What do psychiatric medications do?

By Alice Kim, clinical pharmacist at CHOC Children’s

Mental health is an important part of overall health. Therapy is important, but sometimes, medication is necessary to improve or maintain our mental health. These psychiatric medications are safe and effective when taken appropriately under a doctor’s supervision.

Psychiatric medications influence the chemicals in our brains that regulate emotions and thought patterns. They can reduce symptoms such as loss of energy and lack of concentration, so therapy can be more effective.

Psychiatric medications include a variety of drugs prescribed to treat different types of mental health problems, or to reduce symptoms associated with these problems. There are five main types of psychiatric medication: antidepressants, antipsychotics, stimulants, anti-anxiety, and mood stabilizers.

Antidepressants help reduce feelings of sadness or depressed mood and anxiety as well as suicidal thoughts. They do not, however, “make people happy” or change their personalities. Possible side effects of antidepressants include drowsiness or insomnia, constipation, weight gain, tremors and dry mouth.

Antipsychotic medications help reduce or, in some cases, eliminate hearing unwanted voices or having very fearful thoughts. These medications can promote thinking clearly, staying focused on reality, and feeling organized and calm. They also can help you sleep better and communicate more effectively. Possible side effects of these medication include drowsiness, increased appetite and weight gain, blurred vision, constipation, dry mouth, dizziness, restlessness, shakes and twitches, and muscle stiffness. Rare side effects include seizures and problems controlling internal body temperature.

Stimulants and related medicines help improve concentration and attention spans in both children and adults by reducing hyperactivity and impulsiveness. Possible side effects include trouble falling asleep, decreased appetite and weight loss. Less common side effects can include headaches, stomachaches, irritability, rapid pulse or increased blood pressure. These often go away within a few weeks after stopping use or if your health care provider lowers your dose.

 Anti-anxiety medication can reduce anxiety and help you feel more relaxed. These medicines are generally safe when used as prescribed and usually are temporary, since long-term use can cause dependency. Call your doctor right away if you experience headaches, slurred speech, confusion, dizziness, increased nervousness or excitability when taking these medications.

Mood stabilizers help reduce or eliminate extremes of high or low moods and related symptoms. They should not keep you from experiencing the normal ups and downs of life, though. Side effects can include an upset stomach, drowsiness, weight gain, dizziness, shaking, blurred vision, confusion, or lack of coordination.

How to deal with side effects of medication

Side effects often get better with continued medication therapy. For side effects of mental health medication that linger, here are a few tips:

Side Effect What can be done
Dry mouth Try sugarless gum or mints
Constipation Drink plenty of water and eat lots of fruits and vegetables. Ask your doctor or pharmacist about over-the-counter laxatives.
Nausea or upset stomach Take your medication with a meal. Ask your doctor about anti-nausea medication.
Feeling sleepy Ask about changing the time when you take the medication.

Despite the prevalence of mental illness in the U.S. – one in five people have a diagnosable mental health disorder—an unnecessary stigma remains surrounding seeking treatment and utilizing prescribed medication. If you have a mental illness, know that you are not alone. For those without a mental health condition, educate people around you about the reality that mental illness is more common than people realize and speak out against stigma. By improving mental health education, we can challenge our misinformation and negative attitudes.

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 and to receive tips and education from mental health experts.

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Music therapy in a mental health setting

Music therapy has been part of CHOC Children’s specialized therapeutic programming for more than 10 years. The program has grown recently, due to increased awareness of its effectiveness and a growing need among CHOC patients. We sat down with Kevin Budd, a board-certified music therapist in CHOC’s Mental Health Inpatient Center, to discuss the benefits of music therapy in an inpatient psychiatric setting.

Q: Music therapy is more than just listening to music. What encompasses this practice?

A: Music therapy is the clinical and evidence-based use of musical interventions to accomplish individualized goals. This occurs within a therapeutic relationship between a credentialed professional who has completed an approved music therapy program, and a patient. During music therapy, we address physical, psychological, cognitive and/or social functioning challenges for patients of all ages. Essentially, we utilize evidence-based, musical interventions for non-musical outcomes; meaning music is the tool which helps support a patient’s non-musical need or goal.

Q: How does music therapy support clinical goals?

A: A patient’s clinical goal is the starting point for determining which musical intervention will be most effective. In the Center, these goals could include: mood regulation, self-expression, self-esteem, anxiety, interpersonal effectiveness, treatment motivation, positive coping skills, and more. There’s no one-size-fits-all treatment when it comes to music therapy within mental health. We might work towards their goals several different ways, including: focused music listening, songwriting, song discussion, group instrument playing, music and relaxation, singing, and many others.

For example, if a patient’s clinical goal is to increase identification of positive coping skills, we might work on lyric analysis within the patient’s preferred style of song. We could discuss triggers, resilience, and negative life situations in the song. During this lyric analysis, I can help navigate the discussion to include the patient’s interpretation of the musician’s experience and how it might relate back to their own life. After this discussion, we could rewrite the chorus of the song including identification of a negative situation and a positive coping skill to help address it. The patients can then be encouraged to share what they created— by singing, spoken word, or other creative means.

Within this exercise, not only has the patient identified a negative situation and how to better cope with it within a creative medium, they have experienced the active utilization of a positive coping skill, built up confidence after completing and sharing their creation, felt more connected with others in the group due to being vulnerable and feeling validated, improved their mood from the positive experience, and formed a sense of increased treatment motivation.

Music therapists utilize assessment, treatment planning, and evaluation to determine whether a patient’s current methods of music therapy are meeting their needs. Without treatment goals, there could be no effective music therapy.

Q: What kind of impact have you seen in mental health patients who have participated in music therapy?

A: In any setting, music has an instantaneous effect on our bodies — mentally, physically and behaviorally.

Patients have shared several stories about how music therapy has helped them with their clinical goals. It’s amazing how one musical intervention can address multiple goals.

Sometimes it’s hard for patients to verbalize past trauma or express their current struggles. But with music therapy, they can discuss a song that may relate to their current life situation— whether that be bullying, family problems, feeling hopeless, having anxious thoughts, or another stressor. During this process, patients may be able to process and verbalize more, since the lyrics are an easier gateway for expression.

During group instrument playing, patients who might have difficulty with interpersonal relationships are able to cohesively and successfully play music together in a positive and supportive space without the need to talk.

During group ukulele playing, patients can work on distress tolerance and problem-solving skills while persevering through a challenging task — and by the end, they have improved self-esteem.

Q: What is unique about music therapy in an inpatient psychiatric facility?

A: Music therapy can look different in the inpatient psychiatric setting than in other areas of the hospital.

Within the Center, goals for music therapy are focused on combatting the reasons why a patient is admitted— these could include suicidal ideation, depression, anxiety or other factors that keep these youth from participating in a healthy way in daily life. The goal of the MHIC is to stabilize these patients and provide them with as many resources as possible to cope with their mental health challenges.

Music therapy does just that and provides opportunities for patients to learn, process, practice and discover new skills through tailored music interventions such as group instrument playing, songwriting, music listening, song discussion, beat-making, singing, rapping, and many other techniques. The MHIC offers opportunities for group work, that allows for a diverse group of kids and teens to come together and express themselves in a supportive, safe and validating environment. Individual music therapy sessions are available to patients in the Center who need additional one-on-one support to complement their other treatment.

Q: Why did you want to become a music therapist? Why a mental health setting specifically?

A: I’ve gone through my own mental health challenges throughout my life, and I always found that music validated my journey. Music helped me distract myself and process my feelings. Music met me where I was in the moment and gave me hope. It also gave me a platform to express myself in ways I didn’t know how to otherwise.

When considering career paths, I wanted to find a way to harness the role music had played in my life in a therapeutic way. After receiving my undergraduate degree in music, I developed a special interest where psychology and music intersect—the space where music therapy truly breathes. I pursued my graduate degree in music therapy, and then became a board-certified music therapist.

I feel humbled and fulfilled to be able to support kids and teens at CHOC with the tool of music. By creating an authentic therapeutic alliance, I can support them through a harsh and challenging time in their lives. I am thrilled to be on the front lines of the music therapy program at CHOC Children’s and I look forward to supporting its growth and success in treating pediatric patients.

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 and to receive tips and education from mental health experts.

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Talk Openly To Your Kids About Bullying

Bullying continues to make headlines around the country.  In particular, cyberbullying has become an increasingly common and serious issue largely due to the easy access, and in some cases the anonymity, of digital devices.

CHOC Children’s offers the following tips to help you start a conversation with your child around bullying, and guidelines to help you and your child combat bullying.

Dr. Heather Huszti, chief psychologist at CHOC, says one of the best ways to protect your children from bullying is to talk openly about it. “Have a discussion about why some kids might be bullies,” she says. “You can explain that most bullies have low self-esteem and that they bully other people to try to feel better about themselves.”

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

Dr. Huszti suggests asking your child open-ended questions such as, “Is there anything going on?” or “Is there anything I can help you with?” This approach usually works better than firing off a list of specific questions.

If you learn your child is being bullied, here are some additional steps you can take:

  • Inform your child’s school about the bullying.
  • Talk with the bully’s parents about the behavior.
  • Help your child build up his or her self-esteem. The better your child feels about herself, the less effect a bully will have on her overall well-being.
  • Be mindful of your child’s online activity.
  • Have a plan. Talk about what your child might do if he or she is bullied, including who to tell.
  • Pay close attention to signs from your child that may show something is wrong, such as acting withdrawn, sad or irritable, or changes in their sleep or appetite. Keep in mind however, that sometimes kids will not display any signs at all so it’s important to keep an open dialogue with your child.
Learn more about CHOC’s commitment to mental health

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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.”

psychologist-tips-back-to-school-anxiety
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 and to receive tips and education from mental health experts..



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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.


Related posts:

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  • Music therapy in a mental health setting
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