Let's Talk About Sexting (Part 1)


Sexting is much more common than adults realize…..

“Boys in middle school pressure you so much. I was dating this boy, and he would ask me to send him a naked picture. It got like really bad. He would ask me every day almost, like he wanted to guilt me into doing it. He’d say that everyone did it, and that I should trust him. It was only because he really liked me. I tried saying no. Then he would get mad, and threaten to break up with me. So, finally, I did.”


Sexting can have very serious social consequences for students….

“The next thing I know, it was all over my school. Everybody saw it. Even the high school kids were talking. He swears it wasn’t him, but I don’t know who to trust. I can’t believe how my girlfriends turned on me. I couldn’t walk down the hallway even. I’ve had people who don’t even know me say I’m a slut. I thought, If my parents find out, I’m going to kill myself.”


Sexting can have serious legal consequences for students….

“Some mom called the school. Then of course the Principal gets involved. Don’t even get me started. Seriously, that is when I started to cut.”



    While it is established that 70% of females have had at least one experience of sexual violence from age fourteen through college years, recent research findings alert us to the dangers that lurk in the hallways of our middle schools.

    Substance abuse and sexual violence is becoming increasingly prominent in middle school students across the country. Earlier this week, a study conducted by researchers at the University of Illinois found that almost one in five students in middle school have experienced physical sexual violence while at school. 18-19% students reported being the target of sexual rumors, sexual commentary and homophobic name-calling.



Substance Abuse in Middle School

Use of Illicit Drugs and Alcohol in 8th graders
    •    20% have used alcohol in the past month
    •    9% have used a narcotic in the past month
    •    60% say it is very easily available

Exposure to parental Substance Use Disorders [SUD] before age 14 confers a risk for juvenile SUD

Onset of use before age 15 confers a risk for SUD even 30 years later

The Juvenile Brain and Drugs/Alcohol Use

Onset of SUD in 80% cases is before age 18
The adolescent brain is still developing until age 21
Drugs and alcohol are toxins, and halt development of the Prefrontal Cortex and Striatum

The Power of peers in Juvenile SUD

  • Delinquent peer group
  • Friends using drugs
  • Peer pressure
  • Drug availability
  • Disregard for values
  • Conventionality of drug use

Sexual Violence in Middle School

While it is established that 70% of females have had at least one experience of sexual violence from age fourteen through college years, recent research findings alert us to the dangers that lurk in the hallways of our middle schools.

Earlier this week, a study conducted by researchers at the University of Illinois found that almost one in five students in middle school have experienced physical sexual violence, such as being inappropriately touched against their will, while at school.

18-19% students reported being the target of sexual rumors, sexual commentary and homophobic name-calling. Not so surprisingly, over 8% of the victims denied being sexually harassed, or normalized the behaviors as simply peers joking around with them or seeking attention. They often downplayed harassment by saying that the incidents were “not that bad". 

Dr. Espelage expressed serious concern about student responses, and stated, “This dismissive attitude seems to be indicative of a broader societal force to normalize or legitimize sexually violent acts.” She further emphasized that dismissing sexual violence or harassment as a trivial aspect of students’ lives perpetuates a cycle of sexual aggression.


Excerpt from Dr. Din's book: All The Bus Is A Stage

Most middle school students are determined to take the bus to school. It is on this vehicle that your new sixth grader can show you that he or she is very ready to grow up. Each passenger has a role to play, which is assigned within the first three weeks of the school year. From that point on, they work hard to learn their lines, and pick up the rhythm of an intricate dance. Your benign little fifth grade child has abruptly been morphed into a highly observant and cynical preteen. The focus of this twenty-five minute ride is to learn what is needed to survive the next three years.

Your child is focussed on this lesson far more intently than the math or Spanish class that will challenge them later in the day. It is here that they will learn from the masters - the seventh grade students who are now flush with confidence, having moved up from the humiliation of being at the bottom of the social ladder. 

A few lucky sixth grade girls and boys are elevated to apprenticeship positions, where they lead the social symphony for their year. Eighth grade students are more likely to have positioned themselves as benign grandparents, on their way out to the ‘real world’ of high school. 

This is a performance that is often far too subtle and intricate to be captured on archaic bus cameras. These artists are sophisticated in positioning and cues. They know where and to what extent the lens can pick up their moves. The radio played by the driver protects them further. Inappropriate remarks are drowned by the sounds of traffic, music, engines and the voices of around forty kids. 

Your child is closely scrutinized before they even get on the bus, and so are you. You are given a terse set of instructions for behaviors that you simply cannot exhibit anymore, unless you want to deliberately ruin your son or daughter’s life. Amongst these:

“Please do not stand with me at the bus stop. I am old enough to wait there by myself.”

“Also, please do not wave to me, or add a ‘-y’ to my name.” [Georgey, Mikey, etc]

Mothers are provided with a dress code, so as not to embarrass or humiliate their daughters. They are advised on which lipstick colors are acceptable. You are expected to join the sorority of ‘Mothers Who Are Tolerated.’

What is even more alarming than the content of such a command is the tone used to deliver the message. Your sweet, naive daughter is, for some inexplicable reason, annoyed and tense. Constantly. She says goodbye to you behind closed doors, and hurriedly scurries out, down the driveway and to the corner. You are truly out.

Once on the bus, mirroring sets into motion. Your child keenly scrutinizes his or her peers and learns how to appear fashionably tired, and sufficiently disinterested. It is not hip to be enthusiastic about school any more. This is also where they practice the burgeoning art of flirtation. This is defined largely by swearing, double entendres, ignoring the object of interest, and moody silences. 

As the shuttle pulls into the school parking lot and students pile out, associations with fellow passengers are quickly dismissed. Your child is about to enter the private world of middle school cliques. His or her bond with family is by now a distant memory.


rTMS: Treating Depression Without Medication

TMS (Transcranial Magnetic Stimulation) Therapy is a treatment developed by Neurostar, a Philadelphia based company. This is an FDA approved therapy for the treatment of clinical depression. It is non-systemic (does NOT involve medications that circulate in the bloodstream) and non-invasive (does NOT involve surgery).

rTMS Therapy is the first and only non-systemic and non-invasive depression treatment cleared by the FDA. I have put together some basic information about this therapy to help familiarize you with it. Please feel free to contact me should you have any interest, questions or concerns. 

Candidates for TMS therapy are typically adults who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode. Patients who are unable to tolerate antidepressant medications are good candidates. Given the very real fears and frustrations involving antidepressant medication use, this option for treatment offers hope to many amongst us who continue to suffer the direct and indirect consequences of depression. 

A natural response is to question if this treatment is a hoax. Absolutely not. TMS therapy is scientifically substantiated and has been approved by the US Food and Drug Administration since October 2008. At least 8 out of the top 10 nationally renowned psychiatric hospitals have implemented TMS therapy as a viable treatment option. 

Clinical trials thus far have been extremely promising and support the following:

  • 50% of patients experience significantly reduced symptoms
  • 33% of patients report complete recovery

TMS therapy works at the level of neurons [brain cells] and is a form of neuromodulation. It uses a device that delivers highly focused MRI-strength magnetic pulses to stimulate the prefrontal cortex. This is the part of the  brain that regulates mood. A headpiece is placed against the scalp, which then sparks a small arc of electromagnetic activity within the brain, targeting a specific area. This in turn sets off chemical changes in the prefrontal cortex. Neurons in the prefrontal cortex are then stimulated to make more mood-enhancing chemicals such as Serotonin. 

Patients often wonder what they can expect to experience during the procedure. On average, each treatment session lasts 37 minutes, with 30 sessions scheduled over a 4-6 week period. TMS therapy does not require anesthesia or sedation. During the session, the patient remains alert and free to watch TV, converse or listen to music. They are able to drive themselves to and from the appointment, and return directly to work.

Unlike psychotropic drugs [weight gain, metabolic changes, dyslipidemias, sexual dysfunction] or ECT, the side-effects associated with TMS therapy are relatively mild and typically resolve within the first week of treatment. They are listed as follows:

  • Headaches
  • Scalp discomfort 

Please contact our office to schedule a consultation for you or a loved on suffering from depression. We are committed to making a positive difference in your lives.


  • Many of you, in fact most of you may not have known the student your school and community has lost. Please know that this is not unusual, and does not make you insensitive, or excluded.
  • Most of you are fairly private and do not like others to pry into details of your life. Please offer the same respect to the deceased. We are urging you to NOT probe for details about the event. Please avoid exploration of details of venue or method. 
  • If you are aware of any details, and believe that they be of help in healing the community or preventing further tragedies, please be responsible with the information. Please reach out to an adult faculty member at your school. They will be able to safely guide you to the appropriate support. DO NOT pass information around to peers. Doing so puts other vulnerable peers at risk of imitation.
  • Research finds an increase in suicide by readers or viewers when the number of stories about individual suicides increases. Please try to not discuss with peers stories about other teens you knew who have lost their lives to suicide. 
  • DO share stories about how many, many teens actually do overcome despair, and work through their illness without attempting suicide. Share your story if this is true, but responsibly. It will give hope to many of your peers.  
  • Research finds an increase in suicide by readers or viewers when a particular death is reported at length or in many stories. Please DO NOT tweet, text or Facebook about a peer you have lost to suicide. The more you do so, the more likely it is that a vulnerable peer [perhaps even a friend] will be triggered.
  • Research finds an increase in suicide by readers or viewers when the headlines about specific suicide deaths are dramatic. Please be cautious, respectful and mellow in your written communications such as Instagram, Twitter, Facebook and texting.
  • We are aware of the pain you are experiencing, and respect your need to express yourselves during this difficult time. We do ask however that you NOT create dramatic banners about the specific student suicide death. You may create a general banner supporting suicide prevention instead.
  • Please be aware that while teens lost to suicide had many positive aspects of his/her life and character, they likely had problems and struggles as well. Autopsy studies of suicide victims age <20 years reveal the following:
    • 90% meet the diagnostic criteria for a psychiatric disorder
    • >50% had experienced severe symptoms for >2 years
    • Only >15% are in treatment at the time of their death
  • If you friend was close to the student we have lost, please remind him/her that the suicide was not their fault. Nothing they said or did, or didn't say or do, caused the death. 
  • There are many options for getting help, like medication, psychotherapy, or a combination of both.
  • Exposure to suicidal behavior in your peers increases your own risk for depression, anxiety, and posttraumatic stress disorder. Please seek help should symptoms surface.
  • Just as in other illnesses, a person can receive the best medical treatment available and still not survive. Many however do indeed get better.
  • Only some people die from depression, not everyone. 


[Advice for students who are aware of a peer having suicidal thoughts]

  • Take your friend’s words and actions seriously: Do not assume that they are joking when they talk about suicide 
  • Act immediately: If you think a friend is considering suicide, the first step is to act 
  • Do something: Dismissing their words and actions could be the difference between life and death  
  • Reach out and stay: As their friend, you might be the best person to reach out to them.  If you are not willing to talk to them, who will be? Put your twitter and texting to good use in supporting them.
  • Tell an adult: Whether it is a parent/teacher/coach/school counselor/youth pastor/other trusted adult, seek their guidance. Even if sworn to secrecy, the risk of losing your friend to suicide is not worth keeping a secret.


  • Remind your friend of their worth [combat “worthlessness”]
  • Remind them that they are not alone in how they feel or what they are experiencing [combat “loneliness”]
  • Reassure them that suicidal thoughts are temporary, that there is hope [combat “hopelessness”]
  • Help your friend see that they are depressed and need help. People who need help are often blind to it [combat “helplessness”]
  • With the help of an adult get your friend to a doctor or ER
  • Remind your friend that depression and suicidality are MEDICAL PROBLEMS that can be treated [combat “guilt/self-blame”]


Teens react in many different ways to the loss of a peer to suicide. Please do not feel alone if the way you are feeling is different from your peers. Also, your feelings may fluctuate and change many times during the course of a single day. This is not unusual. Please be kind to yourself and seek support if you are struggling.

  • Abandonment
  • Denial and minimization
  • Guilt, blaming self
  • Anger toward all [deceased/God/self/school/friends/family]
  • Fear of own mortality
  • Numbness
  • Worry regarding losing others
  • Wishing it would all just go away
  • Sadness
  • Embarrassment about return to school or interacting with peers
  • Confusion
  • Loneliness