10/22/19. Dr. Dimitriu was published in Psychology on the topic of bipolar vs borderline personality disorder.

Diagnosing psychiatric illness isn’t easy. There’s usually no lab test, physical indication, or quantitative measurement that can distinguish one illness from another and often no magic bullet that can ensure effective treatment. Clinicians are dependent on a description of symptoms and patterns over time to make a diagnosis and these often appear similar even when the underlying illness is very different.

One example of this difficulty is in the incidence of borderline personality disorder being misdiagnosed as bipolar disorder. Both are characterized by impulsive behavior, mood swings, and suicidal thinking but have different causes and different treatments. Only an experienced medical professional can make the right diagnosis and determine appropriate treatment, but patients and their families can help by paying attention to their own thoughts and feelings and describing them accurately.

Click HERE for the full article

When you look at your teenager, try to soften the lens and view him/her as an oversized toddler. We say this because the developmental changes taking place in a teen’s brain and body as the result of puberty are equivalent to the changes that take place as infants transition into toddlerhood. With that perspective, it’s easier to understand why teenagers need more sleep than they did just a year or two younger.

So just how much sleep do teens need? On average, teenagers need between nine- and 10-hours of sleep per night (the average is about 9.25 hours), but that varies from kid to kid. Keep in mind that things such as involvement in sports, academic drive, or teens experiencing a higher-level of stress or anxiety may require even more sleep to feel and perform their best.

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Help Your Teenager Establish Healthy Sleep Patterns

One of the best ways you can support your teenager is to help him/her establish healthy sleep patterns. A synchronized circadian rhythm has a myriad of health benefits, including getting better sleep, being more alert and attentive in school, supporting healthy metabolism, and minimizing depression, moodiness, or irritability.

Here are some of the things you can do:

Understand their internal sleep rhythm

If you have a teen who is early-to-bed and early-to-rise by nature, lucky you! Most teens experience a shift in their circadian rhythm when they hit puberty, and won’t be sleepy until about two hours later than their previously scheduled bedtime. This is good to note if you have younger children because syncing their sleep times to 7:30 or 8:30pm means they’ll be ready for bed by 9:30 or 10:30 pm when they enter their teens.

Since most junior high and high schools start between 7:30 and 8:30 in the morning, this natural shifting of a teen’s circadian rhythm leaves most teens sleep deprived – they simply aren’t able to get the adequate amount of sleep they need each night.

This explains why so many teens can sleep for up to 12 hours or more on the weekends; they’re not lazy – they’re simply making up for all that lost sleep during the week.

Create a teen-relevant “bedtime routine”

The bedtime routine you created to help your baby, then toddler, then child calm down, relax, and fall asleep probably faded or ceased entirely when your son or daughter hit about 9-, 10- or 11-years old.

Now, it’s time to re-establish some sort of routine to help him/her get into bed early enough to get at least 8 hours – optimally 9 hours – of sleep each night.

Examples include:

• Ceasing all screen activity at least 30-minutes before lights out (more on this below)
• Creating a more relaxed and sleep-friendly atmosphere in the home for the 30-minutes or so before bedtime
• Drinking herbal tea or warm milk or some other non-caffeinated, soothing beverage that signals “wind downtime”
• Installing dimmer switches in main living areas and bedrooms so lights can be dimmed before bed
• Taking a shower or bath
• Playing relaxing music (if they’re up for it – some teens balk at his one)
• Giving them a foot, back, or shoulder rub on the couch

The first week or two is the most important because once the routine is established, it creates an automatic response in the body; the brain and body establish that Steps 1, 2, 3…etc., mean it’s time to go to sleep, making it easier for your child to relax and drift easier into sleep.

Establish set bedtime & wake time

Rule #1 of any “how to get healthy sleep” guidelines is to establish set sleeping and waking times. Again, this is trickier for teens on the weekend. However, if you’ve stuck with it and created a system for weekdays, your teen will more naturally adhere to the same patterns on weekend nights at home.

Turn off screens at least 30 minutes before bedtime

It’s scientifically proven that the blue light emitted from TV, computer, gadget, and phone screens disrupt the brain’s natural melatonin cycles. That makes it notably harder to fall asleep – and stay asleep.

Everyone in the family should turn screens off at least 30 minutes before bedtime, and then dim the lights to mimic the setting of the sun. These two simple steps allow your brain to create the biochemistry required to facilitate sound sleep.

Read this article (as a family!) from Harvard Health about the dark side of blue light.

Don’t allow phones, gadgets, or computers in the bedroom

There are multiple reasons that go far beyond healthy sleep for why phones and other computer-like gadgets have no place in teenagers’ bedrooms – especially during sleep times.

Want some proof? Check out, Teenagers’ Sleep Quality & Mental Health at Risk Over Late-Night Mobile Phone Use.

Good ol’ fashioned alarm clocks (with red light digital displays) work just fine. You can be the best model of this by creating a set “charging station” in a common area where everyone docs their phones/tablets at night. This prevents your teen from countless social media alerts and the temptation of the phone during sleep time.

Do you or someone in your family suffer from insomnia or anxiety? Contact the compassionate team at Menlo Park Psychiatry & Sleep Medicine at 650-326-5888. We’re dedicated to treating any issue as part of a whole, and for finding the most natural and healthy, long-term solution(s).

By Dr. Alex Dimitriu, July 11, 2019

We all have occasional trouble sleeping. Anxiety, jet lag, something we ate, or any number of other things can have us tossing and turning restlessly now and then. Most of the time, these episodes of sleeplessness are of brief duration and with resolution of the root cause we once again sleep for seven to nine hours a night. But for millions of Americans, a night of restorative sleep is elusive and with prolonged difficulty sleeping they suffer both immediate impairment to daytime functioning and long-term risks to health and cognitive function. Read more

By Dr. Alex Dimitriu, March 12, 2019

Sleep isn’t optional. It is one of our most basic physiological needs, right up there with air, water, food, and shelter. It isn’t heroic to go without sleep and it isn’t true that many people need only four or five hours a night. Most of us need seven to nine hours. Critical functions needed to maintain life and health occur while we sleep and insufficient sleep doesn’t just cause daytime fatigue, irritability, and sleepiness but is associated with a broad range of health risks including heart disease, obesity, diabetes, and a weakened immune system. Sleep is a natural function and critical to our health yet millions of people struggle to get to sleep, stay asleep, and get sufficient restful, restorative sleep. Read more

By Dr. Alex Dimitriu, February 21, 2019

We all have occasional trouble sleeping. Stress, anxiety, a change in routine, something we ate, …any number of things might be responsible for a night of restless tossing and turning. For most of us, bouts of insomnia are of short duration. But for many millions of people, sleepless nights are a regular occurrence, as are the daytime sleepiness, irritability, impaired job performance, accidents, and health risks that follow. In search of a good night’s sleep, many are tempted by the quick fix of sleeping pills but while they can be effective in the short term, they don’t offer a long-term solution.

Sleeping pills come with troublesome side effects and most people quickly build up a tolerance to them and must take higher and higher doses to achieve the same effect. No wonder many ask if natural, herb-based sleep remedies might be a better choice. They may be but your first order of business should be to develop better sleep habits and make lifestyle changes that are conducive to better sleep. If you still feel you need help, a natural sleep remedy might be useful, particularly in helping you relax at bedtime. Here are some suggestions that will help you achieve restful sleep. Read more

By Alex Dimitriu, MD, January 22, 2019

With anxiety disorders ranking as the most common mental illness in the United States – affecting 18% of the adult population every year – perhaps it’s not surprising that more than 1 in 10 Americans take antidepressants, the class of medications used most often to combat anxiety. Read more