Ep 125 | Kids are worrying more! Now what?

SPEAKER_01 0:00

86% of all the ones that we surveyed reported worrying, and 73% worried at least once a week or more.

SPEAKER_00 0:16

Welcome to the Voices United in Education podcast. Each week we showcase the teachers, administrators, and community members who go the extra mile to contribute to the success of every student in Escambi County. You'll meet the real people behind the titles and learn about the amazing resources to support every student's success. Mortgage, money, deadlines, and aging parents. Adulthood has a heavy helping of potentials for worry. But childhood, it's supposed to be carefree. Why then are so many kids spending so much time worrying? And what can we do to help? My next guests are the pediatric medical social worker at Namores and a registered clinical social work intern at Greenhouse Counseling. Today they're gonna share their findings of the Why Kids Worry study and helpful tips to help your kids worry less. Advocating for kids, bridging the gap for parents, peaceful warriors, Melanie Freeu and Erica Mack. Thank you, ladies, for being here. Thank you for being I do feel truly like y'all are like the peaceful warriors because it's like the unseen enemy of our kids is this like pressure and the worry. And so y'all are doing the work. So I appreciate that so much. So let's start with the results of the study. Melanie, both of you have anecdotal stories that we will get into for sure, but the data, let's start there that you collected at Namor's. How was the study conducted and what were some of the results?

SPEAKER_01 1:49

So Namor's Children's Health through Kids Health in 2023 surveyed 504 children from the ages of nine to 13 via the internet. And we got some really good key findings about worry. Basically, the finding was 86% of all the ones that we surveyed reported worrying. And 73% worried at least once a week or more in that age group. So that's that's pretty high numbers there. Are those all kids in our area? So they're they're not in our area. They're outside of our area. But Namores felt because of our mental health crisis right now, and especially that we're hearing from the center of disease, you know, an increase in worry and anxiety with our children, with our adolescents, that they wanted to go in and do this study and let's see, you know, what's causing this worry and what can we do as professionals to step in to try to help these children to cope with their worry, to build these skills, because not only are they going to be helpful at this time at their age, it's gonna be helpful through their adulthood.

SPEAKER_00 3:03

Yeah, that's so true. And Erica, you've been in social work for 15 years, and most of your adolescent clients are ages nine to 13. What specific things have you seen them actually worrying about?

SPEAKER_02 3:17

It's really telling from the study because that is the age group. And if you think about it, them being in school, they are anxious about friends and peers fitting in their identity. So those are a lot of the things that I've seen with anxiety. And if you think about it, that's also the age group where we have transitioned. We're transitioning from elementary to middle school, and then from middle school to high school. So if you think about middle school for you or high school, we all know what that was like for us. So now think about that now with the influx of social media. This idea that I have to keep up or I have to have an appearance or I have to have likes and followers at such a young age. So the anxiety and the worrying about do I fit in? Am I accepted? Am I gonna perform? Will people like me?

SPEAKER_00 4:09

It skyrocketed. How do we distinguish normal worry from unhealthy worry?

SPEAKER_01 4:15

So I think to distinguish normal worry, I mean, like we just said, worry is a part of life. And sometimes a little bit of worry actually helps us. It helps us and it helps our children to make better decisions. What we look at is when we start seeing children, especially if it's on a daily basis, if it's starting to affect their daily routine, their daily functioning. We want to look at, you know, how are they functioning in school? Are they still interested in the things that they were being interested in before? Are they pulling back? Are they detaching from things? Are their grades failing? What is their mood at home? Have you seen a drastic change? Children that worry a lot and that start to have anxiety, they start showing signs of detaching, but also anger, more frustration because worry is scary. Even us adults, it scares us. But for children, they're still processing and regulating their feelings. These can kind of, I would say, present in all different fashions that we need to look for and and everything. And I and I always I want to add that I think too, you know, as parents, do that daily check-in. You know, be a part. I know that as parents, we think, you know, our children, they don't want us to, they don't want us to be a part of their life. They don't want us to ask about these things. But these are things that we need to ask, that we need to be aware of. And I think that's a good way to do that is to do a daily check-in.

SPEAKER_00 5:46

What does that sound like though? Because I promise you, parents think they check in. You know what I mean? Like, how was your day? You know, there might say, Well, I picked them up from school. Little Johnny knows he can tell me anything. All right. So what when you say check in, what are y'all thinking versus maybe what parents might be thinking?

SPEAKER_02 6:05

I encourage my parents to be curious about their kids. So it's easy to have those closed end questions where I get a yes or no answer. And even with a simple answer, like it was fine. Then now my next question is, okay, what was fine about today? Because as a child, I may say fine, but in the back of my mind, I'm thinking about the girls that bullied me at recess, or I'm thinking about the teacher that yelled at me, or the teacher that didn't answer my question, or the question that I had that I didn't ask because I was afraid that I would be laughed at. So now I'm curious, and it I don't want to say forcing, but I'm putting my child in a position where now they have to think about their response. And that's so helpful. I mean, and I love what was said about creating that space where we're now having those conversations and we're doing it more often, not just because I want to know. I also want to piggyback off of something that she said earlier about what we can notice. One of the other signs too would be sleeping, like sleeping more or sleeping less. And the same thing with appetite. Like if appetite is increasing or if appetite is decreasing. Those are other ways that parents can be aware or more aware of what may be going on or what may be happening. But creating a safe space. I'm on this journey now where I want to help parents be the safe space, not just create it, but now I'm a safe person. So my child knows that he or she can come to me and talk about their day without me kind of having to ask or proud or be curious. And so now we create a safe space where my kid comes home and like, mom, like today was absolutely awful because or I didn't feel comfortable today because so both of y'all have kids, right?

SPEAKER_01 8:03

I do not no kids. I have stepchildren, that counts, right? That totally have three stepchildren. Take credit for that.

SPEAKER_00 8:08

That counts. Okay, the reason that I'm asking is because as professional mental health people, that perspective of curiosity is easily accessible to you with clients, especially, right? You're like an anthropologist. You're like, wow, so Johnny pulled your hair and that made you punch him in the face. Interesting. You know, you have like more neutral reaction. Right. But as a parent, there is less of a neutral reaction. Absolutely. So being curious is harder. Absolutely. Because you're like, oh, what answer am I gonna get?

SPEAKER_02 8:44

Absolutely. And how am I gonna respond to what I need to do as a parent and what my expectations of you are as my child.

SPEAKER_00 8:52

And your reflection of self-worth as a parent or step parent because you're like, if the answer to the question is, oh, I thought about hurting myself, immediately, parents tailspin of failure. I'm an awful parent. What did I do wrong? We didn't raise you that way, et cetera, et cetera. So my question to you both of you is how do you access that curiosity in an emotionally charged relationship at like a step parent or as a mother?

SPEAKER_01 9:20

I think with anything when you have high emotions, it is challenging, it is hard, but you also kind of have to do that. Okay, let me step back a minute, let me get myself together because I know that something's going on. And so I don't make this situation worse. Let me see what I can do to be helpful. How can I approach this in a helpful way in that my child is going to feel safe coming to me anytime that there is a problem and that they feel safe that they can come and talk to me?

SPEAKER_00 9:51

So you almost use your motherly instincts as a way to control that emotion. Like how I'm gonna go in a helper mode. I'm a helper. Yes, me freaking out right now, not helpful.

SPEAKER_02 10:01

What about you, Erica? In the moment, emotions are high, and so you're not always gonna be able to control it, or it may not come out correctly. So in 15 or 20 minutes, why don't we circle back? And now I can be honest. Hey, listen, I was not expecting your response, and so my reaction was not appropriate in the moment, and I just want to acknowledge that. But that emotion is coming from a place of protection or a place of safety. So now I'm creating this vulnerable space where I'm opening up and I'm sharing something that is extremely uncomfortable with my child. And of course, this is all at an age appropriate level, so we would not be doing this with a a nine-year-old. I mean, we would do it at a nine-year-old's level or a 13-year-old's level, but we're having a conversation about what just happened and how I responded. And now I'm acknowledging that that was not the appropriate way, but this is a conversation that I want to have. And I it's funny, but I tell parents like when in that moment, this is where self-awareness becomes so critical for what happens next, and just being self-aware, like, oh my god, my heart is bracing right now. And just imagine yourself screaming inside of yourself before you respond. So if you can picture yourself screaming without it coming out, it's as if someone took your vocal cords. So now my body is able to respond the way I really want to, but I don't do that in front of my child. And I'm able to just listen. And it may mean like after we've had this conversation, now I walk away and I go scream in the pillow or I walk out. I just take a moment. But it's so important for parents to allow themselves to experience that emotion because it's a real emotion. So we don't want to avoid it or suppress it because you need to experience that that feeling of shock or awe or disappointment or feeling like I've let my child down when in actuality you really haven't, or you feel like you're not protecting your child because they're gonna have those emotions and feelings. But now, after I've allowed myself to do that, I can step back in and now be the support and the safe space that my child needs. And this is also the age where we're working on decision making. So now I'm in a better position to help my child go, oh wow, that was a really hard day. So, what do you think are some steps you could have taken? Or who are the supports at school that you could have talked to? So now I'm redirecting, but I'm also giving my child the space to make the decision and make a better choice, or know that they have support in me and at school.

SPEAKER_00 12:52

I knew that we were gonna go the direction of parenting. I did not expect that we would go the direction of self-care. That is interesting because when you think about why kids worry, you know, their little squishy brains doesn't they don't interpret data in the same way that we would interpret data, right? We could be at the same movie and then, oh, what did you think of the movie? Oh, that's were you in a different movie? You know, they would have a different interpretation. And so a parent who properly filters their own needs, their own emotions, could help, if I'm hearing you correctly, help the kid process their own worry or maybe even worry less, which is really interesting.

SPEAKER_01 13:38

That is, that's correct. And I we talked about this before about as and we do this too at Nemours, um, we look at our patient, right? We have our patient, but we also look at what are the outside factors that could be affecting our patient's care. Person in the environment. It's not, you know, it's not just that person, it's everything that's around that person and that it is affecting them. And in the medical care, and what I see in pediatric medical is when we have a child that comes in, and let's say they're a diabetic and they're not taking their insulin, they're, you know, just their blood sugars are not being controlled. They come in, it's just, you know, they may have to go into the hospital. We have to look at that family as a whole and say, okay, what's going on? Maybe the family didn't have enough money to go and get gas. Maybe the family didn't have enough money to get all of the medications. Maybe this family needs support. Maybe this family needs a little bit extra diabetes education, maybe to, you know, maybe they're not understanding how to calculate these dosage. That's not an easy task. So we look at that at Nemours and say, you know, we our focus is the patient and we are our medical facility, but we know, as our motto is too, we're well beyond medicine. And that's what we do every day.

SPEAKER_00 15:06

So it's almost like the parent asking for help would help reduce the worry of the kid and a medical situation, especially, like the example that you're giving a family with a type one diabetic child could say, Hey, we don't know what what we're doing. We need some support, and we've got these financial stressors. And I know Namor's, you know, it's in every budget of every medical facility, is to offer help to some degree, right? But you have to ask.

SPEAKER_01 15:37

Well, right. I mean, yeah, we would like for people to ask for help. Do people ask for help? No, not normally, they don't. So that's when it comes in with our team. Everybody that comes in contact with our patient, either when they're checking them in or in the room, the nurses, the physicians, we want to assess, ask these questions and get them to talk and to let us know, you know, hey, there's a need. This family has a need. And that's too when I come in as a pediatric medical social worker, they call me in there, and then I'm gonna assess the patient and I'm gonna assess every, you know, try to assess everything that's going on. We call that social determinants of health. So, because like I said, if we have a patient that's not doing well, we want to help them. We want to see what's going on. And with how things are today, you know, people are coming in, they're low on food, they can't afford gas, they can't afford their medications. And what we want to do is we want to make sure that that child and that family is not doing without because that is an additional worry. That child's already worrying about their chronic illness. They're already worrying, they don't want to have diabetes. It's scary. Nobody wants to have it. They want to go to school and they want to, quote, feel normal, is what they tell me all the time. They don't think they're normal children. So when they go to school, they're worried. They feel like they're going to be bullied, they feel like they're going to be picked on because, you know, of their chronic illness. And I see that and I hear that. I've been at Namor's 16 and a half years now, and I hear it almost at least once a week from our patients.

SPEAKER_00 17:14

Since you have been at NAMORAS so long, I did want to ask you about physical symptoms and how worry manifests in bodies. Because you mostly deal with, as you said, patients with chronic, oftentimes complex diseases and conditions. But what does the worry add into that that otherwise would not be present?

SPEAKER_01 17:36

Of course. I mean, as we know too, and as research shows us as well, worry and anxiety, I always call that these are your gut diseases. These are your gut things. So when I say that, it means let's say you have a child and they're starting to worry and everything. And we see a lot of this right before school starts. My stomach hurts. My head hurts. And I'm not saying that you should not address this because there could be something that they may need to see either pediatrician or primary care about or a specialist. But what we do see is an increase, though, when there are things that are going on at school, all of a sudden, the really bad headaches, the stomach issues, not eating, like I know Erica said, the appetite, you know, the sleep is big. I know that teenagers like to sleep, and and we do understand that. But are they sleeping a lot more than what they used to? Are they not wanting to do the things that they did before? Like I said. But anytime, you know, worry can turn into anxiety, then you're going to have some physical effects from that.

SPEAKER_00 18:44

Well, a lot of what you said was behavior change, other than you said my stomach hurts, but yeah, that can kind of be 50-50 with kids, right? Because they know that is automatic. Like, we don't want you to have diarrhea, so we'll just put you in your room, you know. Like, so are there other physical symptoms that parents should be on the lookout for? You said headaches, stomach aches. Is there anything else?

SPEAKER_01 19:08

I think just overall, too, just body aches, just body aches. Yeah, body aches. I think muscle pain. Um, we see a lot of children too. We see a lot of children that have juvenile arthritis. And when we notice that their their worry or their anxieties increase, maybe from a test at school, maybe because of that, they actually present with more increased body pains.

SPEAKER_00 19:32

That is makes some pains. Erica, do you find that the coping mechanisms for kids are very different than the coping mechanisms typically deployed by adults? They're very different.

SPEAKER_02 19:47

And they're not healthy when it comes to kids because this is where we get into cutters, cutting. There's a possibility of kids wanting some kind of escape or a sense of being in control because I'm not in control of my environment. I love that she used the person and environment that is so critical because I don't I can't control my environment, and so we'll see kind of things like that, or there's excess worry, and that's where we get into the anxiety, and so now I may be more fidgety, irritable, and that's where the aggression comes in, or not even irritable, but jumpy, or as we call talking back, as parents would say, there's a lot of talk back, or there's and then the opposite of that is just being extremely withdrawn, like just withdrawing into myself, or withdrawing from friends and things that are used to be familiar or bring me joy.

SPEAKER_00 20:43

That's tricky too, because there's such a like fine line between typical teenage behavior specifically. I know we're talking about, you know, adolescents, young people from a variety of ages, but like everything that you're saying, I'm like, oh, there's a little bit of like hormonal stuff in there too. So I'm really seeing the value of what y'all just straight out of the gate said of setting time aside, like you said, Melanie, to observe your kids' typical behavior and make space for that back and forth communication. That's super helpful.

SPEAKER_02 21:21

And it's and it parents will there's something also within us, we call it the intuition.

SPEAKER_00 21:28

Yeah.

SPEAKER_02 21:28

But there's also something in our gut that would let us know that something is not quite right. We're not sure. And the key for me and what I share with my parents is is the question is, well, how long has this been? How long have you noticed it? Because that's also crucial to when I step in or when I can make some changes or make some adjustments, or begin to create this safe space and get curious about what's really happening. If I have someone or a child that's been totally Over the moon about gymnastics. And slowly it's been four or five weeks now. And I'm noticing that we don't want to go to practice or we don't want to do the things that we used to do once we get home from practice because there's practice, but then there's this extra push to be better, to learn a new skill. Now all of a sudden, every week we go to practice and you're a more reluctant to get out of the car. And I notice when we're at practice, you're not engaging or you're not interacting with the other people on the team the same way. You're not responding to the coach the same way. So there are subtle things and they happen over time. So now I'm more aware of that.

SPEAKER_00 22:44

I'm paying more attention to that. So if you were to start a conversation with your kid along those lines, following those observations, you know, you've been hesitating to get out of the car, you don't want to go to practice, you're making us late to practice, whatever the case is, whatever those tiny observations have added up to be. How do you start that conversation with your kid without making them feel like they're in trouble? Because you know, kids when they think they're in trouble, it's like, I mean, they get squirrely, right? They get just weird. And you're like, I need to have an honest conversation with you. You are not in trouble. How do you remove that feeling of defensiveness from a serious conversation like that?

SPEAKER_02 23:24

It goes back to what I said earlier about being curious. The typical question is, why don't you want to do gymnastics anymore? Exactly. What's wrong?

SPEAKER_00 23:33

And in that tone, what happened? What's your problem?

unknown 23:36

Yeah.

SPEAKER_02 23:37

Would you want to respond to that? Absolutely not. Yeah. Like, oh, here we go again. Right. And most kids, they know their parents and and they're gonna respond that way. Hey, Melanie, I've noticed the past couple of weeks you don't really seem like you're into gymnastics. I'm noticing that it's taking you longer to get ready for practice. Is everything okay? Is did something happen? Are you still wanting to participate? I like that. So now I've asked questions, but I've also created the space. But the main part of that is I've noticed you. I'm paying attention to what's going on. I like that. And even throwing in there, like, hey kiddo, I kind of noticed something's different. Care to share?

SPEAKER_00 24:31

I like the pauses too. It does feel like a rounder. I sound like a hippie.

SPEAKER_02 24:35

It sounds like a nice safe, round place. Well, yeah. So silence is so powerful. And I had to learn this as a counselor because I always want to fill the space. I feel like I have to split fill the space, I have to say something. But silence is so powerful. Even in the awkwardness, it's powerful. And I think that's what gets us as parents is we don't want it to be awkward. And I'll add, we don't want it to be awkward. But I'll add on that, yes.

SPEAKER_01 25:07

Because when you said that, you are correct. Not even in a therapeutic outside. Nobody wants that silence. Nobody wants that space. I went to a training years ago, and that's what they taught us to. They videotaped us and showed us, and we were like, wow, whoa, wait a minute. We're not even giving time. And it was so beneficial, and that's what I do too when I'm working with children and families. Because sometimes, I mean, sometimes they may not have the answer right then. Let them think about it, give them that time. And and even especially with teenagers, they don't want to answer at the beginning. Give them time. And most of them will.

SPEAKER_00 25:46

That's so interesting. I because I'm thinking about the typical pace of our daily lives. Absolutely. Impulsive and full. And not a lot of quiet. And oh, we got an awkward silence. Let me grab my phone. Look at it. Oh, we got a stoplight. Let me grab my phone. Right. TV's on all the time, kind of things. I think there's a lot of takeaways here for parents, but I think there's an a greater opportunity for revamp for how families kind of set up shop with their kids and prepare for whatever's next. Like little kids, let's prepare for those teenage mood swings, you know, by creating those habits of space, space, and togetherness.

SPEAKER_02 26:35

I encourage all of my families and all my parents at least once a week. You should have a family day, family time. Doesn't have to be extravagant. It can be something as simple as playing Uno or creating your own game. And for my parents that have younger kids, I encourage them. Like, we have fancy couches now, so it's a little bit harder. But even removing the cushions from the couch and creating a little TP or a tent, or camping out in the living room, or making a movie night where we got popcorn and pretzels and we're just watching movies. And then the other part of that is not just watching the movie, but afterwards having a conversation about, like, hey, in this particular scene, what would you have done there if you were the director? So now you're getting into the psyche and the mind and the thoughts and the imaginations of your kids, but you've already created this safe space. So now if I need to use that, because I've noticed something that's happened in the past couple of weeks, I can go back to, hey, I remember at movie night, at this particular time, you got kind of quiet. What would you care to share what you were thinking about? Um, or like, hey, I've kind of noticed some things have been going on. If you don't want you don't have to talk about it right now, but maybe tomorrow we can have a conversation, we can talk about it, or you can share. So now I've given you the space, like I don't need an answer right now, but I still notice something is not right. And I just want you to know that I support you, I'm supportive, I'm here, and I'm ready to listen. But when you're ready.

SPEAKER_00 28:15

What's so interesting about what both of y'all are sharing is there was so much temptation for me. I mean, and probably parents too, like, okay, worry, let's open the worry box, see what's inside. Like, worry lives in this, you know, contained space. And what both of you are describing is really actually very empowering because when we conversely, when you think about worry, like, okay, worry is the problem. It's it's like its own thing. Let's hand that off to the counselor. Y'all are both counselors. But what's so interesting is both of you have said it comes back to the relationship that you have with your kid. And at first I was like, well, that's a little overwhelming, but not the way both of you have described it. You would have both described it as actually quite empowering. Like, you know, the parent is the key. And so I I want to hear from you as we wrap up, Melanie. Have you experienced any examples where the parent was like the the key holder to really unlocking the solution that you as a clinical professional who has literal data, you know, but it but it was actually the parent?

SPEAKER_01 29:26

Yeah, most definitely. I actually, it was last year I had a patient. This patient had to undergo surgery and so was out of school for a while. This patient was also very athletic, was in sports uh due to the surgery and the healing. He couldn't go to school. He could not play sports anymore. The mother noticed, she said, okay, something's not right. He's normally easy going, you know, easy going mood, easy going child. And she noticed that he became irritable, more frustrated just every day. And then he started getting angry. And she saw that anger, and she called me and she said, I know that you've talked to me and said you're available if we need to come in and talk. She said, I would really like for you, if you could, to meet with my son and just to make sure I think he really needs to talk to somebody because this is what I'm seeing. So she did. She did what she needed. She saw it, she noticed. She said he's withdrawing, he's angry. This is not typical for him. She also realized, too, he's going through a lot. He's had to give up things. He was nervous about school because he was falling behind. And this was an A-B student. So she noticed all of those things and she reacted. And I think, you know, she did the right thing. And what we did was he did come in. I talked to him, and she was exactly right, exactly how he was feeling. And I did get to link them to a therapist. And I actually saw this patient not too long ago, and just wonderful to see this patient. Good mood, happy, you know, doing well. So, but because that mother was on, I'm gonna say, you know, she was she saw it, she saw those signs, and she reacted, but she reacted too in an open way. I think I recall she said that she took him away by himself to to go shopping or something because this person has siblings. She wanted to have that time to speak to him by himself to see really what's going on.

SPEAKER_00 31:35

Wow. That's like what you said, Erica, that instinct. It really kicked in. I can't thank you enough for this conversation. I think parents will feel like they've got a good mix of practical tips, but also feeling empowered to trust their instincts with their little ones. So, how I would love to wrap this up is with helpful resources in our community that may help them. So, is there anything at Namores that you want parents to know about that they can plug in or bookmark for later?

SPEAKER_01 32:05

So, yeah. So, also too, if you if anyone would like to go back and you know read the more of the survey results from you know what's worrying our kids, you can go to kidshealth.org. It's actually a national online resource for parents and children and teachers that talk about you can type in and search any type of topic. You can type in bullying, you can type in worrying, type in anxiety, you can type in any medical issues. But also, too, I think if anybody has a connection, I know where I work at Nemours, we do have two social workers. We are included a lot with our teams and we're consulted and we make sure that we link our families and patients to community resources.

SPEAKER_00 32:54

Oh, good. Okay, awesome. And Erica, what about greenhouse counseling? How do you have resources specific that are maybe already on your website? Or if not, maybe just tell them like how they could engage with one of y'all at the center?

SPEAKER_02 33:09

Um, well, we are located at uh 1331 Creighton Road in Suite B. We do see kids aged between that age range nine to 13. We are um super excited about future group opportunities. So now we get to work on self-esteem, building conflict res conflict resolution skills. And one of the things that I definitely want parents to know of one great resource it's called the Child Institute. They put out a lot of great information for parents as far as support, understanding the developmental stages, because that's another big key is helping parents understand where their child is in the developmental process. So now I know how to communicate and the best ways to communicate and how much information to give or share or not share.

SPEAKER_00 33:59

That's a huge resource. Thank you again, ladies. I really appreciate this, and hopefully, we'll see less of this in the future. Thank you. Thank you. Thanks for listening. Be sure to subscribe and share. Voices United in Education is a production of the Scandi County Public Schools.