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I talked to Dr. Eli Lebowitz, of the Yale School of Medicine Child Study Center, on the Today's Mama Podcast. You can listen to the full episode HERE.

We had so many questions from listeners and Dr. Lebowitz took some time to provide answers to the questions we couldn't get to in our interview. 

How can we teach our kids the difference between good anxiety and bad anxiety? (Nate) 

Anxiety is "good" when it is keeping us safe and away from danger or when it's prompting us to work hard at things that matter to us.  But it can be "bad" when it is keeping us away from things that are not realistically dangerous or when it makes us so worried about our success that we actually work less well. For example, anxiety about a test can make you study and work hard, but too much anxiety can cause you to actually have difficulty concentrating when studying or to "go blank" during the test. 

How can I shift the conversation from "I can't do this" to something more positive and empowering? I'd love ideas on shifting that internal dialogue. 

Don't make it about doing "this" or not doing "this". Break it down into little steps. Maybe you can't do "this" but you CAN do 5% of this. Maybe you can take one step in that direction. Ask yourself, what's the worst that can happen and is that really all that terrible?

How can you use words, gestures, or physical touch to calm kids down and open up what exactly causes the anxiety? (Dennis)

Getting children to talk about what causes them anxiety can be challenging. A lot of children will find it easier to talk about what "somebody else" might be worried about in the same situation. You can also make it clear to the child that you don't judge their thoughts and that you also have anxious thoughts sometimes and everybody else does too. Sometimes you can use a comic strip with pictures and thought bubbles and the kid could fill in what the person in the picture is thinking in a situation similar to the one that makes the kid anxious. Physical touch can definitely be calming for a child, as long as it is desired by the child and received willingly from a trusted person. When we have contact with someone we feel close to our brain produces a chemical called oxytocin that can help us to feel less anxious, but it's also important that a child learn to cope with anxiety independently, and not only through proximity or contact with a caregiver. 

"Anxiety has hit at inconvenient times for one of our kids, like going to school, where I have other kids to drive etc. Should you leave a kid home if they're having an anxiety attack or somehow make them go to school, or just get in the car? Unfortunately, I've had my kid in the car and literally thought he was going to open the car door and jump while I was driving." (Michael)

If you can avoid a situation where your child misses school because of anxiety then do! It's best not to let a child's anxiety interfere with school attendance and most children who are allowed to stay home will be even more reluctant to go the next time, rather than the opposite. If your child is willing to practice some breathing than try that. If you can get help from someone else (not a parent) that can be very helpful too. Many children will calm down quicker with someone who is a little less close than mom or dad. Focus on just one moment at a time. So if you can get in the car, get in the car. And if you can get to the school, do that next. Even if your child doesn't learn much that day they will learn that they can (and need to) go to school even on difficult mornings. BUT, I do not recommend physically forcing a child to go to school. If your child is physically resisting than using force is not a good strategy. If you really can't make them go then that's OK and it just means you have to come back and make a plan for how to respond. It's never critical that you "WIN" in the moment and trying to use physical force can escalate very rapidly. 

I've read that anxiety can stem from the body's inability to absorb some nutrients like magnesium or zinc. Is that true? How do we fix it? Are there any foods that help or worsen anxiety that could be woven into a daily practice? 

Anxiety is a complex system and many different things can affect it, many of which we do not yet fully understand. There is a lot of research still to be done. My recommendation would be rather than focusing on very special diets or nutrients, to focus on basics. Simply eating healthy, meaning eating regular meals with other people. It does make sense to avoid stimulants such as caffeine that can increase anxious arousal. Regular sleep and physical activity are also some of the most potent things to do for anxiety. 

I would love strategies to help ease fears and anxiety at night for better sleep. My kid has big time fears and separation anxiety at night. She has fear of the anxiety that comes every night, which then prevents her from falling asleep and getting good rest. It’s a vicious cycle.  (Angie)

Here is my patent pending remedy for getting your kid to sleep in bed at night. 

Get your child to play a game that goes like this; Your child has to put on a show, like in the theater. The audience watching hs to be convinced that they are going to sleep in their own bed tonight. But you and I (parent and child) know better. In actual fact, they are going to sleep with you just like every other night. But first, we have to put on the show. So they have to brush their teeth and get ready for bed (and they have to have a bed! You would be surprised how many kids' beds have become a storage area because they've been sleeping with parents for a long time). Then you say goodnight and they get into bed by themselves. But they only stay there for a very short time agreed upon in advance. It could be as short as three minutes for example. Your job (the parent) is to keep track of the time and be accurate! When the time has passed, you come back to the child and tell them great job and game over. Then they can sleep with you as usual. You do that for a few nights and then increase the time a little bit, say to five minutes. Then a few nights later you increase again and so forth. When you get to ten or fifteen minutes, ta-da, your child falls asleep on their own!

What are the best ways to address/support teen boys with anxiety and to avoid toxic masculinity issues? (Naomi)

Having a male figure who can talk openly and honestly about anxiety including their own experience can go a long way. Ask the teen if he prefers to speak with a man or a woman. Some boys will feel more comfortable with one or the other. 

How can I help a friend who suffers from anxiety? (Jen)

Be supportive (acceptance and confidence!). Share some of your own experiences. Tell them about the tools and treatments that exist and that can help them overcome anxiety. If you are seriously worried for them I would also talk with some of the other people in that friend's life. 

If you are a PARENT with anxiety, how can you help an anxious KID? (Erin)

Lots of anxious kids have anxious parents! That can be a big strength because you can understand how they feel and because you can show them that you also have to cope with anxiety in your life. Maybe you can work together - each taking on a challenge of coping with something you are anxious about and encouraging each other to be brave and fight anxiety. Don't hide the fact that you are anxious too and don't blame yourself for your child being anxious! 

How do you help kids with even specific anxiety? Such as a crowded or busy place? (Erin)

For places and situations, my answer would be to practice, practice, practice and don't avoid! Break it down into steps, like a less busy place at first, and then more and more etc. 

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For stressors, most children will show some reaction to a major stressor and this is normal and to be expected. If the problems are persisting over time or the child seems to be showing a major change in behavior or personality, or if they are showing signs of having intrusive bad memories or dreams I would recommend consulting with a professional. 

When do you push them past their anxiety and comfort zone and when do you stop pushing?

First of all: Ask yourself what you are doing before you focus on what they are doing! Are you accommodating their anxiety? If you are then, focus on that first rather than trying to push them.

But as for when to push, I would say if your child is moving forward fro less functioning and coping to more than it is ok for that to be as slow a process as they need and you can let them set the pace to some degree. If they are moving in the opposite direction, from better functioning and coping to less then allowing them to avoid more and cope less will not help 

In general, if your child is receptive to your encouragement then you are heling and you can push away. But when they are simply digging in and pushing back then take a step back and ask yourself "is there another way?". Could you for example set up a reward for them rather than just trying to push, or can you set up a consequence of not coping when appropriate) rather than trying to make them do it. 

About Dr. Eli Lebowitz

2019 Eli Lebowitz

Professor Lebowitz studies and treats childhood and adolescent anxiety at the Yale School of Medicine, Child Study Center, where he directs the Program for Anxiety Disorders. His research focuses on the development, neurobiology, and treatment of anxiety and related disorders, with special emphasis on family dynamics and the role of parents in these disorders. Dr. Lebowitz is the lead investigator on multiple funded research projects, and is the author of research papers, books and chapters on childhood and adolescent anxiety. Dr. Lebowitz’ work has been recognized by private and public organizations including the Brain and Behavior Foundation, the National Institute of Mental Health and The National Center for Advancing Translational Science. He is also the father of three great boys.

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