Sunday, 1 February 2015

The Thirty Minute Challenge: lets save our kids

January 19, 2015

Today, before 2 pm, I had three anxious calls from mothers of pre-teen and teenage kids who were experiencing depressive symptoms and suicidal ideation.  By the end of the week, I will hear from several more.  I have no extra room in my schedule for these troubled teens.  The community has responded to the epidemic of mental illness in this age group by creating an urgent mental health clinic.  It runs from 1 pm to 7 pm every Tuesday.  The schools have responded by creating classes that teach kids how to manage generalized anxiety and panic.

I had a great conversation last week with a teacher.  She was in my exam room for an annual health exam.  People in her age group are very healthy, usually.  Periodic health exams are often opportunities to catch up, share stories, develop a deeper understanding of what makes a person tick:  what do they care about, what drives them, who do they love, what are their greatest fears.

I am always amazed at the number of times my patients discover what my greatest fears are and what makes me tick.  I love children.  I am fascinated by the development of the human brain;  how a tiny newborn brain rapidly develops the capacity to orchestrate a walking and talking toddler.  There is a tremendous accumulation of knowledge and skills in preschool kids:   physical, intellectual and emotional development that rapidly progresses and requires only a few key ingredients provided in a timely fashion, for success.   Kids should be happy and energetic, carefree and curious.  We should hear them singing.....a lot.  They should be eager to head outside to play.  Parents should be dragging them in when the street lights come on.  I am afraid for our kids.

Think about all the good stuff that happens when a kid is outside playing.  There is constant movement and that movement goes on for hours.  I struggle to complete an hour of cross country skiing before my knees ache but I remember when riding my bike all day long caused me no physical discomfort at all.  Except of course when I fell off the bike and skinned my knees which happened often.  I don't see skinned knees in my office anymore.

Think about what happens to that developing brain with hours and hours of daily physical activity.  The pituitary gland at the base of our brain is constantly stimulated allowing for the maximum production of growth hormone.  We grow tall and strong with mighty bones that can easily take us into our nineties.  The brain grows too:  billions of new neurons that construct balance, coordination, gross and fine motor development.  The healthy brain has an intact blood brain barrier.  That's the brain's main line of defence against infection.  Activity makes those neurons function well with healthy synapses that allow for the effortless flow of information from one neuron to the next.  The healthy brain is less likely to develop cancer or succumb to dementia.  Memory and intellect heighten with physical activity.  There is maximum growth, peak intelligence, effortless memory and intact mood.

An hour of exercise everyday is as powerful as a low dose of a selective serotonin re-uptake inhibitor, the most common antidepressant I prescribe.  Does that mean that hours and hours of activity in the growing child allows for mental health and resilience to mood disorders later on in life?  Does inactivity not only decrease mood but also the ability to cope with the normal difficulties and stressors in life? Is this why our chidlren are anxious?  It certainly may be one of the reasons.

The average school-aged child sits in front of a screen or stares at a hand held device for five hours a day.  FIVE HOURS.

Back to my conversation with this lovely teacher.  She lamented at how difficult it was to pull  kids away from their screens and get them outside to play.  She described cajoling kids to come out from under stair wells and behind closed doors to get out to the school yard.  She described how, once there, the kids stood wondering what to do next and most resorted to standing in group circles, all of them staring at their smart phones.

Our kids have forgotten how to play.  

Play is a very important type of physical activity.  Play teaches that miraculous growing brain how to imagine, create, problem solve and work in groups.  Play brings joy and laughter.  It heightens the amount of endorphins ( hormones that give us a sense of well-being and happiness ) in our brains.  Play makes children happy.  But not only that,  play distracts a child from the negative influences too often found on their screens like gratuitous violence, cyber bullying and negative peer group antics.

The Heart and Stroke Foundation recommends less than 2 hours a day of screen time and more than 1 hour a day of physical activity.  These recommendations have been proven to reduce the risk of diabetes, obesity and heart disease.  Not just in the 40 year olds, but in teenagers and 20 year olds where the incidence of these diseases are soaring.  I believe that less than 2 hours a day does not address the emotional consequences of inactivity and lack of play.

I am putting the thirty minute challenge out there.  When my kids were growing up they could not watch any television during the week.  They hated us.  We would set the timer for thirty minutes when they sat in front of a computer screen to play and if they re-set the timer without us noticing, they lost all computer privileges for the rest of the week.  They did not own a cell phone until grade nine and with my two older boys, that cell phone stayed home when they went to school.

Taking the thirty minute challenge requires courage.  It has to start early.  It means you can't use an ipad or smart phone to entertain your toddlers while you are legitimately distracted with something else.   It means that your teenagers will likely want to live somewhere else which may not be a bad thing.  It means you'll have to spend more time playing with your kids, outside or sitting around a dinner table arguing with each other.  At least there, they will learn the intricacies of socialization from their parents and not their peers.

It may mean that you won't be in a position someday of searching for urgent help, that barely exists, for your anxious or suicidal teen.

Dedicated to my new great nephew, Henry John who was born on January 30, 2015.  May your early years be filled with joy, love, laughter and PLAY.

Dr. Anne-Marie Zajdlik MD CCFP
Founder of Bracelet of Hope

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