Teaching Children to be Grateful for Daily Gifts

The Holidays are here and many people, especially parents, are worrying about what gifts to buy people. However, you do not always need to buy a gift to show that you care for someone.

Gratitude is an important lesson and gift for children. What some parents may want to do is instead of buying your child a large number of gifts is to teach them about gratitude. In the United States, we have many children who are homeless and hungry. Yes, in the United States, we do have homeless children. We also have many children who have more toys than they need and are unaware that there are children who are homeless. Therefore, at this time of year, take your child to the store and use some of the money you would have used to buy them gifts and have your child buy gifts for a homeless child. While doing this teach your child about the fact that there are others in need and to appreciate what they have in their lives. Also that giving can be more important than receiving.

Furthermore, I read an article by Joshua Becker and he listed gifts that parents give to their children every day and that children usually do not forget these gifts. I think it is important for parents to remember the daily priceless gifts we give children daily. Especially during this time of year,

Here are some of Joshua Becker’s thoughts. I have countless holiday memories. Very few childhood memories actually include the gifts I received. I distinctly remember the year that I got a blue dirt bike, the evening my brother and I received a Nintendo, and opening socks every year from my grandparents. But other than that, my gift-receiving memories are pretty sparse. Which got me thinking… what type of gifts can we give to our children that they will never forget? What gifts will truly impact their lives and change them forever?

To that end, here is an alphabetical list.

35 Gifts Your Children Will Never Forget:

1. Affirmation. Sometimes one simple word of affirmation can change an entire life. So make sure your children know how much you appreciate them. And then, remind them every chance you get.

2. Art. With the advent of the Internet, everyone who wants to create… can. The world just needs more people who want to…

3. Challenge. Encourage your child to dream big dreams. In turn, they will accomplish more than they thought possible… and probably even more than you thought possible.

4. Compassion/Justice. Life isn’t fair. It never will be – there are just too many variables. But when a wrong has been committed or a playing field can be leveled, I want my child to be active in helping to level it.

5. Contentment. The need for more is contagious. Therefore, one of the greatest gifts you can give your children is an appreciation for being content with what they have… but not with who they are.

6. Curiosity. Teach your children to ask questions about who, what, where, how, why, and why not. “Stop asking so many questions” are words that should never leave a parents’ mouth.

7. Determination. One of the greatest determining factors in one’s success is the size of their will. How can you help grow your child’s today?

8. Discipline. Children need to learn everything from the ground-up including appropriate behaviors, how to get along with others, how to get results, and how to achieve their dreams. Discipline should not be avoided or withheld. Instead, it should be consistent and positive.

9. Encouragement. Words are powerful. They can create or they can destroy. The simple words that you choose to speak today can offer encouragement and positive thoughts to another child. Or your words can send them further into despair. So choose them carefully.

10. Faithfulness to your Spouse. Faithfulness in marriage includes more than just our bodies. It also includes our eyes, mind, heart, and soul. Guard your sexuality daily and devote it entirely to your spouse. Your children will absolutely take notice.

11. Finding Beauty. Help your children find beauty in everything they see… and in everyone they meet.

12. Generosity. Teach your children to be generous with your stuff so that they will become generous with theirs.

13. Honesty/Integrity. Children who learn the value and importance of honesty at a young age have a far greater opportunity to become honest adults. And honest adults who deal truthfully with others tend to feel better about themselves, enjoy their lives more, and sleep better at night.

14. Hope. Hope is knowing and believing that things will get better and improve. It creates strength, endurance, and resolve. And in the desperately difficult times of life, it calls us to press onward.

15. Hugs and Kisses. I once heard the story of a man who told his 7-year old son that he had grown too old for kisses. I tear up every time I think of it. Know that your children are never too old to receive physical affirmation of your love for them.

16. Imagination. If we’ve learned anything over the past 20 years, it’s that life is changing faster and faster with every passing day. The world tomorrow looks nothing like the world today. And the people with imagination are the ones not just living it, they are creating it.

17. Intentionality. I believe strongly in intentional living and intentional parenting. Slow down, consider who you are, where you are going, and how to get there. And do the same for each of your children.

18. Your Lap. It’s the best place in the entire world for a book, story, or conversation. And it’s been right in front of you the whole time.

19. Lifelong Learning. A passion for learning is different from just studying to earn a grade or please teachers. It begins in the home. So read, ask questions, analyze, and expose. In other words, learn to love learning yourself.

20. Love. …but the greatest of these is love.

21. Meals Together. Meals provide unparalleled opportunity for relationship, the likes of which can not be found anywhere else. So much so, that a family that does not eat together does not grow together.

22. Nature. Children who learn to appreciate the world around them take care of the world around them. As a parent, I am frequently asking my kids to keep their rooms inside the house neat, clean, and orderly. Shouldn’t we also be teaching them to keep their world outside neat, clean, and orderly?

23. Opportunity. Kids need opportunities to experience new things so they can find out what they enjoy and what they are good at. And contrary to popular belief, this doesn’t have to require much money.

24. Optimism. Pessimists don’t change the world. Optimists do.

25. Peace. On a worldwide scale, you may think this is out of our hands. But in relation to the people around you, this is completely within your hands… and that’s a darn good place to start.

26. Pride. Celebrate the little things in life. After all, it is the little accomplishments in life that become the big accomplishments.

27. Room to Make mistakes. Kids are kids. That’s what makes them so much fun… and so desperately in need of your patience. Give them room to experiment, explore, and make mistakes.

28. Self-Esteem. People who learn to value themselves are more likely to have self-confidence, self-esteem, and self-worth. As a result, they are more likely to become adults who respect their values and stick to them… even when no one else is.

29. Sense of Humor. Laugh with your children everyday… for your sake and theirs.

30. Spirituality. Faith elevates our view of the universe, our world, and our lives. We would be wise to instill into our kids that they are more than just flesh and blood taking up space. They are also made of mind, heart, soul, and will. And decisions in their life should be based on more than just what everyone else with flesh and blood is doing.

31. Stability. A stable home becomes the foundation on which children build the rest of their lives. They need to know their place in the family, who they can trust, and who is going to be there for them. Don’t keep changing those things.

32. Time. The gift of time is the one gift you can never get back or take back. So think carefully about who (or what) is getting yours.

33. Undivided Attention. Maybe this imagery will be helpful: Disconnect to Connect.

34. Uniqueness. What makes us different is what makes us special. Uniqueness should not be hidden. It should be proudly displayed for all the world to see, appreciate, and enjoy.

35. A Welcoming Home. To know that you can always come home is among the sweetest and most life-giving assurances in all the world. Is your home breathing life into your child?

Of course, none of these gifts are on sale at your local department store. But, I think that’s the point.

Dr. Michael Rubino has 20 years experience working with teens and their parents. For more information about Dr. Rubino’s work and his private practice visit his website at www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3. 

Mental Heakth Issues and the Holidays

For many people the Holidays can be a stressful time.  For some people there is the stress of not having enough money.  For others, they lost a loved one this year and this is the first Holiday without their loved one. For others, there are family issues that make this a difficult time of the year. Finally, for people with mental health issues, the Holidays can be a very difficult time.

For people with mental health issues the Holidays can be difficult for many reasons.  They may be dealing with family issues, financial issues or not feeling happy.  Not feeling happy can be difficult because everyone is supposed to be happy during the Holidays.  At least this is what we are told by society.  Also some people with mental health issues may find the Holidays difficult because their condition is not stabilized yet or the Holidays can be a trigger for their mental health issues.  I see this with the patients I work with who are Bipolar or patients who are dealing with eating disorders.  Just to name a couple of mental health issues that are triggered by the Holidays.

People who are suffering with mental health issues that are triggered by the Holidays need support and understanding. You cannot just tell them to pull it together or to take a pill.  It is not that easy for them.  If it was, they would automatically take those steps on their own to solve the situation.

There are some things that people with mental health issues can do that may help them.  Dr. Pooky Knightsman, who deals with her own mental health issues, describes some of these options in her video.  I have included a link to it so you can watch it.  If you have a loved one who has mental health issues, please watch this video and may be you and suggest some of these ideas to your loved one.  If they work that would be fantastic for the person coping with mental health issues.  If they do not work, please understand the person is not having issues on purpose.  If you love them you need to be patient and understanding and help them through this difficult time.  Here is the link to Dr. Knightsman YouTube video https://youtu.be/ch5JLIYyPtU.

Dr. Michael Rubino is a psychotherapist with 20 years experience treating children and teenagers many of them are Bipolar.  For more information regarding Dr. Rubino’s work or his private practice visit his website www.RubinoCounseling.com.

The Teenage Suicide Epidemic

Suicide is at an epidemic rate in the United States.  According to the CDC it is the third leading cause of death for children between the ages of 10 to 18 years old.  Using a gun in the third most common method of suicide in the United States.  For boys it is the most common way to attempt suicide (CDC).  For many people this may not be surprising.  However, it is time that we seriously try to prevent children from attempting suicide and eliminate this epidemic.

The problem with eliminating this epidemic is the access to mental health care and the stigma society places on mental health care.  As a psychotherapist who treats suicidal teenagers, I have run into numerous difficulties with insurance companies when I have a suicidal teenager or child.  Many insurance companies will only allow the child to be seen once a week.  If the child is acutely suicidal, they usually need to be seen twice a week.  Many parents can barely afford their copayments and cannot pay for an additional session on their own.  This places a great deal of stress on the parents and places the child in danger.

Some people will say the teen should then be hospitalized.  This is not an easy answer either.  There are not many pediatric or adolescent inpatient psychiatric units in our area.  I have had numerous situations where a child or teen may spend over 48 hours in an emergency room because there are no inpatient beds at any of the psychiatric units.  In fact, one Thanksgiving I had a mother page me and I had never seen her son before.  He was suicidal, but the hospital said they had no beds and gave her my number to call and told her she had to leave the hospital.

If a teenager is hospitalized, often they are only allowed to stay 72 hours and then discharged home.  They have to be discharged because the insurance will not authorize more time.  It doesn’t matter what the psychiatrist on the inpatient unit recommends.  The insurance makes their own decision based on the treatment guidelines.  Again this places the child in danger and creates a great deal of stress on the family.  Often parents give up and accept the insurance companies decisions.  It is too much dealing with a child who wants to die and getting the run around by your health insurance that you have been paying high premiums to for years.  Additionally, many times the child or teen is discharged back into my care but I am never notified by the insurance company or hospital and the insurance company does not want my opinion, but they discharge the teen to me for psychotherapy treatment and to monitor.

In addition to the access to mental health care there is the negative stigma associated with it.  Many parents wait a few weeks before bringing their teenager to be assessed for suicidal thoughts.  They do not wait because they are bad parents, they wait due to the shame.  If there child is diagnosed as depressed they are afraid about how people will react to their child and them.  In fact, if a child is out of school due to being hospitalized for being suicidal, we instruct the school administrators to tell the staff the teen was out due to appendicitis or a death in the family.  They are afraid if teachers or students find out the teen was suicidal that people will think the teen is crazy and not want to associate with the teenager.  This may sound bizarre, but it’s true.  Most patients schedule their psychotherapy appointments at times when no one will notice they are gone and try to come into the office without anyone seeing them.  Our society has a very strong negative stigma about mental health.  Many people with mental health issues have difficulty making friends, finding jobs or just being treated as a normal person, if others know they have mental health issues.  This stigma is causing many people not to seek help.  As a result, many teens due commit suicide because they kept their feelings a secret.  They did not want to be labeled a “freak.”  However, this stigma is ruining the lives of many children and teenagers and destroying numerous families.

Mental health care is no different from physical health care.  No one is ashamed of being diabetic so why should a teen have to be ashamed of having depression?  We must demand that insurance companies treat physical and mental health care the same.  Additionally, our society needs to treat them the same and not be afraid of someone who is depressed or embarrassed if you are diagnosed with depression.

Finally, the last issue I want to address is the method many teenagers use.  Many teenage boys use guns because they believe no one can stop them and it is guaranteed to work.  However, this is a myth.  Guns have a strong kick to them when fired and often move slightly.  Many teenage boys try to commit suicide with a gun and instead of committing suicide, they shot their face off.  Instead of dying they end up in ICU in worse condition having to undergo numerous surgeries and being scared for life. This is one reason why we need sane gun laws.  We have laws about how old you have to be to drive or smoke.  We also have laws mandating that we must where seat belts.  We have these laws because research has shown they make us safer.  These laws have not restricted our freedom so sane gun laws will not restrain our freedom.

The ABC News show 20/20 did a story about a young man who was depressed and finally attempted suicide with a gun.  It goes into all the difficulties he faced when the gun moved. He was fortunate because he was eligible for one of the first face transplants.  However, this story shows the destruction that occurs when they use a gun as their method of suicide and it fails.  Please watch and see what this young man and his family must undergo.  While watching the after effects of this failed suicide attempt, think about how senseless it is the millions of teens and families undergo this situation when it could have been prevented if they were not ashamed and had easy access to mental health care. Please watch this show,  26-year-old's incredible face transplant journey: 'I see me' - ABC News - https://abcn.ws/2OLXuL5 via @ABC.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and children.  He is an expert at treating suicidal children and teenagers.  For more information about his work or private practice or if there is an issue you would like him to address visit his website www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3. 

Why Parents Cannot Be Their Teenager’s Friend

Many parents worry because their teenager talk more to their friends than to them.  Often many parents feel like a failure because their teenager is spending more time with friends than them.  This subject is one I hear daily in my office.  Parents are concerned that if their teen is spending too much time with friends, then if their teen is involved with drugs or other issues, they will find out too late.  Unfortunately, many parents tell me they have decided that, “”I am going to be my teenager’s best friend” as a way prevent these problems.

Wrong!! You do not want to be your teen’s friend.  You need to be your teen’s parent.  Your teen has enough friends. Your teen doesn’t need another friend, they need a parent.  They need someone to educate them about life and how to make decisions.

Remember, as a parent it is your responsibility to help guide your teen to be successful as an adult and in life as a productive member of society.  This means at times you will have to set firm boundaries, educate them about life and sometimes tell your teen no.  It is important to remember being a parent is not a popularity contest. You must set appropriate limits for your teen which means at times they will be mad at you.  It is okay if they are mad at you.  This is part of the process a teenager experiences as they are maturing into an adult.

Despite what they say, most teens want and like boundaries.  At times they can be very helpful to your teen. They may be faced with a great deal of peer pressure to do something that they do not want to do and they can use you as the excuse why they cannot do it.  Some may say this is immature because the teen is using their parent as an excuse, but we put our teens in a very, very difficult world so I think they are allowed some extra help now and then.

Another reason why should you not be your teen’s friend because your word and rules will mean nothing to your teen, if you are their friend.  A friend is defined as a close associate.  In other words, teenagers see their friends as equals.   Now think about what this implies, if you are equals, you are on the same level as your teen.  Therefore, they think they know as much as you do and since you are equals they can choose to follow your rules or ignore them as they see fit.

I run into this problem daily in my office.  A parent will say “we have always been best friends, I talk to my teen and their friends about everything and we have good times together hanging out.  I don’t understand why they disregard my authority as their parent.”

The answer is simple: you eliminated your authority as the parent and made yourself an equal as a friend. If you want your teen to respect your authority as the parent, you must remain the parent and not be the friend.

Consider the decisions these teens have to make every day. They are faced with issues regarding alcohol, drugs, sex, gangs and decisions about careers in their future.  Teens live in a very difficult and complex world today.  They need parents to help set appropriate boundaries and guide them so they make the best choices for themselves and avoid a great deal of trouble.  You can only do this as a parent. Remember, as a parent you are not in a popularity contest. You have a responsibility to help guide your teen.  If you want to help them survive high school then be the parent and make the tough, unpopular decisions that are in your child’s best interest. This will help your teen to respect you and the rules you made earlier you can enforce.  If you set yourself as friend and equal, your teen loses respect for you, your advice and your rules. You find yourself powerless and you leave your teen on their own to decide what is appropriate behavior.

This is a difficult time for you and your teenager, but if you maintain your role as parent and your teen maintains their role as child you both will survive high school easier.  Of course there will be difficult moments, but nowhere near as difficult if you blur the relationship boundaries.

Dr Michael Rubino has over 20 years experience working with teenagers and their parents. He is well respected in the community. To learn more about his work or private practice, visit his website at www.rcs-ca.com. You can also email him from this website, if you have questions. 

Teenagers Need Sleep for their Mental Health

School is back in session and the Holidays are upon us and we are no longer on daylight savings time.  The excitement of the Holidays, days off from school and changing the clocks may disrupt the sleep pattern of many elementary, middle school and high school students. Many children and especially teenagers will have activities where they need to stay up later.  This can disrupt their sleep pattern and they may be getting less sleep during the Holidays.  Sleep is very important for children and teenagers.  In fact, research shows that sleep has a big impact on our mental health and physical health.  Research has shown that sleep deprivation can cause a person to  suffer a psychotic break or if the depreciation is really severe it can even result in a person’s death.  I recently received some very good information regarding sleep and mental health.  It was provided by Jenny Thompson who is associated with www.bettermattressreviews.com.  I think it is valuable information for everyone so I have provided it below.

Mental health and sleep are closely related. Sleep problems frequently accompany mental illness, and can even be the first warning sign of a disorder. In turn, lack of sleep worsens mental health symptoms, creating a vicious cycle.

Mental illness is common, with almost 20 percent of Americans suffering from at least one mental health disorder. While only 10 to 18 percent of the general population experience sleep issues, as many as 50 to 80 percent of people with mental illness have trouble sleeping.

Mental health disorders are the largest cause of insomnia. 40 percent of insomniacs and over 46.5 percent of hypersomnias have a comorbid mental health disorder. On the other hand, only 16.4 percent of people have a mental health disorder without any kind of sleep issues.

Sleep problems are closely correlated with ADHD, anxiety disorders, bipolar disorder, depression, and schizophrenia. Below we’ll review how sleep affects several mental health disorders, and provide tips for getting better sleep.

Schizophrenia and sleep

Schizophrenia affects 1 percent of people, or 3 million Americans. Onset often occurs in late adolescence or the early 20s. Individuals with schizophrenia suffer from psychoses such as delusions and hallucinations, and experience difficulty focusing their thoughts and expressing themselves.

Up to 80 percent of people with schizophrenia have sleep problems, including:

Irregular sleeping hours. They may fall asleep anytime during the day or night rather than during the typical overnight sleep period of most people. They may have consistently delayed melatonin release that shifts their sleep pattern later than normal, slowly shift their circadian rhythm later and later each day, or follow no consistent sleep-wake patterns at all.

Irregular sleep quantity. They may get too much (hypersomnia) or too little (insomnia) sleep, as a result of medication side effects, fear or anxiety due to hallucinations (which may cause them to sleep more to escape, or conversely to be afraid of nightmares), or the irregular sleep hours cited above.

Sleep apnea. Individuals with sleep apnea literally stop breathing during the night, due to blocked airways or a miscommunication between the brain and the breathing muscles.

Less refreshing sleep overall. Due to the issues described above, people with schizophrenia experience less refreshing sleep overall because they have trouble getting sufficient amounts of REM sleep.

For many people with schizophrenia, an onset of sleep problems can be a warning sign that psychosis is starting or returning.

A 2012 study of mice found that abnormalities in the SNAP-25 gene are linked to schizophrenia as well as disrupted sleep-wake cycle, suggesting that resolving sleep issues may less or resolve schizophrenia symptoms.

Anxiety disorders and sleep

Generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social phobias, and PTSD are all associated with having anxious thoughts while trying to fall asleep at night and related insomnia.

Source: The National Academies Press

Panic episodes may waken an individual with panic disorder from sleep, thus disrupting their overall sleep quality. Likewise, individuals with PTSD are prone to vivid re-experiencing traumatic nightmares which heighten their bedtime anxiety and also cause interrupted sleep.

Individuals with mood and anxiety disorders may be prescribed various medications such as antidepressants and mood stabilizers which can further interfere with sleep.

Insomnia not only accompanies anxiety; it can cause it. When individuals experience chronic sleep deprivation, it disrupts their serotonin and gamma-Aminobutyric acid neurotransmitter levels, which can result in anxiety. One study found that having insomnia increased one’s risk to have yet another mood or anxiety disorder one year later.

Depression and sleep

Insomnia is one of the biggest risk factors for depression. Lack of sleep worsens mood, and the effect is even worse for individuals with a mood disorder. Depressed people with sleep issues have a higher risk of suicide than depressed individuals without sleep problems.

Treatment is also complicated. While antidepressants boost mood and alertness to help treat depression, that same alertness makes the insomnia persist – and not addressing the insomnia can make individuals less responsive to treatment. But certain prescription drugs for insomnia, like Rozerem, may worsen depression. The key is to find a treatment plan that helps both issues, but not at the expense of either.

Depression and sleep issues are bidirectional. That means the problems of one can worsen the other. The good news is, that also means the improvement of one often fixes the other. For example, 35 million Americans suffer from mild depression (dysthymia). For many, their comorbid insomnia goes away once they begin taking antidepressants.

Bipolar disorder and sleep

Bipolar disorder affects 3 percent of Americans, or 6 million adults. In addition to severe changes in mood, behavior, and energy levels, individuals with bipolar disorder may also experience the following sleep problems:

Insomnia, or difficulty falling or staying asleep

Hypersomnia, or oversleeping, especially during depressive episodes

General sleeplessness, where individuals feel fine even when they’ve had significantly less sleep, although this abnormal sleeping pattern eventually catches up with them

Delayed sleep phase syndrome, where the individual has a delayed circadian rhythm, causing them to naturally start to fall asleep or wake up later than others and experience excessive daytime sleepiness as a result

Irregular sleep-wake patterns from manic episodes and related hyperactivity at night

REM sleep issues like vivid nightmares

Sleep apnea affects one-third of individuals with bipolar disorder, resulting in less restful sleep overall and excessive daytime sleepiness

For individuals with bipolar disorders, different sleep issues may arise depending on when they are in a manic or depressive state.

In fact, for 75 percent of individuals with bipolar disorder, sleep problems are one of the biggest warning signs that they are about to experience a manic episode. For example, sleep loss from chronic sleep deprivation or even a night of jet lag can induce a manic episode. Manic periods are so arousing that individuals can go for days without sleep, or sleep drastically less amounts than usual and not feel tired. However, that lack of sleep makes its mark in other ways, as they’ll still experience the other symptoms of sleep deprivation felt by everyone, including increased irritability, trouble focusing, reduce judgment, depressed mood.

As they enter depressive episodes, bipolar people may experience insomnia or hypersomnia, both extremes which cause further imbalances in mood and increased anxiety.

In between manic and depressive episodes, individuals with bipolar disorder experience poorer quality sleep, occasional insomnia, and interrupted sleep.

Sleep tips for individuals with mental health disorders

There are various psychotherapies that treat mental illness, sleep therapies for sleep problems, and other behavioral changes that can help individuals with mental health disorders sleep better at night.

1. Practice good sleep hygiene.

It all starts with good sleep habits. Good sleep hygiene includes keeping the bedroom cool, dark, and quiet, and limiting stimulating activity before bed, such as watching television, using the computer, or engaging in heavy exercise. Heavy meals, as well as alcohol, drugs, and caffeine, should be avoided in the early evening and late night hours.

2. Be careful with napping.

For individuals with excessive daytime sleepiness, power naps of 20 minutes can help give a sense of refreshment. However, naps longer than 20 minutes should be avoided as they can contribute to insomnia later that night.

3. Try sleep therapy.

There are various psychotherapy options that assist individuals with mental health disorders. There are also many specific therapies designed to treat comorbid sleep problems.

Cognitive behavioral therapy (CBT) has proven very effective for treating insomnia. CBT first helps the patient recognize their harmful or disruptive thought patterns and habits. Then, they learn to replace them with positive thoughts and better ways to cope so they can calm anxieties surrounding sleep as well as the rest of their lives. One study in particular found that six 20-minute sessions of CBT resulted in a nearly 50 percent decrease in insomnia, 20 percent decrease in depression and anxiety, and 25 percent decrease in paranoid thoughts, and 30 percent decrease in hallucinations.

Sometimes taught as part of CBT, meditation and deep breathing exercises can soothe anxious thoughts and help relax the body for sleep. You can find audio files of guided meditation and relaxation exercises on the MIT Medical website.

Sleep restriction therapy involves setting a strict bedtime and waketime, and only staying in bed for that allotted amount of time, regardless of how much sleep the individual actually enjoys. Eventually the body gets used to the new sleep-wake cycle and begins to sleep and wake at the proposed appropriate time. A small 2013 study found that sleep restriction therapy improved sleep and reduced symptoms of insomnia for patients with bipolar disorder.

Chronotherapy works similarly by gradually adjusting the bedtime and waketime. It’s a newer therapy and the research is still bearing out.

Bright light therapy helps reset a person’s circadian cycle and make them feel more awake in the morning. Exercising outside in the morning in areas of bright sunlight can provide a similar effect.

4. Explore natural remedies.

Melatonin supplements help kickstart melatonin production in the brain. These can be helpful for insomnia or anyone who has difficulty falling asleep due to a period of mania or delayed sleep-phase syndrome. Valerian root can also help induce sleep. Both melatonin supplements and valerian root are widely available at pharmacies.

5. Keep a sleep diary.

If you’re concerned you may have a comorbid sleep disorder, a sleep diary can help you track your sleep habits. Note when you fell asleep and when you woke up, the total amount of time you were asleep, and anything abnormal that happened during your sleep, such as nightmares or snoring. If you find you’re not getting enough sleep, you can meet with a sleep specialist for a diagnosis and share your diary with them.

You may also want to consult a mental health professional for an evaluation and/or your primary care physician.

Dr. Rubino has over 20 years experience as a psychotherapist treating children and teenagers. Many children and teenagers have undiagnosed sleep problems.  For more information regarding Dr. Rubino’s work or private practice visit his websites www.rcs-ca.com or www.RubinoCounseling.com or visit his Facebook page www.Facebook.com/drrubino3.