​It is important to realize that not everyone needs medication to treat their mental health symptoms, and not everyone who needs medication will need it forever. The purpose of this article is to provide basic education about psychotropic medications, because I find that most of my clients who take psychotropic medications are under-educated about them, and many clients who do not take medications are scared to start for the same reason.

​Mental health disorders (anxiety, depression, bipolar disorder, etc…) are a result of chemical imbalances in the brain, specifically of the neurotransmitters serotonin, norepinephrine and dopamine.  These chemical imbalances can be endogenous (genetic factors, internally caused), exogenous (life events, trauma, external factors), or both.  Psychotropic medications work to create balance in neurotransmitters by adjusting how the receptors in the brain absorb the chemical, effectively reducing negative symptoms.  Different medications work on different neurotransmitters, and it varies individually what each person’s brain needs or will respond to, depending on symptoms and brain chemistry.  
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Antipsychotic Medications
Used to treat Bipolar Disorder, Schizophrenia, Personality Disorders, Severe Depression and Severe Anxiety.

Used to treat the mood swings of Bipolar Disorder, and sometimes to enhance the effect of other medications when treating Depression. Reduce excitability in the brain, to calm overstimulated and overactive neurons. Many anticonvulsant medications are used as mood stabilizers. Examples: Lithium (Eskalith), Depakote (Divalproex Sodium), Lamictal (Lamotrigine), Tegretol (Carbamazepine), Topamax (Topiramate), Trileptal (Oxcarbazepine)
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Used to treat Attention Deficit Hyperactivity Disorder (ADHD), increase dopamine and norepinephrine. Can be addictive and can easily form a dependence. Examples: Adderall (Amphetamine), Vyvanse (lisdexamfetamine), Focalin (dexmethylphenidate), Ritalin/Concerta (methylphenidate), Dexedrine (dextroamphetamine)
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While a licensed therapist or counselor may be knowledgeable about psychotropic medications, only medical professionals can prescribe them. The medical professionals with the most knowledge and training in prescribing psychoactive medications are Psychiatrists.  Psychiatrists are medical doctors (MD) that have completed residency and training in psychiatry.  Most psychiatrists do not engage in talk therapy; they focus on symptom and medication management in brief (15-20 minute) appointments.
 
Other medical professionals able to prescribe psychotropic medications are Primary Care Physicians (MD/GP), Physician Assistants (PA), Psychiatric/Mental Health Nurse Practitioners (PMHNP), Nurse Practitioners (NP), Certified Nurse Midwives (CNM), and Gynecologists/Obstetricians (OB/GYN).
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In my practice, for someone who is not currently taking psychotropic medications, I will generally recommend medications if we seem to continue hitting a wall with ongoing negative symptoms, despite all reasonable efforts to improve them.  If adding structure, recognizing and changing thinking, improving overall physical health, learning emotional identification and expression, and addressing spiritual health doesn’t improve symptoms markedly, this indicates to me that the symptoms are endogenous in nature, and need chemical help to mitigate.
 

All medications generally have some risk of side-effects, some more troublesome than others.  Speaking with your prescribing physician and doing your own research are important before starting on any psychotropic medication.  Most common side-effects for psychotropic medications are disturbances in sleep and appetite.  Some of these can be mitigated by adjusting the time of day they are taken (morning if the medication is activating to your brain at night), and taking them with food to reduce nausea.
 
Research has shown that the most effective treatment for mental health disorders is a combination of medication and therapy.  Taking psychotropic medications without including therapy will not result in lasting change and improvement in symptoms.  For real and sustained life change, medications can help provide enough of a lift or relief of symptoms so work can happen in therapy, to prevent recurrence of negative symptoms.
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References:
http://www.drugs.com
http://www.pdr.net

I've used this worksheet with my own children, with students I've taught, and with clients, both children and adults. Teaching kids to "tune in" to their bodies is an essential skill and doesn't always come naturally.

There are so many benefits to learning this skill! One is emotional regulation-- kids who can listen to their body have an easier time managing and coping with their feelings, especially the really big ones, like anger, disappointment, fear, frustration, guilt, sadness.. .

They feel more capable, confident, have a more secure sense of self.

They have less behavioral problems, better social skills with peers, more empathy and supportive relationships...

It's not just a skill for kids., Adults benefit in similar ways, too, with overall mental stability, positive sense of self, solid relationships, increased career satisfaction. 

Take a moment today to tune inward,. Breathe in for 4 seconds, hold for 7, and slowly release for 8. Then scan your body and really listen to what each body part is telling you. Maybe some are silent, while others are screaming!

That's ok, no judgement.

All you have to do is listen.

Click to download the PDF to use at home.

What exactly is anxiety? If you’ve ever heard of the “fight or flight” response then you’re halfway there. Imagine you’re alone walking through the woods and suddenly come face to face with a bear. Your heart starts pounding fast, your muscles tense, and your senses become intensely alert. For a split second you're paralyzed with fear. You must make a decision: defend yourself or run.

This is the fight-or-flight response.
 
And it's a completely normal reaction (we humans wouldn't be here without it.) Hundreds of years ago, when we were faced with a physical danger on a daily basis, it was a very important and well-needed response (for instance, to keep ourselves from getting mauled by a bear). In today’s world, most of our dangers are not physical. They’re psychological. And they can’t always be addressed the moment they come up. The longer our fight-or-flight response remains active, the more physically and emotionally drained we become.

​Long ago when there was an imminent physical threat, it usually passed quickly and our fight-or-flight response was deactivated. In our world, since there are so many potential psychological endangerments, sometimes the fight-or-flight response never really gets turned off. This is when a child may begin to see the world as a fearful place. They are stuck in “survival mode.” Not a fun place to be.

​Many parents believe that talking about anxiety will make their child even more anxious. The reality is, providing your child with information about anxiety can help reduce his or her confusion or shame. Understanding what causes anxiety can help children to overcome it. Use "kid terms" to help explain the fight-or-flight response. Discuss why it was helpful back then, how it can be helpful now, and how it can be equally detrimental. Helping kids understand that feeling afraid isn't the same as actually being in a dangerous situation is empowering and can help them feel more in control. 

​Always validate and show acceptance of your child’s worried thoughts and anxious feelings. Make sure your child knows you truly believe what they are saying and that having those scared/worried/anxious feelings is okay. Share some things you were anxious about as a child, and then ask them what their biggest worries are. If they don’t want to talk right away, give them ample opportunities to open up with you through play or downtime during their favorite relaxing or fun activities. 

​Anxiety manifests physically. Ask your child to show you where in their body anxiety occurs, and where it feels the worst. It can be helpful to have your child name their anxiety. For instance, a child could call his anxiety “Mr. Worry Monster” and learn to talk to that anxiety as if it were a person and tell him to go away when not welcome: “Mr. Worry Monster is back this morning, Mom, but since it’s time for school I’m not listening to him. I told him to go away!” Once kids are less afraid, it becomes easier to approach events and situations that have been previously avoided.

​Many children have little time to just “be.” They are easily distracted and tired, juggling school, family, community activities, sports, etc. Sometimes it can just be too much. By practicing mindfulness, kids learn to hit the “pause” button and become aware of how they are thinking and feeling in the present.  There are countless studies showing the benefits of mindfulness and it’s positive effects on our physical and emotional well-being, for both children and adults.​
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One basic exercise I use with my clients is called “Balloon Breaths.” I ask the child to pretend there is a balloon in his belly. Ask him to place his hands on his belly and breathe in slowly in through his nose to fill his lungs all the way up. Meanwhile, blow up the balloon to demonstrate how the “balloon in the belly” gets fully expanded. Next, ask your child to open his mouth and slowly blow all of the air back out, letting his belly sink down flat, as you slowly let air out and deflate the balloon. Some of my clients even carry a little deflated balloon around with them, in their pocket or backpack, as a simple reminder to take “balloon breaths” when they feel anxious thoughts and feelings coming on. By learning a few techniques like this, your child can be well on his or her way to overcoming anxiety. 

​Your child constantly observes and emulates your behavior. Your actions lay the foundation from which your is child building his own beliefs and understanding about the world. If you shy away from discussing mental health, so will your child. If you are open and accepting of your own anxieties and how to deal with them, then so will be your child. If you take time to make sure your emotional and physical needs are met, your child will learn that self-care is an important part of life. 
 
Overcoming anxiety can be a long road, but it can be done. With the consistent practice of mindfulness and other anxiety-reduction techniques, as well as practicing good self-care, keeping a positive attitude, your child can learn how to lower his or her anxiety level. Making an appointment with a local child therapist is often the most important first step. He or she can help facilitate this course with the family, and is often an invaluable teacher and guide in the process. 

Resources:
 
Banyan Tree Counseling: http://www.banyantreecounseling.com
 
Anxiety & Depression Association of America: http://www.adaa.org/
 
Child Mind Institute: http://www.childmind.org/
 
Worry Wise Kids: http://www.worrywisekids.org/
 
The Anxiety Disorders Association of British Columbia: http://www.anxietybc.com
 
KidsHealth: http://kidshealth.org/parent/emotions/feelings/anxiety.html

Some photos of Banyan Tree Counseling's space: Suite 203, 1348 Westgate Center Dr. Winston Salem, NC 27103. There is lots of growing, healing, thriving, playing, and difficult yet joyful work happening in this sacred space... Come join us!

From: Boggle the Owl