good evening and welcome to this special mental health edition of doctors on call I'm Dina claba a psychotherapist and founder of Insight Counseling of Duluth and Virginia and I will be your host for our program tonight on Child and Adolescent mental health this is the first of four special mental health episodes that will be airing throughout this season of doctors on call Future programs will cover the topics of grief and loss PTSD and Trauma and Stress and Anxiety our program is here to answer your questions about mental health issues that may affect you your family or friends please call or email your questions and we will do our best to address them the telephone numbers and email address can be found at the bottom of your screen our expert guests this evening are Anne Meehan a licensed professional clinical counselor and founder of Meehan Mental Health Services and Mary Morehouse is a licensed clinical social worker with insight Counseling in Duluth our phone and email questions are being received this evening by members of the wdse staff who will bring them to me here in the studio now let's begin with a discussion of Child and Adolescent Mental Health good evening Mary and Anne good evening so nice to have you here how about if we start with just if you want to say a little bit about your practice and and would you like to start yeah so I'm Anne Meehan of Meehan Mental Health Services and create Wellness I see children ages 3 and up and my practice mostly specializes with trauma therapy and I have a lot of young people I work with with big feelings and big behaviors that come with it so that's what I focus on thank you Mary I'm I work with at mostly adolescents and young adults mostly with anxiety or anxiety and depression at Insight Counseling here in Duluth and I do both in person and Telehealth thank you well we're especially excited about this topic I think just coming out of the pandemic I'm anticipating I can't wait to see the questions that come in tonight because we're kind of coming out of it and yet clearly as we all know a collective trauma Collective grief that we're experiencing and how do we heal collectively from that experience um if you you don't have to go far to see many of the headlines concerning children and teens and a lot of them can be have been quite alarming the rise of drug use just anxiety so on and so forth and again a lot of what we would expect after uh I mean I say after I know there's still a a great number of people and our communities who are still experiencing the effects so I don't mean to say after but certainly um we're experiencing and holding space for a number of things so I'm curious tonight you know how much of that will be questions around that and I know we've talked a little bit before and then there's also this I mean normal developmental experiences that are happening and always have for children and teens so that said I think about just our communities and I'm so grateful to have this conversation because one of the things you will probably hear is that our our offices are pretty full I mean there is a high demand that I think existed before the pandemic and and I just pulled some data that a report today that was just published in American Psychological Association about the increase in in children and teens as well as health care care workers I do believe one of the I guess positive things to come out of covet is a destigmatization in lots of ways of mental health and people are accessing us which is wonderful that said I hope that our conversation I know it will because we've talked about it will be offer some hope some tangible kind of tips and insights about what parents can do what Guardians can do what our community you know teachers what what our community can do so that said Mary if you I mean anything that comes to mind I guess in what as you think about our communities and and viewers at home tonight what would be helpful yeah it was interesting when the pandemic first started it was interesting to see my clientele who was actually Yay I've been wanting to do online school for a long time and so they were able to kind of work on their own schedule and then other people who that with the social connection really gone and the isolation with the families was really difficult and so when school came back in session when people went back into the classroom it kind of flipped so then it was the people who for that that social connection piece were like oh I'm so glad to be back at school I didn't see those people anymore because they their difficult time was during the isolation piece and then the people who were oh my gosh this has been so great I really like this schedule this Vibe is this is working for me those people those adolescents and young adults have had a harder time kind of transitioning back into kind of this more structured environment that is high school and and college which is primarily what I see so I that that's something that just that really surprised me about kind of that that change and you know and depending on where the child was or adolescent was in their personal development you know you stopped school at seventh grade going and then you're you the first time you were with people is in high school I personally had um a class of 2020 graduate who she didn't get to graduate from high school and so depending on where adolescence and and young adults were their post High School experience whether it's college or other things has been just really different and so that was kind of I guess for me kind of a a surprise and so now we're seeing kind of um that you know because we're all hardwired to connect and so that disconnection for everyone was just so hard and so developmentally when we're disconnected and then we have to go back and we're connected again you may have really gone through a huge natural biological you know change adolescence but you're kind of being hit with in in a new in a space that you haven't been able to kind of slowly grow into you just kind of had to be there so that's that's I think that's kind of a big picture what I've been seeing so it sounds I mean also just everybody's experience was very different yes and a lot of validating and normalizing what it was that they were experiencing yeah how about you Anne I I love what you had to say because I saw a lot of the same a really mixed bag of again the kids who really thrived virtually and the kids that struggled and as we're Switching gears and going back into the classroom I've seen a lot of the young people that I work with struggle with maybe virtual school and the pandemic there might have been less pressure or less deadlines or school was maybe a little bit lower of expectations and then having to go back into that structure of a classroom and being in the class seven hours seven periods a day and having a typical workload there has been some overwhelm with that and with that overwhelm how would you how would you describe that and I guess when I get a lot of people asking me and like what is you know healthy overwhelm and um what would and when is it to the point how do you know for instance if your child should seek individual therapy that's a great question so when I think of stress life is stressful there will never be a a child or adolescent or teen or a grown-up's life that doesn't have those stressful periods and moments and what I think about when I think about the typical stress response of like a test coming up or any other challenges that teens face like a rupture in a friendship where they're maybe not best friends with their best friend anymore typically their stress will come up and it will Peak it will crust and it will come back down and it will be time limited after the stressor is over you'll see it coming down with the problematic overwhelm it's chronic and kids it's almost like if they're swimming they just can't keep their head above water it's all the time it's pervasive and it starts to impact almost every area of their life and and with that how can that thank you that was helpful and now when families when parents grandparents aunts and uncles I'm going to pull everybody everybody in when they're recognizing this what is the best way to respond how can I shouldn't say best way how what is a helpful way to respond to these big emotions and yeah and so I I saw this explanation of worry Stress and Anxiety the other day and I I made a lot of sense to me worries in our head stresses in our body and anxiety is the combination of the two and I just and I love that um and so I think um having a conversation having you know with with someone in a in a in a non non-stressful uh but in a in kind of a calm environment driving in the car where there's no eye contact is a really good is a really good thing um sometime when you when it's not uh you're not putting the somebody up against the wall and you know just saying I've noticed these things is there anything you know want to talk about another really good way is to share your own the adults the caregivers to share your own not to preach to the children or to The Adolescents because that never works but to say I had a really tough time at work today or I was really I was really worried about this I was stressed about this and um boy I didn't know how I was going to figure it out but you know I just did it I figured it out and it was all better so wow I was really worried about something I was really stressed and anxious about it and then I I just figured it out by talking to a colleague or however I figured it out and I got through it so wow that was a really good experience for me so now I learned as a parent you could say wow I learned now you know whatever obstacle comes up I don't necessarily have to know exactly how I get through it I just know I can so I think really kind of showing um telling your kids your own personal stories is a really beneficial way to really to really show to really mirror those kind of positive examples of how adults deal with it mirin and it sounds so authentic you know which I imagine and we talk about co-regulation that that's what we're doing and how we respond you know to our kids to young people can either call in the waters or create turbulence in a way I mean I'll say I feel this way as a clinician too I mean certainly uh dysregulated clinician is not going to do a very good job at regulating a client you know so I mean I love that authenticity that and then I'm hearing you really non-judgmental you know these these adolescents young adults have gone through through their personal developmental stages something that we at my era as a parent I never dealt with that stuff in high school and college and so I think just really giving Grace and space and kindness and really having great understanding in a non-judgmental way is probably the best thing we can do and say yeah of course this is tough I hear you I see you this is tough of course it's tough you live through a global pandemic yes of course I get it just came out with a book I just I love his work and the myth of normal yes book and I love he said these are actually I mean very normal reactions to an abnormal situation you know an abnormal experience yeah our questions are coming in I'm excited with everyone so plugged in to Instagram and social media how has this screen time impacted the mental health of kids today and would you like to start I would so I think there are pros and cons right I think that there's nothing that's concrete to say social media is all good or all bad um what we know what the research shows us is there's a lot of comparison that can happen with social media a lot of things that we might see that are like carefully curated to show a version of ourselves that isn't the whole picture and when teens see this version they can often compare what it looks like to their life or sometimes get feelings of being left out and I think it's really important to open those conversations with teens that that it is just that that this isn't somebody's whole life that isn't their their whole truth and I think that we can have wonderful benefits of connection over social media you can develop I have young people I work with who have whole social connection networks of people that they're really connecting with online and they're really getting some good benefits out of that is great I did participate in speaking of the data and a training that kind of really pointed out that parents may be monitoring screen time and that what content is more valuable and you know more so than the time would you marry your naughty yeah and I you know I and a good conversation that I have in my clinic when I talk to talk to my adolescents and young adults about about their screen time what is the social media Tick Tock Instagram whatever it is and I say well how do you feel after afterwards do you feel better do you feel worse or neutral more often than not it's I you know I I spent too much time I feel worse especially Instagram and I and I like there's I'm not throwing any social media under the bus but I said well then let's do less of what doesn't work and more of what does work and so those social connection pieces those pieces that are good for us that are that social connection more of that and if the Instagram The Tick Tock or whatever is not making you feel better do less of what doesn't work and more of what does work and so I think that we can kind of you know the other thing was during the pandemic the screen time was everything it was their school and it was their social connection and it was chilling out at night watching a movie with the family or whatever it is so it was everything and so now if that was their everything to try and figure out to temper that back and have it try and figure out what that level is it's hard for adults it's hard for adults to figure that out and so of course it's going to be hard for kids who are and you know these companies are extraordinarily good at what they do this it's you know really good algorithms to keep you hooked on and also that's another conversation to have like they're doing it to keep you hooked on kind of thing so do less of what doesn't work and make you you know feel that good and then do more of the social connection piece because there are there are good parts to it too it's a lot of tapping into I mean mindfulness you know and just awareness of what is happening and and recognizing that and another thing that I'll share with teens is really being mindful not only just of platform specific but also who they're following on the platform and being conscious to choose if there's content that's triggering or stressful can we unfollow can we kind of hit the snooze button on some of those accounts to make it a more meaningful experience like you were saying yeah absolutely well and if you're just joining us we're having a lively beautiful discussion about Child and Adolescent mental health the next question when a question says come in why has there been an uptick in young girls being diagnosed with anxiety sounds like somebody's recognizing yeah so there is you know and so that's you know it's always kind of a it's a little bit it's a little bit of a tricky one so there's this generalized anxiety disorder so generally you know if it's life interfering in one or in in two places um in your life then that could be and other qualifications for generalized anxiety disorder and so I think sometimes we have to kind of again pull back and say what again worry stress anxiety what is anxiety and what is kind of the anticipated expected anxiety that we all deal with and then to kind of you know not all things if every all anxiety is generalized is anxiety disorder then nothing is if all traumas you know trauma then nothing is and so I think not all anxiety is a problem with anxiety sometimes we need anxiety it's motivated motivating I was anxious to get here on time tonight because I wanted to make sure that I was here on time that was good that was positive healthy anxiety because I was here on time and I sat in my chair and everything was good and so I so I I think we can have a conversation around around what is harmful anxiety when so it affects kind of that biological eat sleep exercise I always say that that's my three-legged stool as a foundation for everything else so is it affecting eating is it affecting sleeping and is it affecting movement I could also put in connection connection with others but you know really check that eat sleep exercise I talked to everybody about that about this so if it's not affecting the e-sleep exercise if it's being talked about a lot but it was like oh I was sleeping well oh yeah I'm eating fine oh yeah exercise is fine connection was fine I'm just really really stressed oh oh okay are you getting the grades you want are you getting things in on time that kind of thing and so so I think that there has been one of the great things about having a lot of conversation of brown mental health is that we do have a lot we do talk about it more but not everything is going to be a problem with anxiety so I would say look at the more biological factors especially with younger kids too kind of that you know eating eating sleeping that type of thing wonderful yeah and anything that you would want to add about I mean are you seeing more girls and I'm I'm seeing a rise of anxiety in in general I think we're seeing as a whole a rise in mental health and I think on one hand that could also be because we're having a more open conversation about it there's less stigma about mental health difficulties and we're having more people Express that they are anxious and express that they're having difficulties and so that might be another thing that we're seeing that it's safer and easier to talk about anxiety and so it's now more out in the open and the effects of the pandemic were overwhelming all of our nervous systems were on pretty high alert for a big chunk of time and so that also makes sense with with the pandemic huh there was a question that came in kind of meant and Mary you mentioned eating sleep so and so forth and this question is could eating habits affect Mental Health and you want to start there yes um I love I love this question because what we know is the research shows us that our gut is what we would call our second brain and a lot of our chemicals that are the mood chemicals that impact our happiness and our anxiety and stress are actually produced in our gut and they go up to our brain and so the food that we're putting in our gut and what we're eating either can give us energy it can take energy away and it's really important I do share with my clients as well the three big I call my three big things which is sleep exercise and the food that we're putting in our body intentionally I love that I'll add one to it the three and Stillness yes that experience yeah which can be different from sleep you know but those I always say I remember nap time in kindergarten I don't remember nap time after coming to a beautiful school it's a great school but you know I'll I'm thinking of um young adults that I've worked with and sometimes they'll tell me that their favorite class in high school was and it wasn't related to the subject it was the the class where the teacher had a moment of quiet or a moment of mindfulness you know as a as a component of that class so yeah anything that you would want to add Mary about you know yeah I think like I said we talk about it you know I think if anyone stayed in their room and and for 22 hours a day you know during some of this pandemic and ate nothing but junk food everyone no one would feel good I mean if you just eat you know if you eat junk food like No One's Gonna feel no one's going to feel good so it's like the better that the the better you know you you you put in the the better you can you can give out yeah uh what do you do to help a child who is being bullied at school um and I was wondering if we were going to talk about you know if we hadn't touched on any of the trends that we've seen I mean this is not an uncommon one at least from my perspective so what would you say about yeah that's that's an excellent question and it's a deeply complex question because there's multi-layers of the school administration and the social the social groups um that they're all uniquely connected but I think one of the biggest things that you can do for bullying which sounds a little bit odd is work on increasing self-esteem the person that's being bullied work on pumping them up work on highlighting their strengths the caregivers the grown-ups in their life helping them come back to the knowledge of how amazing they are that is one of the biggest interventions as well as understanding when do we Loop in the school when do we when do we get higher level of support depending on the level of severity of the bullying so as a parent and caregiver you can have kind of both of those lenses the child's strengths every child has strengths and focus on whatever that is for for that individual child and so if they really like um you know um like wrestling around you know put them in a Taekwondo class if they really are artistic so try and again to piggyback on what you say really make them um really strong within self and so then whatever comes at them kind of you know rolls off like a you know water off a duck kind of thing and so so kind of make that resiliency that strength from having that come within as you know from a parent find find what what are those kids strengths and let's pump those up I love that you mentioned that because that also reminds me of um connection with activities and extracurricular events and so on and so forth and sometimes I do get the question of it's so great to be connected of course we know that if we need it um to survive is it there's so you know so many options um there can be depending on where you go to school and so on so is there ever when is it too much how do you know well I I would say that it depends on you know each kid is so different I mean I you know just within my own family you know my kids I had some kids that were just going all the time and that they needed to be busy all the time and that's great and some needed that down time and so it really really noticed what what it what fills up the cup of of the child so everyone has that little different need of of what of what gives them happiness zest energy and sometimes it is that more quiet mindfulness that that quiet time and sometimes it's connection connection so it really it just pay attention and each child is individual and so whatever it is for that child then that's where you go that's a great message yeah I mean really honoring who they are yeah absolutely also unique anything in that you would want I think that you had all those areas just taking the temperature of the child of when they're getting to that level of overwhelm globally versus maybe being excited or stressed before a big competition their performance or something like that if it's Global then it's time to consider if it's too much I think we have time for at least this question I I love kids seem sometimes kids can seem nervous or even skeptical skeptical about getting help what are some suggestions you have or maybe you can even Enlighten us on what Cena therapist looks like so maybe kids are more comfortable what does it look like in your office then yeah so I'm a play therapist and I also do a lot of other different types of therapy but usually for kids it they're really leading with what what they need and so most of the time you're meeting with the therapist or a therapist and the therapist the first session will ask a bunch of questions and then after that depending on it could look like talking it could look like playing it could look like whatever is focused on the needs of the child but it's not big or scary and the therapist is just there to learn about what's going on in the child's world and how they can support them the therapist is a member of their this is wonderful Mary just a few seconds left yeah we're you know so we're um uh if we're therapists are mandated reporters so if we suspect abuse or um if we feel that they're a threat to sell for others then we're mandated reporting everything else we don't have to tell anyone you can tell me about your friend stuff you can tell you about how much you don't like your parents or your sibling or that you cheated on a test or whatever is all that kind of stuff that's embarrassing to tell others or that you're a safe space for that yeah Q I want to thank our panelists Anne Meehan and Mary Morehouse for their time and expertise tonight and for those of you who called in or emailed questions doctors on call will be off next week for Thanksgiving please join Dr Peter nalen on December 1st for a program on lower extremity knee hip and foot problems when his guests will be Dr Joe Bianco Dr Patrick Hall and Dr Tolga hanhan I'm Dina claybaugh for the guests and crew here at wdse thank you for watching good night foreign