But when things are off, and maybe it's your digestion, maybe it's aches and pains, there are physical manifestations of stress, and it's your body sounding alarms.

There are absolutely physical manifestations of stress.

And that's what I really want to emphasize because you need to do that sort of body scan or, you know, it's kind of like an emotional body scan, right? Okay, wait, I've had a headache all day today.

Why is it that I have a headache? You know, is it something, is this seasonal allergies? Is it the fact that my, you know, my boss said something that I felt was demeaning and I worked really hard on this project and Right.

It takes that kind of emotional inventory or self-inventory to go through and figure out what is causing these stressors in me.

I didn't sleep well last night.

What were the thoughts in my head? Because oftentimes the thoughts that we're having in our head at four o'clock in the morning that make us not be able to go back to sleep, we're actually not going to solve it.

So

But when things are off and maybe it's your digestion, maybe it's aches and pains, there are physical manifestations of stress and it's your body sounding alarms.

There are absolutely physical manifestations of stress.

And that's what I really want to emphasize, because you need to do that sort of body scan or, you know, it's kind of like an emotional body scan, right? Okay, wait, I've had a headache all day today.

Why is it that I have a headache? You know, is it? Is this seasonal allergies? Is it the fact that my boss said something that I felt was demeaning and I worked really hard on this project? It takes that kind of emotional inventory or self-inventory to go through and figure out what is...

causing these stressors in me.

You know, I didn't sleep well last night.

What were the thoughts in my head? Because oftentimes the thoughts that we're having in our head at four o'clock in the morning that make us not be able to go back to sleep, we're actually not going to solve it.

So what do you do?

Those are important, too.

They are equally as important.

So, right.

You I could hear you, but you couldn't see me yet.

Right.

Initially, we talked about lifelong friends or what we sometimes call family friends and really how core they are for our sense of like someone knowing us and understanding us and understanding our stages of life, right? Close friends are similar.

There's some overlap and really the people we've known for years.

And they're going to get why I'm frustrated where maybe someone at home would not.

Like if you want to change a pattern, whether you reset your morning routine or reset your evening routine where you're noticing anxiety, what should we do?

So I want people to do something that's fairly simple, fairly accessible, and really can help them.

Let's start, you know, we talked about the glass of water.

Let's start with some breathing, right? It doesn't have to be a whole full-blown kind of mindfulness and meditation, but sitting for a moment, a few moments, and doing some deep breathing, right? We talk about box breathing, in for four, hold for four, out for four, hold for four, right? You do some box breathing.

You slow your breathing down.

It gets oxygen into your brain.

It fills up your lungs.

Or what do you do if you're having a panic attack in that moment?

If we're trying to fix, we might actually be cutting and causing problems.

I think this is very often a parenting technique, I mean, and.

we apply it in other areas of our life.

For example, when your children are younger, they'd say, oh, I skinned my knee.

Oh goodness, let me help fix that, right? And so when you have young children, you do fix a lot of things.

You are in frequent problem solving mode.

And sometimes the hardest adjustment as children become teenagers or young adults is to shift back from wanting to fix it all the time to allowing them to come to you and say, you know, here's my problem and then not urgently wanting to fix it, right? To really hold back and say, Let me know if there's anything I can do to help, right? So I'm extending myself, but I'm not trying to automatically fix the problem.

That's a tough one sometimes.

And why does writing it down matter than just thinking about it?

Well, I mean, it creates it as more of a habit and it also reinforces it.

It's the same thing.

I mean, I always go back to being in school, being in middle school and high school, taking notes on things.

And there's actually some research to show that The way that we learned back in middle school and high school by physically taking notes, so listening to information, processing it in our brain, and then putting it in written form reinforces it much better than just listening to it or typing it, right? So it's the act of writing it down transforms it from just being thoughts in our head to actually being real and on paper.

Again, this is not something you share with anyone else.

This is something you can keep for yourself.

It's just how we're moving through our day.

Can you talk a little bit more about that? Is it true that when we take an IQ test, when we're young, IQs don't change much, or you're kind of born with personality?

So, okay, those are great questions.

IQ, IQ is intelligence quotient, right? People that get tested for IQ, this is complicated.

It can be relatively stable, meaning unless you're going through a significant depressive phase or you've had a brain injury, you've had some insult to your brain, As a general rule, your IQ is fairly stable.

It can improve, but good IQ tests are really looking at underlying strengths and weaknesses, not just, you know, your rote learning.

Yeah.

And so... what we say, but in children and adolescents is kind of temperament.

So before we move on to when we're in our early aging phase, what does this tell us about helping mental health?

You're starting behind the eight ball kind of.

So I think that's a really good point, because honestly, all those things that you just mentioned made me envision not wanting to get out of bed either.

Right.

I think when we when we overwhelm ourselves with, you know, the dozen things that we need to get done in a given day or conversely, right, based on the stage of life sometimes that people are in.

Not having any structure to the day makes you say, why bother getting out of bed? Why bother going to bed at a decent time? Because it doesn't really matter when I wake up.

Right.

And what we know is that, you know, the science behind getting yourself to bed at a regular time, getting yourself up in the morning at a regular time helps your overall well-being.

How important is it to limit alcohol?

Do you mean that we should count to 10 or what do you mean by give it time?

By time, what we generally mean is not minutes or hours.

Sometimes it's days or weeks or sometimes even months.

Now, I'm not necessarily referring to things or to issues where there's very significant trauma or really deep-seated grief, although grief actually is something that can improve over time as well.

And time, just the simple lapse of time doesn't always heal things.

It's what you do with that time.

It's bringing more positive things into your life.

Sometimes you catch yourself

We can focus on things that we really are grateful for And that will reduce our stress and even lighten our mood.

Right.

You can find the little things.

You can be grateful that you have heat in your house or that you love the way your bed feels at night and that you're under warm blankets, that you have the ability to buy groceries, that that's Thankfully, this month, you have the money to pay the electricity bill, even though electricity costs are soaring.

There's ways that you can dial it back to really small things that you feel grateful for.

And you can look at it from a past, present, and future.

You find something from your past, a childhood memory, a childhood friend that you're still connected to, something in your present, what you have in the here and now.

But do you think, from where you practice on your side of the couch, especially with young people, when I tell my kids, oh, come on, let's be grateful for this, do you think people are not being grateful enough intentionally?

And also, what about our own personal insecurities or excessive self-doubt or maybe even our own childhood trauma? If you went through something as a kid, should we share that with our kids? Obviously not our five-year-old, but if they're old enough to understand trauma, do we say, oh, yeah, that happened to me or this, you know, so-and-so? I mean, how much do we share?

So I admit that I have a generational bias on some of this, which is I think sharing less in some of these circumstances is better.

So we can take trauma, we can take substance use, we can take, you know, any number of different things.

And I, you know, I admit that this is kind of a generational bias, right? My parents didn't really share anything with me.

You know, I was, you know, navigated a lot of this stuff.

My brothers and sisters navigated a lot of this stuff on our own.

I mean, they were there for guidance, but I think that's very generational.

If we parentify our kids like that, sharing our problems, what happens to them? Why is that damaging?

From your side of the couch, what happens when you identify a kid and does that harm them in any way by giving them a diagnosis?

So let's talk realistically about how this pattern would unfold in school.

Generally, what would happen is that a child struggling in school would, in fact, affect their academic performance, right? you see that the child's falling asleep during the day in school, or their grades are suffering, or they're getting into some behavioral issues.

Something is evident in their performance, in their behaviors, in their attitudes.

This is what you observe.

So it's not like we're just plucking kids out and saying, we think you have a mental health problem.

In fact, I think one of the most important lessons we learned during COVID and during the pandemic is that there is no physical health without mental health and vice versa.

And how does that parlay into academic performance? If for devil's advocate, you say, hey, school is just for learning.

But what are some that you think are practical and easy that someone could use in the moment.

Right, so those are great ideas, right? I sometimes refer to it as box or square breathing, right? So when people are stressed or when they're focused on so many other different things, actually what we do is we take very shallow breaths, right? And that shallow breathing doesn't get as much oxygen through our lungs and into our heart and into our brains and into the rest of our body.

Sometimes just, I call it actually square breathing.

You know, it's like in for a count of four, hold for a count of four, out for a count of four, wait for a count of four, right? So it's just, it's like a box, right? In for four, hold for four, out for four, hold for four.

We kind of imagine a box in our mind.

I'm very visual, so I always think of it like a box.

Just taking a moment to do that.

But if you're not being treated for anything right now, how do you know if you need beyond this?

But important to note that it doesn't always look like that, and we need to look at even some of the inattentive

side.

Right.

So you're bringing up a couple of good points here.

So, yes.

And I do like to point out that we take into account the fact that there is a range of what is considered at least fairly or moderately typical in terms of like motoric restlessness and activity level and impulsivity.

Right.

So what are some of the most common accommodations you would like to see in some of these plans that would help kids at school?

Is that so that's wrong when you're trying to calm them down? How would you do it better?

No, I think I mean, right.

So we all we all either have or know those kids who have very big emotions.

Right.

They don't just express things in small ways.

They express things in big, sometimes explosive ways.

And so in those situations, it's about sort of giving them some space.

And the science shows that if kids are raised in homes where accountability is the norm, meaning I also say I made a mistake, that they then don't fear making mistakes.

Is it something, so to speak, in our environment that's damaging us? Or do we need to think about this as we're just getting better at diagnosing it and it's something we've kind of always had in society?

So this is a good point.

So let's start with the basics.

And the basics is, yes, as you said, CDC is saying estimated one in 31 children are diagnosed with autism.

Is it just that so many more people have autism now than 30 years ago? Yes and no, right? What we know is that the diagnostic criteria for autism has changed since the 90s.

So in the 90s, the diagnostic criteria was much more narrow.

And so it was really mostly diagnosed in childhood and it was mostly the severe cases.

But when you look at the science, nature versus nurture, your genes versus maybe what's going on around you, what does it tell us at this current time?

I know Mel Robbins talks a lot about energy, but this is more than just it's not necessarily airy fairy of woohoo energy, but the energy of the idea that what clicks like you just feel good between each other and that if that doesn't work anymore, that can also be a reason why maybe the friendship fizzles.

Yes.

And energy has a couple of different different parts to it in terms of.

Yeah, sometimes it's like that connection, you just meet someone, you go, I really like that person or I felt very comfortable with that person or we really had a lot to talk about, a lot in common.

And I'm just really talking from a from a friendship perspective, you know, and then you find it.

Oh, well, you know.

that you have other things in common.

Is it important for our wellness to make these adult friendships? And how do we go about that if you're thinking that area in your life is lacking a little?

It's good to have the option for these accommodations and things that can really make a difference.

Absolutely.

A, we need to be advocates for our children, but I think some of that's coming from the old stereotypes.

When I was in school or when you were in school, yeah, there were actually some negative stigma and stereotypes about kids who needed special help, which was kind of a sad commentary on the way things were.

So many more kids now need some accommodations, right? And some might say, well, you know, why do so many kids need accommodations? Well, a more individualized education plan, right? Not an official IEP, that's if you have a, you know, An IEP is when you have an actual diagnostic category.

It could be a learning disability.

It could be a social emotional issue.

Now it's like every kid can see on their snap map if they weren't invited somewhere or, you know, they're not on the group text or, you know, it can be so tricky, especially among teen years.

But how do we handle that? Because some people are just, they're more sensitive, they're more out there, they're more, I mean, do we let our kids have their moment and then go talk about it? Or are we trying to prevent them from having these moments?

Well, that's a really great point and another good example.

It is important to find a way to allow some emotional expression.

Now, that doesn't mean you're cursing and swearing at someone.

That doesn't mean your tantrum's going on for hours at a time.

That doesn't mean you're destroying things, right? So I think some amount of emotional expression is important.

And sometimes it might be, you know what, can you... go to your room and release in there or go out into the backyard and run around a little bit or, you know, sometimes doing something active, right? We say, you know, move a muscle, change your mood.

So mother's well-being has been linked to resilience in

Do we then reward ourselves?

Yeah, and so honestly, it first starts with kind of identifying how stigma and negative self-talk is affecting you, right? You know, the belief in this world that, you know, that it's only made for, you know, and I think honestly, women have a much harder time because there's much more judgment and stigma towards women who are overweight.

than even men.

But, you know, we can get into the gendered aspect of this as well.

But, you know, for anyone to really identify how that stigma is affecting you, how the, you know, used in the old days when we used to look at magazines, right? And we used to see only skinny women had fashionable clothes.

And while I want to dress nice too, but I, you know, I would never fit into those sizes.

And so it's like, it's identifying the stigma, identifying how, those things are really impacting your ability.

Does that mean embracing it, even if it's maybe not the best for your health, is good for your mental health? Or where is that spectrum of, I don't want to hurt my self-esteem, but maybe also you do need to make positive changes?

Can you elaborate?

Yes.

So, you know, one of the things that we look at when we look at overall health, right, mental health and physical health really are the preventative things that we can do.

It is actually much harder to deal with a problem when it is, you know, full blown, right? It could be, you know, someone has an anxiety disorder or depression.

When they are months into that into that either depressive or anxious state, it's actually harder to deal with it than if it's in the early stages.

In the same way, we want the men in our lives to get all the preventative things, you know, regular checkups, any screenings for...

Based on risk factors, there's a family history of colon cancer.

What do you want to say about the role that fathers play and that men play in the family? Because sometimes perhaps they underestimate that they're just as important as the mother.

I mean, I know we've had problems with the pandemic, but where are we now? Have things gotten any better or what's the status of our youth?

So, I mean, this is like a five podcast series in and of itself, but I really do believe that Jonathan Haidt, I believe is how you say his name, who wrote The Anxious Generation.

So I have been saying this, ask any of my colleagues, I have been saying those same things for about 10 to 15 years, that this is what's happening, that our young people are changing and that, you know, electronics and phones and social media are changing our young people.

And it is creating a more anxious kind of generation of individuals.

And so I really support that book and the premise in that book.

Because it just makes sense in terms of what I've seen clinically.

So.

There's a delicate balance there.

Then how does that differ from an IEP or an individualized educational plan?

So an individualized education plan, or IEP, is under the guidelines of special education.

Special education is, I think of them like sisters.

You know, 504 plans and IEPs are like sisters.

As a general rule, IEPs are done when the level of disability is a little bit more severe or overarching or has been... you know, going on for a longer period of time.

You have diagnostic categories under an IEP, like, I mean, these might be a little bit old, but like socially, emotionally maladjusted used to be a fairly common IEP.

I mean, you can get it for physical disabilities too.

But how does this carry over for college? How do we make sure that our older teens are advocating? Do we get involved?

So if you think your child is really suffering from anxiety right now, Do you let them stay at college? Or do you need to worry about them coming home? Or how do you know if you really need to intervene?

So this is a great question and actually one that I've been asked by parents this week.

So I looked at the situation in the context.

So we are about five weeks away from the end of the semester for most colleges.

At this point, I would really want to try to patch together whatever kind of plan to get them through the next five weeks or so.

You know, if this happens on a winter break, that's a different decision.

But I would want to... put together a plan.

What are some of the symptoms that would say, you know, you really are having an anxiety problem, not just experiencing anxiety once in a while?

I want you to weigh in on those two things, and specifically the idea that maybe if you take medication, you're going to be more likely for substance abuse, because the research doesn't show that, right?

Right.

So I've worked with many, you know, dozens and dozens, probably hundreds of families at this point, who have a young person with some of the real serious core deficits in ADHD.

And you know, it wouldn't be uncommon in those situations that a recommendation for a stimulant medication.

Stimulant medication is the really most researched and most used medication in the field of mental health.

And I've heard many parents say to me, I don't want to start my child on medication because it's just going to teach them that it's OK to take drugs.

And I'd say, hold on.

But it's much harder if you're not interested in things, right?