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>> KATHRYN DELONGA: Hi, my name is Dr. Kathryn DeLonga.

I am a licensed clinical psychologist and director of the psychological treatment program

with the Mood Brain and Development Unit.

Our lab is located within the Emotion and Development Branch of the National Institute

of Mental Health at the National Institutes of Health in Bethesda, Maryland.

I have nothing to disclose.

All the opinions I am presenting are my own.

And all this work is supported by the National Institute of Mental Health Intramural Research

Program.

This is a picture of the NIH Clinical Center here at our Bethesda location.

The Mood, Brain and Development Unit is led by psychiatrist Dr. Argyris Stringaris.

And we have a research and clinical team and together we work to improve understanding

and treatment of adolescent depression.

In this short webinar, I'll be talking a little bit about psychological, or "talk therapy"

treatment for clinical depression in adolescents - specifically, I'll be sharing information

about a type of talk therapy called Behavioral Activation, that we offer in our outpatient

clinic to teenagers enrolled in our studies.

Depression is an illness of brain circuitry and chemistry that causes and is caused by

changes in mood, thinking, motivation and behavior.

When you review the scientific research on most effective treatments for depression in

adolescents, what comes up again and again is that the behaviors we engage in make a

difference and can help us feel better or can lead to feeling worse.

Take, for example, Sally, a hypothetical 15-year-old girl who had a fight with a friend.

She's failing in school while her parents are separating.

These are some of the stressful events and the daily hassles that she's been dealing

with.

She gets into this negative mood spiral because she feels sad, worthless, overwhelmed and

angry.

She copes with these big feelings in a pretty natural way.

She skips classes because she is overwhelmed by school and she avoids her friends so not

to be as anxious.

She starts spending a lot of time alone in her room listening to sad music.

So the ways that she is coping actually has some negative consequences as well.

So her friends stop calling, she gets further behind in school, her parents are upset and

get on her case.

So these negative consequences led back to some of these stressful daily hassles.

She feels lousy and it starts this negative mood spiral.

Behavioral Activation is a type of talk therapy that helps teens get unstuck from negative

mood spirals.

With your clinician you work to reverse the negative spiral by noticing the connection

between what you do and how you feel, and gradually adding more small and enjoyable

actions back into your life.

Behavioral Activation is an evidence-based treatment that helps teens engage in mood-and

confidence-boosting activities.

With the goal of decreasing avoidance, bolstering peer connection, and improving engagement

in rewarding activities and incorporates parent involvement so parents gain tools for supporting

their adolescent.

So instead of the negative spiral when feeling depressed and following unhelpful actions

- avoiding, withdrawing and then having those negative consequences and things get worse.

Through behavioral activation you could work with your counselor to start looking at helpful

actions that could help boost your mood.

For Sally, at the start of her treatment her goal was to get out of her pajamas and to

shower every morning.

She noticed that she actually felt a little bit better, more like herself, just by taking

that step.

Then, with her parents support she reached out to her counselor to get excused from some

of the homework she had missed and to get extra support catching up in subjects where

she had fallen behind.

She started spending more time outside her room and reduced the number of hours she spent

on her phone and signed up for a rec basketball league through which she ended up making some

new friends.

Through the treatment her parents also worked with her therapist to learn new ways to encourage,

praise and support Sally for her efforts and progress.

Overall, Sally learned that through taking small, incremental steps, she could do things

that would lead to feeling better, more resilient, more like herself, and that she again felt

hopeful about the future.

So in Behavioral Activation instead of mood directed behavior where you might feel bad

and you don't do anything much because you feel so lousy and then you feel even worse,

we focus on goal directed action.

We focus on goal directed behavior.

Even though you might be feeling bad you will do something fun and you do something because

you set the goal to do it.

For Sally, she got up and showered because she had set that goal even though she didn't

feel like showering.

Then she noticed she felt a little better after that.

So the heart of Behavioral Activation is that action can help you feel more motivated.

So rather than waiting to feel better, do things that align with your values that will

lead to feeling better.

Parents receive coaching and what's helpful to know is that depression makes teens irritable,

angry, oppositional.

As the depression is treated, and with the right kind of support, your child will again

feel interest, joy, motivation and connection.

You can learn skills and ways to support your child to prevent future bouts of depression.

So next steps could be to seek professional assessment for your child and encourage adherence,

work with your child�s treatment team to learn new skills, seek emotional support or

treatment yourself, remove guns from the home and keep medicines or other lethal means in

a safe manner, set appropriate limits on social media, on electronics, on sleep, support sleep

hygiene, and to stay positive and supportive.

Here are 8 things to do to support your teen in general but in particular for those with

depression.

Listen, show your concern and that you are trying to understand your child's perspective,

acknowledge all positive or healthy choices you see, praise steps in the right direction,

express confidence in your teen, model healthy problem-solving, facilitate/support your child's

engagement with healthy activities and a positive peer community, and allow your teen to have

autonomy and independence, while also monitoring and setting appropriate limits.

For more information on talk therapy, what to consider when looking for a therapist,

online resources, federal resources, and a listing of professional organizations with

clinician directories, please visit: https://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml

And for more information about The Mood, Brain and Development Unit's teen depression study,

please feel free to call 301-827-1350.

Find us on the website.

And if you have a child or teen who may be depressed and may be interested in participating

in our study or interested in the inpatient or outpatient treatment program, please get

in touch.

Thank you.

For more infomation >> Behavioral Activation: Treatment of Adolescent Depression - Duration: 6:46.

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Ground Breaking Acne Treatment - Duration: 1:16.

> Okay groundbreaking acne treatment, this is a good one

this is really good acne is the number one reason people go to a dermatologist,

yes and not only in our teenagers but one of the highest populations to get

acne is adult women, so a third of women have severe acne from the ages of 18

until they're 99 1 0, no one talks about this so there's a couple of my most

exciting a trial that we're working on right now is a gold nanoparticle, this is

a treatment in the office and I'm gonna use quotations that cures acne, so you

come for anywhere from one to four treatments of this and it's really neat

these are gold nanoparticles, so tonight a nanoparticle is a teeny tiny particle

you rub it on the skin, activate it with a laser, and it destroys the oil glands

and you can see that clinical photo, it's about 75% improvement, actually he had

87% improvement with just three treatments in the office boom, you don't

have to deal with pills antibiotics co-payments senior dermatologists 100

times, voila and we are starting a study for this in September we've

already done two trials for this company, very exciting, nanoparticles,

it's cool.

For more infomation >> Ground Breaking Acne Treatment - Duration: 1:16.

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Laser Skin Treatment's Benefits - Duration: 1:49.

> Can you explain to our viewers what cutting-edge technology you're using

because, everybody's coming to you for these burns you know if we could go back

to Kim's back, you know they're coming to dr. Weibull because you're using these

lasers that I don't think many people have.> Right well one of the the blessings

of lasers, lasers came to medicine in 1980 to treat poor wine stains of

birthmarks on children, and the particular laser I'm holding here is

called the fractional ablative laser, and that laser was brought to market to

treat wrinkles and we have helped innovate we were the first to treat a

burn patient in the world with these lasers so we have a lot of experience in

artwork it's really what it boils down to,

but these lasers vaporize the scar tissue into tiny little holes so it's

like boiling water on the stove with the tea, it starts as water and it turns into

steam, we steam off the scar and it rebuilds to almost normal skin, and

there's really no wall if you know most of our patients will get between two and

four treatments, but we treated patients 7 to 10 times ,we can make skin almost

look normal, yeah but it's not just how it looks

again with Kim, she didn't care about how it look, she wanted to feel better we

have patients that just want to move open their mouth wider so they can brush

their teeth, page people that if this part of your hand gets stuck I have a

you know a chef and other people that they have to move their hands, so it's

about function, it's about quality of life, pain and itching is another big one

the laser root is like a magic wand I call it, it sort of normalizes that scar

tissue back to almost normal skin, and I think most scar patients don't know

about it, I think a lot of physicians don't know about it because it's new,

and it doesn't just work on burn scars it works on acne scars, surgical

scars, any type of traumatic scar.

For more infomation >> Laser Skin Treatment's Benefits - Duration: 1:49.

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#nofilter Treatment Testimonial 1 - A E Skin - Encino, CA - 818-835-1833 - Duration: 1:52.

Hi my name is Jocelyn.

I first came to Dr. Alex because I was very concerned with sun spots all over my cheeks.

Also, I've had a surgery that left me with scar tissue on my neck

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I posted it online.

And everyone's asking me where I went.

They're saying my skin looks gorgeous.

People used to tell me "Why are you doing it?

There's nothing wrong."

But after they saw me in person, after I got the treatment done,

people were now all of a sudden going crazy over the treatment.

So, I think that's pretty awesome.

I've now done a set of only two treatments, my face, my neck, and my chest area.

And that's about it.

I plan to do a few more.

And Dr. Alex is very patient.

I must say he has this new electronic massage chair that feels like going into a spaceship.

And it relaxed me to the point that I didn't even care what was going on.

Everyone in his staff is very friendly.

I got taken in the room to get my procedure done.

We put the little protectors over your eyes.

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Everyone keeps asking me "Are you ok?

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Is there anything we can do?"

Everything went so smooth.

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And from now on, all my skin concerns, only Dr. Alex!