Co-occurring Disorders in Teens

Drug abuse is a serious problem for teenagers in the United States, but many people fail to realize that drug and alcohol addiction is often accompanied by a mental health condition such as depression, post traumatic stress disorder, or bipolar disorder. When drug or alcohol addiction is compounded by a mental illness, they are known as co-occurring disorders.

 Co-occurring disorders are very common, but only about 10 percent of adults who suffer from them receive treatment for both conditions. To make matters worse, over half of them receive no treatment at all. The problem with treating co-occurring disorders is that most specialists do not focus on treating both substance abuse and mental illness. Many professionals also focus entirely on which condition came first, something that is often impossible to determine; depression or PTSD may drive someone to drugs or alcohol, but substance abuse can also lead to mental illness. It is important to address and treat both conditions.

Treating the Person, Not the Illness

The key to treating a person with co-occurring disorders is to address the whole person. Many treatment options for both mental and physical illnesses only attempt to alleviate the symptoms of the illness. That may appear to work in the short-term, but it doesn't get to the root of the problem. In the case of co-occurring disorders, a young man or woman may be able to kick a bad drug or alcohol habit with treatment, but it doesn't mean much if an untreated mental illness is what drove them to use in the first place. They could have problems later in life because of this, not the least of which is a relapse of their substance abuse problem.

As much as some people may believe otherwise, mental health isn't an exact science. No two people are alike, and no two people will use drugs or alcohol for the same reason. An effective treatment for co-occurring disorders must address not just the substance abuse or the mental illness; it must get to the heart of why a young person is having problems.

Treatment Options

Treating a mental illness is difficult in the best circumstances; what works wonders for one person may be ineffective for someone else. In many cases, finding an effective treatment for a mental health issue is all about evaluating different options to see what works. Things become even more complicated when a mental illness is combined with a substance abuse problem. Still, there have been some treatments that have proven to be more effective than others in addressing co-occurring disorders.

Medication is often helpful in treating conditions such as bipolar disorder and depression, and many of them have proven effective in fighting withdrawal symptoms, making it easier for recovering addicts to stay clean. Another treatment option that has proven to be very effective is psychodynamic psychotherapy. This addresses the person’s feelings and beliefs that are being numbed by the drug abuse in relation to their personal history and unconscious mind. It essentially treats the entire person and addresses their unique situation, something a teenager with co-occurring disorders desperately needs.

This article was written by health blogger Laura Green.  She really stresses the importance of treating co-occurring disorders, and not just one or the other.  Click here for more treatment options. 

Responsible Social Media Use for Teens

Today’s teens love social media as a way to connect with friends and share their passions and interests with others. However, responsibly using social media is something that goes beyond a teen with a new smartphone. Parents should help teens with responsible social media use because misuse can result in a range of issues and problems. Here are some topics that parents absolutely must make sure their teens know more about in order to become responsible social media users:

Privacy

The privacy settings on social media accounts are there for a reason—to prevent anyone from accessing someone’s information. Even though teens may think it is fun to share passwords and account names, they must understand that it opens up the doors for everything from harmless pranks to more serious violations of trust and boundaries. The only way for teens’ social media accounts to stay secure is to keep them completely private, allowing the privacy settings to do their job.

Permanence

Teens may view social media platforms as a way to express what they are thinking in the moment, connect instantly with friends and then move on—never gaining a full understanding of the permanence of information on the internet. Text messages, photos and more never really disappear once they are posted online. Teens should understand that they should never post anything online that they wouldn’t want everyone around them to see or read. A good rule of thumb on this is to think before every post if the content is something they would want their grandmother or their younger sibling to see. If not, don’t post it.

Bullying

Cyberbullying is a growing problem among teens that use social media, and extreme cases of bullying have contributed to teen suicide. Most teens report that they have witnessed some form of cyberbullying in the past year. In order to use social media responsibly, teens should have a clear understanding of what cyberbullying looks like and the steps they can take to get help in dealing with bullies before it’s too late. They should also know the steps to take to report any cyberbullying they witness. Recent laws enacted in many states have criminalized cyberbullying, so there are real consequences for these cruel action.

Monitoring

Part of a teenager’s understanding of the permanence of any data put out onto social media includes knowing that certain organizations use the internet as a resource. For example, law enforcement agencies often check out social media for more information and insight into illegal activities that teens document. Social media photos and texts can help law enforcement recreate timelines, prove alibis and more. Another example is a teen’s current school. The school might choose to monitor social media accounts to ensure that enrollment standards are being met. Finally, college admissions counselors have been known to gain insight, both positive and negative, into applicants by looking them up on social media. Teens should always remember that lots of organizations use Facebook to their advantage, so they should only post neutral or positive events.

Predators

A predators is anyone looking to take advantage of another.  Predators use social media to identify and build “relationships” with potential victims. Whether a predator is after financial information such as PIN numbers, or wants to pursue an inappropriate relationship, teens must be informed about a predator’s tactics. With chat rooms, texting, and private social media groups, it’s very possible for teens to carry on extended, intimate conversations with strangers without parents knowing.

Teens are likely going to use social media with or without a parent’s guidance. Therefore, parents should take the time to talk with them about signification issues related to social media and help them identify ways that they can choose responsible social media use.

Tyler Clark is a freelance writer with expertise in parenting, child development and family dynamics. He urges parents everywhere to teach their teens how to use social media responsibly.

The Importance of Forgiveness

In my private practice as a marriage, family, and child therapist, I often see patients who harbor ills done to them for what seemed like an eternity ago.  Obviously, there may be some things that were done to us in the past that we consider so heinous, that we may never find it within ourselves to forgive.  Fortunately, the aforementioned are usually few and the incidences that we still have not forgiven, once placed in the proper perspective, are issues that we still carry around with us, that could have been forgiven long ago. 

For it is important to note, that when we forgive, we do it as much for ourselves as for the person who wronged us.  As an example, in the divorce class that I teach at the college, the class is shown a statistic that shows that one third of the husbands and over fifty percent of the wives remain intensely angry at their ex spouses ten years after the divorce.  It would certainly be heartening to know that anyone having a dissolution of their marriage this year would have found a means of mitigating that anger so that in 2023, they are no longer imbued with such vitriolic feelings.

Many years ago I heard an apocryphal story that I have never forgotten.  There was an angel who offended G-d and was summarily banished from heaven until he could return with the most precious and meaningful thing in the world.  So he flew down to earth, entered a hospital room and grasped the last breath of a dying man; a man who was revered and loved by all for his generosity and humanitarianism.  With the last breath in his hand, he returned to heaven and showed it to G-d.  He was told that while it was precious and meaningful, it was not the most precious and meaningful thing in the world.  Disappointed, he flew back down to earth and flew into the hospital delivery room and captured the first breath of an innocent infant and once again presented it to G-d.  Again he was told that it was still not the greatest thing in the world. 

Now, totally bewildered, he flew back to earth and came upon a man who was approaching another man’s home to do harm to him for something that this man did to him many years ago.  With weapon in hand, he peered into the window and saw the man sitting on the floor surrounded by his wife and children as they were playing games.  It became quickly evident this man was loved and cherished by his entire family and in spite of what he may have done, he was still a good and loving person.  Outside, the man began to feel contrition and sorrow for the vindictive act that he was originally going to commit.  He fell to his knees and asked G-d to forgive him for the senseless crime that he almost committed and a tear began to cascade down his cheek. 

Just before it hit the ground, the angel caught it and flew back to heaven, presented it to G-d and told him he found the greatest thing in the world…forgiveness… where upon G-d agreed and readmitted the angel to heaven.

Walt Liebman, Ed.S.

In my private practice as a marriage, family, and child therapist, I often see patients who harbor ills done to them for what seemed like an eternity ago.  Obviously, there may be some things that were done to us in the past that we consider so heinous, that we may never find it within ourselves to forgive.  Fortunately, the aforementioned are usually few and the incidences that we still have not forgiven, once placed in the proper perspective, are issues that we still carry around with us, that could have been forgiven long ago.  For it is important to note, that when we forgive, we do it as much for ourselves as for the person who wronged us.  As an example, in the divorce class that I teach at the college, the class is shown a statistic that shows that one third of the husbands and over fifty percent of the wives remain intensely angry at their ex spouses ten years after the divorce.  It would certainly be heartening to know that anyone having a disolution of their marriage this year would have found a means of mitigating that anger so that in 2023, they are no longer imbued with such vitriolic feelings.

Many years ago I heard an apocryphal story that I have never forgotten.  There was an angel who offended G-d and was summarily banished from heaven until he could return with the most precious and meaningful thing in the world.  So he flew down to earth, entered a hospital room and grasped the last breath of a dying man; a man who was revered and loved by all for his generosity and humanitarianism.  With the last breath in his hand, he returned to heaven and showed it to G-d.  He was told that while it was precious and meaningful, it was not the most precious and meaningful thing in the world.  Disappointed, he flew back down to earth and flew into the hospital delivery room and captured the first breath of an innocent infant and once again presented it to G-d.  Again he was told that it was still not the greatest thing in the world.  Now, totally bewildered, he flew back to earth and came upon a man who was approaching another man’s home to do harm to him for something that this man did to him many years ago.  With weapon in hand, he peered into the window and saw the man sitting on the floor surrounded by his wife and children as they were playing games.  It became quickly evident this man was loved and cherished by his entire family and in spite of what he may have done, he was still a good and loving person.  Outside, the man began to feel contrition and sorrow for the vindictive act that he was originally going to commit.  He fell to his knees and asked G-d to forgive him for the senseless crime that he almost committed and a tear began to cascade down his cheek.  Just before it hit the ground, the angel caught it and flew back to heaven, presented it to G-d and told him he found the greatest thing in the world…forgiveness… where upon G-d agreed and readmitted the angel to heaven.

Walt Liebman, Ed.S., is a marriage and family therapist in private practice in South Miami, President elect of the Miami Dade Association of Marriage and Family Therapists and an instructor at Miami Dade College and can be reached at waltliebman@famtherapy.com or by calling 305.665.4177.

                 

WHERE DO RELATIONSHIPS GO WHEN THEY GO SOUTH?

Does that mean that relationships go to Miami or points beyond when there is dissolution of the relationship and couples become divorced?  Being a marriage and family therapist for twenty nine years, an instructor in the Court mandated Children of Divorcing Parent’s Course since its inception twenty years ago and for the past ten years a Parent Coordinator for the Eleventh Judicial Circuit, you wonder how far south do relationships have to go when divorce becomes imminent.  I have witnessed all too often the impact of what once loving couples now engaged in a “War of the Roses,” have upon each other and the real unwitting and innocent victims of  divorce…the children.

With our divorce rate hovering around fifty percent for first marriages and increasing approximately ten percent  for subsequent second and third marriages, these marital disruptions strain parent-child bonds (particularly between fathers and children).  One has to wonder why previous loving couples have to be so destructive  and blatantly malicious towards each other.

Divorce is not dissimilar to death.  In fact, it is a death, the death of a relationship as we once knew it.  Its rippling effect impacts everyone in the family as no one goes through a divorce unscathed, especially our children.  Sometimes, without even being aware of the irreparable harm that we are doing, we use our children as pawns in an attempt to retaliate against the other parent.

Statistics concerning children from divorced homes are foreboding.  They have a higher school dropout rate, arrest rate, incidence of divorce rate when they marry, and a higher teenage suicide rate.  The encouraging news is that it does not have to be this way.  No one is asking you to love or even like your former spouse, though, for your well being and especially that of your children, there must  come a time when you will have to learn to be civil and respectful of each other.  Your child’s well being, psychological, and emotional health is dependent upon this.  Not only will it enable you to better prepare for your future, it will enable your children to more effectively cope with their parent’s divorce, something that you as loving and nurturing parents want very much to do.  Unlike a death, you will continue to see your former spouse at school and religious functions, at your child’s extra curricular activities, graduations, and in all probability, at your child’s wedding.  In fact, one day in all likelihood, the both of you will share grandchildren together.

Remember, how well your children cope with the divorce is mostly predicated on how well you, as parents, handle the divorce.  While the relationship may have boarded a flight south, both of you have the power to disembark without your baggage and allow it to travel south by itself.  What a wonderful idea…unclaimed negative baggage on the carousel, remaining forever unopened.

Walt Liebman, Ed.S., is a marriage and family therapist in private practice in South Miami, President elect of the Miami Dade Association of Marriage and Family Therapists and an instructor at Miami Dade College and can be reached at waltliebman@famtherapy.com or by calling 305.665.4177.

Marriage & Couples Counseling: “And with this ring, I am ready to wed…I think”

“And with this ring, I am ready to wed…I think”

 BY WALT LIEBMAN, Ed.S.

What makes for a good relationship?  I often wonder that.  Can you spot the couple that has one as soon as you meet them?  Can you see it in the way they look at each other, in their touch, and how they speak with each other?  In spite of what the majority of the “how to have a perfect marriage” books say, it is not easily defined and unfortunately I find so many of these books repetitive, self serving and ineffective.  While the majority proclaim to have all of the answers, they obviously do not, else our divorce rate for first marriages would not be hovering around fifty percent for the past half century.

As a marriage and family therapist for the past twenty nine years and an instructor at Miami Dade College in courses covering relationships, marriage, couples communication skills and divorce, I have found that “good relationships” are not easily defined and in fact often may be a mystery in what makes them work.

What are the ingredients for an edifying, loving, and nurturing relationship?  Obviously we should start with the four basic ingredients: effective communication, trust, respect, and a willingness to resolve differences via compromise and negotiation enabling both parties to win.  If we enter into a relationship without all four, it is comparable   to erecting a high rise with cracks in the foundation.  Into the mixing bowl, let’s add dedication, commitment, picking and choosing your battles, and an agreed upon definition of romance, intimacy, financial responsibility and child rearing.  Lastly, and just as important, forget about the notion of adding the desire to change the other person.

While a relationship may be the most difficult task that we ever embark upon, its rewards may be tenfold as long as our expectations are realistic.  Unfortunately, some may think that it is similar to purchasing a new car, whereupon we open the door, smell and feel that rich soft leather, recline in our seats and take our forefinger to push that cruise control button, thinking that we will coast for the duration of our marriage.  If this is the case, we may find ourselves cruising into divorce court.  Sadly, the average length of marriage today is only eight years.  Once a year I have my physical examinations and every six months I visit the dentist.  I even bring my car in for servicing a couple of times per year.  Doesn’t your relationship merit the same care and consideration?  It is so very important to take preventive measures to periodically examine its status.  Seek your spouse’s opinion of your relationship and what you both can do to maintain its dynamic vibrancy.  Or, if you feel improvement is needed, you may want to consider enrolling in a marriage retreat, or entering marriage counseling.  Hopefully your objective is to resolve the problem, should one exist, in lieu of blaming the other. 

With all of these delectable ingredients, it has to taste better than…than chocolate mallow mar cookies.

Walt Liebman, Ed.S. is a marriage and family therapist and parent coordinator in private practice in South Miami and an instructor at Miami Dade College.  Additionally, he is a member of the Collaborative Family Law Institute and President-elect of the Miami Dade Association of Marriage and Family Therapists.  He may be contacted at waltliebman@famtherapy.com or by calling 305.665.4177. http://www.famtherapy.com