Friday, November 29, 2013

Dealing with an Addicted Teen During the Holidays



Published on December 12, 2011 by Ugo Uche in Promoting Empathy With Your Teen

Psychology Today~Once I was working with a family whose son presented with a dire need to be placed into a residential therapeutic program. After a major relapse which led to a return of habitually abusing heroin, I shared with his parents that I believed his life was in danger and that he needed to be placed into residential treatment. This took place some years ago and we were in the month of December.

His mother looked at me keenly and said;
"Ugo can we wait until after Christmas?"
"The choice to wait is yours, but I believe you have run out of time," at this point both parents were frowning at me. The father then spoke up.

"In our family Christmas its scared, I understand you mean well but we are not going to send our son away, especially since we have his grandparents coming over and he hasn't seen them in a year and a half."

"Okay," I replied. "I understand, but could you both share with me how last Christmas went?" 

I already knew the story, both parents had woken up on Christmas to discover that most of the Christmas presents they had wrapped for themselves and their four children had disappeared. After an intense confrontation, my client at the time who according to his parents was clearly under the influence, would claim that he had taken the presents to goodwill, because he believed the family was too materialistic. However what really happened as his parents quickly figured out, was that my client had either sold or pawned the presents for money he used to buy drugs.

After I asked my question both parents didn't answer, they had been reminded how the last two years of their son's addiction had strained the family.

Sometimes in response to stress we create delusions for ourselves. We convince ourselves that things are happening the way we want them to be happening. It's the equivalent of closing our eyes and hoping that the problem will disappear on its own.

Having being raised Anglican, I get the significant of holiday traditions like Christmas. However it's important never to get carried away with traditions or nostalgia this holiday season. If there is a problem with your child or teen that routinely overshadows family affairs, it should be held to a higher priority than traditional celebrations.

As for the family I was working with, they didn't have long to debate over a decision. Their son was arrested on a drug related charge two days later. 


For more information visit: http://www.psychologytoday.com/blog/promoting-empathy-your-teen/201112/dealing-addicted-teen-during-the-holidays

Thursday, November 28, 2013

Washington High School Students More Likely To Smoke Pot Than Cigarettes: Survey



By DONNA GORDON BLANKINSHIP
Huffington Post~SEATTLE  Washington high school students who participated in a statewide survey say they are twice as likely to smoke marijuana as cigarettes, and the state's top health official said Thursday she's worried that a new marijuana law may make prevention efforts more difficult.
High school smoking has decreased significantly across the state, with cigarette smoking down in grades 6, 8, 10 and 12, but the number of high school students who believe using marijuana is risky is also at a low point, health officials said after releasing the 2012 survey results.
More than half of 10th graders said it is easy to get marijuana and about 19 percent said they smoked marijuana within 30 days of the survey. About 27 percent of 12th graders said they smoked pot.
More than 200,000 youth took the voluntary and anonymous survey in October.
In November, Washington and Colorado voters legalized marijuana possession for adults over 21. Possession remains illegal for youth.
Washington Health Secretary Mary Selecky expressed concern that marijuana prevention efforts aren't ready to ramp up in response to the new state law.
"As the perception of harm goes down, use goes up," she said.
Some of Washington's anticipated tax revenue from sales of marijuana at state licensed stores will be devoted to youth prevention education. But Selecky said marijuana stores are expected to open before new money for prevention efforts flows to the state. She noted that the state has worked hard to keep tobacco out of the hands of minors by making it illegal for anyone under 19 to buy cigarettes, but kids are still getting their hands on tobacco.
Washington already does some youth drug prevention, but to get the results seen in smoking prevention, they will need to increase their efforts significantly, Selecky said.
"We have our work cut out for us," she said.
A University of Washington researcher who supported the new marijuana law said it's a big improvement over prohibition alone, since the government has done a lousy job of educating young people about marijuana.
"More adolescents reducing their use of tobacco is an indicator, as I see it, of the effectiveness of well-funded, science-based education," said Roger Roffman, a professor emeritus of social work and a therapist in private practice. "If that can work with tobacco, why wouldn't it work with regard to marijuana?"
He expects this public health effort, which was not included in the Colorado law, will be more effective in preventing harm, and encouraging healthy decisions than prohibition.
The healthy youth survey conducted in 2012 also found that fewer students are using alcohol, compared with 2010. About 23 percent of students in 10th grade reported drinking alcohol over the previous 30 days, compared with 28 percent in 2010. That number peaked at 45 percent in 1999. The 12th grade numbers dropped from 40 percent in 2010 to 36 percent in 2012.
The Healthy Youth Survey is taken every two years by students in grades 6, 8, 10 and 12, in more than 1,000 public schools in Washington.

Wednesday, November 27, 2013

Alcohol and Teens


WebMD

Medical Author:   

Medical Editor: Melissa Conrad Stöppler, MD 

How much alcohol do teens use?
Comment on this
Alcohol is the most frequently used drug byteenagers in the United States. About half of junior high and senior high school students drink alcohol on a monthly basis, and 14% of teens have been intoxicated at least once in the past year. Nearly 8% of teens who drink say they drink at least five or more alcoholic drinks in a row (binge drink).

What are the dangerous effects of alcohol use in teens?

Just a few of the many dangerous effects of alcohol use in teens include the following:
  • Alcohol decreases teens' ability to pay attention.
  • Teens who have experienced alcohol withdrawal tend to have difficulties with memory.
  • In contrast to adults, teens tend to abuse alcohol with other substances, usually marijuana.
  • Male teens who drink heavily tend to complete fewer years of education compared to male teens who do not.
  • The younger a person is when they begin drinking, the more likely they are to develop a problem with alcohol.
  • Each year, almost 2,000 people under the age of 21 years die in car crashes in which underage drinking is involved. Alcohol is involved in nearly half of all violent deaths involving teens.
  • More than three times the number of eighth-grade girls who drink heavily said they have attempted suicide compared to girls in that grade who do not drink.
  • Intoxication is associated with suicide attempts using more lethal methods, and positive blood alcohol levels are often found in people who complete suicide.
  • Teens who drink are more likely to engage in sexual activity, have unprotected sex, have sex with a stranger, or be the victim or perpetrator of a sexual assault.
  • Excess alcohol use can cause or mask other emotional problems, likeanxiety or depression.
  • Drinking in excess can lead to the use of other drugs, like marijuana, cocaine, or heroin.
  • How can parents prevent alcohol use?

    Comment on this
    Clear communication by parents about the negative effects of alcohol, as well as about their expectations regarding drug use, have been found to significantly decrease alcohol use in teens. Adequate parental supervision has also been found to be a deterrent to alcohol use in youth. Alcohol, and other drug use, has been found to occur most often between the hours of 3 p.m. and 6 p.m., immediately after school and prior to parents' arrival at home from work. Teen participation in extracurricular activities has therefore been revealed to be an important measure in preventing use of alcohol in this age group. Parents can also help educate teens about appropriate coping and stress-management strategies. For example, 15- to 16-year-olds who use religion to cope with stress tend to use drugs significantly less often and have less problems as a result of drinking than their peers who do not use religion to cope.

    What are the symptoms and signs of alcohol intoxication?

    Comment on this
    Signs that indicate a person is intoxicated include the smell of alcohol on their breath or skin, glazed or bloodshot eyes, the person being unusually passive or argumentative, and/or deterioration in the person's appearance or hygiene. Other symptoms of intoxication include flushed skin and memory loss.

    What is alcoholism?

    As defined by the Diagnostic and Statistical Manual of Mental Disorders, alcoholism (alcohol dependence) is a negative pattern of alcohol use leading to a number of problems, which may include needing more alcohol to get intoxicated (tolerance), difficulties that occur when the effects of alcohol wear off (withdrawal), using more alcohol or for longer time than intended, and other life problems because of the use of alcohol.
    Five stages of alcohol and drug use have been identified. The first stage is described as access to alcohol rather than use of alcohol, tobacco, inhalants, or other drugs. In that stage, minimizing the risk factors that make a teenager more vulnerable to using alcohol are an issue. The second stage of alcohol and other drug use ranges from experimentation or occasional use to regular weekly use of alcohol, tobacco, inhalants, or other drugs. The third stage is characterized by youths further increasing the frequency of alcohol use and/or using alcohol and other drugs on a regular basis. This stage may also include the teenager either buying drugs or stealing to get drugs. In the fourth stage of alcohol and drug use, adolescents have established regular usage, have become preoccupied with getting intoxicated ("high") and have developed problems in their social, educational, vocational, or family life as a result of using the substance. The final and most serious fifth stage of alcohol or other drug use is defined by the youth only feeling normal when they are using. During this stage, risk-taking behaviors like stealing, engaging in physical fights, or driving while intoxicated increase, and they become most vulnerable to having suicidal thoughts.

Tuesday, November 26, 2013

Information For Parents About Teen Suicide


KidsHealth~The tragedy of a young person dying because of overwhelming hopelessness or frustration is devastating to family, friends, and community. Parents, siblings, classmates, coaches, and neighbors might be left wondering if they could have done something to prevent that young person from turning to suicide.
Learning more about factors that might lead an adolescent to suicide may help prevent further tragedies. Even though it's not always preventable, it's always a good idea to be informed and take action to help a troubled teenager.

About Teen Suicide

The reasons behind a teen's suicide or attempted suicide can be complex. Although suicide is relatively rare among children, the rate of suicides and suicide attempts increases tremendously during adolescence.
Suicide is the third-leading cause of death for 15- to 24-year-olds, according to the Centers for Disease Control and Prevention (CDC), after accidents and homicide. It's also thought that at least 25 attempts are made for every completed teen suicide.
The risk of suicide increases dramatically when kids and teens have access to firearms at home, and nearly 60% of all suicides in the United States are committed with a gun. That's why any gun in your home should be unloaded, locked, and kept out of the reach of children and teens.
Overdose using over-the-counter, prescription, and non-prescription medicine is also a very common method for both attempting and completing suicide. It's important to monitor carefully all medications in your home. Also be aware that teens will "trade" different prescription medications at school and carry them (or store them) in their locker or backpack.
Suicide rates differ between boys and girls. Girls think about and attempt suicide about twice as often as boys, and tend to attempt suicide by overdosing on drugs or cutting themselves. Yet boys die by suicide about four times as often girls, perhaps because they tend to use more lethal methods, such as firearms, hanging, or jumping from heights.

Which Teens Are at Risk for Suicide?

It can be hard to remember how it felt to be a teen, caught in that gray area between childhood and adulthood. Sure, it's a time of tremendous possibility but it also can be a period of stress and worry. There's pressure to fit in socially, to perform academically, and to act responsibly.
Adolescence is also a time of sexual identity and relationships and a need for independence that often conflicts with the rules and expectations set by others.
Young people with mental health problems — such as anxiety, depression, bipolar disorder, or insomnia — are at higher risk for suicidal thoughts. Teens going through major life changes (parents' divorce, moving, a parent leaving home due to military service or parental separation, financial changes) and those who are victims of bullying are at greater risk of suicidal thoughts.
Factors that increase the risk of suicide among teens include:
  • a psychological disorder, especially depression, bipolar disorder, andalcohol and drug use (in fact, approximately 95% of people who die by suicide have a psychological disorder at the time of death)
  • feelings of distress, irritability, or agitation
  • feelings of hopelessness and worthlessness that often accompany depression
  • a previous suicide attempt
  • a family history of depression or suicide
  • emotional, physical, or sexual abuse
  • lack of a support network, poor relationships with parents or peers, and feelings of social isolation
  • dealing with bisexuality or homosexuality in an unsupportive family or community or hostile school environment

Warning Signs

Suicide among teens often occurs following a stressful life event, such as problems at school, a breakup with a boyfriend or girlfriend, the death of a loved one, a divorce, or a major family conflict.
Teens who are thinking about suicide might:
  • talk about suicide or death in general
  • give hints that they might not be around anymore
  • talk about feeling hopeless or feeling guilty
  • pull away from friends or family
  • write songs, poems, or letters about death, separation, and loss
  • start giving away treasured possessions to siblings or friends
  • lose the desire to take part in favorite things or activities
  • have trouble concentrating or thinking clearly
  • experience changes in eating or sleeping habits
  • engage in risk-taking behaviors
  • lose interest in school or sports

What Can Parents Do?

Many teens who commit or attempt suicide have given some type of warning to loved ones ahead of time. So it's important for parents to know the warning signs so teens who might be suicidal can get the help they need.
Some adults feel that kids who say they are going to hurt or kill themselves are "just doing it for attention." It's important to realize that if teens are ignored when seeking attention, it may increase the chance of them harming themselves (or worse).
Getting attention in the form of ER visits, doctor's appointments, and residential treatment generally is not something teens want — unless they're seriously depressed and thinking about suicide or at least wishing they were dead. It's important to see warning signs as serious, not as "attention-seeking" to be ignored.

Watch and Listen

Keep a close eye on a teen who is depressed and withdrawn. Understanding depression in teens is very important since it can look different from commonly held beliefs about depression. For example, it may take the form of problems with friends, grades, sleep, or being cranky and irritable rather than chronic sadness or crying.
It's important to try to keep the lines of communication open and express your concern, support, and love. If your teen confides in you, show that you take those concerns seriously. A fight with a friend might not seem like a big deal to you in the larger scheme of things, but for a teen it can feel immense and consuming. It's important not to minimize or discount what your teen is going through, as this can increase his or her sense of hopelessness.
If your teen doesn't feel comfortable talking with you, suggest a more neutral person, such as another relative, a clergy member, a coach, a school counselor, or your child's doctor.

Ask Questions

Some parents are reluctant to ask teens if they have been thinking about suicide or hurting themselves. Some fear that by asking, they will plant the idea of suicide in their teen's head.
It's always a good idea to ask, even though doing so can be difficult. Sometimes it helps to explain why you're asking. For instance, you might say: "I've noticed that you've been talking a lot about wanting to be dead. Have you been having thoughts about trying to kill yourself?"

Get Help

If you learn that your child is thinking about suicide, get help immediately. Your doctor can refer you to a psychologist or psychiatrist, or your local hospital's department of psychiatry can provide a list of doctors in your area. Your local mental health association or county medical society can also provide references. In an emergency, you can call (800) SUICIDE.
If your teen is in a crisis situation, your local emergency room can conduct a comprehensive psychiatric evaluation and refer you to the appropriate resources. If you're unsure about whether you should bring your child to the emergency room, contact your doctor or call (800) SUICIDE for help.
If you've scheduled an appointment with a mental health professional, make sure to keep the appointment, even if your teen says he or she is feeling better or doesn't want to go. Suicidal thoughts do tend to come and go; however, it is important that your teen get help developing the skills necessary to decrease the likelihood that suicidal thoughts and behaviors will emerge again if a crisis arises.
If your teen refuses to go to the appointment, discuss this with the mental health professional — and consider attending the session and working with the clinician to make sure your teen has access to the help needed. The clinician also might be able to help you devise strategies to help your teen want to get help.
Remember that ongoing conflicts between a parent and child can fuel the fire for a teen who is feeling isolated, misunderstood, devalued, or suicidal. Get help to air family problems and resolve them in a constructive way. Also let the mental health professional know if there is a history of depression, substance abuse, family violence, or other stresses at home, such as an ongoing environment of criticism.

Helping Teens Cope With Loss

What should you do if someone your teen knows, perhaps a family member, friend, or a classmate, has attempted or committed suicide? First, acknowledge your child's many emotions. Some teens say they feel guilty — especially those who felt they could have interpreted their friend's actions and words better.
Others say they feel angry with the person who committed or attempted suicide for having done something so selfish. Still others say they feel no strong emotions or don't know how to express how they feel. Reassure your child that there is no right or wrong way to feel, and that it's OK to talk about it when he or she feels ready.
When someone attempts suicide and survives, people might be afraid of or uncomfortable talking with him or her about it. Tell your teen to resist this urge; this is a time when a person absolutely needs to feel connected to others.
Many schools address a student's suicide by calling in special counselors to talk with the students and help them cope. If your teen is dealing with a friend or classmate's suicide, encourage him or her to make use of these resources or to talk to you or another trusted adult.

If You've Lost a Child to Suicide

For parents, the death of a child is the most painful loss imaginable. For parents who've lost a child to suicide, the pain and grief can be intensified. Although these feelings may never completely go away, survivors of suicide can take steps to begin the healing process:
  • Maintain contact with others. Suicide can be a very isolating experience for surviving family members because friends often don't know what to say or how to help. Seek out supportive people to talk with about your child and your feelings. If those around you seem uncomfortable about reaching out, initiate the conversation and ask for their help.
  • Remember that your other family members are grieving, too, and that everyone expresses grief in their own way. Your other children, in particular, may try to deal with their pain alone so as not to burden you with additional worries. Be there for each other through the tears, anger, and silences — and, if necessary, seek help and support together.
  • Expect that anniversaries, birthdays, and holidays may be difficult. Important days and holidays often reawaken a sense of loss and anxiety. On those days, do what's best for your emotional needs, whether that means surrounding yourself with family and friends or planning a quiet day of reflection.
  • Understand that it's normal to feel guilty and to question how this could have happened, but it's also important to realize that you might never get the answers you seek. The healing that takes place over time comes from reaching a point of forgiveness — for both your child and yourself.
  • Counseling and support groups can play a tremendous role in helping you to realize you are not alone. Some bereaved family members become part of the suicide prevention network that helps parents, teenagers, and schools learn how to help prevent future tragedies.
Reviewed by: Michelle J. New, PhD
Originally reviewed by: Matthew K. Nock, PhD


Monday, November 25, 2013

Teen Drug Use Increases When There Are Half-Siblings At Home




Huffington Post~According to a new study, teens who have half-siblings with a different father are much more likely to experiment with drugs and sex before they reach the age of 15 than adolescents who only have full siblings.
The study, carried out by Karen Benjamin Guzzo of Bowling Green State University and Cassandra Dorius of Iowa State University, used data from the National Longitudinal Study of Youth to look at "multi-partnered fertility" (MPF), or having children with multiple partners.
"For children, MPF means having a half-sibling, but it also means, for first-born children, that they usually experienced their biological parents splitting up -- if they were together at all, lived in a single mother household for some time, experienced their mother finding a new partner at least once and perhaps lived with a stepfather, and finally experienced their mother having a baby with a new partner," Guzzo said in a press release.
The researchers found that children who have a half-sibling with a different dad are about 65 percent more likely to have used some form of illegal drugs, including marijuana, uppers, inhalants, cocaine, crack, hallucinogens or sedatives before their 15th birthday than kids with only full siblings. These teens are also 2.5 times more likely to have sex by the time they reach the age of 15.
"We find that first-born adolescents with half-siblings with the same mother but a different father do have less favorable outcomes compared to their peers with only full siblings, even after accounting for the mother's background characteristics, socioeconomic factors the child experienced growing up, and family instability and structure," Guzzo said.
This isn't the first study to look at how familial instability influences a child's development. A University of Virginia study in July 2013 found that infants who spent at least one night a week apart from their mothers due to joint custody formed less secure attachments to them. And a recent study in the Journal of Consumer Affairsfound that compulsive buying behavior in adulthood can be a result of parental divorce in childhood.
For more information visit: http://www.huffingtonpost.com/2013/08/12/teen-drug-use_n_3745341.html

Sunday, November 24, 2013

Stubborn Cycle of Runaways Becoming Prostitutes



By E. C. GOGOLAK

New York Times~At the age of 14, Ann ran away from home. She had been living with her aunt and uncle in the South Bronx, a situation made untenable, she said, because she was frequently being raped by her cousin.


With very few options on the street, Ann soon accepted an offer of housing from a man whom she began to think of as her boyfriend. Her view of him would change with each beating he administered, and the many paid sexual liaisons she would have for him.
He would take her to Manida Street, a section of the Hunts Point neighborhood in the Bronx that is notorious for prostitution.
“I would go out there and I would give him the money,” said Ann, who is now 25, and, fearing retaliation, spoke on the condition that only her middle name be published. “And he would beat me up.”
Her experience is not unusual. The Justice Department has estimated that about 450,000 children run away from home every year and that one-third of teenagers on the street will be approached by a pimp within 48 hours of leaving home.
The situation can be particularly acute in New York City, where there are an estimated 3,800 homeless children but only 250 city-financed youth shelter beds.
In June, the City Council held a hearing to consider granting more funds for services for runaway and homeless youths; the Council ultimately decided against the request.
The money from the state that is funneled into the budget for beds and services for runaway and homeless youths has been cut more than half since 2008, to about $745,000.
A joint study released in May by Covenant House and Fordham University, which interviewed nearly 200 randomly selected runaway and homeless youths in New York City over the last year, found that nearly one in four participants either had been victims of trafficking or had exchanged sex for basic needs like food and shelter.
Of those participants, almost half reported doing so because they had no safe place to sleep.
“The stories look very, very similar. Depressingly similar,” said Rachel Lloyd, the founder and chief executive of Girls Educational and Mentoring Services, or GEMS, an organization that provides services to youths in the city who are caught up in trafficking or otherwise exploited.
“There has been trauma, abuse, neglect, something that is going on,” Ms. Lloyd said. And there was an intervention or a failed intervention. Then they meet a boy, a man, a friend.
“It’s, ‘I ran away, I was sleeping on the trains for two days, I met a guy. He was nice to me. He said he’d take care of me,’ ” explained Ms. Lloyd, herself a former prostitute. “Then adult predators take advantage of them, very quickly.”
Even when children make it to the shelters, there is no guarantee that a bed will be available; Covenant House turns away 200 to 400 children each month. And the pimps know that those who tend to approach Covenant House may be vulnerable.
“Kids tell us, ‘I was down the block and this guy offered me a place to stay,’ ” said Simone Thompson, director of operations at Covenant House.
A pizza shop at Ninth Avenue and 41st Street, about a block from the shelter, she said, is a popular target area. On West 41st Street, between the pizza shop and the shelter, there is a block of scaffolding that the Covenant House staff tells children to avoid, because it is another hot spot for pimps on the prowl for new recruits.
“You just don’t know who is who,” Ms. Thompson said.
Victoria, 20, sat quietly in an office in Covenant House, near the Port Authority Bus Terminal. Wearing a pink knee-length skirt, a denim jacket, low heels and a cross pendant, she looked like someone on the way to church, rather than someone who had spent the last four years homeless, on and off the street, and the better part of the last two years working as a prostitute.
Falling into the child welfare system when she was 16, Victoria was staying at a group shelter on Staten Island when she met a man on the street. He was nice to her, he offered her a place to stay and they started dating, she said.
“I was so innocent,” Victoria said, “I fell right into the trap.” For the next year and a half, this was her pimp.
“Out of 10 girls, I would say nine girls do it or have done it. That’s how many girls. Even here,” she said, referring to Covenant House.
“They feel like it’s the only option they have.”
Adriana, 23, grew up in the South Bronx and started working as a prostitute when she was 14, after running away from home. Her stepfather had been raping her since she was 11, she said, and he would leave money next to the bed every time so that she would keep it a secret.

When she first ran away, she would sleep at the “trap house,” a neighborhood spot where people would sell drugs and hang out. That was when the man who would become her pimp started talking to her about working for him, Adriana said in an interview.
“He gave me a place to sleep, he gave me food,” she said. “At that point, that’s all that mattered.”
Adriana stayed with her pimp, on and off, for the next six years.
For those unfamiliar with the dynamics of prostitution, it might be puzzling that these women do not leave their violent pimps. In a recent case that Cyrus R. Vance Jr., the Manhattan district attorney, brought against a father and son running a sex trafficking ring, women who worked for the pimps testified on their behalf.
“It’s the Stockholm syndrome,” said Linda Poust Lopez, now a judge in Bronx Criminal Court, who as a longtime Legal Aid lawyer often defended “commercially sexually exploited” girls and young women.
“This is the only ‘love’ they’ve ever known. Quote-unquote love.”
Ann, Adriana and Victoria are no longer with their pimps, although their time spent with them is marked by pregnancies and, for two of the women, arrests.
Adriana now works at GEMS as a mentor to those who have been commercially sexually exploited. On a recent afternoon at the organization’s headquarters — the location and clients’ full names cannot be used, because of the staff’s obligation to protect clients from retaliation by pimps — Adriana spoke of her concern about the public perception of teenage prostitutes.
“I think people need to realize that it’s not a choice that we make. It’s life situations that cause us to do the things we need to do to survive,” she said.
“I feel like people don’t stop to realize that these are girls. No one wakes up and says, ‘I want to be a prostitute today.’ ”

Saturday, November 23, 2013

Teens Health~Common Sleep Problems


TeensHealth~Garrett had a hard time waking up for school during his sophomore year. At first he thought it was because he'd been going to bed late over summer vacation and then sleeping in the next day. He assumed he'd adjust to his school schedule after a couple of weeks. But as the school year progressed, Garrett found himself lying awake in bed until 2 or 3 in the morning, even though he got up at 6:30 AM every day. He began falling asleep in class and his grades started to suffer.
Most teens don't get enough sleep, but that's usually because they're overloaded and tend to skimp on sleep. But sleep problems can keep some teens awake at night even when they want to sleep.
Over time, those nights of missed sleep (whether they're caused by a sleep disorder or simply not scheduling enough time for the necessary ZZZs) can build into a sleep deficit. People with a sleep deficit are unable to concentrate, study, and work effectively. They can also experience emotional problems, like depression.

What Happens During Sleep?

You don't notice it, of course, but while you're asleep, your brain is still active. As people sleep, their brains pass through five stages of sleep. Together, stages 1, 2, 3, 4, and REM (rapid eye movement) sleep make up a sleep cycle. One complete sleep cycle lasts about 90 to 100 minutes. So during an average night's sleep, a person will experience about four or five cycles of sleep.
Stages 1 and 2 are periods of light sleep from which a person can easily be awakened. During these stages, eye movements slow down and eventually stop, heart and breathing rates slow down, and body temperature decreases. Stages 3 and 4 are deep sleep stages. It's more difficult to awaken someone during these stages, and when awakened, a person will often feel groggy and disoriented for a few minutes. Stages 3 and 4 are the most refreshing of the sleep stages — it is this type of sleep that we crave when we are very tired.
The final stage of the sleep cycle is known as REM sleep because of the rapid eye movements that occur during this stage. During REM sleep, other physical changes take place — breathing becomes rapid, the heart beats faster, and the limb muscles don't move. This is the stage of sleep when a person has the most vivid dreams.

Why Do Teens Have Trouble Sleeping?

Research shows that teens need 8½ to more than 9 hours of sleep a night. You don't need to be a math whiz to figure out that if you wake up for school at 6:00 AM, you'd have to go to bed at 9:00 PM to reach the 9-hour mark. Studies have found that many teens have trouble falling asleep that early, though. It's not because they don't want to sleep. It's because their brains naturally work on later schedules and aren't ready for bed.
During adolescence, the body's circadian rhythm (sort of like an internal biological clock) is reset, telling a teen to fall asleep later at night and wake up later in the morning. This change in the cir

Periodic Limb Movement Disorder and Restless Legs Syndrome

People with these conditions find their sleep is disrupted by leg (or, less frequently, arm) movements, leaving them tired or irritable from lack of sleep. In the case of periodic limb movement disorder (PLMD), these movements are involuntary twitches or jerks: They're called involuntary because the person isn't consciously controlling them and is often unaware of the movement.
People with restless legs syndrome (RLS) actually feel physical sensations in their limbs, such as tingling, itching, cramping, or burning. The only way they can relieve these feelings is by moving their legs or arms to get rid of the discomfort.
Doctors can treat PLMD and RLS. For some people, treating an iron deficiency can make them go away; other people may need to take other types of medication.

Obstructive Sleep Apnea

A person with this sleep disorder temporarily stops breathing during sleep because the airway becomes narrowed or blocked. One common cause of obstructive sleep apnea is enlarged tonsils or adenoids (tissues located in the passage that connects the nose and throat). Being overweight or obese can also lead a person to develop obstructive sleep apnea.
People with obstructive sleep apnea may snore, have difficulty breathing, and even sweat heavily during sleep. Because it disrupts sleep, someone with sleep apnea may feel extremely sleepy or irritable during the day. People who show signs of obstructive sleep apnea, such as loud snoring or excessive daytime sleepiness, should be evaluated by a doctor.
cadian rhythm seems to be due to the fact that the brain hormonemelatonin is produced later at night in teens than it is for kids and adults, making it harder for teens to fall asleep. Sometimes this delay in the sleep-wake cycle is so severe that it affects a person's daily functioning. In those cases it's called delayed sleep phase syndrome.
Changes in the body clock aren't the only reason teens lose sleep, though. Lots of people have insomnia — trouble falling or staying asleep. The most common cause of insomnia is stress. But all sorts of things can lead to insomnia, including physical discomfort (the stuffy nose of a cold or the pain of a headache, for example), emotional troubles (like family problems or relationship difficulties), and even an uncomfortable sleeping environment (a room that's too hot, cold, or noisy).
It's common for everyone to have insomnia from time to time. But if insomnia lasts for a month or longer with no relief, then doctors consider it chronic. Chronic insomnia can be caused by a number of different problems, including medical conditions, mental-health problems, medication side effects, or substance abuse. People with chronic insomnia can often get help for their condition from a doctor, therapist, or other counselor.
For some people, insomnia can be made worse by worrying about the insomnia itself. A brief period of insomnia can build into something longer lasting when a person becomes anxious about not sleeping or worried about feeling tired the next day. Doctors call thispsychophysiologic insomnia.

Reflux

If someone has gastroesophageal reflux disease (GERD), stomach acid moves backward up into the esophagus, producing the uncomfortable, burning sensation known as heartburn. GERD symptoms can be worse when someone is lying down. Even if someone doesn't notice the feelings of heartburn during sleep, the discomfort it causes can still interfere with the sleep cycle.

Nightmares

Most teens have nightmares on occasion. But frequent nightmares can disrupt sleep patterns by waking someone during the night. Some things can trigger more frequent nightmares, including certain medications, drugs, or alcohol. Ironically, sleep deprivation can also be a cause.
The most common triggers for more frequent nightmares are emotional, such as stress or anxiety. If nightmares are interfering with your sleep, it's a good idea to talk to a parent, doctor, or counselor.

Narcolepsy

People with narcolepsy are often very sleepy during the day and have sleep "attacks" that may make them suddenly fall asleep, lose muscle control, or see vivid dreamlike images while dozing off or waking up. Someone's nighttime sleep may be disrupted, with frequent awakenings throughout the night.
Narcolepsy can be disturbing because people fall asleep without warning, making it hazardous to do things like drive. A person's schooling, work, or social life can be affected by the unusual sleep patterns.
Narcolepsy is not that commonly diagnosed in teens, although many cases go unrecognized. People usually first begin to have symptoms between the ages of 10 and 25, but may not be properly diagnosed until 10-15 years later. Doctors usually treat narcolepsy with medications and lifestyle changes.

Sleepwalking

It's rare for teens to walk in their sleep; most sleepwalkers are children. Sleepwalking may run in families. It tends to happen most often when a person is sick, has a fever, is not getting enough sleep, or is feeling stress.
Because most sleepwalkers don't sleepwalk often, it's not usually a serious problem. Sleepwalkers tend to go back to bed on their own and don't usually remember sleepwalking. (Sleepwalking often happens during the deeper sleep that takes place during stages 3 and 4 of the sleep cycle.)
Sometimes, though, a sleepwalker will need help moving around obstacles and getting back to bed. It's also true that waking sleepwalkers can startle them (but it isn't harmful), so try to guide a sleepwalker back to bed gently.

What Should I Do?

If you think you're getting enough rest at night and you're still feeling tired during the day, it's a good idea to visit your doctor. Excessive tiredness can be caused by all sorts of health problems, not just difficulties with sleep.
If a sleep problem is suspected, your doctor will look at your overall health and sleep habits. In addition to doing a physical examination, the doctor will take your medical history by asking you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. The doctor also might do tests to find out whether any conditions — such as obstructive sleep apnea — might be interfering with your sleep.
Different sleep problems are treated differently. Some can be treated with medications, whereas others can be helped by special techniques like light therapy (where someone sits in front of a lightbox for a certain amount of time each day) or other practices that can help reset a person's body clock.
Doctors also encourage teens to make lifestyle changes that promotegood sleeping habits. You probably know that caffeine can keep you awake, but many teens don't realize that playing video games or watching TV before sleeping can do the same thing.
Reviewed by: Mary L. Gavin, MD