Lepage Associates Newsletter
Mental Health Matters
August 2009
Lepage Associates
Call: (919) 572-0000
In This Issue
Back To School
Substance Use and Recovery
Suicide Prevention
Back to School Strategies 
for Better Success
The summer is just about over, and thus the school routine is about to start. Smooth transitions can be accomplished; below are some tips on what you can do to make going back to school a pleasurable experience. Also, success at school is vital to a child's self-esteem and sense of self; below are some strategies to help your child succeed at school.
1. Prepare in advance. Help your child know what to expect and if there will be any changes to anticipate.
2. Talk about feelings. Encourage your children to talk about their feelings and help them put a positive spin on going back to school.

3. Develop a checklist to help get you and your child ready for school.

4. Be there. Be involved with dropping off and picking up from school, especially the first couple of days. 

5. Let teachers and counselors know what's going on. If there have been any significant changes or stressors, the school can be an excellent support system. 

6. For children starting school, or a new school or new program: Read books about school to your child. Reading books with children is a great way to introduce any experience. They can see how other children beginning school or a new program have the same feelings of uncertainty and how they overcome them.
Succeeding at Homework:
1. Buy a planner or calendar and write down all assignments. 
2. Avoid procrastination by developing a few short goals instead of a large one. For example, finish two pages of a paper per day, not 10 pages by the day before it is due.
3. Complete homework in advance, not the day it is due, to allow for questions and more free time.
4.  Have homework reviewed by a peer, parent, or teacher before turning it in.
5. If there are questions about the assignment, ask the teacher to prevent careless mistakes.
6. Avoid the television or turn it off if it is impossible to be in a different room.
7. Don't work on a bed, or anywhere you take naps, to prevent falling asleep.
8. Eat beforehand or bring a small snack to limit yourself to until work is done.

9. Have proper lighting to keep you awake and motivated.

10. Avoid heavily trafficked areas to stay on task and not converse with friends.
11. Work when you are most active (mornings or late nights).
12. Reward yourself with short 5-10 minute breaks when working on longer projects.
Succeeding with others: 
1. Interact with your teacher, show they that you are interested and that you care.

2. In larger classrooms, introduce yourself to the teacher to become more comfortable with asking them for help.
3. Ask questions and if you don't understand something, don't be afraid to get more details.
4. Talk to students in the class who share an interest in learning the material and work together.
5. Organize study groups with friends to help further your knowledge.
6. Most importantly, celebrate success on an exam with friends to encourage you to do the same thing next time.


Monthly Reader
Each month we will recommend a book that someone at our practice has found useful. This month's book is:
 From Binge to Blackout: 
A Mother and Son Struggle with Teen Drinking
by Chris and Toren Volkmann 
The Bridge is a documentary to help understand the reasons behind why people commit suicide and the effects on those left behind. 



With summer almost over, children returning to school, and cooler months ahead, August and September are good months to think about stress management. 
Stress is dealt with by people in a number of ways. Here are some interesting stress management techniques, as well as discussion of the stress-related topics of alcohol and drug use, and suicide prevention.
BACK to SCHOOL: It's that time of year again! Check out the helpful strategies below to help your child transition back to school have success with homework and peers. Check out our School Success Screening, too. This is a quick assessment we can do to see if there are any red flags regarding how your child will do in school.
Healing Arts Practices for Stress Reduction
By: Paula Huffman, owner,
Yoga and Healing Arts Center

There are a wide variety of ways to reduce stress. Yoga, belly dance, QiGong, and Tai Chi, can be fun alternatives to a more typical exercise routine, and massage therapy, meditation groups, acupuncture, chiropractic and reiki services can also be beneficial stress reducers. Yoga can be adapted to meet a person's needs regardless of any physical limitations they may be experiencing.

Restorative Yoga is a series of poses in which you are effortlessly and completely supported with bolsters, blankets and pillows. This practice creates a deeply relaxing, healing and meditative experience. Restorative yoga is especially effective during times of increased stress related to illness, injury, or major life changes. Restorative poses are sequenced to alternately stimulate and relax the body to move toward balance. Poses provide stretching of different areas of the body along with joint opening and muscle relaxation. The outcome is a general sense of deep relaxation, opening and rejuvenation. Mindfulness Based Stress Reduction and Pain Management Programs are programs designed to introduce coping techniques to those who are experiencing stress in their life related to general life circumstances, illness, and or chronic pain.
Paula Huffman owns the Yoga and Healing Arts Center, and focuses on the healing and restorative aspects of yoga through the development of both physical and spiritual awareness. Paula has also studied with Jon Kabat Zinn and the Center for Mindfulness at UMass. To learn more about the services offered at Paula's center visit www.hillsboroughyoga.com.
September is National Alcohol
and Drug Addiction Recovery Month
Like all behaviors, drug and alcohol use occurs along a continuum. Some of us drink 'socially' or use drugs 'recreationally.' Others find themselves using substances in a way which leads to some mild impairment in their lives while others use to an extent that can be devastating or even deadly.      
A common misconception is that the user does not wish to quit and is content with their use. Most 'addicts' desperately want to end their dependency but have had little success because of the chemical and psychological dependence. They may earnestly try to quit but soon return to their habit when attempting to quit without assistance. Therapists, trained in substance use, can help an individual combat their use, help their family, and make recommendations for when medical intervention is necessary.
Not all substances are illegal drugs. Some common household products can be ingested to achieve a 'high.' Some drugs are inhaled, such as powdered cocaine, while others are 'huffed' such as gasoline and glue. Common prescription medications can be used such as Valium, Xanax, or Oxycodone. Other drugs that are taken in pill form, which are called 'uppers' and 'downers,' include amphetamines, sedatives, pain killers, and hallucinogens. Injectable drugs include heroin. Smokeable drugs include crack cocaine, marijuana, and cigarettes. Alcohol is also considered a substance and common household products such as vanilla extract made be ingested as well.
There are two distinct categories of problem substance use, abuse and dependence.
Substance abuse involves the recurrent use of a chemical that leads to distress for the individual or people around them. Difficulties can include: (1) not fulfilling major role obligations at work, home, or school such as repeated absences or neglect of one's children; (2) placing oneself in physically hazardous situations, such as drinking and driving, or (3) legal problems such as disorderly conduct. Also, despite overwhelming physical and social difficulties, such as arguments with a partner or physical fights, abusers will continue their habit.
Substance dependence or 'addiction' also involves the recurrent use of a chemical. Individuals who become dependent on substances develop tolerance and/or withdrawal. Tolerance occurs when an individual needs more of the substance to have the same effect and/or has less of an effect when using the same amount. Withdrawal includes physical symptoms that are specific to the substance and/or taking the substance to avoid the withdrawal. Therefore, when someone attempts to quit using it, they often claim to "not feel quite right" and return to their addiction.
Other symptoms of dependence include: (1) taking the substance in larger amounts or over longer periods than was intended; (2) a persistent desire or unsuccessful effort to cut down on use; (3) spending a great deal of time in activities to obtain the substance; (4) giving up or reduced participation in important social, work, or fun activities; (5) using despite knowing that it is problem. There are psychological symptoms associated with dependency as well. For example, smokers who use a cigarette during a specific time each day may feel the need to smoke during that time. Alcoholics going to a restaurant with friends may have the urge to drink solely because there is alcohol available. 
If you or someone you love struggles with substance use or dependence, there are many ways to find help. Our website Resources page lists some free or reduced fee local resources. At Lepage Associates we have psychologists who specialize in working with users, and family and friends affected by use. Our Addictions & Compulsions group, Co-Dependency Support group, DBT group, and Women's group can also be helpful. Our Substance Abuse Assessment can help you determine what level of treatment is required for a person struggling with this problem. Our staff would be happy to speak with you and provide more information and guidance.

Suicide Prevention Can Help Save Lives 

September also houses National Suicide Prevention Week. The major elements of suicide prevention include awareness, open communication, and knowledge of access to resources.
A suicidal crisis often occurs when someone is experiencing an intense depression. You may notice changes in someone's behavior such as negative thoughts and actions, harmful acts, and deteriorative functioning. Despite the intensity of suicidal thoughts, they are usually associated with problems that can be treated. Individuals experiencing a suicidal crisis are usually overwhelmed and are unable to think of alternative solutions in their current state of mind. Therefore, people need help from their loved ones to encourage them to get help. Suicidal crises are almost always temporary and the most important aspect is getting through the crisis without self harm.

Risk factors for suicide include psychiatric disorders, genetic predisposition, history of attempted suicide, and impulsivity. Other warning signs are: (1) looking for ways to die (internet searches, acquiring a gun or pills, etc), (2) preoccupation with death, (3) becoming suddenly happier and calmer, (4) loss of interest in things the individual used to care about, (5) visiting or calling people one cares about (good-bye calls), (6) making arrangements to settle affairs, and (7) giving things away (such as prized possessions).
You can use this common acronym when assessing risk factors:
I - Ideation (thinking, talking, or wishing about suicide)
S - Substance use or abuse (increased use or change in substances)
P - Purposelessness (no sense of purpose or belonging)
A - Anxiety (restlessness, irritability, agitation)
T - Trapped (feeling like there is no way out)
H - Hopelessness (there is nothing to live for, no hope or optimism)
W - Withdrawal (from family, friends, work, school, activities, hobbies)
A - Anger
R - Recklessness (high risk-taking behavior)
M - Mood changes (dramatic changes in mood)
Open Communication
It is a common misconception that talking about suicide can give someone the idea of suicide. If you are recognizing the warning signs of suicide, do not be afraid to ask about it. Initiating this conversation can give the individual the opening to discuss their thoughts and feelings.  If you fear that someone may take their life, be willing to listen and take them seriously. If you are feeling suicidal...Do not keep these thoughts to yourself!  There are people willing to listen and offer a helping hand. 

There is no shame in seeking professional help. If there is a risk of suicide do not leave the person alone until help is available, and remove any sources that can aid in a suicide attempt. Do not hesitate to call 911 or take the person to the nearest emergency room. It is important to encourage the individual to follow up with treatment once the suicidal crisis passes. There are many protective factors that an individual can use including the assistance of professionals. Other resources include family and community support, skill building, and religion/spirituality. Helping the individual identify reasons for living can help sustain a person in pain.

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