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Kids and Mental Health with Dr Josephine Elia Pt 2

07/01/21 Josephine Elia, MD, Nemours/A.I. duPont Hospital for Children|Sidney Kimmel Medical College of Thomas Jefferson University;

Season 3 | Episode 4 Pt 2


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Josephine Elia, MD >>  Kids who do best are the ones whose parents are functioning best. And that may be one of the key things to take home. Because oftentimes, we don't take care of ourselves or we neglect ourselves because we're taking care of everyone else. We can't think that way.

Joe McIntyre>> Welcome back to the Merck Manuals Medical Myths podcast. Thanks for joining us. I'm your host, Joe McIntyre, and this is part two of our discussion with Dr. Josephine Elia a psychiatrist with a specialty in child and adolescent psychiatry at Nemour's AIfred I duPont Hospital for Children in Delaware. Dr Elia, thanks for coming back. Now, how can parents help tackle some of these challenges with kids and perhaps foster greater resilience, or just improve their children's mental health in general?

Josephine Elia, MD >> Having just one adult who cares about the child who the child feels connected to increases resilience, just across the board. And if a child, you know, is in the situation where they may have lost their parents or their parents or killed themselves.You know there's studies showing that formal youth mentoring programs where you match the child with an adult volunteer. What, you know, can, can be helpful. Bottom line is that kids need adults to be able to be resilient.

Another one is friendships. We're social beings, and having close friends, you know your own age or share your own interest is critical. And if you can foster those friendships if you can help your child to understand the importance of that. And you do that by getting to know your child child's friends. So open up your home to your child's friends get to know your kids friends, get to know their parents is really important.

Studies are also consistently showing that faith in religion, provide benefits in reducing stress, overcoming adversities. And, you know we we all are going to face adversities. And as parents, what's the thing that we want to do we want to prevent our kid from ever falling down or having them be hurt in any way. That's not reality. And we need to be prepared for those things to happen.

Nature exposure is is an incredible protective factor. And you don't need to live across Central Park in Manhattan. Right. And the studies are showing that, obviously, walking in a park walking, you know, outside is important, but even just having the visual exposure to plants to a single plant has beneficial effects.

Exercise is another critical factor, any kind of physical movement, improves the brain. It improves mood and improves our ability to learn. Again, you don't need to go run a marathon. You just need to walk for five minutes is all is all you need to do, because sometimes we think we need to like as parents want to do the perfect thing we need to do, you know, we need to be just good enough. And even if we do a little bit of one of these things, it can be helpful.

One of the things that we don't take advantage of enough are things like music, and music, allows one to get in touch with emotions that we may not be able to even verbalize or the we may not even be able to be aware of. And again, you don't need to be the first violin player in the Philadelphia Orchestra.

You need to just hum a tune in your head, but music brings us to the present. And not only can it be enjoyable but it can be helpful. I think sports we know a little bit more about because I think we do value team sports a great deal. And there's a lot of opportunities for children to be on the baseball team or the soccer team or so on.

But if they're not available that's alright as well, getting just the soccer ball or just any ball and playing in the backyard or in the, you know, on the back street where there's no cars, just with another kid is just as good. One of the reasons I think sports can be really healing and really helpful is, they bring us to the present. You cannot go and catch a ball, unless you're in the very, very, very present, right, or kick a ball. It just doesn't happen.

Other things are to encourage curiosity. During COVID We were all going through stressful times, the kids that we saw that did well, they became curious about what was happening and why and, you know, they started to report on these different things and record them so that they could be like an active participant, rather than just feeling like they might, might have been a victim of the circumstances. Kids don't always necessarily talk about things, but they'll draw you pictures. They communicate in so many different ways, and having them do that in those ways, can be very helpful.

I think one of the main challenges we have as parents, these days, that our parents didn't have so much in the past is exposure to all this internet to all the media stuff. And it's critical, because we can't monitor, and we don't know what the kids are seeing and. And, you know, it takes the kid away from their presence and their situation, so limiting those, obviously, our media or Internet has incredible advantages, and we're so lucky to be living in an age that we have, but we don't want it to take over our lives.

Joe McIntyre>> So when should a parent seek help from a medical professional when it comes to their child's mental health, you gave so many great solutions so many great opportunities for parents to help improve their child's meant to help but when should they seek the advice of a medical professional?

Josephine Elia, MD >> Any time a parent is asking that question, or is struggling with what may be going on with their child. The pediatrician or their primary clinical, you know, provider that they're working with, you know, hopefully should be the first place that they can go and get their sense whether you know my just being an anxious parent and worrying unnecessarily is it's just me, or, you know, let me tell you what's going on and then help me figure it out. Oftentimes in schools, and now that many, you know, many of us women are in the workforce. We're seeing it in preschools, it's a preschool teachers, it's the school teachers that are seeing the kids in the group situations that sometimes they will call the parent or they'll tell the parent. This is what's going on, and we need to figure out how to how to fix this. So, it's better for parents to seek help earlier rather than later. And if it's just a case of you being an anxious parent, that's okay too. You know, as parents, and again for having gone through this myself, I would worry even like if even for physical symptoms is my pediatrician and I think that I'm overreacting or that I don't know what I'm doing.

But that's the risk, you're going to take. So parents shouldn't feel uncomfortable in seeking help at any stage in development, whether the kid is, you know, six months, or whether the kid is 16.

Joe McIntyre>> Did you know you can use Merck to find in depth content about hundreds of medical topics, including those that may be difficult to spell? Simply browse by using the letter spine search function on our website is the best first place to go for easy to understand medical content.

Joe McIntyre>> Now, I'm sure I'm not a parent myself but you certainly are. Dr. Elia, when parents are dealing with a health issue with their child whether mental or physical whatever it may be, It can be so very stressful on parents. How can parents maintain their own mental health when they're dealing with, you know, some struggles with their children?

Josephine Elia, MD >> So that's so critical, right, because the kids who do best are the ones whose parents are functioning best, and then maybe one of the key things to take home is oftentimes we don't take care of ourselves or we neglect ourselves because we're taking care of everyone else. We can't think that way. And it's important for us as parents to take care of ourselves.

Being a parent. It's the most difficult job. If things go well then you can take credit even though you may not be the best parent. I always feel like you know, a healthy child makes even a mediocre parent look good.

I tell that to my kid I'm working. He's a healthy kid, I was an okay parent but he mad me look really good. Every day here at the hospital, you know, we see parents with children with a struggling with all sorts of disorders. And these parents are just incredible. And often, you know what we hear from them is they feel like it's their fault, some way, or that they're not doing things right, or maybe you know, When the kid was one day of age thing, something or other, which may totally be irrelevant. So I think parents need to just take credit for having chosen, you know the most difficult job in the whole universe, and give themselves credit every single day.

Some of the things that I think are helpful for us parents is gratitude. And again, lots of studies are showing us, waking up each day, including the day with gratitude, makes the rest of the day, you know, go better even if it's gonna be a bleak day.

And there's a couple of books by Dr. Edith Eger, she survived the Holocaust. And one of the things that she teaches us is that there's a gift, in every circumstance. So even if it's, if you've had a bad experience and I know that none of us you know are gonna have the horrendous experiences that she had when she was a teenager, and she can take in and look at such terrible things and look, I think you've seen them, we certainly can to. Other things that are really important, is to actively reach out to someone else.

Don't wait for someone to reach out to you actively move out, even if it's just to say hello, even if it's just to give a smile is important. We need to have distractions. Distractions aren’t just superfluous, you know, useless things. They're critical, they can be anything to plant a tomato plants, you know, put together a crossword puzzle play an instrument, but they're critical. We need to accept that we're humans and as parents we do we think we're going to be the best or otherwise where we're terrible need to be just good enough. So, we all have those weaknesses. Let's not push them away, but what accept them in every chapter to a higher power, regardless of, you know your religious beliefs or how you're feeling, because we're not going to be able to do this alone. Another thing I often give this example to parents, when we're treating anxious kids, anxiety, just like a virus is contagious.

If you the parent are anxious, you can just assume that your kid is absorbing your anxiety, even though you may not be aware of it. So, controlling our own anxiety is really important, even just learning how to do a breathing exercise. So you calm yourself down you go into the next room, and give yourself two minutes, you do those breathing exercises, not, not when you're feeling anxious, you do them every day. So like those muscles those brain muscles to help you calm down or in shape, so that when you begin to feel that panic, you can reach for them easily.

And my last thought is to actively and deliberately counter negativity, and it's important to really do this deliberately in a book, it's called ”the power of bad” , the author's Tierney and Baumeister point out that there's just a natural tendency for negative events and emotions to affect us more strongly than positive ones. And they refer to this as the negativity bias. And so, if these negative things, you know, really can distort our perception. We need to be aware of it, and even a single instance of an unkind behavior can tend to create a negative impression that cannot easily be undone and these negativity effects can be enduring. And it's important to eliminate them, rather than just accentuate the positive and some practical things that you can do with that. It can take four to six positive experiences to counteract a negative one.

So, be the one to actively and deliberately provide these positive experiences to others, regardless of, you know, whether you like them or don't like him or whatever, because you'll benefit from that.

Joe McIntyre>> Well, Dr. Elia, thank you so much for coming on the podcast, I think you shared a ton of useful information, not just for parents but for anyone who, who, who interacts with the child, whether it be like you said, an aunt and uncle, interacting with a niece or nephew, so much great information to improve children's mental health and make sure that parents especially are aware of when their children are dealing with some mental health issues.

Additionally, Dr. Elia also has a recent editorial on the Merck Manuals for anyone to read that dives even deeper into some of the topics we talked about today. So I will leave our listeners with this as we always do with the Merck Manuals.

Josephine Elia, MD >> Medical knowledge is power. Pass it on.



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