Rena-Fi: Interview with Dr. Sharon Saline
Depression Myths
What people get wrong about depression:
- You could make it go away if you tried harder.
- An incident must have happened to make you depressed. Otherwise you wouldn’t be sad.
- If you practiced more gratitude, you’d feel better.
- 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
22 News Mass Appeal: Tips on starting a new routine with your children
ImpactADHD: Fostering Resilience for Kids with Anxiety
CHADD: How Does an ADHD Diagnosis Affect Self-Esteem?
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! 
Upjourney: How to Live with a Narcissist, According to 9 Experts
Parentology: Teaching Your Child Not To Be Jealous
Parenting in the Thick of It Podcast: Interview with Dr. Sharon Saline
HuffPost India: How To Break Up With Your Therapist And Start Over With A New One
Click logo below to read more.
Overcoming Distractions Podcast: How to combat shame when you are an adult with ADHD
The Greenfield Recorder: Book Bag: ‘What Your ADHD Child Wishes You Knew’ by Sharon Saline
Habits that Hurt Mental Health
I see a few major habits in my clients that hurt their mental health more than help them.
- 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.
- 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.
- 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.
Psychology Today: You've Got A Job—Now What?
22 News Mass Appeal: Four parenting tips to help students have a successful school year
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:
- 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.
- 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.
- 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:
- 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.
- 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.
- 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!
22 News Mass Appeal: Three Reasons Why Pets are Good for Kids