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Your Questions About Anxiety Answered by Dr. Meg Meeker

Kid who's anxious about starting school? Meds vs. natural approaches? Time for a new pediatrician? Dr. Meg has answers!
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​I talked to Dr. Meg Meeker about anxiety on the Today's Mama Podcast. You can check out the full episode HERE. She's brilliant and you'll get great tips for your kids and YOU. Make sure to check it out!

Our listeners submitted questions about anxiety and Dr. Meeker has answered them here:

I don’t know if I have anxiety enough to be medicated, but it’s enough to me crazy on occasion. Any advice?

Yes. Living with anxiety is really challenging. First, try and see if you can find the root of the anxiety. In other words, is there anything that triggers it? One of the most important things to do is try to see if it is related to anything. Many people who live with post- traumatic stress disorder, for instance may have anxiety because something from pain from their past gets triggered. This can even happen subconsciously.

Second, see if anyone else in your family suffers with anxiety. Sometimes anxiety can be genetic but this can be hard to detect because kids can have anxiety simply because their parents were anxious but did not have a genetic basis for it.

Anxiety is treatable so be confident in that. The first thing you want to do is find a therapist who is trained in cognitive behavioral therapy. CBT relieves anxiety by training your mind to identify thoughts and feelings of anxiety and replacing them with more positive ones. It works but can take several months but is well worth the time and investment of energy.

As far as medication, this really depends upon how severe your anxiety is. If it occurs a couple of times per week and doesn’t last more than an hour or two, you may not want to take medication. If, on the other hand, it is really disrupting your life, go see your internist or family doctor. There are medications that work very well that are not sedatives (Valium, Xanax, etc.) These are not recommended long term because they can become addictive.

Studies show that if you combine CBT with medication, the outcomes can be better than treating it with one or the other alone. In fact, I think it is wisest to use CBT whenever you are on medication.

If you are having panic attacks, you should definitely see your physician because you can get past them.

Finally, be encouraged. Having anxiety is really hard but you can really get better with good help.

I’d love advice for kids with anxiety starting school! My middle schooler needs to just do it and make the jump but she has so much anxiety and it’s giving me anxiety. How do I support her? Balanced with pushing her?

Many kids have anxiety about starting school, no matter what grade they are in. Before you push her, find out the answer to a couple of questions- don’t ask her to answer them (you may make her more anxious) but ask other mothers of children in her class. First- what is the teacher like? The students? Is there a bully, recess that she is afraid of, PE or even about leaving you? Many kids have difficulty leaving parents if they are worried about them but this usually happens at a younger age. Is afraid she won’t be able to find her locker? Often kids have a specific fear that they don’t want to talk about- particularly a bully. They are afraid of the repercussions.

If you feel that the school is good, that the teachers are nice and that her classmates are reasonably kind (there will be some kids that aren’t nice but they’re not bullies) then make her go. Drop her off in front of the school and don’t bring her to her classroom. Reinforce that she can do this and that you have confidence in her. If you go in and act unsure about how things will go, or sad about leaving her, she will be more anxious. Here are some things that can help.

On the first day, tell her that you will be picking her up (even if she rides the bus) and taking her out for ice cream or something that she can look forward to. Also, tell her teacher (in private) that she is very anxious and ask if she will help her out.

Then I would begin talking now about the positive aspects of school and tell that most kids don’t like going at some point. Let her know that this is normal and by all means, DO NOT let her see your anxiety. If she senses that you are worried, her anxiety will get more intense. She really needs you to be calm and confident.

Finally, talk to her at bedtime. Most kids are their most relaxed at bedtime when they are winding down and will open up. Gently ask her if she ever gets scared of anything. Then just listen to her. If she divulges anything, don’t over react. Let her know that he fears are normal and that she can talk with you about them at any time. Then, let her know that they will go away and that going to school will make them better (assuming they have to do with school.)

Remember that most kids with school anxiety get better over time and this happens usually sooner rather than later.

My pediatrician kind of blows off anxiety as something they’ll outgrow. Should I get a second opinion, see a naturopath, counselor? Or let it go? Ack!

Yes, you should get a second opinion. Find a seasoned pediatrician who works with behavioral issues with kids so that you can get to the bottom of this. As far as naturopathic remedies, I am not against them but have never found anything that works. If you start down this road, you will become frustrated trying one after another. And remember, folks who sell them will tell you that one thing works while another will insist on something else. You don’t want to become more anxious yourself.

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My own anxiety is very related to my cycle. So I’m not even sure what to ask. My hormones are just out of whack, I’m convinced.

Yes- there are things that you can do. First, start by seeing an internist. Your problem is not uncommon at all. May women get severe PMS and there are effective ways to treat it. Because PMS is hormonally based (it is NOT just in your head) there are medications that you can use to either regulate your hormones or take something like an SSRI antidepressant like Celexa, Zoloft or Lexapro. While you don’t have depression, these can really help your mood swings during your cycles. Your internist can talk further with you and see if this is a right fit for you.

When should you pursue medication vs. counseling vs. natural approach? That’s exactly where I’m at with my 11 year old.

First, you need to discuss this with your pediatrician. Your child is young for medication and I wouldn’t recommend it. That said, I don’t know your child. My first approach would be to find out what may be causing the anxiety- is it a specific issue like school, friends, homework? Then, I would go to a counselor yourself, without your child, and see what you can do. Sometimes parents can be trained to deal with anxiety without having the child go.

As I said earlier, I’m not a fan of naturopathic remedies for anxiety per se. The reason is, we haven’t found one that really works (though many folks who sell them claim they do) and trying one remedy after another can make you very frustrated. I would spend time trying to calm your child’s home life, make sure they have a routine and don’t let them watch shows that might be scary or filled with too much noise or action. If your child spends time on social media, this can really make anxiety worse. If they paly a lot of video games, dial them way down. These too, do the opposite of calming them but make them anxious. Finally, put order and calm in your child’s life. Having routine helps kids regulate their emotions and gives them much needed down time and relaxation.

My child asks me 1,000 questions a day. I think she’s curious but I also think she’s anxious, and I also think it’s REALLY ANNOYING. It wears me out. Any advice for moms with kids who won’t stop talking?

Yes, get some earplugs! Really, it depends on how old your child is. If she is 2 or 3, wait it out because it will go away. I know it is hard, but keep telling yourself it will get better. Many kids this age ask questions over and over. This can particularly tough if you are in the car for a long time.

As far as her being anxious, again, if she is young, her questions don’t come from anxiety, just curiosity and the love of talking a lot.

If, on the other hand, your child is 6-11, this may be from anxiety. Children this age often repeat questions or ask new ones because they are worried about something bad happening and they want reassurance. If this is true, I would probe a bit and see if there are any worries your child is having. For instance, many kids in first or second grade worry about their parents dying and this causes even generalized anxiety.

Finally, if your child is a bit older, he may not have anxiety but obsessive-compulsive disorder. I have seen kids as young as 3 who exhibit signs of OCD. You can tell OCD because kids do the same thing, ask the same questions over and over. They usually don’t ask different questions but the same ones. If you feel this could be OCD, go see your pediatrician because there are things we can do to help.

If you think that your child is just asking tons of questions but acts perfectly calm, don’t worry about anxiety. But if he appears to need reassurance, this could be anxiety. I would talk to his pediatrician about it. In the meantime, try distractions. Whenever he gets anxious, give him a chore to do or go outside and play. And- if he is old enough, try to figure out what is making him anxious and work with him on replacing anxious thoughts with positive ones.

Listen to the full interview with Dr. Meg Meeker:

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