Anxiety in Children: How to Know When to Seek Treatment or Medication

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mental health journey right now nearly

one in three teenagers will meet

criteria for an anxiety disorder by the

age of 18 this alarming number is still

rising in this exclusive 6 episode

series clinical psychologist dr. Judy ho

walks you through signs of anxiety in

your child how to help them cope with

phobias and perhaps most importantly how

to find the best treatment plan for

long-term mental wellness

welcome to the med circle original

series anxiety and children coping with

phobias and finding the right care Oh

dr. ho we just completed filming your

second series of I love it this was so

such a great conversation because we

really got granular with the topic of

anxiety and phobias as it relates to

children yes you explain that they

handle anxiety and phobias differently

not only children as a as a subset of

people but also really small children

ages you know 10 and below and also

teenagers explain a little bit about

what anxiety looks among those different

age groups well the first thing that

comes to mind is that anxiety does

present differently in our younger

people and oftentimes it has much more

of a bodily focus component especially

for younger children they haven't

developed the vocabulary words yet to be

able to describe their feelings at all

times and so oftentimes anxiety will

present as a stomachache or a headache

or distraction in school and sometimes

you can go down the wrong path

diagnostically when you listen to those

and take them completely at face value

yeah I was really surprised to hear how

common the misdiagnosis were in children

who are being brought to a therapist or

a psychologist or a psychiatrist for

anxiety and end up getting the wrong


of ADHD bipolar disorder OCD whatever

whatever they are you talked about some

of the tips that parents can use to do

the best they can to not get a wrong

diagnosis what were some of those tips

well the first thing is arm yourself

with education so you gotta make sure

you understand when a diagnostic term

has been thrown around by a therapist or

somebody else that thinks that they know

their child I've also known that teacher

sometimes will diagnose the child and

say I think your child has ADHD

well whatever term has been thrown

around as a parent go and do the

research and do the research with

credible sources so get a copy of the

gsm you can buy it it is expensive but

you can buy the DSM is the Diagnostic

and Statistical Manual of Mental

Disorders that providers use to diagnose

mental conditions but also there are

credible websites like for example NIH

National Institute of Mental Health they

have some of these listings that are

actually accurate to the diagnostic

manner so arm yourself for that

knowledge first and also make sure that

you ask your provider whoever is giving

you that diagnosis what that means ask

them to have a direct dialogue with you

don't just take it at face value well

what does this mean in general and what

does it mean in my child yes what are

you seeing in my child that makes you

think that they had this diagnosis and

then the follow up to that is how do we

address it what's the treatment plan

make sure that you get satisfactory

answers from that you also we talked

about phobias yeah what is a phobia a

phobia is an irrational fear of really

anything under the Sun there are

different types of phobias too things

that are kind of a blood injury type

there's contamination phobias there's

animal phobias and their situational

phobias so there's really four kind of

different categories of phobias that

people can have children tend to have a

lot of object focus phobias and often

interestingly also a cleanliness

contamination fear and it's interesting

because sometimes phobias are really

sort of just developmental they can be

afraid of the monsters under their bed

for six months and that'll go away but

when it doesn't go away then it's time

to seek treatment especially if it

starts to impair the child in their

functioning and prevents

I'm doing the things that they have to

do as a child what I really enjoyed

about this series is that you didn't

just say oh well if you think your kid

has anxiety you need to take him to a

therapist which is what I think most

parents would expect the answer to be

especially talking to a doctor it you

gave actionable tips on dialoguing with

your child whether they're four years

old or fourteen years old what specific

questions to ask them to see if they had

an anxiety issue or a phobia that

required the attention of a professional

or if it was something that they could

just try to mitigate at home that's huge

that's a time saver yes money saver yeah

it's a huge education yeah so many

benefits to that absolutely and we don't

want to over pathologize anxiety which

we all feel nervous and anxious

sometimes so this is a very common human

condition so what I really want people

to know is that sometimes there are

things that you can do at home

evidence-based strategies of coping that

you can teach your children and if they

can manage it on their own they don't

really need therapy

and sometimes it's developmental maybe

it's situational maybe it's a particular

class at school a particular person and

once that stressor passes the anxiety

does as well so we don't want to make

people rush to doctors offices and

panicking because they think that their

child has some kind of severe anxiety

diagnosis when they maybe don't right

and if they are in that space of alright

this anxiety is getting out of control

they won't be able to go to school there

they can't sleep because they're too

anxious whatever the symptoms may be you

gave some really great advice about

finding the right doctor how to go about

doing that

and my favorite part inner viewing the

doctors here's what you had to say about

that let's take a look I want to really

get it specific here for the parents

talking to the therapist when they're

still figuring out if it's the right fit

or not for their child yes

what are let's say three to five of the

questions they've got asked okay I would

ask what their experience is treating

children with X problem for a particular

age range

so what's your experience treating

children with obsessive-compulsive

disorder between the ages of 5 to 7

mm-hmm because some people are amazing

at treating individuals of different

ranges of Ages but maybe not so much for

the age of your child there is a

difference as we talked about this is

why you're doing the child series on

anxiety because children and anxiety

it's a different thing than teenagers

and anxiety then adults with anxiety

then older adults of anxiety so you want

to know that they've had some experience

and be able to describe that to you

another really important question is to

ask them what kind of theoretical

modality they work from is it play

therapy is it psychodynamic is it social

learning is that cognitive behavioral is

a straight behavioral you want to know

where they're going to be taking your

child in terms of the techniques that

they're teaching them psychodynamic

therapy is much more insight oriented it

may not be appropriate for a younger

child behavioral therapy is very

appropriate for actually children of all

ages but especially younger children

when they need that tangible immediate

outcome to know that they're actually

learning something new really great

advice and even if you get the doctor

that you think is best and your teen is

on board or your five-year-old seems to

be enjoying the sessions even then there

can be the possibility of a misdiagnosis

what would you advise parents to do if

they feel like the diagnosis their child

got was wrong well first I need to talk

to the provider who gave the diagnosis

ask them the questions let them know

that you have some concerns that it

might not be the appropriate diagnosis

and share what those concerns are and if

you still get a satisfactory answer and

you still have some just you know

concerns that maybe it doesn't quite

describe your child the way that you see

your child you should get a second

opinion and I encourage people to be

transparent with their primary provider

whoever has been helping them up into

this point about that yeah they

shouldn't feel like it's a slap in the

face if they just want to get a second

opinion it can only help the child more

just to get another good professionals

eyes on it yeah I also and it was funny

our director after we stopped filming

the episode about to pinch

said hey thanks for explaining all of

those to me because there's a little

confused we went through and you

explained it so clearly

SSRIs yes which are selective serotonin

reuptake inhibitor I don't have it okay

so sorry what's the second one

benzodiazepine and beta blockers and

beta blockers and how those are used in

anxiety and the treatment of phobias and

how those can be used in children and

the things to look out for what are the

big we won't go into every single detail

of all three of those they can watch the

series to see that but what are the big

takeaways that parents need to know

before medicating their child if that

options on the table well if that

options on the table you need to make

sure that you have researched the

medication class as much as possible so

you can ask informed questions of your

prescribing provider if you are seeing a

good psychiatrist or somebody else who

has a specialty in dealing with mental

health related medications for children

they should also be able to give you

some helpful information to let you know

what side effects to watch work because

children's systems are more sensitive

than adults and sometimes are different

than adults so the side effect profiles

can be very different so we want to be

very very careful with that but we also

talked about how important sometimes

psychotropic medications can be

especially because it helps them to

receive the therapy a little bit more

right it helps them to learn the coping

strategies a little bit more and in fact

I have known patients who will take beta

blockers or benzodiazepines before they

have to do an exposure to a feared

stimulus when they're doing phobia

treatment what's too scary to even for

example get on that get on that plane to

do the phobia that I have of flying but

maybe if I take a beta blocker I'll at

least get on the plane and then be able

to practice my coping strategies while

I'm there yeah that makes sense yeah I

also shared a personal story about my

diagnosis with depression and anxiety at

the age of nine years old and how taking

a medication affected me let's give the

viewers a quick look at that story I

said that at nine years old I mean you

talk about depression and anxiety it was

off the tribe I think it was I don't

have anything

parent to accept my own experience but I

mean just constantly in tears running

into the kitchen to grab a knife just

just just a really tortured

nine-year-old and I went to a

psychiatrist and I was put on Prozac and

I don't know if they had a pill or not

but back then but they would take Prozac

in a syringe and I remember at the sink

my mom would squirt this liquid at my

mouth and it tasted horrible blah blah

but I remember I mean probably two or

three weeks later going oh my gosh I can

I can hear you yeah I can see you I can

wake up I can grab this without I mean

everything seemed clear and how I

assumed everyone else was living yeah

and so I only share that story because

that was my experience yeah and if you

don't want to use medication don't use

medication right right but if you do use

medication there can be benefits as well

as a negative side effects but there can

be benefits as well and for me that that

changed everything yeah and I still feel

that way that medication has helped me

and I'm on medication now and I feel

like it does help me the biggest lesson

I learned from you and I learned it

actually in our depression and substance

abuse series and then it was reinforced

here was the power of interviewing

doctors yeah you gave the people

permission to do it yes you gave them

the questions to ask and I actually

asked you a question and I was so

shocked at your response let's just I

want them to see this too so let's take

a look at that interaction right here

what percentage of new parent patients

ask you questions before they bring

their child in less than two percent and

what percentage should be asking

questions 100% it's a huge problem I

know they don't ask I have to ask them

they'll say well I don't want to

schedule a session okay but for what for

what just oh I know yeah yeah and how

are you so sure you just want to

schedule a session first yeah sometimes

I have to engage them first and then I

interview I basically start the

interview I'm like okay well tell me a

little bit about what's going on how

long has it been going on how old is

your child what else have you tried and

then they answer obviously because when

you ask somebody a question they answer

it but I'm the one doing all of the

asking which is interesting that they

are so ready just to schedule a session

without their you know anything that I

do yeah Wow

2% yes crazy little I mean it's a job

right so you should feel very

comfortable in interviewing your job

applicants yeah and so when it's a

doctor who's gonna be treating the

mental health of your loved ones you

would think that you want to ask them

those questions yet only 2% have ever

asked me they just want to get an

appointment right away

and I told you I had all four of my

wisdom teeth removed two years ago yes I

don't think I asked that dentist one

question but I asked a lot of questions

before I bought my new TV right not that

right not good we need to be taking this

as seriously as we do our TV show I get

that you also shared with med circle

members and myself something you haven't

shared in the past which is your

wellness tips wellness program in

conjunction with treatment can make just

everything work better what is a

wellness program a wellness program is

really about a lifestyle it's a way that

you live your life so that you can

increase satisfaction well-being quality

of life better physical mental health

and more connectedness with the people

that you care about yeah and it's you

don't have to go therapy to have a

wellness no it's it's things like

healthy eating some kind of exercise

regimen yeah good sleep habits right

taking care of yourself through hobbies

and enjoyable activities and scheduling

them in making sure that you have time

for your loved ones making sure that you

have time to relax moderate use of

alcohol and consider not using any drugs

hopefully yeah that would be a good

thing especially if you have a more

severe mental health condition even

recreational use of drugs like marijuana

can sometimes make it worse and you

talked about sleep hygiene yeah new

favorite phrase so you going to do that

this year

I love that they'll be implemented for

me tonight yes hi Jean yeah I know what

that is definitely watch the series and

I just want people to know exactly what

the series includes so I'm gonna go one

by one in each episode real quick to

tell them what it includes in the first

episode we do a really big in-depth dive

into what anxiety is what those phobias

are and how it can look within your

child and number two we show you how to

spot the signs it's not as easy as just

understanding the disorder because it

manifests in a lot of different ways in

different people so dr. ho gives you

actionable advice the questions to ask

and how to have that conversation with

your child whether that child is three

years old or 13 or 17 years old we then

talked about how to find the right

doctor do you see a psychiatrist do you

see a psychologist do you see a

therapist do you see all three how often

do you go we don't know what questions

to ask how to even begin your search how

to interview these doctors all of that

is covered so that your child has the

biggest chance for success then we talk

about how to find the right treatment

options and the right diagnosis how do

you know if your diagnosis is right how

can you put your child's treatment and

your child's future in the best possible

light so that they are successful and

number five we go in-depth into other

treatment options because the first one

doesn't always work specifically we

talked about the SSRIs the Bindo die as

of pains did I say alright and so DS and

beta blockers it's a clearer explanation

on exactly how to be it's a clearer

explanation on those medications and how

they can affect your child and then

finally we end this series with a

wellness program now this is good

regardless if your child has anxiety or

not a wellness program is always

something that people can benefit from

and that's this series in hole I think

will really change the lives of children

that will change the lives of parents

but definitely children I hope so and I

think that the wellness program combined

with knowing what to do when your child

shows anxiety it's really sort of a

combination of prevention and

intervention yeah we can always do

prevention always and when we're

especially stressed that's when

really want to increase your wellness

program take a look at it make sure that

you're doing as much as possible to

maintain a good healthy lifestyle for

yourself we're so lucky to have you

we're so so look people are so lucky to

have this information so thank you for

sharing your wisdom with these people

and I'm really excited to hear your

thoughts about this series you can go to

med circle comm and become a member

right now I'm Kyle Kittleson and

remember whatever you're going through

you got this