Chapter 4 excerpt from my upcoming book “Handbook for Raising an Emotionally Healthy Child”
As I mentioned in previous blogs, I have been writing a parenting book. Well, I am about four chapters into it now and am feeling great about it. In fact, I have sent a query letter to a literary agent with hopes of representation. Because I am always eager to have feedback, I have decided to post an excerpt from the chapter that I just recently finished. So, enjoy and I look forward to you feedback.
Chapter 4: Adolescence
Adolescence (11 to 18 years)
Looking back over the last decade, you have successfully developed routines and you have managed transitions. You even survived temper tantrums and the influence of peers. But you ain’t seen nothing yet. I welcome you to adolescence.
Adolescence is best described by the opening line from the Charles Dickens classic, “A Tale of Two Cities.”
“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going direct the other way…”
Although Dickens was talking about London and Paris prior to the French Revolution, the words certainly hold true to adolescence. The relationship that you have developed thus far with your child will be put to the test, on a daily basis. There will be times when you look at your child and cry because they are so mature and adult-like. At other times, your adolescent will act so much like a toddler that you will cry, wondering how he or she will ever make it as an adult. There will be other times that your relationship with your child will be so strained, that you will cry because of what he or she said to you or did “just to spite” you. In other words, buy a lot of tissues and get that calming bath ready, because you need to be prepared for frustration and emotion like you have not yet seen.
Now, I am sure that there are those of you reading this who will say that I am exaggerating or being over dramatic. But there will be others who would say that I have said so far is not giving the turbulence justice. As a result, be aware that, like all other areas of development, there is some variability. As such, I will be speaking about adolescents in general, with a few examples, just to help with the points.
Globally speaking, adolescents present a set of challenges that many parents find difficult to tolerate. Parents are often torn between several potential roles. While they want to hold onto their historic roles of parent, authority, and decision-maker, they also find themselves wanting to befriend, bend, and let-go of their child. Many parents will swing between these roles, making them feel as though they are being ripped apart by their own decisions. As such, this may be the first time that you find yourself unsure as to what to say or do. Hopefully, you will find some comfort in knowing that most parents of adolescents are experiencing the same feelings. You should also be comforted in knowing that your adolescent is feeling exactly the same way. In fact, when I work with adolescents and their parents, one of the most common phrases I hear (from adolescents and parents alike) is, “I feel like I am bipolar.” Most of them do not truly mean that they are manic-depressive. Rather, they describe themselves as swinging between happiness to sadness, calmness to hostility, and enjoyment to anger. So, before we talk about some specific strategies for parents, let’s take a few minutes to talk about why this is such a turbulent time for everyone.
Piaget described adolescence as the Formal Operational Stage of development. During this time frame, adolescents continue to develop many of the cognitive skills that began in the Concrete Operational Stage. They begin to have the ability to think abstractly, logically, and in an organized manner, allowing them to think beyond the world of concrete reality and consider symbolism and abstraction. While some adolescents will have completely mastered this new perspective by the age of 15 years, others take longer to become fully able to utilize these skills consistently.
Some of you are probably flipping back to the beginning of this chapter. How can teenagers be capable of such advanced thought and consideration, but behave the way they do? Good question. Here is what I think causes all of the problems, emotion. Let me explain what I mean.
During adolescence, teenagers are attempting to create their own identity. They are developing their independent identities, which means that they must separate from you, their parent, and gravitate towards those who resemble what they see as their own ideal selves (their peers). While this sounds obvious, it is not so clear cut. On one hand, adolescents have their parents. Supports who have always been there for them and love them unconditionally. On the other hand, they have the wax and wane of friendships, relationships that they have to work on. Relationships that are very fragile and inconsistent.
Imagine standing at the base of a rocky cliff at the edge of the ocean. On one side you have the strength of immovable rocks and on the other, you have the ebb and flow of the powerful ocean. When the ocean is calm, you are able to stand with no problem. You can easily manage the rocks and the ocean. As such, you are calm. However, when the oceans are rough. As storms rage. When waves relentlessly crash against you, you find yourself drowning in the water, while your body pounds against the jagged and hard cliffs. You are anything but calm. You begin to panic, because now, everything around you is an enemy. You are unable to problem solve. You are unable to think about consequences. You simply want to survive.
In this analogy, the cliffs did not change, as a parent, you do not change. The ocean, your child’s friends, are ever changing, creating frustration and fear. Creating emotion. It is that emotion, the fear of losing those with whom they identify, that makes it impossible for them to consistently make appropriate decisions. This is the reason why you and your teenager can be getting along wonderfully one minute, but be screaming at one another the next. They are just trying to survive.
So as the winds of adolescence blow, we as parents have a choice. We can continue to be immovable and allow our children to crash against us, or we can be a solid foundation, while finding some flexibility in our expectations. Either way, parents must learn tolerance. You must be able to look beyond the immediate and remember that this is a marathon, not a sprint.
Update
I have not posted a blog in the last few weeks for several reasons. First, the holidays made it difficult to keep up with posts. I tried to cut back on “work” and just spend time with my family. It was great and we had loads of fun, but I am glad to be back at work.
The other big reason for my absence is that I have been working on a book. I am actively writing a parenting book that I hope to finish and have published within the year. It has taken a considerable amount of time, but it has been a great process. I have considered posting excerpts of it on this site, but I am cautious because I do not want anyone to take my ideas before I can get them published. As I continue to fight with myself about this, I will keep you posted.
Anyway, I will post more when I can. I am considering a few specific topics for my next real post, but I have not decided on one yet. If you have any requests, please feel free to ask.
Hope your New Year has been great,
Dr. B
How to Maintain Your Mental Stability Throughout the Holidays
The holidays are a challenging time for everyone. On the one hand, it is a time full of cheer, love, and celebration. Regardless of your beliefs, the holiday season is one of the few times of the year when families get together and spend time with one another.
Unfortunately, the holiday season is a very trying time for a lot of people, especially in the economically challenged times we are living in right now. As a result, I thought that I would write a quick post to discuss five things that you should do to help maintain your mental stability over the holidays.
1. One of the main reasons people struggle with the holidays is because of money. We feel obligated to buy gifts for others and usually spend much more than we intended. Most of the time, this is a stress that we impose on ourselves. No one says, “When you buy me a gift, make sure you spend a lot of money.” As a result, it is important to be economical and realistic about gift giving. For those outside of your family, a nice card is usually sufficient to express your love and appreciation for them. For those in your family, a family picture or other homemade gift could be given instead of a costly store-bought present. When buying for your children, I understand that gifts are “necessary.” However, remember that their expectations on gifts are only as high as you set them. That is, there is no reason to imply to them that they will get a $900 ATV when you can only afford a $50 remote control car. To give you a ball park, there are those who suggest spending no more than 1% of your annual income on Christmas gifts. Therefore, if you make $50,000 per year, you should only spend a total of $500 on gifts.
2. Another way people get stressed in the holiday season is because they become over committed. That is, they keep saying, “Yes.” Unfortunately, the more one says yes, the more one has to do. There are those families in which one person agrees to make dinner for the entire extended family. There are those families in which one person agrees to host three holiday parties and get-togethers. This stretches not only monetary resources, but also one’s mental and emotional resources. While I know that it is nice to be the one the rest of the family can rely on to make things happen, remember, that there are times in which the best thing that you can do for yourself, is to say, “No.”
3. Time is another huge issue for families this time of year. In fact, it is such an important issue, that it makes up 2 of the 5 issues that I am talking about. The first issue with time is related to how you delegate your time. Many people plan with the idea that there are 24 hours in a day. While this is true, there are in fact 24 hours in a day, it is important to remember that all 24 hours are not usable. You have to sleep and you have to eat. In all, you only have about 16 usable hours in a day, and that reduces to 8 if you work full time. Therefore, it is important that you delegate your time accordingly. Do not expect to do 8 hours worth of work in 2 hours. Be wise and don’t be afraid to ask for help!
4. The second time-related issue has to do with quality. A great deal of time can be saved if you use your time wisely. For example, when shopping for gifts, it is important to create a list of gifts before going shopping. If you are an internet person (if you are reading this post, I assume that you are), you know that most stores have websites. Explore websites to find which stores have the items on your list and make note of which stores you need to visit. This will save you considerable time, as you will not have to go store to store looking for a particular item. This quality use of your time will help with your frustration, save you time, and will probably even save you money!
5. Finally, to combat those holiday blues, it is important to remember the true reason for the holiday. Despite your heritage and particular celebratory activities, the holidays are here as a time of joy and cheer. They are not intended to see who can spend the most money, who can do the most for the family, or got the biggest present. The holidays are here to close out the year on a positive note. To reflect on the past year and make plans for the next. Sit with your family and talk about the good things that happened over the past year and come up with ideas for how to make next year even better!
I want to wish everyone a happy holiday and remember, if you aren’t happy, you can’t make anyone else happy!
Dr. B
What is ADHD, really?
A few days ago, I was working with a mother who was concerned that her son had ADHD (Attention Deficit Hyperactivity Disorder). She said that she knows “a little” about ADHD, but was not sure if ADHD explained some of the difficulties that her son was experiencing at home and at school. So, I thought that I would write a little about what ADHD is and, most importantly, what it is NOT.
Here is a little history about ADHD before we discuss what it is. ADHD is the newest label of a disorder that has been around for a long time. It has had many different names and children with impulsivity and restlessness was described in writings since at least the 1700’s. Prior to the 1960’s, many physicians believed that children with inattention, overactivity, impulsivity, and learning difficulties experienced some type of mild encephalopathy (which basically means a disease in the brain). They said “mild,” because these people, usually kids, had average to above average intelligence and were not “severely” impaired. Further, there were no true clinical findings of brain damage. As time passed, it became problematic to “suppose” that there was brain damage in these people. Therefore, in the late 1960’s, things began to change when several labels began to emerge to describe this condition. Clinicians began using labels such as “Minimal Brain Dysfunction,” or MDB, and “Hyperkinetic Reaction of Childhood” to diagnose individuals with average or above average IQ who experienced behavioral and learning difficulties. In the mid to late 1970’s, however, the label changed yet again. Around that time, there was a great deal of education reform occurring in the US. In fact, it was not until the mid 1970’s that laws were passed that required public schools to educate all children (remember that, prior to these laws, many children were not educated in schools). The passing of these laws necessitated a method for identifying children who had difficulties learning. It was at that time that learning disabilities were first truly identified. At the same time, the American Psychiatric Association was redefining “Hyperkinetic Reaction of Childhood” and first used the label “Attention Deficit Disorder with or without Hyperactivity.” As the education system defined learning disabilities, and the American Psychiatric Association defined ADD, the group of children previously diagnosed with MBD or Hyperkinetic Reaction of Childhood were split into one of the two groups, ADD or learning disabled, based upon their symptoms. ADD with or without Hyperactivity (which was typically abbreviated as ADD/H) was, again, relabeled in 1987, when the American Psychiatric Association referred to it as ADHD (Attention Deficit Hyperactivity Disorder). ADHD has been the title used for this condition since that time. ADHD has been around for a long time and has had many aliases over the years.
So, what makes up a diagnosis of ADHD? Well, you can Google (or Bing) “ADHD diagnosis” and have millions of hits (I just Googled it and got 3,870,000). Many of those hits will give you the criteria that professionals use to make the diagnosis. Therefore, to reduce repetition, I will just give you a summary. There are three subtypes of ADHD: Predominantly Inattentive Type, Predominantly Hyperactive/Impulsive Type, and Combined Type. The inattentive type suggests that the person has multiple symptoms of inattention. Typical symptoms of inattention include difficulty focusing, making careless mistakes, forgetfulness, misplacing things, etc. To meet criteria, a person has to have at least 6 symptoms of inattention (as defined in the criteria). The hyperactive/impulsive type suggests that the person has multiple symptoms of overactivity and impulsivity. Typical symptoms include acting as if “driven by a motor,” difficulty sitting still, fidgetiness, interrupting others, and acting without considering the consequences. To meet criteria for the hyperactive/impulsive type, a person must have 6 symptoms, as defined by the criteria. If a person must have 6 inattentive symptoms AND 6 hyperactive/impulsive symptoms, then they meet criteria for ADHD, Combined type.
While the symptoms mentioned above are the primary behaviors of ADHD, there are several other things that have to be present before a true diagnosis of ADHD can be made. First, there must be symptoms prior to the age of 7 years. A person, based upon the current diagnostic criteria made by the American Psychiatric Association, cannot be diagnosed with ADHD unless symptoms were present early in life. This, of course, creates some questions related to “Adult Onset ADHD.” It is certainly possible that a person can make it through their childhood and adolescence without being diagnosed as ADHD, only to be diagnosed with ADHD as an adult. However, to accurately make the diagnosis, the adult must report symptoms that existed before the age of 7. This creates some challenges, as there are many conditions that create inattention and forgetfulness that are not ADHD (i.e., depression and anxiety). Therefore, accurately diagnosing ADHD in adults is somewhat challenging.
The issue of age creates a similar problem when trying to diagnose children. It is becoming more common that I will have parents bring young children, 3-5 years old, to my office for an ADHD evaluation. I often resist making a diagnosis of ADHD in individuals that young, though there are some children who obviously have difficulties. For the remaining young children, however, ADHD-like symptoms is a way of life. Have you ever seen a kindergarten classroom? I am awed by those teachers! They must frequently change activities, keep the children engaged, and be entertaining for 7 and a half hours a day. Why? Because most of those children would easily lose their attention to task and become overactive if they were not constantly stimulated. It is not until children are 8 or 9 years old that we expect them to have calmed down and have the ability to focus on a task for more than a few minutes. Isn’t it interesting that it is around that time (2 and 3 grade) that we expect kids to be able to read chapter books and answer questions about what they have read? It is because most of them are not able to focus long enough until they are that old. It does not mean that they had ADHD!
The second issue that must be addressed before an accurate diagnosis of ADHD can be made is the need for the individual to have symptom related problems in more than one setting. The majority of patients that I see are self-referred. That means that they were not referred by another professional or by the school. In children, that means that I am seeing them because their parents feel as though there is a problem. I have often begun an ADHD evaluation with a child, only to find that the teacher has no concerns with the child’s behavior. The teacher indicates that the child can sit and focus, attend to task, and never gets into trouble for being out of his seat. Situations such as this rarely qualifies a child as being ADHD. Think about it this way. If a child has ADHD, it means that they CANNOT focus and attend. They have significant difficulty sitting still and resisting impulsive responses. If these are things that they CANNOT do, how is it that they can do it at school if they really have ADHD? The answer, they do not really have ADHD. Now I should note that I said it “rarely” qualifies for a diagnosis of ADHD. There are times when a fabulous teacher (there are a lot of them out there) is able to create a classroom setting that effectively manages children with mild ADHD. So, of course, this must be taken into consideration. Nonetheless, 9 times out of 10, if a child has behavioral issues at home, and there are no issues at school, it is not ADHD. It is something else.
The other scenario is when the child has problems at school and no issues at home. This one is a little more challenging. Sometimes children do not have any problems at home because there are no demands placed upon them. They do not have chores or homework. They do not have to do things that they do not want to do. In these situations, ADHD is still a possibility and further testing is needed.
This brings me to the last section to discuss, testing for ADHD. Today, ADHD is a condition that is diagnosed based upon clinical findings. Although there are researchers searching for some type of laboratory test to identify ADHD, it remains that the only way to test for ADHD is through neuropsychological testing and observations. In my clinic, I perform multiple tests to assess intellectual ability, academic achievement, executive functioning (a big topic I will discuss in a different thread. Just note here that ADHD is considered a disorder of executive function), and attention. In addition, I provide forms to parents and teachers to complete to assess ADHD behaviors at home and at school. For adults, I perform a similar battery of tests and provide them with self-report questionnaires (questionnaires that they fill out about themselves) and encourage them to have one of their parents help them complete a questionnaire that asks about their childhood.
ADHD is the most common psychological/psychiatric diagnosis made in children. Further, I believe that the number of ADHD diagnoses will continue to rise. Though I will save it for a different post, I believe that there are many things happening in education these days that are “causing” ADHD symptoms in children. As educational expectations rise, and fourth grade students continue to be asked to learn algebra and geometry, students are going to have ever more difficulty focusing and concentrating in school. Behavioral issues will continue to rise, not because more kids have ADHD, but because we are creating a setting that is not appropriate for them, developmentally. At many schools, kids can’t even talk at lunch any more! Wow, I will save that soap box for later …
Autism and Parent Training
I was not sure what I wanted to discuss for my first, truly mental health related post. There are many “hot topics” out there right now and there is so much to say about them all. Nonetheless, as I was making my decision, I was reading in the Journal of the American Academy of Child and Adolescent Psychiatry, which is THE JOURNAL for child and adolescent psychiatry. In the Journal’s December 2010 issue (yes, you will have somewhat of a jump start by reading this post) there is an article written by researchers at the NIMH Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. In this article, the authors describe the results of a study meant to compare the benefits of medication alone to medication plus parent training in reducing the behavioral issues associated with Autism, PDD-NOS, and Asperger’s Disorder (if you do not know the differences between these diagnoses, keep checking this site, as I will be posting other threads to describe them in more detail). In this post I will review the article as well as give you my own impressions and views.
In the article, the authors reported that there has been a significant increase in the use of medication in children with Autism and Autistic Spectrum Disorders (ASD) over the past few years. In fact, research suggests that 45 to 83% of individuals with ASD are prescribed medications. The most common medications prescribed are selective serotonin reuptake inhibitors (SSRI; e.g., Prozac), antipsychotics (e.g., Risperdal and Abilify), alpha 2 adrenergic agonists (e.g., Clonidine), psychostimulants (e.g., Ritalin), and anticonvulsants (i.e., Depakote). While most of these medications are used “off label” (meaning that they are not FDA approved for children with ASD), in October 2006, the FDA has approved the use of Risperdal (risperidone) for use in children with ASD who exhibit maladaptive and aggressive behaviors. Further, in November 2009 (just a few weeks ago) the FDA approved Abilify (aripiprazole) for use in ASD related irritability. Unfortunately, while these medications to be beneficial, research has shown that there are no lasting benefits once the medication is discontinued.
<<I want to add a brief note here. The last statement I made, regarding the lack of continued benefit once the medication is discontinued, should not be surprising to anyone. Medications do not teach skills. Medications do not teach right from wrong. All that medication does is make you “available.” I will spend more time on this issue in another post, but the primary purpose of medication is to stop a particular behavior or set of behaviors. Medication, in and of itself, does not teach appropriate behaviors!>>
Because medication has no long lasting gains once it is stopped, the researchers at RUPP Autism Network conducted a study to determine the benefits of adding a Parent Training (PT) program to the treatment of children with ASD. In this study, 124 children between the ages of 4 and 13 years participated. To be included in the study, the children had to have a diagnosis of Autism, PDD-NOS, or Asperger’s Disorder. In addition to other inclusion and exclusion criteria, the participants had to demonstrate clinically significant behavior problems.
As part of the 24-week study, all of the children were prescribed risperidone (though a few were changed to Abilify during the study as a result of poor response), but only a portion of the participants also received PT. This design allows for comparisons between two groups; the group where the children were just getting medication (MED) and the combination group where the children were getting medication and the parents were receiving PT (COMB). The researchers used multiple rating scales to assess behavioral issues, which were administered throughout the study to measure changes in the severity of the child’s behavior. Through this research study, the researchers hoped to demonstrate that risperidone treatment coupled with PT would be superior to risperidone treatment alone in reducing serious behavior problems in children with ASD.
The results of this study are very promising. Children in both groups demonstrated improved compliance, as reported by their parents. However, the COMB group reported greater improvements in compliance than those seen in the MED group. That is, although all of the children demonstrated improvement, children whose parents were in the PT program demonstrated greater improvement. Even more exciting was the fact that the children in the COMB group showed greater reduction in irritability. Again, although all of the children demonstrated less irritability, the children whose parents received the PT demonstrated the greatest improvement.
This study demonstrated, yet again, the benefits of behavioral and psychological treatments in the management of challenging behaviors. While medication is a useful tool for treating troublesome behaviors and emotions, the addition of psychological treatment (in the form of parent training, behavioral support, and therapy) results in greater, longer-lasting benefits. I frequently recommend my patients to prescribing physicians to determine if medication could be helpful for them. While I do not believe that medication is a “cure-all,” it has its place in helping the patient become “available” to the treatment I am providing. Once the patient has benefitted from my treatment, there is the potential that the medication can be reduced or even completely stopped. While all patients cannot be taken off of their medications, the additional benefits of psychological support are clear and well worth the additional treatment. Now, if only we could get the insurance companies to agree…
Here is the reference for those of you who would like to see the full article:
Aman, MG; McDougle, CJ; Scahill, L; Handen, B; Arnold, LE; Johnson, C; et.al. (2009). Medication and Parent Training in Children with Pervasive Developmental Disorders and Serious Behavior Problems: Results From a Randomized Clinical Trial. Journal of the American Academy of Child & Adolescent Psychiatry. 48 (12), p. 1143-1154.
Update on joining
I guess I should have included some of this information in my initial post. To join, you will click the Log In button at the top right area of the page. You will then want to click on Register. The site will ask for your username and will e-mail to you a password (please be sure to check your junk mail box). Once you log in, you will be able to change your username, password, and other profile information.
Sorry for the additional steps, but again, I hope that the site will be a comfortable place to find answers.
Thanks,
Dr. B
What is The Mental Breakdown?
Well, what does one write for their first blog? I guess I should pass along some information about the site that you have found. So, what is The Mental Breakdown?
I will start out by telling you a little about me. My name is Dr. Berney Wilkinson (you can call me Dr. B) and I am a clinical psychologist. I began working in the mental health field in 1997, when I came to be employed at a hospital in-patient facility. At the time, I was completing my undergraduate degree and helping with research in the Department of Psychiatry and Behavioral Medicine at the University of South Florida. Between my hospital work and my research experience, I developed a deep interest in working with children and adolescents with mental health issues.
In 1999, I began my graduate training in the School Psychology program at the University of South Florida. School psychology was my field of choice because my initial goal was to work primarily with children and adolescents, and where do they all go… school. While in graduate school, I had the unique opportunity to combine my medical experience (from my research in psychiatry) with the training I received in school. Together, these paths converge in a wide array of interests, including pediatric psychology, neuropsychology, and parent training. Upon completion of my graduate studies, I returned to my roots as an Assistant Professor in the Department of Psychiatry and Behavioral Medicine at the University of South Florida.
While working as an Assistant Professor, I helped with medical student education and the training of psychiatry and pediatric residents. In addition, I began working in forensics and completed a postgraduate program in school neuropsychology. My primary role, however, was as a clinician in the Silver Child Development Center. I completed post-graduate training with a clinical psychologist and was subsequently licensed in the State of Florida as a clinical psychologist.
In June 2008, I resigned from my position at USF and entered a private psychology practice in central Florida. In my private practice I work with patients and clients of all ages. I conduct psychological, psychosocial, psychoeducational, psychosexual, forensic, and neuropsychological evaluations. I work with individuals struggling with a wide array of mental health conditions. In fact, my broad expertise has afforded me the opportunity to present lectures at state and national conferences. In addition, I now teach graduate level counseling courses at Webster University’s regional campuses across Florida.
Despite my history of work in hospitals, at universities, and in private practice, I have felt as though there is so much more that needs to be done. While I enjoy working individually with my patients, I have always wanted to reach people on a broad scale. It is from this frustration that I developed my vision of The Mental Breakdown.
So, here we are, back to the initial question, “What is The Mental Breakdown?” Though the name is a clever title suggested to me by a colleague, my vision and concept of The Mental Breakdown is so much more. This site will begin as a simple blog to talk about mental health issues. I will “Breakdown” mental health information so that it is meaningful to the people who need it the most. I have always been frustrated with the medical and psychological field and their relative inability to communicate in a language that most people can understand. Sure psychologists and physicians can talk with one another in a jargon that they understand, but when it comes to communicating with those of you who have not had the same training, they so often fall short. Further, The Mental Breakdown will bring mental health concepts and issues to you when you need them. I will be posting blogs regularly to discuss a wide array of topics, from specific mental health conditions to treatment modalities. We can even discuss public policy issues, medications, and school related issues. As the site grows, so will the information provided. I will keep an archive of my posts and your questions so that others can benefit from your inquiry. Over time, the site will shift from strictly blog format, to a fully functional website that has all the information that you will need to answer your mental health questions.
To ensure that this site is a safe place for interested individuals to post questions, seek answers, and consult with me and others who have experience with mental health concerns, the site requires that you join and I will have to approve your post. While this safeguard is not meant to serve as a censor, it is designed to ensure that everyone feels comfortable posting their questions without the risk of confrontation, arguments, and conflict. Therefore, I encourage you to join my blog and ask questions. I will respond to questions regularly and will give you the most up to date information that I have available, without the smoke and mirrors, and in a language that you can use. I also encourage each of you to respond to questions and posts on the site. Although I will provide my impressions and ideas, each of you have experiences and suggestions that may be just as valid and useful for others. So please, share your own experiences, you never know how they may help others.
There is one last issue to present, which you will likely read throughout my blog. While I am a licensed psychologist, I have to inform you that the information that I provide is not to be considered a form of treatment. The information on The Mental Breakdown or any other web site should not be used as a substitute for professional healthcare. You should always consult your health professional before acting on any information seen on this site.
So there it is. This is The Mental Breakdown and I hope that I can make it live up to my expectations. To do so, I hope that what I have to say gives you the information that you are looking for. I hope that you will take part in this venture and together, we can help bring awareness of mental health issues to those who are most in need.
Thanks for reading and I will be writing again soon.
Dr. B
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This is a test post. It is not intended to contain or impart any actual content or information, overt, covert, or otherwise.