This is the best health podcast brought to you by wake forest Baptist health in partnership with med costs. Good day everyone. Welcome back to the latest best home podcast episode, Justin Gomez here on behalf of wake forest Baptist health. Thank you for joining us once again. We're going to continue our conversation on this episode that we've, we've done in the last several episodes. Just talking about topics surrounding Covid 19 coronavirus. Trying to provide as many resources as possible to you, the listeners about various topics surrounding working through Coronavirus and Covid 19 and, and how we can best manage various aspects of our life and hearing from some of our experts at wake forest back to so. So we have a return guest this, this episode. I'm excited to talk with her once again. Dr Ellie Marie .
She is going to be talking to us today about stress and anxiety management with kids and adolescents specifically. So before we get into the conversation, I do like I have in the previous podcast. So they only being coded 19. I just want to let our listeners know, do you have any questions about Kobe 19 and I'm just looking for additional resources. We have lots of great information on the website, wakehealth.edu/Coronavirus wakehealth.edu/coronavirus one to also remind everyone that our covert 19 hotline is active and available for you cause you need to call in and ask specific questions. That's three, three six seven zero three three six seven zero code. So plenty of information on that website. Y'all can go check it out. All of the previous coven 19 related podcasts are on there as well. So just want to remind everyone of that. We, we do want to get into this conversation and, and looking forward to just some kind of best practices and some, there's a wisdom and advice from dr . Before we get started, doctor, if you just want to remind everyone, maybe not everyone listened to the previous podcast, but just tell us a little bit about yourself how long you've been with wake forest Baptist health and maybe what you do on a day in and day out basis here as part of our organization. Sure. Thank you. Yes. Thank you first of all for the further and also
To your team for everything that you are doing to share information with our community. For the people that don't know me, I'm a pediatric psychologist at Brenner's she drank hospital and I'm an assistant professor in the department of pediatrics and basically I work daily with kids and teenagers under families. And basically we kids that have chronic medical conditions and also co-morbidities with mental health issues that I related with depression, anxiety and other related symptoms. And also bilingual. I'm a licensed psychologist and I work also with Hispanic communities in the clinics. That's a good .
Yeah. Thank you so much. I'm as if people listening, I couldn't pick up there. We do have the added benefit and resource of the doctor being bilingual. So just like our initial podcasts with doctor , this podcast will also be in both English and Spanish. Mostly her speaking extensively in Spanish. I will try my best not to embarrass myself and hopefully that this, we just want this to be a resource and be able to get out to as many people in our community as possible. No matter if their first language is English or Spanish. So I'm definitely grateful for this opportunity to be able to do those podcasts in both English and Spanish. Mmm. So thanks for just kind of reminding us about what you do on a day to day basis and you know, with coronavirus Covid 19 I think it's been pretty well documented in the media and the press and online. There's just various increase express orders and, and certain areas where anxiety has increased in many of our lives. Mmm.
You know, I think to some degree, humans are creatures of habit and we've had to throw some of our old habits out the window and try and reestablish new habits and new processes and schedules. Especially with children if we have children in the household whether they be, you know, younger kiddos or older school age children. And, and that brings potentially a whole new set of challenges and anxiety inducing situations. So with that you know, part of helping our children process through this whole situation with coded is hopefully coming alongside them in, in situations that they find stressful or anxiety, whether it be with virtual learning or you know, not being able to communicate how they usually communicated or hung out with her, with their friends. So yeah, just the whole set of, of situations that arise that caused stress with, with kids and adolescents. So, Mmm. You know, looking forward to, to your thoughts on some of these questions, doctor, and we'll jump into the first one. And just as a reminder, it's stress and anxiety management with kids and adolescents. It's Monday holidays.
So I just want to dive into the first question. You know, what are, what are some of the normal responses to stress or anxiety in children and adolescence? I don't understand this and pay alleys or unfair done.
So basically it is important to understand that gym people like adults experience stress on can come from a variety of sources like you know, school or friends or the situation at home while we are living now, Waco in 19. And some stress could be positive, you know, like that stress that make us do things or react over situations. Like for example, when we are having a performance in sport or dance or when we're going to have a test or when we need to react over a emergency. But when we are under too much stress and that can start to affect our functioning or our daily activities, we need to start to be other over that. So basically when we talk about that we need to start to see the behaviors and the changes in behavior and mood that they can have. I'm not going to give some examples.
Most a , eh, boy they said a and you can start to see fears and concerns for their health and their loved ones. And you can also see changes in sleep or eating patterns or addicts for example. They are sleeping too much or they are sleeping too little. They start to have nightmares or they start to eat more than your shawl. They start to have changes in their weight, like gaining weight or losing weight. You can see also changes in behaviors. For example, crying tomorrow I try aggressive behaviors or outbursts, Appalachian mainly in teenagers that they prefer to be alone. Lack of motivation that they don't want to do things that they enjoy before they don't feel like, like they want to do it. John , or you can see also like changes in, in like in their concentration. Like they can not concentrate as usual but they start to be easily distracted. Also, you can see like mood changes, for example, being more irritated than usual or excessive fears or I don't know, anger or sadness lie. They are more sad than usual or kind of worry all the time. And finally, all their symptoms could be changes in the physical centers or laser start to have pain, like stomach aches or headaches. And it's not any medical reason. Like, you know, he's not anybody who's are, they are not sick. They are just having this changes. In now.
Well, that's, that's very helpful too. I think for parents to be able to, I have several of these possible signs that they can, that they can identify and you know, initiate a conversation with their children or the adolescents about, you know, helping them identify some of their feelings. You know, I got to kind of leads me into the second question. You know, once, if you identify some of these behaviors or changes in your children and you started to have a conversation with him about it you know, what's the best way to address feelings of fear and uncertainty? With, with our kids and our adolescents it's and set the dome break on listening. You'll see this.
Okay. so I think it is natural that our kids are teenagers have concerns and being worried maybe with this new, you know, situation that we are leaving. But it's very important to provide space to share their fears feelings and concerns like an open conversation about it. And, and I think it's very important also to explore what are the stressors because maybe you're a teenager and your little kid did not have the same concerns. Yeah. I mean maybe they're going to have the front kind of stressors at the prison and it's the same situation, right? And try to find out the way to normalize the situation. I know it was very difficult to normalize our new reality, but when we talk about normalize is how we can provide security, I'm asking questions, I'm offering clear information about, you know, what they are experienced, what is happening, what we are doing and help them to feel in control over the situation. For example, you can help on, you can share with them how they can fight the vitals or what we are doing, you know, against that for simple hand washing or you know, we need to eat well or what we are doing different that can help us to have like control over the situation. I think that going to help Stu decrease the fears, feeling of uncertainty in, in kids and teenagers. They get maybe persona cetera.
Okay, well that is helpful. So ultimately, you know, as parents or guardians or caretakers, you know, we want to have our kids, you know, it's our natural tendency to, to want to protect them, shelter them, guard them. You know, part of that would just be wanting them to and you know, how, how does the stress level that maybe they have been having or to help reduce the stress level. So if you want to talk to us just for a minute about how stress and anxiety might, might be reduced in children and adolescents.
Okay.
I think that would be, I think that'd be great. So it's three and .
So we were to, eh, I think it's very important to think that everyone managed stress and anxiety in different ways and not necessarily what works for me when I worked for my kids or what works for my little kids going to work for my teenagers. We need to be clear about the differences in age and understanding, but also explore how they work, you know, better in certain situations. And I would recommend to start with asking the specific questions. For example, what do you care about? How do you feel are questions that you can ask to your teenager until you're a little kids and probably you want to have answers are totally different. And based on that you can kind of start to address that. And you can also try to maintain the routine as, as possible in our new reality. And I know we have been talking about this in many occasion about like, yeah, keep the routine, but how are we going to keep the routine when we are having all this changes?
And when we talk about maintain routine is basically be flexible but at the same time trying to maintain the times that you were waking up usually or at the time that you are going back to bed. Usually the time that you eat your meals in family or the time try to make time for free activities for play, you know, also for the teenagers to coordinate with their friends. Even using video games or you know video calls. It is important also to try to identify activities that help them to express or regulate their emotions. For example, you can use arts, dance, music, sports as an activity to do that and not necessarily you're going to be talking about that. You know, sometimes teenagers doesn't like to talk about it, but they can use this kind of activities to regulate or express how they feel and just doing body, you know, movements or just doing some physical activities or just, I don't know, doing an hour PS can help them to express that.
Also you can promote activities like you know, exercises or physical activities in Dubai by jar or going to do some hiking if possible or maintain a healthy diet, good sleep, going to help to manage the stress and reduce the anxiety. Also how you can use your support system life for example, family and friends and try to connect with them using phone calls or video calls. Now we have a lot of axes do that and are free using WhatsApp or Facebook messenger. Now I think even g-mail have like FaceTime platform. You can even use your face vein. It's like a lot of stuff out there I assume that are free and accessible for the families to connect with their loved ones. And, and also it's very, very important to try to avoid or limit to much as pusher to media or social media. Because sometimes we obviously into Marsh information and it's kind of scary. Can just increase their stress. So if you can just decrease that or limit the access that they are having to this news or, you know, social media news about the numbers on how many people are dying. You know, I may have been new people are sick. I've been that going to help us do the reviews, their concerns or worries. So basic. I'm it'd be .
Thank you doctor. This is good information. I know that, you know, lots of, lots of us parents or guardians with, with kids in the house now for this extended period of time. It's just, it's a new world to us. Yeah. So, you know, you know, I like the idea of obviously there are certain instances or incidents that happened that would peak stress or anxiety. So there's kind of that IQ, but then there's, you know, maybe some kids are adolescent teens are, maybe I have this kind of underlying current of anxiety or stress that maybe they need help talking and identifying, walking through. Mmm. So I guess thinking not necessarily with just one, one off incidents, but what are some kind of overall strategies or ongoing strategies or coping skills that we can help implement with our children for managing stress? Either being with, with younger kids or older or, or adolescents. So adolescent.
Okay. So we can be this person. This is strata is like for cats because it could be many. So I just going to try to give you some examples and you know, that things that we can use at home and always remember that if you feel like after try this stuff, the stuff that I mentioned before, you feel like it's not helping and is getting worse. Always gone to there, you know, professional help like psychology or a psychiatrist or even with your primary care doctor, they can do a referral and tried to see how we can help. But it's some stuff that you can do. For example we can use exercises of like relaxation skills or the breathing exercises. I always recommend with the little ones that is a little bit more difficult, you can even use resources like, okay, let's use is a flower and let's see how we can go, you know, smell the flower and that means that you are doing inhale and then you're going to do bubbles and you are Excel.
You know, it's kind of, you can play, but at the same time you are giving them some coping skills with a teenager is more like, you know, you can use even phone apps like Headspace or calm app that they have some exercises for teenage years that they can use and then they love to Knology. So that is one resource for them. And they can also use the breathing or diaphragmatic breathing in which they are using that muscles to kind of relax their nervous system. Well the thing that we can use is mindfulness exercises. I love mindfulness exercises because we can use that with so little. I means that you can use all your senses, you know, connect with your five senses in different ways. And while we are looking with mindfulness exercises is try to move our thoughts to the present moment and with the here and now and is how you can connect with, for example, with the nature and let me use, use my sense for that.
For example, let me feel the breeze in my face or let me just listen to the birds that are singing or let me just stash the grass with my feet is different symbols that you can use that are helping you to kind of ground and connect with the present moment instead to be in your own head thinking about what going to happen. One is you know, what is the future looks like, be so stressed out. So I think the art, just simple strategies that you can use, but you can add meditation exercises. Joe guys are sizes, physical activity like sports. Dancing is very helpful to arts, drawing music, people that play instruments. All that activity helps to manage his stress and anxiety and our coping skills. I always said that it's important to identify what are the interests and talents of your kids. And based on that you can use that as a coping skill. I think that is very useful because you are using something that they already know or they already likes and use that for something positive. Like use that when you are feeling stressed or when your a fetus scare, when you're feeling sad. And I think that is the best option with, with kids that are little even with teenagers. So and then the eh, Gusto.
Great info. Once again, dr, you know, as we wrap up we're getting ready to come to a conclusion with this episode and you know, a lot of this is great information and integrated advice and I kind of want to follow up. I think maybe one of the tendencies, but some parents and guardians, caretakers have
Mmm.
You know, if they don't want to necessarily, if they feel like the conversation might be uncomfortable on some level to talk about anxiety or stress or problems or issues, you know, maybe some people just try and deal with it by ignoring it and let go. If I just kind of don't look at that for awhile or don't think about that it'll just kind of resolve itself or go away. And you know, I'm really glad that you're providing these, these chips and pieces of, of advice to help people talk through the situations and help them with their kids and adolescents. And, you know, we talked about this on our previous podcast, but in case someone didn't didn't hear that one. You know, as we wrap up, just I guess generally speaking, you know, as opposed to ignoring it because more than likely your kids, you know, it's, they, they know about Covid 19, they know about Coronavirus. It's not like they don't know about it. It's dramatically impacted the vast majority of our lives. You know, how should we just go and talk generally about covert 19 and what it's doing with, with our lives and you know, maybe the different types of anxieties or stress stress points that that is creating. You know, how can we talk to our kids and adolescents about this or .
Yeah. And I've been, that is a very important question and I've been many people as these that are sometimes just ignoring the situation or they don't know how to address the situation. And we just put like a taboo, you know, on that. Like, I don't wanna talk about that because they're going to just increase the stress and sometimes just to not talk about it and you're gonna increase the stress because it's just scary when we can not just process our dogs. So again, first of all, I think you need to ask questions. What they know about copy 19, why they heard about it, what are their concerns, what they, what they understand for that, what are their fears? And you can sit down with them and have a conversation based on their age. Clearly about, you know, all this questions because do them going to have the same conversation with the little one that you're going to have a good teenager, 15 a year.
You need to be more clear. And obviously with the little one you maybe can use a storybooks and I can share with you later just saying maybe for the website, some storybooks that are out there that you can use with kids that are in Spanish and English about Coby 19 and use a lot of good nights illustrations for them. And also with teenagers. Something that I usually recommend is if they ask you a question that you didn't know, use that as an opportunity and, and you can sit down with them and do the search together. You know, you can sit down with the computer with a cell phone and try to ask, answer the question together and you know, use resources, the CDC information or the information to share what are the concerns. Also you can share information about how the community is helping and how they are doing changes to keep them safe, but also as a family, what we are doing, you know, what we can do to keep them safe about the cutter and abiders and explained to them, be friends, you know, like it's more risky for people that are sick or for people that are videoed doesn't mean that we don't gonna take care of ourselves.
But if we are healthy and we, you know, mindset and immune system healthy like eating well, sleeping well that they're going to help us to be, you know, no say but healthy. So basically I think that is some, you know, strategies that you can use. Also you can, it's very important to be available or accessible to your kids. And when I say available means physically but also emotionally and support them and nurtured them in this process because sometimes I don't want to have it specifically works for you, but you're going to know what he is best. Something is odd. And when we are open and honest about that and we can show there are all emotions, you know, that it's okay to be scared. I'm scared to or it's okay to be stressed out. I'm stressed out too, but I'm doing this to feel better.
And maybe you can involve them in activities like let's do exercise together or let's, I dunno, play game together or let's do something new, video games together. I don't know. It's just trying to look new alternatives to spend more time with your teenagers and with your get little kids because being at home so much, it's hard for them and they are not in their regular activities. So I think the stress is just increasing for that reason. I would say so. I think that is a way that you can kind of touch that topic and promote stability with modeling. You know, if you are those stress out on you, the know how to manage your own emotions, for sure. They just gonna receive that and they're going to feel the stress out about it. Or wait for us.
Thank you so much dr . I appreciate you taking the time. Once again, this has just been really helpful information when people take the time to listen to it and in garner some, some best practices tips on, on communicating with our children and helping them through, you know, what they feel might be a stressful or anxiety inducing situation. Mmm. So this has been great. Appreciate, appreciate you taking the time. Everyone listening out there. The doctor didn't mention, you know, obviously if you have more questions or once you reach out to you know, talk to a provider or have your child talk to their provider about certain anxiety or, or stressful situations. You know, that's what, that's what the doctor and her colleagues are there for. So please feel free to reach out. You can just visit our website, wake health.edu or you can also visit Brenner children's dot org Brenner children's that word. And psychiatry and counseling information on both websites. You can also just call seven one six. Wait, and they'll connect you with, with the right department for additional resources for, for your family. So once again, appreciate your time, ma'am. I hope that you are doing well and hopefully we'll get to chat again soon.
Thank you so much Justin for the opportunity and for, you know, there's bilingual podcasts that can also give information out to our Spanish speakers in the community too.
Yeah, absolutely. Absolutely. It's been a great thank you to everyone listening out there and until we chat again, please be well,
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