving you valuable information about the effectiveness of your words and whether or not you need to change direction.

3. Why am I invested in saying these things? 

   Identify your goals in this conversation. Are you engaged in clarifying a direction, are you giving them helpful feedback, are you trying to keep them safe? Why you are talking to them directly affects how you talk to them.

4. Could I listen more and talk less? 

   Sometimes we fill in uncomfortable gaps or anxious moments with words. Open spaces in conversations with kids give them time to reflect on what you're telling them and think about what they want to say in return.

This takes time to learn and practice makes progress. Be kind to yourself when you see that cartoon bubble, regroup and try again next time. To give yourself a useful reminder, write WAIT NOW on a post-it and put it on your refrigerator!

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Read more blog posts:

• Parenting Older Teens with ADHD: Land the Helicopter and Focus on Scaffolding
• ADHD and Negativity: Why ADHD kids and teens say "No" and how to help them communicate
• ADHD and Anger in the Family: Manage Outbursts with STOP-THINK-ACT

https://drsharonsaline.com/product/home-seminar/  

Teens and Summer Jobs

When teenagers get their first job, they're very excited to make and have their own money. Managing that money, though, is often a bit of challenge. They may have held small jobs like babysitting or dog-walking before, but they don't know how to use a bank account, write a check and kept track of what they're spending. Many of them use debit cards without understanding how to monitor what they're spending and overdraw their accounts quickly. This is especially true for teens with ADHD. It's critical for parents to help their kids learn about money management and budgets.

I've worked with many kids who come to my psychotherapy office and have no idea how to make a simple budget. They don't know how to total up monthly expenses and subtract them from their paycheck to see how much spending money they actually have or what they can save because no one has shown them. Several young adults have asked me to teach them how to write a check.

I advise newly employed teens to live in a cash world for a while so they can grasp how much money they actually have and see how they spend it. Forget debit cards: instead, once their checks are deposited, tell them to take out the sum that they'll need for the week. Help them open up both checking and savings accounts so they can start to put away some portion of their earnings for something special in the future. This teaches how to save. Most kids proudly tell me how much money they are saving. It makes them feel like adults and contributes to the autonomy that teens need (and want) to develop. 

Read other family and parenting topics here.

How You can Avoid the 3 Most Common Mistakes Parents Make with Kids with ADHD

As you crawl into bed after another long day struggling about school, chores and technology with your child or teen with ADHD, do you ever feel like throwing in the towel? You’re not alone. Many parents of kids with ADHD feel frustrated and dejected. In your efforts to help your son or daughter get their homework done, make it to sports practice and pick up their room, do you feel like none of your reminders stick? What could you do differently to foster long term results?

In spite of the pushback and yelling you may receive, your child or teen with ADHD really needs you to hang in there.  They can’t learn those all-important executive functioning skills like organization, planning, prioritizing and self-regulation without you. But, if you lose it when they're already upset, if you don't work with them on solutions to daily challenges and if you notice their efforts and encourage their progress, you won't be assisting them to build the essential life skills and self-esteem they need. My 5C’s approach--self-control, compassion, collaboration, consistency and celebration--provides the tools for you to create lasting changes. You'll be more of the parent you want to be and your child really needs.  Let’s look at the 5 common mistakes parents of kids with ADHD make (without shame or guilt!) and how you can avoid them: Mistake #1: Losing your temper: It’s natural to get upset when someone’s screaming, kicking or hitting you. But your agitation only adds fuel to their fire. The first order of business when things are escalating is to regulate yourself. By managing your own feelings first, you'll be in a better space to act effectively and teach your child to do the same. This doesn’t mean never getting upset or always feigning calmness. Instead, you notice when you’re becoming riled up and try to bring yourself back. You stop what you’re doing, take some deep breaths, call a pause in the action and re-orient. Like your GPS, your re-center without judgment. Mistake #2: Excluding them from participating in creating solutions to daily problems. Kids with ADHD, even young children, have their own ideas about what isn’t working and what could be better. This input is very important. They spend all day at school--a place where they often face social, academic or emotional challenges and hear about how, where and when they’ve missed the mark. They're given directions about how to do things differently that may not make the most sense for how their particular brain works. When parents or caregivers include the opinions of kids with ADHD to address problem areas, there’s more buy-in and, ultimately, cooperation. Collaboration means working together with your child (and other important adults) to find solutions to daily challenges instead of imposing your rules on them. This collaboration offers a “we” attitude instead of a “you” attitude: they see you more as an ally instead of an opponent. Mistake #3: Being too focused on the outcome and ignoring their efforts along the way. Many parents, understandably, want to see immediate changes in their child’s behaviors when they give feedback or start a behavioral plan. You are helping them achieve steps towards being the responsible, productive adult you both want to see. But sometimes these goals overshadow the efforts. Acknowledging their progress with genuine, positive comments actively counteracts the dominant negative messages they hear daily. Studies have found that a 3:1 ratio of positive comments to negative ones makes a big difference in promoting behavioral changes and can-do attitudes. If you are struggling with a child or teen with ADHD and would like to learn some sure-fire tips for improving cooperation and reducing arguments, please join me for my upcoming 4 session online workshop:  https://drsharonsaline.com/product/adhd-teleseminar/ .  

Parents, here's how to talk to your teen about self care

"Talking to your teen about self care can be difficult, so we spoke with leading experts on teen psychology to find out the best way parents can approach their teens to talk--and what skills they recommend you try!"

From Mentally Fit Response by Dr. Sharon Saline: I am a clinical psychologist and author of What Your ADHD Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life. I specialize in working with kids, young adults and families living with ADHD, learning disabilities and mental health issues.

There are a few challenges that parents face when talking with or trying to help their teens.

Parents quickly move into problem-solving mode which usually doesn’t work for teens. They want to feel heard and met where they are but often parents tell them how to be different, how they ‘should be’. Sometimes parents are too reactive to their teens: afraid of what they’re hearing or angry when their ideas are rejected. When they become upset, it’s like throwing kindling on the fire of their kids’ issues. The conversation now involves two people whose emotions are running the show instead of only one.

Talking to a teen about self care has to start with compassion: accepting your child for who they are and acknowledging the efforts you see them making.

Teens are very quick to become defensive and dismissive. Using phrases such as “I notice” or “It seems like” is an effective way to communicate your observations without pushing them away. Then follow up with questions that encourage their participation in solving the problem: “What are your ideas about?” or “How can I support you in doing things differently?” Routines are helpful as long as they’re written down and posted somewhere. Otherwise, the parent becomes a reminder machine. It may seem juvenile to a teen but until that routine is firmly ensconced in their brains, having it written down is key.

Parents can help their kids by first and foremost setting a positive example of self-care and attention to wellbeing.

Being available to listen non-judgmentally and use reflective listening tools is extremely helpful for promoting honest, heartfelt discussions. Bedtime is usually a good time to connect with a teen and often when they want to chat. That can be tough for tired parents so set a limit around how long you’ll talk with them and prop open your eyes as best you can. Car rides are another natural, comfortable time to check in. Perhaps agree in advance to discuss 2 good things and 1 challenging thing about your days. Setting boundaries around screen time not only promotes mental health.

Seek additional support.

Finally, if you are arguing a lot with your teen or if they are showing atypical levels of anxiety, stress, isolation or negative moods, then seeking family or individual counseling them would be important. If they are resistant to going alone, then start with family work on improving your communication.

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Important New Research Alert: What you can do to make sure your student gets what they need

A recent national study of approximately 2500 youth with ADHD ages 4 to 17 revealed some alarming findings about how the needs of students with ADHD are NOT being met. Although the majority of students were receiving one or more interventions, the authors, led by George DuPaul, Ph.D. of Lehigh University found that at least one in three students with ADHD received no school interventions even though they showed significant academic and social difficulties.[1] This is especially true for kids from non-English speaking and/or lower income families. Other shocking results: One in four students with ADHD had repeated a grade, one in six had been expelled from school. In addition, middle and high school students with ADHD were less likely than elementary school students to receive any school services despite similar if not worse academic and social functioning.[2] Honestly, I am quite distressed by the results of this study. Given that school is often the hardest area of functioning for kids with ADHD and there’s been so much professional development for educators about ADHD in the past decade, I guess I had naively believed that things were better than this. While this study sheds a glaring light on the lack of educational support and interventions for ALL kids with ADHD, those youngsters from non-English speaking families or those with fewer means have educational needs that are particularly neglected. Such disparities in who or who doesn’t get help means that education—a fundamental American value as the path for people to overcome racial and/or socioeconomic obstacles to find success on their own terms—is actually thwarting kids with ADHD. This is completely unacceptable. School-based interventions improve classroom behavior, academic performance and social relationships. For middle and high school with ADHD this current is particularly critical: they already run a higher risk for underachievement and dropping out. This current study also implies that services kids receive in elementary school are discontinued as they mature. It’s a sad irony I’ve seen too many times: when kids with ADHD have useful scaffolding and are doing better, the services are later withdrawn because of their success. Instead, these interventions need to remain in place to help with the increasing executive functioning demands for independence in middle and high school. What can you do to make sure your son or daughter is getting the services they need?

1. If your child was given a diagnosis of ADHD by a primary care or mental health provider and has not received an IEP or 504 evaluation, call the school and set up a meeting right away. Since your son or daughter already has a diagnosis and meets criteria for one of these interventions, you are entitled to have a meeting. Don’t be afraid to be persistent.
2. If your son or daughter already has an Individualized Educational Program, a 504 accommodation plan or a Functional Behavioral Assessment Plan, you can request an informal gathering of administrators, teachers and counselors to discuss the support services that are already in place. You many also ask for a formal team meeting to re-evaluate the existing IEP and make changes to it.
3. I recommend at least one informal meeting of the people at school who know and/or teach your child or teen per year so that you discuss academic and social goals and set up a method of communication that works for everyone. It’s great if the student can participate in part of this meeting as well so their perspective is both heard and integrated into the plan.
4. If you are unsure about the level of the services that your child is supposed to receive or unclear if the services are indeed being provided, then consider one of these options: A) Asking for someone (of your choice or the school’s) to observe your child in a few different environments at school and share those findings with you and the team; B) Consulting with someone outside of the school such as a learning specialist, ADHD coach or psychotherapist to review what’s in place for your student and make helpful suggestions; C) Speaking with an educational advocate to help you assess your situation and look at possible options.           

[1, 2] https://www2.lehigh.edu/news/george-dupaul-1-in-3-students-with-adhd-receive-no-school-interventions