How teens can deal with bullying: Teen advisers weigh in

One in five students age 12-18 in the U.S. have experienced bullying, according to the National Center for Education Statistics and Bureau of Justice. More than 70% of young people say they have seen bullying in their schools. Kids and teens who are bullied can experience physical and mental health issues, and problems at school.

CHOC Children’s teen advisers share their own experiences observing and dealing with bullying, and what they do to cope. CHOC experts also weigh in on what parents can do to support a child who is being bullied.

Talk openly about bullying

One of the best ways to protect your child from bullying is to talk openly about it, says Dr. Heather Huszti, CHOC’s chief psychologist.

Dr. Heather Huszti
Dr. Heather Huszti, chief psychologist at CHOC Children’s

“Have a discussion about why some kids might be bullies. You can explain that most bullies have low self-esteem and that they bully other people to try to feel better about themselves,” she says.

CHOC teen adviser Heather Bisset, age 14, has seen this play out firsthand.

“When someone bullies another person, it is often because they are insecure and do not know how to emotionally handle it,” she says. “A bully does and says things to make others feel hurt or down, and if you do not show a response, they will most likely leave you alone.”

choc-childrens-teen-advisor-heather
Heather Bisset, a CHOC Children’s teen adviser

Dr. Huszti also recommends parents ask open-ended questions of their children such as, “Is there anything going on at school?” or “Is there anything I can help you with?”

She adds that this approach usually works better than firing off a list of specific questions and can facilitate a bond between parent and child that will encourage them to open up to you when something is affecting them.

Find a trusted adult to talk to

CHOC teen adviser Zoe Borchard, age 15, knows the benefits of having someone to talk to when you have been bullied.

“At a high school football game, a girl that I don’t even know called me stupid along with a bunch of other nasty words behind my back. When I heard what she had said, I thought it wouldn’t affect me at first, but it started to eat away at me. I walked away to a quieter area during halftime and called my mom. I told her what happened, and it made things a million times easier to process and even let go,” she recalls. “To this day, I’ll call my mom every time I need help. If you can find someone you trust to share your problems with, it lightens your emotional load and gives you room to breathe and feel better.”

choc-childrens-teen-advisor-zoe
Zoe Borchard, a CHOC Children’s teen adviser

Teens can look beyond their parents in finding someone to talk to.

“The best advice I could give someone who is being bullied is to talk to an adult you trust and know is willing to help you,” says CHOC teen adviser Carina Alvaro, age 16. “This could be a teacher who has openly expressed willingness to help, or another trusted adult who can help you resolve these problems.”

choc-childrens-teen-adviser-carina
Carina, a CHOC Children’s teen adviser

Teens and cyberbullying

Nearly 15% of high school students have experienced cyberbullying, according to the Centers for Disease Control. Cyberbullying can include text messages, instant messaging and other apps, social media or gaming.

CHOC teen advisers see a clear link between social media and bullying.

“Social media plays a part in bullying because it’s a lot easier to target someone and attack them online,” says Sanam Sediqi, age 16, a CHOC teen adviser. “On social media, everyone is hiding behind a phone or computer screen, so they more freely throw out hurtful comments towards the victim, often without actual consequences.”

choc-childrens-teen-adviser-sanam
Sanam, a CHOC Children’s teen adviser

CHOC teen adviser Layla Valenzuela, age 14, agrees.

“Having the power of technology comes with responsibility. When you send a message, people can’t see your face or hear your voice, so there is no way of conveying sarcasm or playfulness,” she says. “A simple joke could be interpreted in an unintentional, harmful way. Being responsible for everything you do online is a huge part of being considerate and staying away from bullying.”

choc-childrens-teen-advisor-layla
Layla, a CHOC Children’s teen adviser

Social media and technology use contributes to a rising number of mental health concerns in young people, says Dr. Christopher Min, a CHOC Children’s psychologist.

“Technology is great, but it has consequences, especially on our younger population,” he says. “it’s made teenage culture very unstable.”

Tips for staying safe online

Dr. Min offers the following tips for parents on how to keep kids safe online:

  1. Monitor teens’ social media use
  2. Encourage teens to get together in person
  3. Remember that parents control access to social media

For teens, his advice includes pausing before posting.

“When you’re ready to post something, pause for five to 10 seconds to consider your actions, the post’s meaning and the possible consequences,” he says. “This will help you avoid posting things you don’t want cemented on the internet forever.”

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Dr. Christopher Min, a pediatric psychologist at CHOC Children’s

What to do if your child is being bullied

There are several things parents can do if they learn their child is being bullied, Huszti says, including:

  1. Inform your child’s school about bullying
  2. Talk to the bully’s parents about the behavior
  3. Help your child build up their self-esteem. The more solid their self-esteem, the less impact a bully’s behavior will have on their overall well-being.
  4. Monitor your child’s online activity.
  5. Remind your child of the trusted adults in their lives in whom they can confide.
  6. Pay attention to signs in your child that show something is wrong, such as acting withdrawn, irritable or sad; or changes in appetite or sleep. Some children will show none of these signs, so an open dialogue with your child is key.
  7. If your child needs additional support, ask your pediatrician for a referral to a pediatric psychologist.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.



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Back-to-school anxiety remedies

Transitioning from carefree summer days into a structured school day can be stressful for children. From a change in environment to new names and faces, heading back to school can be a stomachache-inducing, palms-sweating time for many kids and teens.

Many parents wonder if kids are faking these feelings to get out of going, but back-to-school anxiety is a real phenomenon, says Dr. Christopher Min, a pediatric psychologist at CHOC Children’s. Back to school anxiety occurs when nervousness goes into overdrive, causing physical, behavioral or cognitive consequences that can impact a child’s mindset and ability to perform in school.

“It’s easy for us as adults to forget what it’s like to be a kid,” Min says. “It can be really scary.”

psychologist-tips-back-to-school-anxiety
Dr. Christopher Min, a pediatric psychologist at CHOC Children’s

A child’s job is to go to school, Min says, and their workload doesn’t simply include academics. School is where they learn and practice everything from social skills with peers and authority figures, to learning boundaries and appropriate behavior, to practicing physical activity, to selecting food on their own and eating without their parents.

“The likelihood that at least one of these things will create apprehension or anxiety in kids is great,” Min says. “So many things are packed into one environment.”

It’s important for parents to remember that children are just starting to learn these life skills when they’re in school.

“Not only are kids asked to encounter a multitude of new situations at school, but they’re still developing the skills necessary to succeed,” Min says. “They don’t have mastery of these skills yet; they’re still learning them.”

For parents struggling to determine whether their child is creatively avoiding school responsibilities or dealing with legitimate back-to-school anxiety, Min suggests looking for patterns in behavior.

Look back at their history with school, he says. What tends to happen in the weeks or days leading up to a new school year? How does your child adapt to changes? Does the behavior dissipate as the school year progresses?

“I like to empower parents and remind them that they are the expert on their children,” Min says. “Parents know their own children best. They know what their children do in provoking situations.”

Children are at increased risk for anxiety-based school refusal during periods of transition, such as when they start kindergarten, or move to a new school for junior high or high school, Min says.

“Every kid deals with school-based anxiety differently,” Min says. “However, boys tend to externalize their behavioral, such as acting out. Girls tend to internalize their behavior, which can be interpreted as being moody.”

Once their behaviors are identified, Min encourages parents to help their children cope with their anxiety by practicing easing into the school year.

“As adults, we wouldn’t go into a presentation at work, or show up for a marathon without preparing,” he says.

Kids tend to have a different sleep schedules and less structure during summer months, so in the weeks leading up to the first day of school, start to adjust their sleep and wake schedules.

Min also encourages graduated exposure, where parents can slowly introduce new routines in their child’s day.

“Practice their morning routine before school starts. You can even practice driving to school and show them where you will drop them off and pick them up,” he says.

Making small adjustments at home to help them prepare for the new school year will help them ease into the other transitions that come when school starts.

Although it can be stressful for parents to see their child struggling with a school transition, they shouldn’t immediately jump in to “rescue them,” Min says.

“With school avoidance, if you “rescue” a child or keep them home, that is detrimental because it reinforces their anxiety, and teaches their brain that school is a threat and something to be avoided.”

He encourages parents to partner with their child in managing their anxiety— while still going to school —and over time the anxiety will decrease with repeated exposure.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.


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Rent Choco’s boat and support mental health programs

Enjoy the Southern California weather on Choco’s custom boat and support CHOC’s mental health programs at the same time. A portion of every rental will support these programs, and a generous donor is making waves with a $50,000 matching gift.

choc-childrens-custom-electric-boat

For rental information, please visit the Lido Marina Village Electric Boat Rental website at eboatsrental.com to get started and select “Book Now.” Be sure to select the CHOC boat.

You can also sponsor a ride on the boat for a CHOC family dealing with a serious illness or injury. Two-hour vouchers/gift certificates can be purchased at the rental office or online at eboatsrental.com. For a tax-deductible gift, make your gift via check or online donation to CHOC Foundation and designate it towards “CHOC Boat Ride.”

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.



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6 major types of anxiety disorders

Anxiety is a normal human emotion and is part of life. Anxiety is only considered a disorder if it causes significant distress and/or keeps a person from keeping up with at least one part their life, including school, work, relationships, responsibilities or enjoyable activities. Anxiety disorders often persist over time and generally do not go away on their own. When anxiety disorders are left untreated, many people develop depression because of the toll that the anxiety has taken on their life. Anxiety is treatable by a mental health professional with short-term therapy if there are no other challenges or concerns.

We spoke to several pediatric psychologists at CHOC Children’s for an overview on the six major types of anxiety disorders.

 Phobias are intense fears of specific animals, objects or situations. This would include a fear of dogs, spiders, heights, blood draws, the dentist, or anything else. A person with a phobia either goes out of their way to avoid the feared objected or situation, or they face it, but they experience extreme distress. The fear has to last at least six months before it is considered a phobia. Children with age-appropriate fears are not the same as phobias; e.g., a 3-year-old who is afraid of the dark.

 Generalized anxiety is when someone worries about a range of different topics, which may include school or job performance, finances, world events, natural disasters, relationships with others, and other topics. These worries are hard to control and keep popping up, making it hard for people to focus on their activities. Worries happen often and intensely enough that they make it difficult to concentrate and may cause or worsen headaches, stomach aches, muscle tension, and irritability.

 Panic disorder is when someone experiences panic attacks that get in the way of their life in some way. Panic attacks can include any combination of sensations, including racing heart, rapid breathing, chest pain, dizziness, nausea or abdominal pain, blurred vision, sweating, shaking, feelings of doom, feeling like the world isn’t real (as though you are in a dream or a movie), or experiencing the moment as though you are outside of yourself. The person may also experience fear of losing control, or fear of dying or going crazy. Panic attacks can be triggered by something specific, or they can occur seemingly out of the blue. They usually reach their peak intensity within 15 minutes. It is important to note that someone can have panic attacks without having panic disorder. When someone has panic disorder, they either avoid situations that they think will cause a panic attack (such as going to the mall, going to the movie theater, or driving), or they experience ongoing worry that they will experience another attack. In the case of panic disorder, panic attacks should not be better explained by a specific phobia or by social anxiety.

 Social anxiety disorder (also known as social phobia) is a persistent fear of being judged or evaluated by others, accompanied by intense discomfort interacting with others. Someone may be intensely afraid of saying the wrong thing or feeling stupid or embarrassed. This anxiety can happen in just one specific situation, such as giving presentations at school, or in many situations wherein a child is very uncomfortable interacting with peers and adults. As a result, the person with anxiety may avoid interacting with others but still feel comfortable with close friends and family. The person with anxiety may also request that others speak for them, such as ordering food for them at a restaurant. There is a difference between shyness and social anxiety disorder. Shyness involves some minor discomfort interacting with people in certain situations, whereas social anxiety disorder actually gets in the way of the individual’s functioning at home, school, work or in their social circle. Occasional, fleeting discomfort in social situations is not necessarily an indicator of social anxiety disorder.

 Obsessive compulsive disorder (OCD) and Post-traumatic stress disorder (PTSD) used to be grouped with anxiety disorders, but now they are classified under their own category because they have unique causes, unique brain structures involved, and unique treatments that make them separate from anxiety disorders.

Separation anxiety disorder is when someone has persistent and excessive worry about being separated from or losing a caregiver or attachment figure. Separation anxiety can be a normal part of a child’s early development, but when the anxiety becomes excessive it can impair their development. Separation anxiety generates thoughts about what will happen to their caregiver when they are separated, such as whether the caregiver die or become ill. The individual also worries about what would happen to themselves if they are separated from their caregiver, such as will they get hurt or will something bad happen to them. Due to this heightened level of anxiety, the person can come across as “clingy” toward their caregiver and have difficulty leaving their side to go to school, be home alone, or go to sleep by themselves. Often, separation anxiety can occur after a stressor or loss. For example, for a young child after the loss of a pet, or for a young adult when they move out of their parent’s home for the first time.

The important thing to remember is that anxiety is both common and treatable. If your child is experiencing anxiety that is getting in the way of their activities or responsibilities (like school or chores), medical care, or relationships with others, consider reaching out to their primary care physician or a mental health provider about available treatment options.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

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What to do if my child is suicidal: 8 tips for parents

A serious public health problem, suicide is one of the leading causes of death in children and adolescents.

And while suicide and depression are interwoven, other triggers of suicidal thoughts and actions can include a romantic relationship breakup, failing in school, being bullied, or experiencing abuse, loss or other trauma.

Here’s what parents need to know about suicide prevention:

1. Know the warning signs

  • Pay attention to children talking about wanting to die or kill themselves, feeling hopeless, having no reason to live, or being a being a burden to others.
  • Suicide notes are a very real sign of danger and should always be taken seriously. These notes may be in the form of letters, emails, social media posts or text messages.
  • If someone has attempted suicide in the past, they are more likely to try again.
  • Watch for children making final arrangements like saying goodbye to friends; giving away prized possessions; or deleting social media profiles, pictures or posts.
  • Making sudden dramatic changes can be a sign too. Watch out for teens withdrawing from friends and family; skipping school or classes; becoming less involved in activities that were once important; avoiding others; having trouble sleeping or sleeping all the time; suddenly losing or gaining weight; or showing a disinterest in appearance or hygiene.
  • A suicidal child or adolescent may show an increased interest in guns and other weapons, may seem to have increased access to guns or pills, or may talk about or hint at a suicide plan.
  • Sudden risky behaviors can indicate suicidal thoughts. Watch for increased use of alcohol or drugs, showing rage or talking about seeking revenge. Self-injury is also a warning sign for young children and teenagers.

2. If you have any suspicion, ask your child if they are thinking about killing themselves. This will not put the idea into their head or make them more likely to attempt suicide.

3. Listen to your child without judgement and let them know you care.

4. Help your child stay engaged in their usual coping activities life family activities and sports.

5. If your child is in danger, stay with them or ensure they are in a private, secure place with another caring person until you can get further help.

6. Remove any objects that could be used in a suicide attempt like medications, guns, sharp knives, ropes or cords, or cleaning products.

7. If danger of self-harm or suicide is mounting, call 911.

8. Know your resources.

  • Find a therapist by calling CalOptima Behavioral Health at 855-877-3885 or checking with your insurance provider on its website or phone number printed on the back of your card.
  • Here are other ways to get help for a child having suicidal thoughts: Call the MHSA Suicide Prevention Line at 877-727-4747 or the National Suicide Prevention Lifeline at 800-273-8255. Text CONNECT to 741741. Call 911 or go to the nearest emergency department.
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