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ADHD Diagnosis: Complexities and Caveats

ADHD

The Philippines has made significant strides in mental health awareness, thanks to professionals, advocates, and service users’ efforts. Initiatives such as the Philippine Mental Health Act (R.A. 11036) and the recognition of the rights of psychosocial disabilities under the Magna Carta for Disabled Persons (R.A. 7277) have played pivotal roles in this progress. Advocacy groups are also pushing for legislation like the Neurodivergent People’s Rights Act (H.B. 9787).

Despite these advancements, stigma and misunderstanding surround neurodevelopmental disorders, particularly Attention Deficit Hyperactivity Disorder (ADHD). This is a developmental disorder characterized by patterns of hyperactivity, inattention, or a combination of the two. A diagnosis is given based on the severity of symptoms, level of impairment, and the presence of symptoms since childhood. Globally, ADHD affects 5-7.2% of youth and 2.5-6.7% of adults ,,; but Philippine figures are unfortunately scarce and outdated.

Consider a young boy in his Grade 1 classroom, labeled as “makulit,” “pasaway,” and even “bad,” while he struggles with symptoms of ADHD that go unrecognized. Similarly, imagine a woman in a bustling high-rise building, where her difficulties staying organized lead to exclusion from important email correspondences and social gatherings, all because her colleagues are unaware of her ADHD diagnosis.

Unfortunately, ADHD is still so often shrouded in stigma. Those grappling with the disorder find themselves wrestling to keep pace with the demands of daily life, be it at school, work, or social settings.

Recognizing ADHD as a genuine challenge and not a character flaw, is vital for supporting individuals and dispelling misconceptions.This condition, when properly diagnosed, can be life-saving, paving the way for individuals to alleviate suffering and reclaim their power. But however well-intentioned, there is still a risk of overdiagnosis- an issue that is particularly prevalent in the realm of ADHD, but also within the realm of mental health diagnoses at large. Overdiagnosis can occur due to various factors, ranging from clinician practices to caregiver influences, but this often looks like overprescription of medications and unnecessary interventions. In the case of ADHD, changes in criteria in the

Diagnostic and Statistical Manual of Mental Disorders between its fourth and fifth editions have contributed to this concern- it added examples of symptoms seen in adolescents and adults, lessened impairment criteria, and revised the age of onset.

We must also remember that for children, a certain level of kulit is normal and developmentally appropriate. It is a quintessential part of childhood, after all — to dash around, create chaos, and indulge in one’s imagination. However, what distinguishes ADHD diagnosis is the severity and persistence of symptoms over time to the point that there is impairment.

Context also may play a role in facilitating overdiagnoses and misdiagnoses. While legislative progress and heightened awareness have improved access to care, our “digital by default” age has introduced new challenges, further complicating the diagnostic process for mental health disorders. For example, during the pandemic, the proliferation of misleading TikTok videos about ADHD posed a significant risk, as many individuals were facing attention challenges. A study revealed that over half of these videos were misleading, with non-healthcare professionals being the primary uploaders, potentially leading to widespread misinformation and self-diagnosis among their viewers.

On the other hand, many individuals may go undiagnosed until much later, their struggles well-masked by societal expectations and coping mechanisms. There exist gendered differences in the diagnosis of ADHD: boys are significantly more diagnosed with ADHD compared to girls due to differences in presentation. Girls with ADHD often exhibit the inattentive type, which may not manifest as disruptive behavior and consequently may be overlooked for treatment unless their symptoms significantly impact their daily functioning.

And with any diagnosis, whether physical or not, early intervention is crucial. Effective treatment during childhood can significantly improve symptoms and overall functioning, leading to better outcomes. Unfortunately, if left untreated until adulthood, ADHD can result in chaotic lifestyles, other co-occurring mental disorders, and challenges in various aspects of life.

The journey towards an ADHD diagnosis can be unexpectedly complex. For individuals who resonate with ADHD symptoms, every step of the way demands cautious decision-making. It is crucial to be discerning with the information you consume and the healthcare providers that you trust. Ensure that they are equally diligent.

Self-reflection is also essential. Clarify your “why” behind seeking a diagnosis—It could be that receiving ADHD treatment might help you lead a much more fulfilling life. It could also be that you want relief from years of overcompensation. Whatever your “why” is, seeking a comprehensive assessment is essential in this process to tailor-fit treatment to your unique brain. It is not a one-size-fits-all diagnosis, however general the diagnostic manual may make it appear to be; a detailed picture of how your mind works, pinpointing your strengths and challenges, will help specify what you need.

Seeking consultations from various professionals, such as clinical psychologists and psychiatrists, can offer valuable insights and interventions for managing ADHD. Therapy is a crucial component of tailored interventions—it provides individuals with a safe space to learn more about themselves, as well as equips them with essential skills and strategies to cope with their symptoms. Additionally, executive function coaching can further empower individuals with ADHD to navigate daily challenges effectively and achieve their goals. Executive function coaching focuses on enhancing skills like organization, time management, and task prioritization- these are skills that are often affected by ADHD symptoms. By addressing these areas, your quality of life may be significantly enhanced.

Despite the leaps and bounds in mental health perceptions, access, and service delivery, there is still much work to be done. Whether for ourselves or others, there is no time like the present to advocate for better education on mental health concerns like ADHD. Indeed, it is an ongoing journey to challenge misconceptions, develop discernment, and embrace the complexities of these issues. However, it is essential to see the merit in all this effort, to recognize that finally receiving the proper help can save lives. By advocating for improved access to accurate diagnosis and comprehensive treatment, we can empower individuals with ADHD to finally thrive in their communities.

For Executive Functioning (EF) coaching and other clinical services, contact us at clinic@wethriveinc.com.

Sources:

https://lawphil.net/statutes/repacts/ra2018/ra_11036_2018.html
http://hrlibrary.umn.edu/research/Philippines/RA%207277%20-%20Magna%20Carta%20of%20Disabled%20Persons.pdf
https://hrep-website.s3.ap-southeast-1.amazonaws.com/legisdocs/basic_19/HB09787.pdf
Posner J, Polanczyk GV, Sonuga-Barke E. Attention-deficit hyperactivity disorder. Lancet. 2020;395(10222):450–462. doi: 10.1016/S0140-6736(19)33004-1.
 Song P, Zha M, Yang Q, Zhang Y, Li X, Rudan I. The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis. Journal of Global Health. 2021;11:04009. doi: 10.7189/jogh.11.04009.
Thomas R, Sanders S, Doust J, Beller E, Glasziou P. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and metaanalysis. Pediatrics. 2015;135(4):e994–e1001. doi: 10.1542/peds.2014-3482.
 Merten, E. C., Cwik, J. C., Margraf, J., & Schneider, S. (2017). Overdiagnosis of mental disorders in children and adolescents (in developed countries). Child and adolescent psychiatry and mental health, 11, 1-11.
Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 7, DSM-IV to DSM-5 Attention-Deficit/Hyperactivity Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ 
American Psychiatric Association. (2022). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
Yeung, A., Ng, E., & Abi-Jaoude, E. (2022). TikTok and attention-deficit/hyperactivity disorder: a cross-sectional study of social media content quality. The Canadian Journal of Psychiatry, 67(12), 899-906.
Bruchmüller, K., Margraf, J., & Schneider, S. (2012). Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis. Journal of Consulting and Clinical Psychology, 80(1), 128–138. https://doi.org/10.1037/a0026582 
 Ginsberg, Y., Quintero, J., Anand, E., Casillas, M., & Upadhyaya, H. P. (2014). Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature. The primary care companion for CNS disorders, 16(3), 23591.

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Blog Everyday Thriving General Wellbeing Practices

Eco-diving, Mindfulness, and the Art of Buoyancy in Daily Living

As a diver, I am captivated by the underwater world’s wonder, beauty, and diverse range of life. However, with this fascination comes the responsibility to experience the underwater realm in a way that respects and preserves its delicate ecosystems. This has led me to adopt the principles of eco-diving, mindfulness, and buoyancy, which have not only transformed my diving experiences but also profoundly impacted my daily life.

I now view everyday life as a journey filled with challenges, choices, and opportunities for growth. Amidst the hustle and bustle, I have found unexpected inspiration and guidance. The principles of eco-diving, which focus on minimizing our impact on the environment, have taught me to be more mindful of my actions and their consequences. Mindfulness, which involves being present at the moment and observing my thoughts and emotions without judgment, has helped me develop a greater sense of self-awareness and emotional regulation. The concept of buoyancy, which refers to the ability to control one’s depth and movement underwater, has taught me the importance of balance and adaptability in all aspects of life.

Here are some nuggets of wisdom I have learned along the way that I feel are worth sharing:

1. Making Sustainable Choices

As I navigate the aisles of grocery stores or scroll through online shopping platforms, I am often reminded of the impact of my choices on the environment. Inspired by eco-diving, I have begun to prioritize sustainability in my purchases. Opting for reusable products over single-use plastics, choosing items with minimal packaging, and supporting eco-conscious brands have become small yet meaningful steps toward reducing my ecological footprint. While seemingly insignificant, these choices collectively contribute to a more sustainable lifestyle that aligns with my values and commitment to protecting the planet.

2. Embracing Mindfulness

Amid busy schedules and never-ending to-do lists, it has become crucial to have moments of mindfulness to maintain my mental well-being. Drawing inspiration from my experiences underwater, where every breath serves as a reminder to stay present in the moment, I am trying to incorporate mindfulness practices into my daily routine. Whether it is taking a moment to fully appreciate the aroma of my morning coffee, enjoying a brief walk to appreciate the beauty of nature, or doing breathing exercises before bed, these moments of stillness help me to stay grounded in the present and provide a sense of tranquility amidst the chaos of life.

3. Engaging in Active Conservation Efforts

Although I do not get to go diving very often, my passion for marine conservation goes beyond just exploring the ocean’s depths. After seeing the positive impact of community-driven initiatives while eco-diving, I have actively sought opportunities to contribute to local conservation efforts. This has included participating in beach clean-ups, volunteering with environmental organizations, and promoting sustainable practices within my community as much as possible. Through these experiences, I have realized the power of collective action in preserving our planet. They have allowed me to make a more significant impact and given me a sense of connection and purpose that goes beyond myself.

4. Finding Balance Amidst Chaos

In a world that can often feel chaotic and overwhelming, it has become a constant pursuit to master the art of buoyancy, both underwater and in daily life. As I adjust my buoyancy to maintain stability in the water, I have learned to navigate life’s ups and downs with resilience and adaptability. Trying to prioritize self-care, setting boundaries, and embracing imperfection have become invaluable tools to maintain balance amidst life’s challenges. While the journey towards equilibrium may be ongoing, each moment of grace and resilience serves as a reminder of the inherent strength within myself.

5. Cultivating Connections with Nature

Despite the demands of modern life, I have made a conscious effort to reconnect with nature in meaningful ways. I take leisurely walks and pause to admire the beauty of the sky. These moments of communion with the natural world nourish my soul and replenish my spirit. The awe inspires me, and the wonder I experience underwater has helped me appreciate the intricate beauty of the world around me and the profound interconnectedness of all living beings.

6. Mindful Consumption

As I continue to learn and navigate the complexities of consumer culture, I have become increasingly mindful of my consumption habits and their impact on the planet. Drawing from the principles of buoyancy control, which emphasize awareness of one’s surroundings, I have cultivated a more conscious approach to shopping and consumption. Whether reducing waste, opting for sustainable alternatives, or supporting local artisans and businesses, each choice reflects my commitment to being a responsible steward of the Earth’s resources.

7. Embracing Community and Collaboration

One of the most important lessons I learned from my experiences underwater is the power of community and collaboration in bringing about positive change. Last year, I went on a solo dive trip with the Coral Reef & Rainforest Conservation Project (CRCP). I witnessed firsthand how eco-divers work together to protect vulnerable marine ecosystems. Since then, I have been actively seeking opportunities to collaborate with like-minded individuals and organizations in my community. Whether joining forces for environmental advocacy, volunteering for conservation projects, or simply sharing ideas and resources, these collaborative efforts remind me of our collective strength in shaping a more sustainable future.

The principles of eco-diving, mindfulness, and buoyancy can guide us toward a more conscious, connected, and compassionate existence in our daily lives. These timeless truths can help us navigate the complexities of modern living and find solace and inspiration. Embracing the journey with an open heart and a sense of wonder can lead us to a more fulfilling life. As a diver, I have learned valuable lessons by adopting these principles, becoming a more responsible and balanced individual who strives to positively impact the environment and the people around me.

References:

https://biologicaldiversity.org/programs/population_and_sustainability/sustainability/live_more_sustainably.html
https://www.weforum.org/agenda/2022/10/3-ways-help-consumers-make-more-sustainable-choices
https://www.greenmatch.co.uk/blog/how-to-be-more-eco-friendly
https://www.unep.org/explore-topics/resource-efficiency/what-we-do/sustainable-lifestyles
https://www.linkedin.com/pulse/power-mindful-consumption-why-cultivate-restful-world-khan-bhaduri
https://coralreefandrainforestconservationproject.org/
https://www.sciencedirect.com/science/article/pii/S0969698923002783
https://www.sciencedirect.com/science/article/pii/S1877042815020200

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General

FREE leadership events: Leading with Care

This mental health month, we invite you to set up camp in the workplace

and respond to this special call.

We Thrive is offering a two-part FREE leadership event
“Leading with Care: The Neuroscience and Practice of Leading a Culture of Care in the Workplace” on October 24 and November 7, 2023.

Scan the QR codes to register or click these links:

Set Up Camp October 24 (online via zoom)

Build the Fire November 7 (onsite at We Thrive Clinic-Tektite Building,Ortigas)

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General News & Events

Thrive! A Parent’s Journey to Resilience, out now!

The much awaited book “Thrive! A Parent’s Journey to Resilience” has recently been published!

Written by We Thrive clinicians Cherie Lo, Dr. Jabby Herrera, Malyn Domingo and Rhoanne Ramas, together with We Thrive co-founder Mel Tan and former We Thrive consultant Karyl Abog, “Thrive!” tackles the neuroscience of stress, how it affects parenting and gives concrete strategies for parents to navigate the ever-changing landscape of childrearing.

“Stress is a common experience in our lives. It affects us in different ways depending on our background, our vulnerabilities, and our strengths. Most of us can cope. Stress can even lead to growth. But what happens when stress becomes chronic, unpredictable, and intense?”

A group of clinicians breaks down the science of stress in simple and accessible language. They have compiled valuable insights on mental health practices from years of experience and research. Complete with tools necessary to develop self-care and compassion, this book will help readers navigate their road to resilience and, in turn, raise resilient children”

Here are some of the photos from the book signing at the Manila International Book Fair where the signed copies of the books were sold out!

Copies of Thrive! are available at the We Thrive Clinic in Tektite and online through Lazada and Shopee.

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General

World Suicide Prevention Day: Responding to suicide with resilience and compassion

suicide prevention

Trigger warning: this article discusses sensitive topics related to self-harm, suicide, and other similar experiences. If you need to talk to someone or if you are in need of urgent help, please proceed to the nearest hospital emergency room, or proceed to the end of this article for the contact numbers of various local 24/7 crisis lines.

In We Thrive, our work is embedded with the assumption that life is inherently meaningful and worthwhile. In the process of learning to regulate, relate, and reflect, we also develop a sensitivity to at least three underlying intuitions about our lives: first, that it “make sense and has continuity”, and that the logic of life, while not always completely clear, eventually unfolds; second, that it is “directed and motivated by meaningful goals”, whether or not we have fully grasped these goals; and third, that it “matters to others” — saying not just that the outcomes of our life’s work has value, but that the presence of our life in and of itself is valuable (DeAngelis, 2018).

Sadly, this intuition of life’s purposefulness is not always immediately apparent nor secure. We can be met by challenges so intense that they disturb or even completely discredit it. For many, how life unfolds can lead to the perception that life simply may not be worth it, and can lead further to the conclusion that the only way out is to take one’s own life. And the great tragedy of human experience is that these conclusions are acted on too often. Among young people in particular, suicide is the fourth leading cause of death globally (WHO, 2023). And based on recent national studies, Filipinos are not exempted from this pain: as deeply worrying data from the Young Adult Fertility Survey 5 (YAFS5) has recently shown, 17% of young Filipinos reported suicidal ideation, 7% have attempted suicide, and more than half reported that they have not reached out to anyone about these experiences (UPPI, 2022).

To honor World Suicide Prevention Day on September 10, we wish to briefly discuss some facts about the nature of suicide, and to raise awareness about how we can effectively respond to this issue with greater wisdom and compassion.

First, let’s address some MISCONCEPTIONS  about suicide:

  1. People with diagnosed mental health conditions are NOT the only ones who think about attempting, or try to attempt, suicide (Fuller, 2020). It is true that psychiatric illnesses such as depression, substance use disorders, and related conditions are found in a large number of cases (Brådvik, 2018). That said, estimates of people living with such conditions who actually attempt suicide quite low, with one study putting lifetime risk at just 4% (Bostwick and Pankratz, 2000). Even in the case of depression, the most commonly assumed cause in the popular imagination, “a large percentage of severely depressed patients never think about suicide” (Pompili, 2019). Non-psychiatric health problems (e.g. type 2 diabetes, see Gómez-Peralta et al., 2018), socioeconomic inequalities such as poverty (Bantjes et al., 2016) and immigrant status (Forte et al., 2018), or experiences of discrimination such as on the basis of sexual orientation and gender identity (Henry et al., 2021) are also well-known risk factors.
  2. Talking about suicide does NOT make someone more like to attempt suicide (Dye, 2022). This idea draws from a phenomenon commonly called “suicide contagion”: the uptick in cases after a report of suicide in mainstream media, such as of a celebrity figure; or in one’s immediate communities, such as of a friend (Poland, Lieberman, and Niznik, 2019). There is ongoing work towards reducing these risks, such as through evidence-based guidelines for responsible suicide reporting (Gould and Lake, 2013). But we know that simply talking to someone about it does not make it more likely that they will do it (Dazzi, Gribble, Wessely, and Fear, 2014). And the key word here is “responsible”: suicide contagion emerges when conversations about suicide are mishandled, such as excessive focus on the means of death, or failing to include accessible resources for seeking help (Utterson, Daoud, and Dutta, 2017).
  3. Thinking of, or attempting, suicide is NOT a sign of weakness or of moral failure (Sharma, 2021). One of the most difficult things about responding to suicide is that, while there is an abundance of knowledge about potential vulnerabilities, “no risk factor, including classification of diagnostic subtype, has been reliably shown to predict suicide” (Bostwick and Pankratz, 2000). So when we hear about suicide, what we are witnessing is an ultimately incomplete picture of a long and difficult journey, whose roads could have led to any other path, and whose particular tragic conclusion we can only ever speculate. To make assumptions about personal integrity, ulterior motive (e.g. seeking attention), or anything else about a person’s suicide assumes a level of understanding that we simply don’t have. If we want to be of any help, the first step would be to exercise some restraint on our own personal prejudices, so we can approach the question with more humility, curiosity, and kindness.

Misconceptions aside, the next question is about what we actually know can alert us to the risk of suicide. Of course, any such “warning signs” must be understood within a person’s context of adversity, and why they might experience such adversities as unbearable or insurmountable. Such contexts can be individual (e.g. a debilitating physical or mental conditions), relational (e.g. serious family conflicts), communal (e.g. unstable access to basic needs), or cultural and systemic (e.g. discriminatory attitudes towards particular groups) (CDC, 2022). Keeping these in mind, there are some potential warning signs which can alert us to such intense distress:

  1. Taking more interest in suicide than what would normally be expected (e.g. looking up information about different methods of ending one’s life), or making preparations as if one’s life will end (e.g. giving away prized possessions) (Sharma, 2021).
  2. Increased withdrawal or isolation from one’s significant relationships such as loved ones and other social groups (Dye, 2022).
  3. Increased statements which are self-deprecating (e.g. “I am useless”), express a serious sense of hopelessness (e.g. “There is just no way out”), and/or explicitly concern ending one’s life (e.g. “It would be better if I were gone”) (AFSP, 2023).
  4. Negative changes in one’s routines, such as reduced enthusiasm or commitment to hobbies or other interests; as well as disruption of regular bodily functions, such as eating habits, sleep, and hygiene practices (Ellis, 2019).
  5. Intense and unusual dysregulations in mood (e.g. increased agitation, lethargy, sadness) and accompanying shifts towards more dangerous and reckless behavior (e.g. substance use, violence, risky sexual activity, and self-harm) (Cleveland Clinic, 2021).

Lastly, whether you are someone whose loved one has attempted suicide, or perhaps you yourself live with thoughts of suicide, what is important is not just the apparent “causes”, but the “capacities” we have cultivating resilience in such difficult and complex situations. This can include ensuring access to urgent care after an attempted suicide (BeyondBlue.Org, 2022); creating a “safety plan” to help recognize triggers and coping techniques (Samaritans, 2023); and understanding the unique recovery process with the help of a professional (Raypole, 2019). Admittedly, this process of building resilience, with all its steps and caveats, can be confusing and overwhelming. But we can organize our approach within the framework commonly referred to as “suicide resilience”, described by five defining attributes (Wang, Lu, and Dong, 2022):

  1. Social support. Who can be trusted and turned to in times when life seems too much to handle, and when life seems to have no other reasonable options? Who can provide the necessary guidance, presence, and sense of security so that responding to life’s immense difficulties can be done with more efficacy, more compassion, and less crisis? 
  2. Coping strategies. What can be done, as an individual and with others, that allows for building up the ability not just to more effectively tolerate distress, but also more effectively relish and take pleasure in life? What allows for more awareness of, and more compassionate responses to, the experiences that heighten the risk for suicide? 
  3. Psychological capital. What resources are available, within oneself and within one’s many different roles and relationships, which can help grow one’s inner resources of optimism, hope, gratitude, and even forgiveness? Within one’s limitations, and doing the best one can given these harsh circumstances, how can wellbeing be strengthened?
  4. Meaning in life. One’s experiences can lead, with a terrible but clear logic, to the conclusion that suicide is the best solution. But what else might there be in the experience of life that might allow a person to seriously reconsider the possibility that living is also a viable option — not just viable, but even necessary, for pursuing one’s ideals, values, and goals? If one chose to live, what sense of purpose can encourage a person to persevere, and even joyfully accept, what life has to offer?
  5. Sense of responsibility. What obligations would a person leave behind, not just to loved ones but to themselves, if suicide is chosen? And is the person willing, given the things that are important to them, to give up on such obligations?

For mental health support services, email us at resilientteams@wethrivewellbeing.com or contact us to sign-up for sessions with our mental health clinicians.

If you need to talk to someone or if you are in need of urgent help, please proceed to the nearest hospital emergency room, or call these 24/7 crisis lines:

DOH-NCMH Hotline

0917-899-USAP (8727)

0966-351-4518

0908-639-2672

(02) 7-989-USAP (8727)

1553

Hopeline PH

0917-558-HOPE (4673)

0918-873-4673 (HOPE)

(02) 8-804-HOPE (4673)

2919

In Touch Crisis Line

0917-800-1123

0922-893-8944

(02) 8-8937603

References (in order of appearance)

  1. https://www.apa.org/monitor/2018/10/cover-search-meaning 
  2. https://www.who.int/news-room/fact-sheets/detail/suicide 
  3. https://www.uppi.upd.edu.ph/sites/default/files/pdf/YAFS5_National_Dissemination_Slides_FINAL.pdf 
  4. https://www.nami.org/Blogs/NAMI-Blog/September-2020/5-Common-Myths-About-Suicide-Debunked 
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165520/ 
  6. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.157.12.1925
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025580/ 
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454768/ 
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068754/ 
  10. https://www.mdpi.com/2673-866X/1/3/13 
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543655/ 
  12. https://heartlandhealth.org/2022/09/suicide-fact-vs-fiction/ 
  13. https://www.nasponline.org/publications/periodicals/communique/issues/volume-47-issue-5/suicide-contagion-and-clusters%E2%80%94part-1-what-school-psychologists-should-know 
  14. https://www.ncbi.nlm.nih.gov/books/NBK207262/ 
  15. https://pubmed.ncbi.nlm.nih.gov/24998511/ 
  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376723/ 
  17. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/8-common-myths-about-suicide 
  18. https://www.cdc.gov/suicide/factors/index.html 
  19. https://afsp.org/risk-factors-protective-factors-and-warning-signs/ 
  20. https://www.bridgestorecovery.com/blog/5-warning-signs-of-suicidal-behavior-that-are-easy-to-miss/ 
  21. https://my.clevelandclinic.org/health/articles/11352-recognizing-suicidal-behavior 
  22. https://www.beyondblue.org.au/mental-health/suicide-prevention/after-a-suicide-attempt 
  23. https://www.samaritans.org/how-we-can-help/if-youre-worried-about-someone-else/supporting-someone-suicidal-thoughts/creating-safety-plan/ 
  24. https://www.goodtherapy.org/blog/when-life-continues-recovering-from-suicide-attempt-0215197 
  25. https://www.frontiersin.org/articles/10.3389/fpsyt.2022.984922/full
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General

Celebrating Pride Month with PwC

Photo credit: PwC

It has been such a delight to take part in the #PwCACManila‘s Pride Month celebration!

We Thrive consultants Jan Castañeda and Mike Shimamoto sat down with KC Cadiz (PwC Talent Development for Emotional Intelligence Leader) and Ronnel Franco (Shine member) for a wellness session entitled Cultivating a Culture of Care for LGBTQ+ People in our Families.

It was a meaningful session with some psychoeducation, sharing of insights and communal singing.

Take a look at some of the event photos below:

Photo credits: PwC Acceleration Center Manila and We Thrive Team
Categories
Blog Everyday Thriving General Wellbeing Practices

Social Emotional Parenting for the Next Normal

Pandemic Parenting

The past three years of pandemic have been quite challenging for children and adults alike.  As students adjusted to online classes and distance learning modalities, parents adjusted to work from home settings where the lines between work and home were blurred in a sea of online meetings in shared spaces at home, while juggling work, parenting and multiple responsibilities.  Many parents were thrust into an extra role of being their children’s “home schooling teacher” – supervising their children’s learning, troubleshooting tech issues during online classes, being the videographer + editor for their children’s video recorded homework, picking up and submitting modules from school, on top of the stress of working from home, and coping with their own personal concerns – health, uncertainties in the midst of a pandemic. Parents had to grapple with their overwhelming worries and fluctuating emotions, as they tried to support their children’s academic and socio-emotional needs.  

This is to acknowledge that parents pour out their time and effort, their heart, mind and soul into raising their children: It is never easy – during pre-pandemic, pandemic, and “next normal” times – the range of emotions both parents and children face in these disruptions and transitions shifts from day to day, sometimes hour to hour.

Next Normal Parenting

After these past three years of lockdowns, quarantines and limited movements, we are all finally taking steps forward in this “next normal”.   Students are returning to full face to face or hybrid (face to face + online) learning modes.  Parents can breathe a bit easier with our “homeschooling” load lightened, although we may have some concerns or fears about the adjustments our children have to go through – “This will increase my child’s exposure to Covid and other viruses.”; “After these years of being stuck at home, will my child be able to re-adjust to interacting with other kids again?”; “After all these years of online classes, are there learning gaps in my child’s education?  Can they readapt again to regular in-person classes?”  These fears are valid and understandable.  As parents, you can process these fears when you tap into your social and emotional skills, and you can also model these skills for your children to use as they navigate this transition.

SEL approach – Practicing SEL Parenting Skills

According to the Collaborative for Academic, Social and Emotional Learning (CASEL), “social and emotional learning (SEL) is an integral part of education and human development. SEL is the process through which all young people and adults acquire and apply the knowledge, skills, and attitudes to develop healthy identities, manage emotions and achieve personal and collective goals, feel and show empathy for others, establish and maintain supportive relationships, and make responsible and caring decisions.”

We can learn, and practice social emotional knowledge, attitudes, skills and strategies together with our children. This can pave the way for positive life experiences, with many benefits to practicing social emotional learning (SEL) – improved performance in school and work, better management of emotional distress, fostering healthy relationships with one’s self and others.

FOSTERING SELF AWARENESS

Being a parent is a journey of self-discovery – we come face to face with our own emotions, beliefs, strengths and weaknesses as we raise our children.  By recognizing and acknowledging how thoughts, feelings and actions are interconnected in a healthy way, within ourselves, and within our own children – – this guides us in the way we make decisions, and helps our children to develop more insights into their internal experiences and external actions.    When we encourage our children to share about their day, and actively listen to them, children will open up to share their feelings and thoughts.  When they encounter some awkwardness as they move from online interactions with friends to face-to-face interactions, we can support them by teaching them to use “I” statements as they identify feelings (“I felt shy when I met my classmates again.” ; “I felt weird seeing a big classroom filled with people again, I miss being by myself in a quiet room” ; “I felt happy to see all my friends and to talk with them after these years of just chatting or video calls online.”).  

You can encourage them to share about their feelings by opening up the conversations with some “kumustahan” questions: “Would you like to share about how school has been today?”; “Would you like to talk about how your day went today?”.  This approach will help them to understand and unpack what feeling excited, happy, worried or sad is about, and they are better able to manage their emotions.  We can also encourage them to engage in activities that promote self-reflection – such as journaling or sharing the highs and lows of their day – “What is one thing you are thankful for today?  What is one thing that you felt could have been better today?”. The more our children discover their sense of self, the more this nurtures their self-esteem.

ENHANCING SELF-MANAGEMENT

Understanding the interrelations of feelings, thoughts and actions can lead parents and children to regulating these through self-management.  During changes and transitions, there will be a lot of mixed emotions that our children may go through. When our children are feeling overwhelmed and emotionally upset (dysregulated), we can try practicing co-regulation with them.  Co-regulation, sometimes called mutual regulation,  involves a parent or caregiver stepping in to help a child to identify, manage and process their intense emotions.  When a child’s emotions are fueled by high energies, we avoid matching their high energy, and try to do emotional modeling – we model the calm behavior we would like to see in our child, by using a warm, soothing tone of voice, instead of mirroring their upset emotions.  

We can share emotional regulation strategies with them – such as relaxation breathing exercises, mindfulness exercises – quiet time, focusing on the present moment, muscle relaxation, body scan, five senses exercise, using the “feelings wheel” (a tool used to help us define specific emotions we are feeling – for kids age 4-11), and for teens and adults).  We can also use mobile apps: Headspace and Insight Timer have a number of tracks that can help you and your child practice mindful breathing. These emotional regulation strategies help children and adults regain control when they’re feeling upset or overwhelmed.  

We take note that what works for us as adults may not always work for our children.  We need to match the emotional regulation strategy with the needs and developmental age and stage of our child.  It might be hard to get a 2-3 year old toddler to do meditation, but maybe we can try practicing mindfulness of the 5 senses with them: “What do you see?  What do you hear? What do you smell?  What do you taste? What do you feel in your hands? in your feet? How does your body feel right now?”. By understanding one’s emotional triggers, more impulse control can be practiced. Practicing these self-management skills can help us and our children to evaluate our decisions and actions in challenging situations.  We can ask our children to share about their concerns, or problems they may be experiencing – we can also encourage them to think of possible solutions to their problems, the pros and cons, as well as the impact of these on people they deal with day to day.  

MAKING RESPONSIBLE CHOICES

When parents assess their goals, social situation, and foster understanding of self, they are able to develop responsible decision making skills, which leads to positive choices. Our actions as parents have an impact on our children; children are very observant and they can pick up on our behavior.  When we are mindful of the modeling they see in us, and in our pro-active choices, our children develop an innate sense of taking ownership of choices they make. Sometimes, our children may approach us and ask us – “Mom / Ma / Dad / Pa, what would you do in this situation?”  While our tendency as parents oftentimes is to give them advice on what to do, we can consider pausing for a while and giving them the space to come up with their own decision.  

The “stop light approach” can be helpful here – Red = stop and pause, Yellow = take a breath, Green = think through the options and make your decision. “I hear you have this situation right now – what are the things that need to be worked out? What options or choices do you have right now? How do you think you can help in this situation?”. This nurtures in them the ability to take some time to slow down, think through different options, consider the consequences of their actions, and make decisions based on positive values, empathy and fairness.  This empowers our children to make responsible choices that consider their well-being and the well-being of others. 

DEVELOPING SOCIAL AWARENESS

We live in communities, cultures, and societies, and we share this social setting with our children.  With a return to in-person school settings, they develop a keen awareness of the need to build relationships and strong friendships.  Part of our community fabric includes weaving an understanding of various races, genders, cultures, ages, religions – cultivating in our children a respectful approach towards differences, and empathic understanding of the world we live in today.  When students return to in-person classes, they will be sharing stories of their pandemic experiences with their classmates, and while there are many common experiences, they may have to confront different realities and socio-economic difficulties that many people endured.  

As your child shares with you these stories, this can be a conversation prompt to promote perspective taking: “How do you think that felt like for your friend?”, to promote showing concern for others’ feelings: “You sound happy to know your friend felt excited to be with classmates again.”, to promote empathy and compassion: “You feel sad when you heard about your friend’s troubles.”.  This can also open exploration of opportunities for serving the community in their own small ways, and doing their part in creating healthy, safe and positive spaces in the community.

NAVIGATING RELATIONSHIPS

As we build relationships in our families and communities, our children are learning from us, and along with us, how to act in varying social situations. 

Seclusion from their friends and classmates during the pandemic can take its toll on our children, as they ease back into being with friends, we can support them by checking-in daily on how they are coping with this resumption of in-person interactions, and actively listening to their concerns, worries and feelings.   

We can nurture open communication by being fully present and paying full attention to our children when they are talking with us – this will help them feel that we care about what they have to say, and make them feel heard and understood.  “I hear that you enjoyed school time today.” or “I hear that you felt sad today.” are some sample responses of how to apply listening skills that encourage our children to share more openly with us. This helps  us to better understand their thoughts, feelings and experiences. Nurturing this open communication with our children can create that space where they are able to process relationships and friendships – enhance cooperation, fairness, kindness, and helpfulness towards others, develop empathic listening, manage opposing views and conflicts, and recognize and regulate emotions.  This strengthens our relationships in the family, maintains healthy friendships in the school, and deepens their sense of community.  

Although this “next normal” is still full of uncertainty – and we can expect that there will be bumps, twists and turns this transition brings, we can lean on these social emotional skills to help us respond to the call of these ever-changing times. By opening up our emotions, thoughts, and incorporating social emotional learning into our daily practice, with intentionality, we model these skills that our children will gain through observation and active engagement; this empowers them to establish self-awareness, emotional regulation, empathy, positive communication in their interactions with others.  We continue to build their resilience, and to create a nurturing environment that supports their growth, development, and well-being throughout the different stages and challenges that life brings.

SOURCES:

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Blog Everyday Thriving General

Words of wisdom from the moms at We Thrive

Mother’s Day is right around the corner so we rounded up the best advice that the moms from our We Thrive team could share and here’s what they had to say:

Raise the child you have, not the child you or others think you should have.

See your children for who they are and for their strengths, gifts and capabilities. See the best things about and make them feel really seen and heard. Rather than looking at what they are not doing, or are doing wrong, or belaboring who they are not, the invitation is to accept and celebrate our children for who they are. In so doing, hopefully our children learn to appreciate and value themselves the way we as loving parents, try to see them.

Ninin Sumpaico-Jose

As a first time mom, it helps me to remember that just like my baby, I am growing and learning too. It makes sense that I’m still figuring things out. Acknowledging my own development as a mother gives me more self compassion and gratitude for the gift of growing with my baby everyday.

Triza Guerrero-Cheng

There’s a lot of unsolicited advice, but the best I got were random advice after I gave birth to my first child – Sleep while your baby sleeps; At night, breastfeed in side-lying position, roll your baby to your other side when changing sides; and other breastfeeding-related concerns.

Most moms would say that the first months are the hardest, but going through it all with 3 kids, I must say that the hardest is keeping your identity in place while finding the balance between being a mother, wife, a house manager, and a career woman all at the same time. Most will ask how to balance time from all the responsibilities, but what I usually say is, you can’t. You can’t do all things in one sitting, some things just have to wait. And as much as possible, ask for help. Other responsiblities such as housework and teaching the kids can be better done by other people, like a househelp and a tutor. What matters most is the quality of time you give to your kids.


I only have 2 simple advice – enjoy the mealtimes with your family, and sleep well.

Dr. Janice A. Camarillo

A dear friend once told me “Remember to give yourself as much love and compassion as you give your child.”

I’ve had to keep this advice in mind everyday especially knowing that moms (actually women in general), have a greater tendency to put the needs of others ahead of themselves. In order for me to show up at my best and be truly present as a mom, I have to ensure that I take care of myself too. That means being okay with taking breaks, making room for mistakes, asking for help, saying ‘no’ to a lot of things, sitting with a lot of discomfort and trusting that it’ll be okay despite the uncertainties.

Paula Garcia-Ramos

Best advice I got in my later years as a mom: 😂
If you hate yourself, you probably need rest.❤️
If you hate everyone else, you probably need a snack.🥰

Advise i can give to other moms:
“Ni calvo, ni con dos pelucas.”
( Not bald, no wigs)
Which means balance, equanimity, equilibrium and not to sweat the small stuff.❤️

Margarita “Tucci” Reyes

And here’s a look back at the interview we did with Techie Duran-Dy on everyday thriving as a mom.

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General

We Thrive Clinicians finish ACT training series with Dr. Susan Wilkens

Last Wednesday May 3, 2023, We Thrive clinicians wrapped up their Acceptance and Commitment Therapy (ACT) Training Series with Susan Wilkens, PhD entitled “Using ACT with Parents and Caregivers”.

The training series was conducted via zoom and comprised of four once a month sessions from February to May. Some of the topics covered were basics of ACT, psychological flexibility, mindfulness and acceptance, commitment and action, case conceptualization and case application.

The We Thrive team sends our gratitude to Dr. Wilkens for sharing her time and expertise with us!

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Blog Everyday Thriving General

Happy International Dance Day!

It’s International Dance Day and we’re turning the spotlight on Laya Alampay as she shares her insights on dance and wellbeing.

Laya is a We Thrive clinician, Ateneo MA student and part time lecturer, UP Streetdance alum and member of The Crew

Here’s a bonus video!

https://www.instagram.com/reel/CiCwR_ErH7q/?utm_source=ig_web_button_share_sheet