Maimonides的Life Forward计划旨在为艾滋病毒和艾滋病的布鲁克林患者提供最佳的医疗和社会服务。莫妮卡·吉丹(Monica Ghitan)博士讨论了生活远期计划如何提供心理支持,营养咨询以及其他服务以及出色的医疗服务。


Deborah Howell(主持人):您知道,冠状病毒大流行使我们很多人想知道孩子们还好。今天加入我们,谈论大流行对儿科心理健康的影响,是April Toure博士在精神病学系Maimonides医学中心的精神科医生。这是Maimo Med Talk。我是您的主人,Deborah Howell。欢迎Toure博士。今天很高兴能和我们在一起。


主持人:So I think one of the goals we have as parents and physicians is to try to get an overall picture of our kids’ mental health, kind of a before and after the pandemic picture, how are some ways we can do this and really, how are our kids doing these days?

图雷博士:好吧,您知道,我认为简短的答案是孩子们在挣扎。我认为就像其他所有人一样。One way to think about it though, just to put it into context, is that even before the pandemic started, at least over the last decade, there’s been a lot of data and evidence showing that different mental health concerns have been on the rise for some time in kids. That includes like increased rates of depression, increased like emergency department visits for psychiatric concerns. And unfortunately death by suicide has become one of the top leading causes of death in teenagers.





You know, kids spend so much time with their teachers and what their counselors at school that sometimes they’re really, you know, frontline in a good position to kind of tell when things are not going well, bring that to parents attention and then give them resources to try to get connected to additional support. So with kids not being in school in-person for so long, certain concerns like that maybe were missed and delayed.


图雷博士:嗯,当然咯。因此,您知道,我实际上与与家人一起工作的孩子和与家人一起谈论的方式以及我发现有用的类比实际上是在考虑与其他医学问题(例如高血压)有关的考虑,例如压力。因此,我的思考方式是,您知道,每个人都有血压,并且有一系列健康,正确和被认为是正常和安全的血压。但是,当您的血压太高的时间太长时,我们知道这可能会导致其他各种问题。在那时,我们认为它是需要干预或治疗的疾病高血压或高血压。因此,我想到焦虑和抑郁,并非常类似地解释这些是焦虑和抑郁是感觉,它们是我们所有人都需要体验的情绪,并且发挥了作用。它们非常重要。But when that emotional state kind of takes over and it’s too intense for too long, and it makes it hard for us to do the things that we need to do and function like we want to, that’s when we get concerned and start to consider it something that may be a disorder or something that needs intervention or needs additional help.




有了抑郁症,我们经常会考虑很多人,有些人会像您一样想到您,例如小熊维尼角色,对吗?就像他有点像一个大块的肿块一样,似乎很伤心和下降,甚至慢动作的动作和谈话。事实就像在成年人中一样,它通常看起来像这样。就像一个真正的悲伤和慢动作的人一样,也许是哭泣的咒语。对于孩子来说,它往往更像是强烈的烦躁,例如不要碰我,不要打扰我。就像,你为什么和我说话?它还可能导致睡眠变化,食欲改变等问题。I think one thing that probably stands out a lot besides the irritability is like, when your kid doesn’t even want to do the fun stuff anymore, like when they can’t even get out the bed to like play their video games or talk to their friends or get outside.



图雷博士:是的,有点。因此,当我们考虑年幼的孩子,大孩子和年幼的孩子之间的差异时,我通常会想像,您知道,或多或少,正确的是。因此,在和年幼的孩子中,焦虑和抑郁症实际上更有可能以某些人所说的话(例如行为方式)出现,这意味着他们可能更有可能喜欢发脾气。您知道,这确实是预期的两三年。正确的。You know, everyone, I think knows about like the terrible twos, but if you have a five-year old or a seven year old, who is having a lot of similar tantrums like what you saw them when they were younger, that’s actually sometimes a sign or a symptom of anxiety or depression.

另一种方式可能更有可能与年龄较小的孩子和大孩子一起出现,这是我们所说的躯体抱怨,这只是意义,就像我们的情感在身体上真正经历的所有这些方式一样。因此,对于年幼的孩子来说,尤其是当他们可能没有太多的话可以描述自己的感觉时。它可能会像胃酸痛或头痛一样出现,似乎并没有消失,或者似乎并没有真正的原因。因此,它可能会出现更多的身体症状。And like I said, kids in general, including teenagers compared to adults, might, may be much more likely to present with like a lot of intense irritability, rather than maybe the more stereotypical picture of like someone who’s just looks really sad and crying and withdrawn.


图雷博士:是的。我的意思是,我真的希望我们对此有明确的答案。And I think just what we do know about previous you know, natural disasters that have happened or significant global events is that the likely answer is you know, years, maybe even decades, one to both fully understand and investigate what impact it’s having, but also like actively dealing with the fallout from it.





图雷博士:是的。所以,我真的很喜欢这个问题。当我与之交谈并与之合作时,我会喜欢它。因此,我认为有几个,我想说的是,我认为这种方法确实不合适。像每个人和每个家庭一样。因此,这将是一个弄清最适合您家人的过程。Some general ideas though, is that I think it does help to start with finding some trusted resources, to even just educate yourself about what’s going on and trying to set up practices within your home that do allow opportunities for your kids to share what’s happening because you know, that can be really powerful.




And another thing that I think is super important for parents right now, especially with the school piece is I really encourage parents to be as active as they can and as proactive as they can in touching base with the teachers and other professionals at their child’s school to have a sense of what is going on for their kid in the classroom, ways that they can try to support them at home, just because we know this can be a really big source of stress for kids, and also trying to see what supports may even be already available within their school to help with what’s going on.


图雷博士:因此,您知道,我想我想我只是鼓励父母弄清楚将有什么帮助。您知道,就像我们一样,我们经常使用像飞机的氧气类比,您必须先戴上面具,然后才能帮助别人。And this is actually really panned out a lot, even at looking at data around depression in parents and how, when that parent gets help for their depression, whether whether it’s you know, a mother or a father that it can reduce the depression that’s being seen in the kid. And so I think that’s just a powerful example of how it can be really hard when you are actively trying to take care of this human being who really needs you and you really care about to like figure out like how do I also prioritize taking care of myself, but we know that kids are struggling, but that their parents are struggling too. Right. And so I think as parents are trying to address what’s going on with their kids, I just really encourage them to not lose sight of what’s going to help them be their best self too.






Deborah Howell(主持人):April Toure博士是Maimonides医学中心精神病学系的精神科医生。要预约成人或儿童心理健康服务,请致电718-283-7864。有关一般信息,请访问。这是Maimo Med Talk。

我是您的主人,Deborah Howell。保持良好。并感谢您的聆听。



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