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Major Depressive Disorder: How I Manage

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By Deborah Serani, PsyD, as told to Hallie Levine

When it comes to talking about how depression affects relationships, I’m the expert. And it’s not just because I’m a psychologist. I’ve lived with major depressive disorder since I was 19. I not only work on this issue with my patients, but I encounter it in my own life every single day.

There’s no doubt that strong relationships can help provide a buffer against depression and lessen the severity of depressive episodes. One study, for example, followed American adults aged 25-75 for 10 years and found that people who reported poor relationships with their spouse or other family members were at higher risk of depression.

But it can be hard to maintain relationships when you’re hurting so much yourself. Here’s what I tell my patients and what I want everyone who experiences depression, and those who care about them, to know.

Depression can be hard to understand because it’s an “invisible” illness. This is especially true if you struggle with it yourself. Most of us “get” that a broken leg is an injury, for example, and that we need a cast and crutches so we can move around. But if you have symptoms of depression such as moodiness, difficulty concentrating, trouble sleeping, and just generally feeling sad and uninterested in anything, it can be hard to resist the temptation to just tell yourself to snap out of it.

But if you don’t accept the fact that your depression is real, and just as much of a chronic illness as high blood sugar or arthritis, you’ll be setting yourself up for relationship trouble. Why? You’re setting unrealistic expectations for yourself.

Your loved ones want to help you and make your life easier. They need you to tell them what you’re up for, and when you need help, or a break. Spouses and other family members tend to over-worry. You can make their lives and yours easier if you’re simply upfront about how you feel.

Make clear that depression isn’t your everything. It’s easy for loved ones to mistake real, authentic sadness or irritability for depression. You might be upset about the situation in Ukraine, or worried about COVID-19, and a loved one will mistake these genuine emotions as just a relapse of symptoms.

Again, they’re just looking out for you and your health. I recommend that you be upfront with them and say, ‘No, it’s not that I skipped my medicine, or that my depression is worsening. I have a real legitimate reason to be upset, and it’s X, Y or Z.’ Then talk to them about it. You’ll feel better for sharing your thoughts and they’ll feel better knowing that you’ve got a handle on your symptoms.

This is especially true when it comes to children. My daughter, who is now in her 30s, is used to having a mom with depression. When she was little, I could tell that she worried about me when I seemed quiet or moody. I’d at times have to reassure her that mom was fine.

Kids who have parents with depression tend to feel like they need to walk on eggshells, that they don’t want to upset that parent. They want to be caretakers, and they forgo their own needs because they want to make sure that they don’t set up a row of collapsing dominos for their mom or dad with a chronic illness.

It’s important that both you and your partner reassure them that they don’t need to feel that way. Let them know that yes, you’re OK, but you might need some time in the sun or to go for a walk outdoors to regroup and begin to feel like yourself again. Just as it’s important for you to check in on your own mental health, check in on theirs.

Be selective about who you share your depression diagnosis with. It might seem that you “should” be open about your depression and let your boss and co-workers know. But think carefully before doing so. Yes, we’ve come a long way in understanding mental illness, but it’s still stigmatized. Employers view depression differently than other chronic conditions like heart disease.

I’ve found this to be true in my own professional life. Yes, I’ve found that it helps patients to know that I also have days when I struggle to get out of bed, or that I’m well acquainted with the side effects of certain antidepressant medications. The stigma I’ve faced has been, surprisingly, from other therapists, who feel that I’m oversharing.

As a result, I’ve learned to be very careful about whom I share personal struggles with. You can have depression and be a wonderful parent and have a stellar career. But there’s still this misconception that if you have this condition, you’re flawed as a person. It’s very sad, but unfortunately, it’s a reality.

Check in with yourself frequently. It won’t just help you; it will help your relationships. I ask patients to ask themselves these three questions at least once every few weeks:

  • Has your partner commented that you seem more moody, sad, or irritable lately?
  • Have you found yourself struggling every day for at least 2 weeks in more than one situation? (For example, feeling overwhelmed with both your work and your kids.)
  • Are you finding it hard to do things with family and friends that you usually enjoy, like seeing a movie or going out to eat?

If at least one of your answers is yes, then check in with your therapist. And if you don’t have a therapist right now, consider getting one. You may also be due for a medication check, whether it’s to change drugs or up your dose.

Make it a priority to have some self-care time, too. It may seem like a luxury you can’t afford, either financially or time-wise. But if you take just a few minutes a week, whether it’s going to the gym or taking a relaxing bath, you’ll feel better about yourself and be more willing to give in your relationships. Trust me. Your partner, kids, friends, and other family members will thank you.

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The Truth About Whole-Body Scans

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Take a drive around certain neighborhoods in Los Angeles and you may spot as many signs advertising body scans as burger joints. Or maybe you’ve seen the ads on TV or the internet: “Protect your health! Get a body scan now!” 

Are whole-body CT scans really able to do that – and what are the risks? And are DEXA scans a good way to check on your body composition?

While technologies vary, most of these high-tech checkups use computed tomography (CT) scans to examine your entire body or specific parts, such as the heart and lungs, to try to catch dangerous diseases in earlier, more curable stages.

During the 15- or 20-minute scan, you lie inside a doughnut-shaped machine as an imaging device rotates around you, transmitting radiation. The technique combines multiple X-ray images and, with the aid of a computer, produces cross-sectional views of your body. By examining the views, a doctor can look for early signs of abnormalities.

The scans aren’t cheap – whole-body scans run anywhere from $500 to $1,000 per scan and usually aren’t reimbursed by insurance. And the question of how helpful these scans really are is a matter of debate among medical experts.

Advocates promote scans as a smart part of a routine physical exam. But if you’re healthy, with no worrisome symptoms, a scan is usually not warranted, says Arl Van Moore, MD, a radiologist and clinical assistant professor of radiology at Duke University Medical Center in Durham, NC, who is also a spokesman for the American College of Radiology (ACR).

According to the ACR’s official position, there’s not enough evidence to recommend scans for those with no symptoms or family history suggesting disease. But Van Moore sees a possible exception. “There may be a benefit to people at high risk of lung cancers, such as current smokers or those with a long history of smoking,” he says. 

For healthy people, the scans may cause undue worry – for instance, by finding something that turns out to be benign. Plus, the amount of radiation exposure, especially with frequent scans, is another concern. If scans are done too often, the radiation exposure may actually increase the number of cancer cases over the long term, according to a 2004 report in the journal Radiology.

The American College of Preventive Medicine says that whole-body scans “aren’t very good at finding cancer in people without symptoms” and that the radiation you get from these scans can increase your risk of cancer.

Before scheduling a body scan, talk to your doctor about your overall health risks and how a scan may or may not help you. In particular, ask yourself:

  • What’s your history? Do you have a personal or family history of lung disease, heart disease, or specific cancers?
  • Did you inhale? Are you a longtime smoker?
  • If so, how long? Even if you’ve quit smoking, for how many years were you an active smoker?

 

This is a different type of scan, called DEXA (dual energy X-ray absorptiometry). You might have heard of DEXA scans to check on bone density to see if you have osteoporosis or osteopenia. It uses low-level X-rays to check on your body composition, like how much body fat you have and where it is in your body. 

There are various ways to measure your body fat. Experts have told WebMD in the past that DEXA scanning is a “very good technique” and “one of the most accurate methods out there.” And researchers have called it the “gold standard” for checking on body composition – specifically, for bone, fat, and muscle. But it’s not covered by insurance, unless you’re getting a DEXA scan to screen for bone density. The cost of a DEXA scan varies, starting around $75 in some cases.

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5 Family and Community Engagement Strategies to Improve Student Outcomes

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Strong school-family-community partnerships bring exceptional value to children’s education. A recent book by Karen L. Mapp, a senior lecturer at the Harvard Graduate School of Education, and four other co-collaborators synthesizes the available research to explain who benefits from these partnerships and the many advantages of family and community engagement.

Everyone Wins! The Evidence for Family-School Partnerships & Implications for Practice (Scholastic, 2022) cites various research to demonstrate how family-community-school partnerships benefit all stakeholder groups when they’re approached effectively:

  • Students have higher grades, better attendance, deeper engagement in school, greater self-esteem, and higher rates of graduation and college attainment.
  • Educators enjoy better job satisfaction, better success motivating students from different backgrounds, more family support, and an improved mindset about students and their families.
  • Families have stronger relationships with their children and better rapport with educators. They can navigate school policies and advocate for their children more effectively.
  • Schools enjoy a better climate, more support from their community, and improved staff morale—leading to better teacher retention.
  • School districts and communities become better places to live and raise children. They experience fewer disciplinary problems, greater participation in afterschool programs, and more family and student involvement in decision-making.
community members talking and hugging in matching green volunteer t-shirts in front of an outdoor mural

What elements make school-family-community partnerships particularly effective? Here are five tips for how school systems can successfully promote family and community engagement in education and drive better student outcomes.

1. Successful Family Engagement Requires Intentional Leadership

Engaging with families has to be a core activity and not just an afterthought. It requires a total commitment by school and district leaders, and this commitment must include investing in the tools and training needed to help educators effectively engage with families from all backgrounds. It must be a real and intentional focus, and as Mapp says: “It’s real when I see it on your budget sheets.”

2. Teachers and Administrators Must Communicate Clearly and Consistently

To encourage family involvement in their children’s education, educators must interact with families frequently—and in many ways. For instance, teachers and administrators might engage with families in person during school drop-off and pick-up periods, set up a Family Information Board in the school’s lobby, write and distribute regular newsletters or blog posts, and/or send emails or text messages to parents.

Communicating effectively is one of the National PTA’s “National Standards for Family-School Partnerships,” which guides how schools and families should work together to support student success. Teachers and administrators should learn about and meet families’ preferred methods of communication, and families should be able to share and receive information in culturally and linguistically relevant ways.

3. Develop Healthy, Positive Relationships Based on Mutual Trust and Respect

Interactions between educators and families should be positive and reciprocal, with families feeling valued and supported. Educators can establish trust and encourage healthy, two-way communications with families by sharing information about their children’s positive behaviors and accomplishments and which skills may need work. Listen to all parents and provide opportunities for shared decision-making.

4. Be Mindful of Diversity, Equity, and Inclusion

Welcoming all families and fostering a sense of belonging is another National PTA standard. When families engage with your school, do they feel respected, understood, and connected to the school community?

To ensure equity and inclusion, learn about the families you serve and their unique needs and challenges. Use culturally responsive engagement practices. Create opportunities for connection, especially with historically marginalized families and students. Learn about and seek to remove barriers for families to participate fully in their children’s education.

5. Help Families Support and Extend the Learning at Home

Students learn more effectively when they have opportunities at home to practice, reinforce, or extend the skills and lessons they’ve learned in school. Educators can facilitate this process by giving families specific ideas for expanding their children’s learning at home, such as by incorporating core math and literacy concepts into everyday routines.

Schools can also make instructional resources such as take-home packs, activity sets, and other materials available to families to support their children’s education.

How School Specialty® Can Help

School Specialty has more than six decades of experience in providing tools, resources, and strategies that promote successful education both in school and at home. We offer arts and crafts, early childhood, ELA, math, science, STEM/STEAM, physical education, special needs, and social emotional learning resources for families, as well as games, puzzles, and general supplies.

How do you promote family engagement in your classroom and community? Let us know in the comments!



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Preteens and skincare: What parents should know – CHOC

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Published on: April 16, 2024
Last updated: April 9, 2024

Should teens and preteens be using so many skincare products with fancy ingredients? A pediatric dermatologist answers parents’ questions.

Link: https://health.choc.org/preteens-and-skincare-what-parents-should-know/

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