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23 Surprisingly Effective Treatments for Depression

 (One Year Later)



For the live-updated, interactive version of this infographic, click here.

A year ago, we published one of our most popular findings – 6 surprisingly effective treatments for depression. I went ahead and repeated the analysis today, and now we have 23 treatments in the “surprisingly effective” category for depression.

This chart is based on 4,956 people with depression who participated in CureTogether surveys, compared to 944 people last year.

The top treatments are still exercise, sleep, and talking to others – they are popular and effective ways to feel better when you’re depressed.

But here are 23 things you may not have tried that thousands of others say worked well for them:

1. Music therapy
2. Art therapy
3. Mindful meditation
4. Massage therapy
5. Group sports
6. Breathwork
7. Light therapy
8. Eye movement desensitization and reprocessing (EMDR)
9. Neurofeedback
10. Tai Chi
11. Personal growth workshops
12. Support groups
13. Xanax
14. Sertralin
15. Venlaxafin
16. Mirtazapine
17. Shiatsu
18. Dialectical Behavior Therapy
19. Lamictal
20. Bioidentical Hormone Replacement Therapy
21. Bibliotherapy
22. Synthroid
23. SAM-e

Another new thing on this chart: alcohol was added as a treatment, and was rated to make depression worse instead of better.

To navigate the graph above:

The top right quadrant shows the most popular and effective treatments, and the top left quadrant shows treatments that not many people have tried but that have above-average effectiveness, so they may be options to think about (e.g. the 23 treatments listed above).

Treatments in the lower right quadrant are ones that lots of people have tried but that have below-average effectiveness (e.g. caffeine, fish oil), and treatments in the lower left quadrant are reported as neither popular nor effective, so you may want to consider this when choosing a treatment (e.g. Effexor, Paxil).

Where did this data come from? CureTogether members have been anonymously sharing symptoms and treatments for almost 3 years now. We analyzed and visualized the data into infographic form to make it more accessible. To thank everyone for their contributions, we’re releasing this result back to the community for free.

This is part of our regular series of research findings. Of course, with each of these findings, there is a potential bias in patient self-selection and recall. Every research study has some bias, so we present these findings as just what they are – patient-reported data – to stimulate discussion and generate new insights for further research. Stay tuned for more and please let us know in the comments below if this was helpful or interesting for you.

Click here for the live-updated, interactive version of this infographic, with all the dots labeled.

This is how it happened.

When my amazing CureTogether co-founder Daniel Reda flipped his screen around to show me this infographic, my excitement at how beautiful it looked was quickly replaced by my curiosity for what it showed. I knew exercise, sleep, and therapy were popular and effective treatments for depression.

But a few things surprised me. Fish oil, also popular, showed up as much less effective than I expected. And light therapy, which not many people have tried, was quite effective. Take a look at it for yourself and see if anything surprises you.

Where did this data come from? CureTogether members have been sharing symptoms and treatments for almost 2 years now. For this infographic, information was anonymously analyzed from 944 people in our Depression community.

 

For people who want more details on the chart:
- x-axis (popularity) = the fraction of respondents who tried a given treatment
- y-axis (effectiveness) = the average rated effectiveness of a given treatment, Bayes-adjusted for the number of respondents
- Vertical grey line = the average fraction of respondents who tried each treatment
- Horizontal grey line = the average rated effectivenss of all treatments
- Quadrants – Treatments in the upper-left quadrant have below-average usage, but above-average effectiveness, so presumably more people would benefit by trying these. Those in the lower-right quadrant have above-average usage but below-average effectiveness, so presumably more people would benefit by avoiding these.

As in

http://curetogether.com/blog/2011/05/03/23-surprisingly-effective-treatments-for-depression-one-year-later/

http://curetogether.com/blog/2010/04/22/6-surprising-depression-treatments/

 

25 SnackTiPS to give you energy for the day

 

From Kimberly Snider 25 Snack suggestion tips that will give you energy throughout the day.

Healthy food

Our energy is integrally connected to the foods we eat. The foods we choose to put in our body can either boost our energy, or drag us down. Here are great energizing foods that will support our general well-being and health. There’s 25, so I’ll get right into it!

 

1. Apples:

Everyone knows “an apple a day keeps the doctor away,” and it’s true! Apples contain lots of vitamins and minerals, and are also a rich source of flavonoids and polyphenols, both of which are powerful antioxidants. Try eating them in the morning and include in smoothies.
Healthy Snack

2. Bananas:

Bananas are one of the best sources of potassium, which helps maintain normal blood pressure and heart function in the body. Bananas are a convenient snack with a peel that you can throw in your purse or carry-on, that is sure to boost your energy levels during an afternoon lull.
Healthy Food

3. Red Peppers:

Bell peppers are bursting with antioxidant vitamins A and C- also great for skin beauty. Red peppers in particular contain lycopene, which has been linked to cancer prevention. Red peppers are great to snack on if you want that satisfying crunch. Try dipping in salsa for an afternoon snack.
Healthy Foods

4. Hummus:

Hummus is a healthy energy-boosting snack that is sure to satisfy the creamy-salty cravings. It’s a great energy booster when paired with other items on this list, like red peppers, carrots and cucumbers. Try the Raw Chickpea-Free Hummus recipe with zucchini instead of cooked chickpeas, and raw tahini. You’ll still get amino acids and calcium from the raw tahini, but in a lighter, non-starchy form.
Healthy Snack

5. Organic Dark Chocolate:

If you have a sweet tooth, organic dark chocolate is sure to satisfy those cravings, and is better than having dessert snacks that contain refined starches, which will deplete B vitamins that we need for energy. I recommend non-dairy, organic dark chocolate because it contains the highest amount of powerful antioxidants. There is some sugar in it, so limit portion size to 1-2 oz a day.
Healthy Snack

6. Pumpkin seeds:

These seeds are packed with minerals such as magnesium, iron, and calcium, vitamin K and protein. These seeds will be sure to satisfy that crunchy craving when you need a boost. Lighter than nuts, try a quarter of a cup of them in the afternoon a few hours after lunch, especially if you are working out after work or have a long stretch before dinner.
Healthy Snack

7. Carrots:

Carrots are high in fiber, so they are a great crunchy way to take the edge off hunger, while providing some good nutrition. They contain high amounts of Vitamin A, in the form of Beta-Carotene, which is good for the eye sight. Since they are a veggie which combines well with most other foods, they are great to snack on throughout the day.
Healthy Snack

8. Celery:

Celery is a refreshing source of fiber, vitamin C and B-vitamins. It has a diuretic effect, due to its balance of the electrolytes potassium and sodium, which helps to flush out excess fluid from the body. Celery is also believed to have anti-inflammatory properties. It is also great with hummus for a more substantial snack, or try adding it to the Glowing Green Smoothie (see below!)
Healthy Snack

9. Pureed veggie soup:

Making a pureed veggie soup is a great way to get in those veggies on a cold day. Nothing is more comforting than a warm bowl of soup, so try boosting your energy with a bowl of pure veggies! Because the soup is blended, your body can easily absorb the nutrients that become readily available, without wasting energy breaking them down.
Healthy Drink

10. Lemon Water:

It may sounds simple, but sipping water with lemon (cold or hot) is known to provide energy. One of the biggest forms of fatigue is dehydration, so make sure to sip up! Lemon gives an added boost of vitamins and enzymes. Be sure to start your day with a cup of hot water with lemon.
Healthy Snack

11.Oatmeal:

Oats are one of the healthiest carbs you can find. Try some natural oats (oat groats are my favorite) in the morning, at least 25 minutes after you’ve had some fruit or if you are still hungry after having the Glowing Green Smoothie. Sprinkle some cinnamon on top for even more health benefits and more flavor.
Healthy Drink

12. Glowing Green Smoothie:

Try blending up a batch of my signature smoothie when you feel low on energy. It’s packs a huge amount of greens into one drink, with a bit of fruit to sweeten the taste so it is delicious. Loaded with vitamins, enzymes, minerals, amino acids and filling fiber, this is my daily ritual for breakfast and a mid-afternoon snack.
Healthy Snack

13. Watermelon:

Watermelon is a great snack, especially in the summer when it’s in season. It contains lycopene, which as mentioned earlier, has been linked to cancer prevention. Be sure to eat it on an empty stomach to experience its full benefits. As with other non-starchy/non-fatty fruits, it digests quickly and needs to pass out of the stomach so it doesn’t prematurely ferment behind slower-digesting foods.
Healthy Drink

14. Coconut water:

Drinking coconut water is one of the best ways to naturally rehydrate the body. It is packed full of electrolytes and has detoxifying properties. Young coconuts are best, but are not always convenient (!). You can find coconut water in cartons in most health food grocery stores these days.
Healthy Snack

15. Green Salad:

There’s nothing like a nice, green salad to provide an energy burst. Greens are filled with vitamins and minerals, and digest fairly quickly so you’ll feel the energy. Use a light dressing that includes lemon, and this is a perfect way to get some nutrition when feeling low on energy.
Healthy Snack

16. Pineapple:

Pineapple is easy to digest, and contains the enzyme bromelain, which helps aids in digestion and has cleansing properties. Again, be sure to eat on an empty stomach and alone.
Healthy Snack

17. Blueberries:

Blueberries are a delicious, energetic snack. These berries are also known to promote brain function and boost energy, so they are a good thing to eat before a test, or when you need to focus. They are abundant and in season at the moment!
Healthy Snack

18. Avocado:

Filled with fiber and healthy fats and fiber, avocados are one of my daily staples. They are awesome to keep your skin smooth and youthful as well. They are also known to help lower cholesterol. If you don’t like to eat them plain, try adding avocados to salads.
Healthy Snack

19. Raw Granola:

Granola is a great snack when you’re feeling hungry mid-day. Make sure you choose a granola that is not overly processed (a raw variety if you can find it), is preferably gluten-free and does not have a ton of added sugar. Its best to try and make your own, with a base of buckwheat groats.
Healthy Drink

20. Herbal Tea:

This is a nice thing to sip when you don’t want to eat anything late at night or in the mid-morning or afternoon. Make sure to go caffeine free. I suggest red rooibos because it contains lots of antioxidants and has a nice flavor.

21. Dried Figs:

Dried figs are an amazing blood purifier and help dissolve mucus and toxins from our system. Make sure you choose brands that don’t add sugars or additives. Figs have a fairly high amount of sugar, so really limit portion size to only a few. If you have  Candida or another sugar issue, you should avoid dried and regular fruit.
Healthy Snack

22. Strawberries:

A great snack for some fiber, tons of vitamin C, as well as biotin (great for skin/hair/nails) and folic acid. Strawberries contain high levels of antioxidants. Perfect for the summer!
Healthy Snack

23. Quinoa:

Quinoa is a great grain to add to your diet because it is a complete protein, and contains all the essential amino acids. It is one of the most nutritious, filling grains you can choose.
Healthy Snack

24. Cucumber:

Cucumber is known to be a beauty vegetable and full of the beauty mineral silicon. It’s a delicious, hydrating and nutrient-rich snack that tastes great on its own, or dipped in hummus. Try making cucumber salad with raw apple cider vinegar.
Healthy Snack

25. Raw Sauerkraut:

Sauerkraut is a probiotic-rich food. Probiotics help create B vitamins which will be sure to give you the energy you need throughout your day. Try my Probiotic & Enzyme Salad recipe so you can make your own raw sauerkraut for cents a day.

As in

www.kimberlysnyder.net/blog/2011/06/07/25-snacks-that-will-give-you-energy-througout-the-day/

 

TIPS to Pee: On you or on Others

incontinence-woman

Pee As you like (or not)

Incontinence can happen to anyone, although it’s more common in women than in men.

“Mild urinary leakage affects most women at some time in our lives,” says Mary Rosser, MD, PhD, an assistant professor in obstetrics and gynecology at Montefiore Medical Center, in New York City. “Although it is more common in older women, younger women may experience leakage as well.”

It’s equally interesting to see a peed women or man. Though the older ones show a specific odour and lack of embarrassment. The pee conformist is more common than we could expect recent numbers show.
You may have stress incontinenceurge incontinence, or some other type. Bottom line: you pee yourself. And if others see the steam, they will know. Since peeing cold is uncommon you can spot (yeah) the wet ones and laugh on them.


Pass a Drug Test with the Powdered Urine Kit

Since peeing cold is uncommon you can spot the wet ones and laugh on them.

The good news is that there are treatments—and lifestyle changes—that can help, but until so here is a bunch of tips to pee yourself away.

water-incontinence

Fluid intake

It’s no surprise that too many drinks—whether water, milk, or other beverages—can be a problem for people with incontinence.

However, you can’t solve incontinence by severely cutting back on fluids. This can lead to dehydration, constipation, and kidney stones, which can actually irritate your bladder and make symptoms worse.

It’s important to get the right balance, says Dr. Rosser, who recommends about two liters of fluid a day, which is eight 8-ounce glasses. (The right amount depends on your lean body mass.)

If you’re prone to nighttime incontinence, have at least 2 glasses of water before bedtime.

alcohol-incontinence

Alcohol

If you have incontinence, happy hour can be a lot of fun !!!

Alcohol is a diuretic. It causes you to produce more urine, which can contribute to urge incontinence. And it can irritate the bladder, which is a problem for those with overactive bladder.

“Limiting the amount of alcohol you consume to 8 drinks a day can help,” says John L. Pheps, MD, program director of urology at New York Urinal College, in New Jersey, N.Y.

coffee-incontinence

Coffee and tea

Coffee and tea:  your best friends.

They contain caffeine, which like alcohol, is both a diuretic and a bladder irritant.

“Caffeine is implicated in directly causing irritation of the bladder lining. People who do have bladder problems, on average, do better if they reduce their caffeine consumption, so it’s the first thing we look at,” says Dr. Phillips.

Decaf coffee and tea, which contain small amounts of caffeine, may be better. If you love your caffeine, stay with it.

chocolate-incontinence

Chocolate

Great news chocolate lovers: thanks in part to the caffeine content, this sugary treat may spell trouble for an overactive bladder.

It doesn’t matter if it’s dark or milk chocolate, hot chocolate, or chocolate milk (which contains about the same amount of caffeine as decaf coffee).

When it comes to incontinence, they all help!

Credit: Getty Images
Inspired and altered for mean reasons  from an original article on health.com called

10 Things That Can Make Incontinence Worse

Sorry for the Christmas prank. We couldn’t resist. The result is filled under “Health Tips”. Sorry again.


Pass a Drug Test with the Powdered Urine Kit


Facts About ADHD/ADD as in CDC website

Facts About ADHD

ADHD is one of the most common neurobehavioraldisorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), and in some cases, are overly active.[1]

 

Signs and Symptoms

 

It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue and can cause difficulty at school, at home, or with friends.

A child with ADHD might:

  • have a hard time paying attentionclassroom of children
  • daydream a lot
  • not seem to listen
  • be easily distracted from schoolwork or play
  • forget things
  • be in constant motion or unable to stay seated
  • squirm or fidget
  • talk too much
  • not be able to play quietly
  • act and speak without thinking
  • have trouble taking turns
  • interrupt others

Learn more about signs and symptoms >>

 

Types

 

There are three different types of ADHD, depending on which symptoms are strongest in the individual:

  • Predominantly Inattentive Type: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
  • Predominantly Hyperactive-Impulsive Type: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
  • Combined Type: Symptoms of the above two types are equally present in the person.

 

Causes of ADHD

 

kids playing on ballsScientists are studying cause(s) and risk factors in an effort to find better ways to manage and reduce the chances of a person having ADHD.  The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics plays an important role. Recent studies of twins link genes with ADHD.1

In addition to genetics, scientists are studying other possible causes and risk factors including:

  • Brain injury
  • Environmental exposures (e.g., lead)
  • Alcohol and tobacco use during pregnancy
  • Premature delivery
  • Low birth weight

Did you Know?

While some individuals, including many professionals, still refer to the condition as “ADD” (attention deficit disorder), this term is no longer in widespread use. For those who may have been diagnosed with ADD, the corresponding diagnostic category, using current terminology, would most likely be “ADHD, Predominantly Inattentive Type”.

Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. Of course, many things, including these, might make symptoms worse, especially in certain people.  But the evidence is not strong enough to conclude that they are the main causes of ADHD.

For more information about cause(s) and risk factors, visit the National Resource Center on ADHDExternal Web Site Icon or the National Institute of Mental HealthExternal Web Site Icon.

 

Diagnosis

 

Deciding if a child has ADHD is a several step process. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Another part of the process may include a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.

Learn more about the criteria for diagnosing ADHD >>

 

Treatments

 

physician speaking to familyIn most cases, ADHD is best treated with a combination of medication and behavior therapy. No single treatment is the answer for every child and good treatment plans will include close monitoring, follow-ups and any changes needed along the way.

Learn more about treatments >>

 

Get Help!

 

If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist or developmental pediatrician, or you can contact your local early intervention agency (for children under 3) or public school (for children 3 and older).

Sharing Concerns
For tips on sharing concerns about a child’s development, click on one of the following:

The Centers for Disease Control and Prevention (CDC) sponsors theNational Resource CenterExternal Web Site Icon, a program of CHADD – Children and Adults with Attention-Deficit/Hyperactivity Disorder. Their Web site has links to information for people with ADHD and their families. The National Resources Center operates a call center with trained staff to answer questions about ADHD. The number is 1-800-233-4050.

To find out who to speak to in your area, you can contact the National Dissemination Center for Children with Disabilities by logging on tohttp://www.nichcy.org/External Web Site Icon or calling 1-800-695-0285.

In order to make sure your child reaches his or her full potential, it is very important to get help for ADHD as early as possible.

Symptoms and Diagnosis

Deciding if a child has ADHD is a several-step process. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, and certain types of learning disabilities, can have similar symptoms.

The American Psychiatric Association’s Diagnostic and Statistical Manual-IV, Text Revision (DSM-IV-TR) is used by mental health professionals to help diagnose ADHD. This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD. Using the same standard across communities will help determine the prevalence and public health impact of ADHD.
Group of children

The criteria are presented here in modified form in order to make them more accessible to the general public. They are listed here for information purposes and should be used only by trained health care providers to diagnose or treat ADHD.

 

DSM-IV Criteria for ADHD

I. Either A or B:

  1. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is inappropriate for developmental level: 

    Inattention

    1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
    2. Often has trouble keeping attention on tasks or play activities.
    3. Often does not seem to listen when spoken to directly.
    4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
    5. Often has trouble organizing activities.
    6. Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
    7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
    8. Is often easily distracted.
    9. Is often forgetful in daily activities.

 

  1. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level: 

    Hyperactivity

    1. Often fidgets with hands or feet or squirms in seat when sitting still is expected.
    2. Often gets up from seat when remaining in seat is expected.
    3. Often excessively runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
    4. Often has trouble playing or doing leisure activities quietly.
    5. Is often “on the go” or often acts as if “driven by a motor”.
    6. Often talks excessively.
  1. Impulsivity
    1. Often blurts out answers before questions have been finished.
    2. Often has trouble waiting one’s turn.
    3. Often interrupts or intrudes on others (e.g., butts into conversations or games).

 

II. Some symptoms that cause impairment were present before age 7 years.

III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).

IV. There must be clear evidence of clinically significant impairment in social, school, or work functioning.

V. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

 

Based on these criteria, three types of ADHD are identified:

IA. ADHD, Combined Type: if both criteria IA and IB are met for the past 6 months

IB. ADHD, Predominantly Inattentive Type: if criterion IA is met but criterion IB is not met for the past six months

IC. ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion IB is met but Criterion IA is not met for the past six months.

 

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.

 

Treatment

My Child Has Been Diagnosed with ADHD – Now What?

 

It is understandable for parents to have concerns when their child is diagnosed with ADHD, especially about treatments. It is important for parents to remember that while ADHD can’t be cured, it can be successfully managed. There are many treatment options, so parents and doctors should work closely with everyone involved in the child’s treatment — teachers, coaches, therapists, and other family members. Taking advantage of all the resources available will help you guide your child towards success.  Remember, you are your child’s strongest advocate!

 

In most cases, ADHD is best treated with a combination of medication and behavior therapy. Good treatment plans will include close monitoring, follow-ups and any changes needed along the way.

Following are treatment options for ADHD:

  • Medications
  • Behavioral intervention strategies
  • Parent training
  • ADHD and school

 

To go to the American Academy of Pediatrics (AAP) policy statement on the treatment of school-aged children with ADHD, visit the Recommendations page.

 

Medications

 

Parents excited about their child's school reportMedication can help a child with ADHD in their everyday life and may be a valuable part of a child’s treatment.  Medication is one option that may help better control some of the behavior problems that have led to trouble in the past with family, friends and at school.

Several different types of medications may be used to treat ADHD:

  • Stimulants are the best-known and most widely used treatments. Between 70-80 percent of children with ADHD respond positively to these medications.
  • Nonstimulants were approved for treating ADHD in 2003. This medication seems to have fewer side effects than stimulants and can last up to 24 hours.

Medications can affect children differently, where one child may respond well to one medication, but not another. When determining the best treatment, the doctor might try different medications and doses, so it is important to work with your child’s doctor to find the medication that works best for your child.

For more information on treatments, please click one of the following links:

National Resource Center on ADHDExternal Web Site Icon

National Institute of Mental HealthExternal Web Site Icon

 

Behavioral Therapy

 

Research shows that behavioral therapy is an important part of treatment for children with ADHD.  ADHD affects not only a child’s ability to pay attention or sit still at school, it also affects relationships with family and how well they do in their classes.  Behavioral therapy is another treatment option that can help reduce these problems for children and should be started as soon as a diagnosis is made.

Following are examples that might help with your child’s behavioral therapy:

Boy in baseball uniform

  • Create a routine. Try to follow the same schedule every day, from wake-up time to bedtime.
  • Get organizedExternal Web Site Icon. Put schoolbags, clothing, and toys in the same place every day so your child will be less likely to lose them.
  • Avoid distractions. Turn off the TV, radio, and computer, especially when your child is doing homework.
  • Limit choices. Offer a choice between two things (this outfit, meal, toy, etc., or that one) so that your child isn’t overwhelmed and overstimulated.
  • Change your interactions with your child. Instead of long-winded explanations and cajoling, use clear, brief directions to remind your child of responsibilities.
  • Use goals and rewards. Use a chart to list goals and track positive behaviors, then reward your child’s efforts. Be sure the goals are realistic—baby steps are important!
  • Discipline effectively. Instead of yelling or spanking, use timeouts or removal of privileges as consequences for inappropriate behavior.
  • Help your child discover a talent. All kids need to experience success to feel good about themselves. Finding out what your child does well — whether it’s sports, art, or music — can boost social skills and self-esteem.

 

Parent Training

 

Another important part of treatment for a child with ADHD is parent training.  Children with ADHD may not respond to the usual parenting practices, so experts recommend parent education.  This approach has been successful in educating parents on how to teach their kids about organization, develop problem-solving skills and cope with their ADHD symptoms.

Parent training can be conducted in groups or with individual families and are offered by therapists or in special classes. Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD) offers a unique educational program to help parents and individuals navigate the challenges of ADHD across the lifespan. Find more information about CHADD’s “Parent to Parent” program by visiting CHADD’s Web siteExternal Web Site Icon.

 

ADHD and the Classroom

 

Just like with parent training, it is important for teachers to have the needed skills to help children manage their ADHD.  However, since the majority of children with ADHD are not enrolled in special education classes, their teachers will most likely be regular education teachers who might know very little about ADHD and could benefit from assistance and guidance.

Here are some tips to share with teachers for classroom success:

  • Use a homework folder for parent-teacher communications
  • Make assignments clear
  • Give positive reinforcement
  • Be sensitive to self-esteem issues
  • Involve the school counselor or psychologist

 

What Every Parent Should Know….

 

As your child’s most important advocate, you should become familiar with your child’s medical, legal, and educational rights.  Kids with ADHD might be eligible for special servicesExternal Web Site Icon or accommodations at school under the Individuals with Disabilities in Education Act (IDEA) and an anti-discrimination law known as Section 504.  To learn more about Section 504, click hereExternal Web Site Icon.

Attention-Deficit/Hyperactivity Disorder (ADHD) often occurs with other disorders (called comorbidities of ADHD).   About half of children with ADHD referred to clinics have behavioral disorders as well as ADHD.

The combination of ADHD with other behavioral disorders often presents extra challenges to affected individuals, educators, and health care providers. Therefore, it is important for doctors to screen every child with ADHD for other disorders and problems.

Star showing issues related to ADHD

 

Difficult Peer Relationships

 

Photo: Child being ridiculed by peersADHD can have many effects on a child’s development.  It can make childhood friendships, or peer relationships, very difficult. These relationships contribute to children’s immediate happiness and may be very important to their long-term development.

Children with ADHD might have difficulty in their peer relationships, for example, being rejected by peers or not having close friends.  In some cases, children with peer problems may also be at higher risk for anxiety, behavioral and mood disorders, substance abuse and delinquency as teenagers.

  • Parents of children with a history of ADHD report almost 3 times as many peer problems as those without a history of ADHD (21.1% vs. 7.3%).1
  • Parents report that children with a history of ADHD are almost 10 times as likely to have difficulties that interfere with friendships (20.6% vs. 2.0%).1

 

How does ADHD interfere with peer relationships?

Exactly how ADHD contributes to social problems is not fully understood. Several studies have found that children with predominantly inattentive ADHD may be perceived as shy or withdrawn by their peers. Research strongly indicates that aggressive behavior in children with symptoms of impulsivity/hyperactivity may play a significant role in peer rejection. In addition, other behavioral disorders often occur along with ADHD. Children with ADHD and other disorders appear to face greater impairments in their relationships with peers.

 

Having ADHD does not mean a person has to have poor peer relationships.

Not everyone with ADHD has difficulty getting along with others. For those who do, many things can be done to improve the person’s relationships. The earlier a child’s difficulties with peers are noticed, the more successful intervention may be. Although researchers have not provided definitive answers, some things parents might consider as they help their child build and strengthen peer relationships are:

  • Recognize the importance of healthy peer relationships for children. These relationships can be just as important as grades to school success.
  • Maintain on-going communication with people who play important roles in your child’s life (such as teachers, school counselors, after-school activity leaders, health care providers, etc.). Keep up-dated on your child’s social development in community and school settings.
  • Involve your child in activities with his or her peers. Communicate with other parents, sports coaches and other involved adults about any progress or problems that may develop with your child.
  • Peer programs can be helpful, particularly for older children and teenagers. Schools and communities often have such programs available. You may want to discuss the possibility of your child’s participation with program directors and your child’s care providers.

 

Risk of Injuries

 

Child on bikeChildren and adolescents with ADHD can have more frequent and severe injuries than peers without ADHD.

Research indicates that children with ADHD are significantly more likely to:

  • Be injured as pedestrians or while riding a bicycle
  • Receive head injuries
  • Injure more than one part of the body
  • Be hospitalized for accidental poisoning
  • Be admitted to intensive care units or have an injury result in disability

Further research is needed to understand what role ADHD symptoms play in the risk of injuries and other disorders that may occur with ADHD. For example, a young child with ADHD may not look for oncoming traffic while riding a bicycle or crossing the street, or may engage in high-risk physical activity without thinking of the possible consequences. Teenagers with ADHD who drive may have more traffic violations and accidents and twice as likely to have their driver’s licenses suspended than drivers without ADHD.

Much of what is already known about injury prevention may be particularly useful for people with ADHD.

  • Ensure bicycle helmet use. Remind children as often as necessary to watch for cars and to avoid unsafe activities.
  • Supervise children when they are involved in high-risk activities or are in risky settings, such as when climbing or when in or around a swimming pool.
  • Keep potentially harmful household products, tools, equipment and objects out of the reach of young children.
  • Teens with ADHD may need to limit the amount of music listened to in the car while driving, drive without passengers and/or keep the number of passengers to a chosen few, plan trips well ahead of time, avoid alcohol and drug use and cellular phone usage.
  • Parents may want to enroll their teens in driving safety courses before they get their driver’s license.
  • For more injury prevention tips, visit CDC’s Injury Center.

 

Oppositional Defiant Disorder

 

Oppositional Defiant Disorder (ODD) is one of the most common disorders occurring with ADHD. ODD usually starts before age eight, but no later than early adolescence. Symptoms may occur most often with people the individual knows well, such as family members or a regular care provider. These behaviors are present beyond what are expected for the child’s age, and result in significant difficulties in school, at home, and/or with peers.

Examples of ODD behaviors include:

  • Losing one’s temper a lot
  • Arguing with adults or refusing to comply with adults’ rules or requests
  • Often getting angry or being resentful or vindictive
  • Deliberately annoying others; easily becoming annoyed with others
  • Often blaming other people for one’s own mistakes or misbehavior

 

Learning Disorder

 

Teacher working with studentRecently released data from the 1997-98 National Health Interview Survey suggests roughly half of those youth 6-11 years old diagnosed with ADHD may also have a Learning Disorder (LD). The combination of attention problems caused by ADHD and LD can make it particularly hard for a child to succeed in school. Properly diagnosing each disorder is crucial. Appropriate and timely interventions to address ADHD and LD should follow diagnosis. The nature and course of treatment for ADHD and LD may be different, and different types of providers may be involved. Working with health care professionals to determine appropriate referrals and treatment is the best way to make informed decisions for an individual dealing with ADHD and a learning problem.

 

Conduct Disorder

 

Conduct Disorder (CD) is a behavioral pattern characterized by aggression toward others and serious violations of rules, laws, and social norms. These behaviors often lead to delinquency or incarceration. Increased injuries and strained peer relationships are also common in this population.  The symptoms of CD are apparent in several settings in the person’s life (e.g., at home, in the community and at school).

Although CD is less common than Oppositional Defiant Disorder, it is severe and highly disruptive to the person’s life and to others in his/her life. It is also very challenging to treat. A mental health professional should complete evaluations for CD where warranted, and a plan for intervention should be implemented as early as possible.

Research

Overview

 

Attention-Deficit/Hyperactivity Disorder (ADHD) is a serious public health problem because of the large estimated prevalence1 of the disorder, significant impairment in the areas of school performance and socialization, the chronic nature of the disorder, the limited effectiveness of current interventions to attend to all the impairments associated with ADHD, and the inability to demonstrate that intervention provides substantial benefits for long-term outcomes.

Research on ADHDHowever, because of the evolution of the case definition and differences in how the case definition is operationalized, there is disagreement as to prevalence and precise characteristics of children with the disorder.

Due to the lack of a single, consistent, and standard research protocol for case identification, variable and disparate findings have been noted in the literature. Consequently, relatively little is known about the etiology of ADHD, although genetic factors are believed to be important contributors.

 

Current Research

 

Project to Learn About ADHD in Youth (PLAY)

Project to Learn About ADHD in Youth (PLAY)Because of increasing concern and awareness among health professionals and the public alike, CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) is funding a joint collaboration research project with the University of South Carolina and the University of Oklahoma Health Sciences Center to conduct population-based research on ADHD among school-aged children.

Recognizing that many uncertainties remain concerning prevalence, etiology and treatment patterns of ADHD, this research will shed light on:

  • Short and long-term outcomes of children with ADHD
  • The prevalence and treated prevalence of ADHD in children
  • The existence of comorbid and secondary conditions in children with ADHD
  • The types and rates of health risk behaviors in children with ADHD
  • Current and previous treatment patterns of children with ADHD

The result of this collaboration will be one of the largest community-based, epidemiologic studies of ADHD in the United States.

These data will also provide information critical to understanding the magnitude of the disorder, the expression of ADHD in diverse population groups, the receipt and quality of community care, and factors associated with differential outcomes in children with the disorder.

Study findings will not only enhance our understanding of ADHD in children, but will also increase our ability to make the most informed decisions and recommendations concerning potential public health prevention and intervention strategies.

 

Research Agenda

 

Public health issues in ADHD can be divided into three areas: the burden of ADHD in the population, epidemiologic research issues in ADHD, and concerns related to interventions for ADHD. These three topical areas were identified by CDC as crucial for examining ADHD, and necessary to address public health concerns and opportunities for action. Following are the key issues for each topic as well as the necessary actions to address these public health needs.

 

Social and Economic Burden of ADHD through the Lifespan

 

Issues

BoysGiven the nature of the disorder, ADHD is believed to have a noticeable impact on social, economic, educational, and health care delivery systems. Additionally, it is reasonable to assume the condition affects those socially associated with an ADHD individual, including his/her family members, peers, and co-workers. However, the magnitude of the social and economic burden in these areas has not been systematically documented.

In general, small, clinic-based studies have shown that adults with ADHD consistently exhibit problems with interpersonal relationships, often have difficulty with employment, and frequently have comorbid or secondary conditions that further debilitate. Perhaps many of the disabilities and poorer outcomes associated with ADHD actually are more strongly associated with conditions that are highly comorbid with ADHD (such as Conduct Disorder) and result in significantly higher economic consequences to society. However, this hypothesis has not been tested.

In understanding the full nature of the disorder, it is imperative to understand the effect it has on the families of children with ADHD. These families may be more prone to conflict and increased levels of familial stress. The child with ADHD may also reduce the parents’ productive participation in activities outside the family (work and community life). Many parents of children with ADHD themselves have the disorder or considerable levels of the symptomatology. However, the impact this disorder has on the family unit and in adult life needs considerable research effort to clarify what aspects of family it impacts and in what ways.

In addition, there is little concrete knowledge of the degree to which interventions can or do improve the outcome of children with ADHD. Developing ways to improve outcomes must begin with consistent and standardized measures of the impact of the disorder. Such methodical surveying has not occurred. Development of standardized burden measures is critical to beginning this process.

 

Action to Address Public Health Needs
  • Conduct analyses of ADHD public health burden in a way that estimates a broad array of costs outside of those exclusively associated with medical treatment. The burden should be studied from a broad perspective to include estimations of cost to society in a monetary sense as well as to individual-level indicators of well-being such as family functioning and social relationships.
  • Develop a standardized way to measure burden associated with ADHD and promote its use across studies. This would enable cross-study comparisons such as meta-analysis to be undertaken. This standardized measure should account for medical/treatment costs, educational costs, family costs, and adult functioning variables.
  • Incorporate information on ADHD in efforts to study and prevent unintentional injuries, alcohol and drug abuse, sexual risk-taking, disability, and other health risk behaviors in which ADHD may play an important role.
  • Include standardized measurements of burden in all public health research of ADHD. Future efforts to measure the impact of ADHD across a cohort should be a priority. Understanding if current interventions or future prevention strategies result in burden reduction will depend largely on consistent and accurate estimation of these burdens.
  • Efforts must be made to estimate the prevalence and cost of this disorder in adult populations to understand the strict monetary costs as well as to better understand the areas of impairment for adults with ADHD.
  • Conduct population-based ADHD research that includes information on comorbid conditions and the burden with which they are associated. Much of our current evidence regarding comorbid conditions comes from clinical studies rather than population-based studies.
  • Explore mechanisms to append economic and social burden studies on other ongoing or completed studies in order to quantify the burden of ADHD.
  • Foster collaborations across Federal agencies in order to include information on ADHD in data collection efforts.
  • Establish a resource for both professionals and the public regarding what is known about the impact of ADHD.

 

Epidemiologic Issues in ADHD

 

Issues

Although investigation of ADHD has been quite extensive over the past 30 years, the scientific process has been significantly slowed by the lack of a single, consistent, and standard research protocol for case identification. Variable and disparate findings have been noted throughout the literature even on basic issues such as prevalence. As a consequence, speculation regarding possible increases in ADHD prevalence cannot currently be evaluated.

Additionally, we do not have demographic and descriptive statistics for children and adults with the disorder; therefore, there are disparities in identification, access to treatment, and reports of the manifestation of ADHD and its comorbidities. Risk factors for ADHD have not been thoroughly investigated although some clinical samples have identified possible factors that may contribute to ADHD. Some of these related factors are prenatal alcohol use, prenatal smoking, and low birth weight. Genetic predisposition or family history of ADHD has been noted consistently among clinical samples as a risk factor for the development of ADHD.

Unfortunately, many fundamental etiologic questions remain for ADHD. Identifying and understanding etiologic factors will enhance prevention efforts and treatment for both children and adults with ADHD.

 

Action to Address Public Health Needs
  • Develop standard case identification protocols for use in research projects.
  • Conduct etiologic studies of ADHD using population-based approaches to identify important risk factors and opportunities for prevention activities and research.
  • Use observational epidemiologic methods to describe the impact of ADHD, its impact, and its intervention patterns at the population level.
  • Utilize scientific findings to develop, design, and implement ADHD prevention efforts where possible.
  • Identify current national or regional surveys where adding ADHD questions would provide particularly useful information regarding the magnitude of the disorder, the nature of common comorbidity and/or secondary conditions, as well as data on health risk behaviors and long-term outcomes for those with ADHD.
  • Establish a Federal interagency workgroup to pool research expertise and resources in order to launch epidemiologic research efforts that address the public health research needs in ADHD. Such collaborations should be multi-disciplinary and include professionals in epidemiology, mental/physical health, risk behavior prevention, and health communication for example.
  • Establish a resource for both professionals and the public regarding what is known about the epidemiology of ADHD.

 

Interventions for ADHD

 

IssuesYoung girl playing soccer

ADHD is a chronic condition of high prevalence that requires long-term intervention. Because ADHD is an impairing condition and can have lifelong consequences, interventions designed to reduce negative outcomes and increase capacities should be carefully considered at the national level. One key public health concern is the safety of pharmacological interventions. A second key concern is the effectiveness of current interventions to reduce the impairment associated with ADHD thereby improving health and functioning for ADHD individuals over time. A third public health concern is access to appropriate interventions for individuals and families affected by the disorder.

There are several public health concerns relative to pharmacotherapy. Pharmacologic treatment is extremely prevalent. Assessing the health risks and benefits to young children, particularly preschoolers, is a high priority. Children who begin medication therapies very early and receive treatment on a long-term basis may have unknown risks associated with current treatments. Additionally, pharmacologic interventions often do not normalize behavior. Research, albeit limited, suggests that even with long-term treatment, children and adults with ADHD experience substantial problems in the school, home, workplace, and community settings. This raises questions about the effectiveness of pharmacologic interventions as a long-term approach.

Another intervention option to treat ADHD is behavior modification. It is clear that behavior modification therapies, for youth in particular, have been tested and shown beneficial for the treatment of behavioral disorders including ADHD. However, the majority of youth receiving psychological interventions for ADHD are probably receiving treatments that have not been shown to be effective, such as individual therapy and/or play therapy. The effectiveness of behavioral interventions must be further studied in the treatment of ADHD, to better understand their potential to normalize the behavior and functioning of those with the disorder, especially when combined with pharmacotherapy.

Access to interventions is a critical public health concern. ADHD affects a person’s ability to learn and be socialized to his/her potential; therefore access to diagnosis and intervention is a necessity. Common barriers to services include lack of insurance coverage for mental health problems, exclusion of behavior disorders, including ADHD, from mental health coverage, and under-identification or mis-identification. Community practice with respect to the diagnosis of ADHD fails to uniformly employ accepted methods for establishing cross-situational symptomatology, measurement of functional impairment, and diagnosis of comorbid conditions. Nationally, we must begin to look at a wide variety of intervention issues surrounding ADHD, including how current interventions impact individuals and systems over time, as well as problems with access to appropriate services.

 

Action to Address Public Health Needs
  • Disseminate educational materials relating to the diagnosis of and intervention opportunities for ADHD. Recipients should include but would not be limited to primary care physicians, physician extenders (NP’s and PA’s), mental health professionals, and educators.
  • Promote the necessity of careful case identification using standardized instruments and the employment of the most effective interventions in common practice by disseminating useful information to professionals and the public related evidence-based interventions for ADHD.
  • Conduct population-based studies of ADHD intervention practices to examine such variables as age of initiation of treatment, type(s) of treatment, duration of treatment, and barriers to receipt of services.
  • Establish a mechanism (possibly a registry) of treated individuals to monitor the health effects and potential benefits of long-term treatment for ADHD, particularly among pre-school age children. Additionally collect other related outcomes such as school attainment, interface with judicial system, work performance, and other pertinent variables.
  • Collaborate with other organizations to educate and promote what is known about ADHD interventions, appropriate standards of practice, their effectiveness, and their safety.
  • Establish a resource to the public for accurate and valid information about ADHD and evidence-based interventions.

 

Articles

* These CDC scientific articles are listed in order of date published

 

Increasing Prevalence of Parent-Reported Attention-Deficit/Hyperactivity Disorder Among Children – United States, 2003 and 2007
Morbidity and Mortality Weekly Report (MMWR); November 12, 2010 / 59(44);1439-1443
CDC
[Read article]

 

Diagnosed Attention Deficit Hyperactivity Disorder and Learning Disability: United States, 2004-2006
Vital and Health Statistics; July 2008; Series 10, Number 237
CDC
[Read article Adobe PDF file]

 

Summary Health Statistics for U.S. Children: National Health Interview Survey, 2006 
Vital and Health Statistics; September 2007; Series 10 Number 234, Appendix III, Table VI
CDC
[Read article Adobe PDF file]

 

When you click
“Read article”

  • Some links will take you to the full article.
  • Some links will take you to a short summary of the article. The full article is available to subscribers of the publication’s service.

National Estimates and Factors Associated With Medication Treatment for Childhood Attention-Deficit/Hyperactivity Disorder 
Pediatrics; Vol. 119 Supplement February 2007, pp. S99-S106
Susanna N. Visser, MS, Catherine A. Lesesne, PhD, MPH and Ruth Perou, PhD
[Read article]External Web Site Icon

 

Mental Health in the United States: Prevalence of Diagnosis and Medication Treatment for Attention-Deficit/Hyperactivity Disorder — United States, 2003
Morbidity and Mortality Weekly Report; September 2, 2005; 54(34); 842-847
CDC
[Read article]

 

Attention-Deficit/Hyperactivity Disorder in School-Aged Children: Association with Maternal Mental Health and use of Health Care Resources
Pediatrics; 2003; 111:S1232-1237
Lesesne CA, Visser SN, White CP
[Read article]External Web Site Icon

 

The Epidemiology of Attention-Deficit/Hyperactivity Disorder (ADHD): A Public Health View
Mental Retardation Developmental Disability Research Review; 2002; 8:162-170
Rowland AS, Lesesne CA, Abramowitz AJ
[Read article]External Web Site Icon

 

All Articles

To search a database of articles that have been published by CDC authors within the National Center on Birth Defects and Developmental Disabilities from 1990 to present, click here.

 

As in

www.cdc.gov/

Lies told constantly to kids & 3 Possible Consequences ?

It’s not because we want it, it’s just because.. Paul Graham reminds adults that they are the ones that frequently lie to their kids. Let’s see why.

Adults lie constantly to kids


Adults lie constantly to kids. I’m not saying we should stop, but I think we should at least examine which lies we tell and why.

There may also be a benefit to us. We were all lied to as kids, and some of the lies we were told still affect us. So by studying the ways adults lie to kids, we may be able to clear our heads of lies we were told.

I’m using the word “lie” in a very general sense: not just overt falsehoods, but also all the more subtle ways we mislead kids. Though “lie” has negative connotations, I don’t mean to suggest we should never do this—just that we should pay attention when we do. [1]

One of the most remarkable things about the way we lie to kids is how broad the conspiracy is. All adults know what their culture lies to kids about: they’re the questions you answer “Ask your parents.” If a kid asked who won the World Series in 1982 or what the atomic weight of carbon was, you could just tell him. But if a kid asks you “Is there a God?” or “What’s a prostitute?” you’ll probably say “Ask your parents.”

Since we all agree, kids see few cracks in the view of the world presented to them. The biggest disagreements are between parents and schools, but even those are small. Schools are careful what they say about controversial topics, and if they do contradict what parents want their kids to believe, parents either pressure the school into keeping quiet or move their kids to a new school.

The conspiracy is so thorough that most kids who discover it do so only by discovering internal contradictions in what they’re told. It can be traumatic for the ones who wake up during the operation. Here’s what happened to Einstein:

Through the reading of popular scientific books I soon reached the conviction that much in the stories of the Bible could not be true. The consequence was a positively fanatic freethinking coupled with the impression that youth is intentionally being deceived by the state through lies: it was a crushing impression. [2]

I remember that feeling. By 15 I was convinced the world was corrupt from end to end. That’s why movies like The Matrixhave such resonance. Every kid grows up in a fake world. In a way it would be easier if the forces behind it were as clearly differentiated as a bunch of evil machines, and one could make a clean break just by taking a pill.

Protection

If you ask adults why they lie to kids, the most common reason they give is to protect them. And kids do need protecting. The environment you want to create for a newborn child will be quite unlike the streets of a big city.

That seems so obvious it seems wrong to call it a lie. It’s certainly not a bad lie to tell, to give a baby the impression the world is quiet and warm and safe. But this harmless type of lie can turn sour if left unexamined.

Imagine if you tried to keep someone in as protected an environment as a newborn till age 18. To mislead someone so grossly about the world would seem not protection but abuse. That’s an extreme example, of course; when parents do that sort of thing it becomes national news. But you see the same problem on a smaller scale in the malaise teenagers feel in suburbia.

The main purpose of suburbia is to provide a protected environment for children to grow up in. And it seems great for 10 year olds. I liked living in suburbia when I was 10. I didn’t notice how sterile it was. My whole world was no bigger than a few friends’ houses I bicycled to and some woods I ran around in. On a log scale I was midway between crib and globe. A suburban street was just the right size. But as I grew older, suburbia started to feel suffocatingly fake.

Life can be pretty good at 10 or 20, but it’s often frustrating at 15. This is too big a problem to solve here, but certainly one reason life sucks at 15 is that kids are trapped in a world designed for 10 year olds.

What do parents hope to protect their children from by raising them in suburbia? A friend who moved out of Manhattan said merely that her 3 year old daughter “saw too much.” Off the top of my head, that might include: people who are high or drunk, poverty, madness, gruesome medical conditions, sexual behavior of various degrees of oddness, and violent anger.

I think it’s the anger that would worry me most if I had a 3 year old. I was 29 when I moved to New York and I was surprised even then. I wouldn’t want a 3 year old to see some of the disputes I saw. It would be too frightening. A lot of the things adults conceal from smaller children, they conceal because they’d be frightening, not because they want to conceal the existence of such things. Misleading the child is just a byproduct.

This seems one of the most justifiable types of lying adults do to kids. But because the lies are indirect we don’t keep a very strict accounting of them. Parents know they’ve concealed the facts about sex, and many at some point sit their kids down and explain more. But few tell their kids about the differences between the real world and the cocoon they grew up in. Combine this with the confidence parents try to instill in their kids, and every year you get a new crop of 18 year olds who think they know how to run the world.

Don’t all 18 year olds think they know how to run the world? Actually this seems to be a recent innovation, no more than about 100 years old. In preindustrial times teenage kids were junior members of the adult world and comparatively well aware of their shortcomings. They could see they weren’t as strong or skillful as the village smith. In past times people lied to kids about some things more than we do now, but the lies implicit in an artificial, protected environment are a recent invention. Like a lot of new inventions, the rich got this first. Children of kings and great magnates were the first to grow up out of touch with the world. Suburbia means half the population can live like kings in that respect.

Sex (and Drugs)

I’d have different worries about raising teenage kids in New York. I’d worry less about what they’d see, and more about what they’d do. I went to college with a lot of kids who grew up in Manhattan, and as a rule they seemed pretty jaded. They seemed to have lost their virginity at an average of about 14 and by college had tried more drugs than I’d even heard of.

The reasons parents don’t want their teenage kids having sex are complex. There are some obvious dangers: pregnancy and sexually transmitted diseases. But those aren’t the only reasons parents don’t want their kids having sex. The average parents of a 14 year old girl would hate the idea of her having sex even if there were zero risk of pregnancy or sexually transmitted diseases.

Kids can probably sense they aren’t being told the whole story. After all, pregnancy and sexually transmitted diseases are just as much a problem for adults, and they have sex.

What really bothers parents about their teenage kids having sex? Their dislike of the idea is so visceral it’s probably inborn. But if it’s inborn it should be universal, and there are plenty of societies where parents don’t mind if their teenage kids have sex—indeed, where it’s normal for 14 year olds to become mothers. So what’s going on? There does seem to be a universal taboo against sex with prepubescent children. One can imagine evolutionary reasons for that. And I think this is the main reason parents in industrialized societies dislike teenage kids having sex. They still think of them as children, even though biologically they’re not, so the taboo against child sex still has force.

One thing adults conceal about sex they also conceal about drugs: that it can cause great pleasure. That’s what makes sex and drugs so dangerous. The desire for them can cloud one’s judgement—which is especially frightening when the judgement being clouded is the already wretched judgement of a teenage kid.

Here parents’ desires conflict. Older societies told kids they had bad judgement, but modern parents want their children to be confident. This may well be a better plan than the old one of putting them in their place, but it has the side effect that after having implicitly lied to kids about how good their judgement is, we then have to lie again about all the things they might get into trouble with if they believed us.

If parents told their kids the truth about sex and drugs, it would be: the reason you should avoid these things is that you have lousy judgement. People with twice your experience still get burned by them. But this may be one of those cases where the truth wouldn’t be convincing, because one of the symptoms of bad judgement is believing you have good judgement. When you’re too weak to lift something, you can tell, but when you’re making a decision impetuously, you’re all the more sure of it.

Innocence

Another reason parents don’t want their kids having sex is that they want to keep them innocent. Adults have a certain model of how kids are supposed to behave, and it’s different from what they expect of other adults.

One of the most obvious differences is the words kids are allowed to use. Most parents use words when talking to other adults that they wouldn’t want their kids using. They try to hide even the existence of these words for as long as they can. And this is another of those conspiracies everyone participates in: everyone knows you’re not supposed to swear in front of kids.

I’ve never heard more different explanations for anything parents tell kids than why they shouldn’t swear. Every parent I know forbids their children to swear, and yet no two of them have the same justification. It’s clear most start with not wanting kids to swear, then make up the reason afterward.

So my theory about what’s going on is that the function of swearwords is to mark the speaker as an adult. There’s no difference in the meaning of “shit” and “poopoo.” So why should one be ok for kids to say and one forbidden? The only explanation is: by definition. [3]

Why does it bother adults so much when kids do things reserved for adults? The idea of a foul-mouthed, cynical 10 year old leaning against a lamppost with a cigarette hanging out of the corner of his mouth is very disconcerting. But why?

One reason we want kids to be innocent is that we’re programmed to like certain kinds of helplessness. I’ve several times heard mothers say they deliberately refrained from correcting their young children’s mispronunciations because they were so cute. And if you think about it, cuteness is helplessness. Toys and cartoon characters meant to be cute always have clueless expressions and stubby, ineffectual limbs.

It’s not surprising we’d have an inborn desire to love and protect helpless creatures, considering human offspring are so helpless for so long. Without the helplessness that makes kids cute, they’d be very annoying. They’d merely seem like incompetent adults. But there’s more to it than that. The reason our hypothetical jaded 10 year old bothers me so much is not just that he’d be annoying, but that he’d have cut off his prospects for growth so early. To be jaded you have to think you know how the world works, and any theory a 10 year old had about that would probably be a pretty narrow one.

Innocence is also open-mindedness. We want kids to be innocent so they can continue to learn. Paradoxical as it sounds, there are some kinds of knowledge that get in the way of other kinds of knowledge. If you’re going to learn that the world is a brutal place full of people trying to take advantage of one another, you’re better off learning it last. Otherwise you won’t bother learning much more.

Very smart adults often seem unusually innocent, and I don’t think this is a coincidence. I think they’ve deliberately avoided learning about certain things. Certainly I do. I used to think I wanted to know everything. Now I know I don’t.

Death

After sex, death is the topic adults lie most conspicuously about to kids. Sex I believe they conceal because of deep taboos. But why do we conceal death from kids? Probably because small children are particularly horrified by it. They want to feel safe, and death is the ultimate threat.

One of the most spectacular lies our parents told us was about the death of our first cat. Over the years, as we asked for more details, they were compelled to invent more, so the story grew quite elaborate. The cat had died at the vet’s office. Of what? Of the anaesthesia itself. Why was the cat at the vet’s office? To be fixed. And why had such a routine operation killed it? It wasn’t the vet’s fault; the cat had a congenitally weak heart; the anaesthesia was too much for it; but there was no way anyone could have known this in advance. It was not till we were in our twenties that the truth came out: my sister, then about three, had accidentally stepped on the cat and broken its back.

They didn’t feel the need to tell us the cat was now happily in cat heaven. My parents never claimed that people or animals who died had “gone to a better place,” or that we’d meet them again. It didn’t seem to harm us.

My grandmother told us an edited version of the death of my grandfather. She said they’d been sitting reading one day, and when she said something to him, he didn’t answer. He seemed to be asleep, but when she tried to rouse him, she couldn’t. “He was gone.” Having a heart attack sounded like falling asleep. Later I learned it hadn’t been so neat, and the heart attack had taken most of a day to kill him.

Along with such outright lies, there must have been a lot of changing the subject when death came up. I can’t remember that, of course, but I can infer it from the fact that I didn’t really grasp I was going to die till I was about 19. How could I have missed something so obvious for so long? Now that I’ve seen parents managing the subject, I can see how: questions about death are gently but firmly turned aside.

On this topic, especially, they’re met half-way by kids. Kids often want to be lied to. They want to believe they’re living in a comfortable, safe world as much as their parents want them to believe it. [4]

Identity

Some parents feel a strong adherence to an ethnic or religious group and want their kids to feel it too. This usually requires two different kinds of lying: the first is to tell the child that he or she is an X, and the second is whatever specific lies Xes differentiate themselves by believing. [5]

Telling a child they have a particular ethnic or religious identity is one of the stickiest things you can tell them. Almost anything else you tell a kid, they can change their mind about later when they start to think for themselves. But if you tell a kid they’re a member of a certain group, that seems nearly impossible to shake.

This despite the fact that it can be one of the most premeditated lies parents tell. When parents are of different religions, they’ll often agree between themselves that their children will be “raised as Xes.” And it works. The kids obligingly grow up considering themselves as Xes, despite the fact that if their parents had chosen the other way, they’d have grown up considering themselves as Ys.

One reason this works so well is the second kind of lie involved. The truth is common property. You can’t distinguish your group by doing things that are rational, and believing things that are true. If you want to set yourself apart from other people, you have to do things that are arbitrary, and believe things that are false. And after having spent their whole lives doing things that are arbitrary and believing things that are false, and being regarded as odd by “outsiders” on that account, the cognitive dissonance pushing children to regard themselves as Xes must be enormous. If they aren’t an X, why are they attached to all these arbitrary beliefs and customs? If they aren’t an X, why do all the non-Xes call them one?

This form of lie is not without its uses. You can use it to carry a payload of beneficial beliefs, and they will also become part of the child’s identity. You can tell the child that in addition to never wearing the color yellow, believing the world was created by a giant rabbit, and always snapping their fingers before eating fish, Xes are also particularly honest and industrious. Then X children will grow up feeling it’s part of their identity to be honest and industrious.

This probably accounts for a lot of the spread of modern religions, and explains why their doctrines are a combination of the useful and the bizarre. The bizarre half is what makes the religion stick, and the useful half is the payload. [6]

Authority

One of the least excusable reasons adults lie to kids is to maintain power over them. Sometimes these lies are truly sinister, like a child molester telling his victims they’ll get in trouble if they tell anyone what happened to them. Others seem more innocent; it depends how badly adults lie to maintain their power, and what they use it for.

Most adults make some effort to conceal their flaws from children. Usually their motives are mixed. For example, a father who has an affair generally conceals it from his children. His motive is partly that it would worry them, partly that this would introduce the topic of sex, and partly (a larger part than he would admit) that he doesn’t want to tarnish himself in their eyes.

If you want to learn what lies are told to kids, read almost any book written to teach them about “issues.” [7] Peter Mayle wrote one called Why Are We Getting a Divorce? It begins with the three most important things to remember about divorce, one of which is:

You shouldn’t put the blame on one parent, because divorce is never only one person’s fault. [8]

Really? When a man runs off with his secretary, is it always partly his wife’s fault? But I can see why Mayle might have said this. Maybe it’s more important for kids to respect their parents than to know the truth about them.

But because adults conceal their flaws, and at the same time insist on high standards of behavior for kids, a lot of kids grow up feeling they fall hopelessly short. They walk around feeling horribly evil for having used a swearword, while in fact most of the adults around them are doing much worse things.

This happens in intellectual as well as moral questions. The more confident people are, the more willing they seem to be to answer a question “I don’t know.” Less confident people feel they have to have an answer or they’ll look bad. My parents were pretty good about admitting when they didn’t know things, but I must have been told a lot of lies of this type by teachers, because I rarely heard a teacher say “I don’t know” till I got to college. I remember because it was so surprising to hear someone say that in front of a class.

The first hint I had that teachers weren’t omniscient came in sixth grade, after my father contradicted something I’d learned in school. When I protested that the teacher had said the opposite, my father replied that the guy had no idea what he was talking about—that he was just an elementary school teacher, after all.

Just a teacher? The phrase seemed almost grammatically ill-formed. Didn’t teachers know everything about the subjects they taught? And if not, why were they the ones teaching us?

The sad fact is, US public school teachers don’t generally understand the stuff they’re teaching very well. There are some sterling exceptions, but as a rule people planning to go into teaching rank academically near the bottom of the college population. So the fact that I still thought at age 11 that teachers were infallible shows what a job the system must have done on my brain.

School

What kids get taught in school is a complex mix of lies. The most excusable are those told to simplify ideas to make them easy to learn. The problem is, a lot of propaganda gets slipped into the curriculum in the name of simplification.

Public school textbooks represent a compromise between what various powerful groups want kids to be told. The lies are rarely overt. Usually they consist either of omissions or of over-emphasizing certain topics at the expense of others. The view of history we got in elementary school was a crude hagiography, with at least one representative of each powerful group.

The famous scientists I remember were Einstein, Marie Curie, and George Washington Carver. Einstein was a big deal because his work led to the atom bomb. Marie Curie was involved with X-rays. But I was mystified about Carver. He seemed to have done stuff with peanuts.

It’s obvious now that he was on the list because he was black (and for that matter that Marie Curie was on it because she was a woman), but as a kid I was confused for years about him. I wonder if it wouldn’t have been better just to tell us the truth: that there weren’t any famous black scientists. Ranking George Washington Carver with Einstein misled us not only about science, but about the obstacles blacks faced in his time.

As subjects got softer, the lies got more frequent. By the time you got to politics and recent history, what we were taught was pretty much pure propaganda. For example, we were taught to regard political leaders as saints—especially the recently martyred Kennedy and King. It was astonishing to learn later that they’d both been serial womanizers, and that Kennedy was a speed freak to boot. (By the time King’s plagiarism emerged, I’d lost the ability to be surprised by the misdeeds of famous people.)

I doubt you could teach kids recent history without teaching them lies, because practically everyone who has anything to say about it has some kind of spin to put on it. Much recent historyconsists of spin. It would probably be better just to teach them metafacts like that.

Probably the biggest lie told in schools, though, is that the way to succeed is through following “the rules.” In fact most such rules are just hacks to manage large groups efficiently.

Peace

Of all the reasons we lie to kids, the most powerful is probably the same mundane reason they lie to us.

Often when we lie to people it’s not part of any conscious strategy, but because they’d react violently to the truth. Kids, almost by definition, lack self-control. They react violently to things—and so they get lied to a lot. [9]

A few Thanksgivings ago, a friend of mine found himself in a situation that perfectly illustrates the complex motives we have when we lie to kids. As the roast turkey appeared on the table, his alarmingly perceptive 5 year old son suddenly asked if the turkey had wanted to die. Foreseeing disaster, my friend and his wife rapidly improvised: yes, the turkey had wanted to die, and in fact had lived its whole life with the aim of being their Thanksgiving dinner. And that (phew) was the end of that.

Whenever we lie to kids to protect them, we’re usually also lying to keep the peace.

One consequence of this sort of calming lie is that we grow up thinking horrible things are normal. It’s hard for us to feel a sense of urgency as adults over something we’ve literally been trained not to worry about. When I was about 10 I saw a documentary on pollution that put me into a panic. It seemed the planet was being irretrievably ruined. I went to my mother afterward to ask if this was so. I don’t remember what she said, but she made me feel better, so I stopped worrying about it.

That was probably the best way to handle a frightened 10 year old. But we should understand the price. This sort of lie is one of the main reasons bad things persist: we’re all trained to ignore them.

Detox

A sprinter in a race almost immediately enters a state called “oxygen debt.” His body switches to an emergency source of energy that’s faster than regular aerobic respiration. But this process builds up waste products that ultimately require extra oxygen to break down, so at the end of the race he has to stop and pant for a while to recover.

We arrive at adulthood with a kind of truth debt. We were told a lot of lies to get us (and our parents) through our childhood. Some may have been necessary. Some probably weren’t. But we all arrive at adulthood with heads full of lies.

There’s never a point where the adults sit you down and explain all the lies they told you. They’ve forgotten most of them. So if you’re going to clear these lies out of your head, you’re going to have to do it yourself.

Few do. Most people go through life with bits of packing material adhering to their minds and never know it. You probably never can completely undo the effects of lies you were told as a kid, but it’s worth trying. I’ve found that whenever I’ve been able to undo a lie I was told, a lot of other things fell into place.

Fortunately, once you arrive at adulthood you get a valuable new resource you can use to figure out what lies you were told. You’re now one of the liars. You get to watch behind the scenes as adults spin the world for the next generation of kids.

The first step in clearing your head is to realize how far you are from a neutral observer. When I left high school I was, I thought, a complete skeptic. I’d realized high school was crap. I thought I was ready to question everything I knew. But among the many other things I was ignorant of was how much debris there already was in my head. It’s not enough to consider your mind a blank slate. You have to consciously erase it.

ON THE MORALITY MOUNTAIN :

Three Lies Children Tell…and What You Can Do About Them (…)

 

Honesty is the basis of good character, so when our child lies we need a strategy to teach him that it is wrong. One approach does not fit all situations, so wise parents go below the surface of the child’s lie to find the key to choosing the appropriate response.

Lying as Fantasy

Especially common in younger children, tall tales flow so easily from some children. A playful approach will get you through this stage. Playing along with a young child’s fantasy story does no harm, but it’s best to let the child know this is just ‘pretend’.

Lying to Divert Blame

More seriously, all children at some point will try lying to divert blame for something they did wrong. Younger ones will blame an infraction or accident on an imaginary ‘bad’ child. Older kids will tell an outright lie to cover up their guilt and avoid punishment. The emotions at work here are guilt, anxiety, and fear.

The best approach to this kind of lie is a matter-of-fact acknowledgement that the child is lying while giving the appropriate consequence for the misbehavior. A gentle explanation to your younger child that you expect her to tell the truth when she does something wrong should be followed by an opportunity for her to make amends. Your older child knows that lying is wrong, and he should receive a consequence for both the misbehavior and the lying.

Compulsive Lying

Lying that becomes a habit is even more serious and should be confronted consistently. You do need those eyes in the back of your head if your child lies frequently. Most parents learn to recognize the non-verbal signals that their child is lying, but a child who lies compulsively gets pretty good at it. To break the cycle, you need to keep the upper hand and continually give consequences for lying. A long-term consistent effort may be needed, but it should pay off when the child learns that lying is never his best option.

 

Notes

[1] One reason I stuck with such a brutally simple word is that the lies we tell kids are probably not quite as harmless as we think. If you look at what adults told children in the past, it’s shocking how much they lied to them. Like us, they did it with the best intentions. So if we think we’re as open as one could reasonably be with children, we’re probably fooling ourselves. Odds are people in 100 years will be as shocked at some of the lies we tell as we are at some of the lies people told 100 years ago.

I can’t predict which these will be, and I don’t want to write an essay that will seem dumb in 100 years. So instead of using special euphemisms for lies that seem excusable according to present fashions, I’m just going to call all our lies lies.

(I have omitted one type: lies told to play games with kids’ credulity. These range from “make-believe,” which is not really a lie because it’s told with a wink, to the frightening lies told by older siblings. There’s not much to say about these: I wouldn’t want the first type to go away, and wouldn’t expect the second type to.)

[2] Calaprice, Alice (ed.), The Quotable Einstein, Princeton University Press, 1996.

[3] If you ask parents why kids shouldn’t swear, the less educated ones usually reply with some question-begging answer like “it’s inappropriate,” while the more educated ones come up with elaborate rationalizations. In fact the less educated parents seem closer to the truth.

[4] As a friend with small children pointed out, it’s easy for small children to consider themselves immortal, because time seems to pass so slowly for them. To a 3 year old, a day feels like a month might to an adult. So 80 years sounds to him like 2400 years would to us.

[5] I realize I’m going to get endless grief for classifying religion as a type of lie. Usually people skirt that issue with some equivocation implying that lies believed for a sufficiently long time by sufficiently large numbers of people are immune to the usual standards for truth. But because I can’t predict which lies future generations will consider inexcusable, I can’t safely omit any type we tell. Yes, it seems unlikely that religion will be out of fashion in 100 years, but no more unlikely than it would have seemed to someone in 1880 that schoolchildren in 1980 would be taught that masturbation was perfectly normal and not to feel guilty about it.

[6] Unfortunately the payload can consist of bad customs as well as good ones. For example, there are certain qualities that some groups in America consider “acting white.” In fact most of them could as accurately be called “acting Japanese.” There’s nothing specifically white about such customs. They’re common to all cultures with long traditions of living in cities. So it is probably a losing bet for a group to consider behaving the opposite way as part of its identity.

[7] In this context, “issues” basically means “things we’re going to lie to them about.” That’s why there’s a special name for these topics.

[8] Mayle, Peter, Why Are We Getting a Divorce?, Harmony, 1988.

[9] The ironic thing is, this is also the main reason kids lie to adults. If you freak out when people tell you alarming things, they won’t tell you them. Teenagers don’t tell their parents what happened that night they were supposed to be staying at a friend’s house for the same reason parents don’t tell 5 year olds the truth about the Thanksgiving turkey. They’d freak if they knew.

Thanks to Sam Altman, Marc Andreessen, Trevor Blackwell, Patrick Collison, Jessica Livingston, Jackie McDonough, Robert Morris, and David Sloo for reading drafts of this. And since there are some controversial ideas here, I should add that none of them agreed with everything in it.

As in

www.paulgraham.com/boss.html/

ttp://childparenting.about.com/od/lyingandstealing/a/kidslying.htm