Ms. Nancy Louise Hornstein, M.D.

Often they are, particularly when combined with brief therapy. Its important if not responding to see a psychiatrist as opposed to primary care doctor to adjust the dosage or change which medication is used. It takes 2-4 weeks for a response to medication to occur

Social anxiety is a complicated psychiatric problem. Many people achieve partial or total relief by visiting a psychiatrist for a combination of medications and therapy. Its symptoms can wax and wane in severity of a persons lifetime. Some individuals may achieve total remission especially when they master some mindfulness techniques a therapist can teach you more about

If your child truly has attention deficit disorder, Ritalin can be a god-send. Often it enables a child to learn and behave in ways where he or she gets much more positive feedback from adults and peers. It must be carefully dosed and worked with to minimize negative side effects such as irritability when it wears off and loss of appetite. Research shows a better outcome for children with ADJD who receive a combination of stimulants and counseling. I have success stories galore of kids who were struggling at school and with peers who have become successful adults, college graduates and are now married with their own families without any bad effects. That being said, Ritalin is often given to children presenting with problem behaviors or learning who do not have ADHD. It is massively overprescribed and the true nature of the child’s problem is never addressed. The dosage is often not carefully titrated or regulated and little is done to help the child cope with side effects.

When given in error, much harm can be done as it’s like taking “speed” or “meth” if given to a child that does not have ADHD and can inhibit learning and lead to drug problems. In children who truly have ADHD, Ritalin has the opposite effect, slowing down their thinking so their mind isn’t racing and helps them pay attention. A single dose or several doses will rarely be detrimental, although occasionally a child will have a rapid heart beat and cannot take the drug. If a child has ADHD there should be marked improvement in the child’s ability to sit still and pay attention. If this effect is not seen, the diagnosis or dosage is off and should be attended to immediately.

In general, anxiety disorders such as social phobias, panic attacks, generalized anxiety are responsive to SSRI’s such as Zoloft, Paxil, Lexapro. Over a month period, the disorder vastly improves. This is coupled with anxiety management techniques. Medications such as Xanez (Alprazolam) or Ativan any short half life benzodiazepines should not be given. If the anxiety is too strong immediately, hydroxyzine may be given while waiting for SSRI to become effective. Buspirone or Buspar is also a useful anxiety blocker. Benzodiazepine sedatives are highly addictive and should not be given. Depending on your child’s diagnosis, the cause of anxiety determined by a child psychiatrist, other medications may be recommended.

The hormone changes of puberty may be playing a role, but remember, not all teens act this way in puberty. The hormone changes can trigger depression, which can lead to all these changes as can teen drug use which is widespread now even in this age group. Discuss these changes with your son's pediatrician or schedule a mental health evaluation. It is better to
intervene early with these symptoms.

Your daughter's symptoms could be quite serious, I would take her to her pediatrician for an evaluation immediately.

I would definitely take her to her doctor for an evaluation. Depression is much easier to treat when it is mild before suicidal ideation or a host of other complications arise. While everyone can experience moments of depression, ongoing depression is not normal and has profound negative consequences on self image self esteem and development

To some extent all teenagers become self involved as part of this period of development. Setting up a behavioral program focused on her earning points towards privileges for showing respect and consideration is much more effective than grounding. A behavioral therapist can help you set this up.

A behavioral program that seeks to reward her for controlling her anger would be the most helpful. A behaviorist can help you set this up for your daughter

The reasons for this type of nervousness can be many. Sometimes these symptoms are caused by a chemical imbalance and are helped by antidepressant medication. Other factors such as traumatic experiences could be playing a role. She should be evaluated by a child psychologist

I am concerned your son has gone a month without speaking to you after his father died. Without knowing your son's age or more information about your family’s situation or circumstances surrounding the father’s death, it’s difficult to answer. I’m surprised that your son has spent any time not talking to you due to his father’s death. In general, I would recommend that you and your son go to see a family therapist. The therapist may want to spend some time alone talking with your son before family therapy begins.

One of the most effective ways to encourage positive coping strategies is for your daughter to learn some breathing and relaxation exercises to use to help her get through episodes of anxiety. A counselor can teach them to her and you and they can be used for almost any age person from young children to old people. If your daughter is an older teen there are also a variety of APs available for phones that offer help doing these exercises. It’s important for you to remain calm and matter of fact. Anxiety is a feeling. It can’t in and of itself kill you. It can be pushed through. Anxiety can in a sense feed on itself and keep growing because the person suffering from it is afraid of the feeling. There are medications available that help correct chemical imbalances that may be part of causing people to suffer from anxiety. Try to stay away from addicting drugs such as Xanax (alprazolam) or Lorazepam as ultimately they create dependency and make the condition worse. Low doses of antidepressants such as Zoloft can often help as can medications such as Gabapentin. A psychiatrist can determine if medication is needed or refer you to a therapist that can help with managing anxiety.

Sometimes anger like that coming before or at puberty can be a manifestation of a chemical imbalance. Boys tend to show depression through anger whereas girls become irritable and emotional. At other times, it’s part of the maturational steps involved in separation and individuation that are occurring at this time. A child psychiatrist can assess your son and give advice as to how best help him with his anger. The school counselor may also be able to give you some direction with him.

The term means half-way between being asexual and sexual and is used to refer to someone who doesn’t have a sexual attraction to either boys or girls unless there is an emotional bond. It’s not an unhealthy way of being for an adolescent.

These symptoms do sound like panic or anxiety attacks, but can come from several underlying diagnoses. I would recommend starting with your pediatrician who needs to check his thyroid and labs then getting a referral to a child psychiatrist for an evaluation. His symptoms are painful enough it’s important to evaluate the cause and then get the right help for him.