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Dr Kelly Boland: Hi, I'm Dr. Kelly Boland and I'm a psychology fellow at St. Louis Children's Hospital, and I am a mom doc.

Melanie Cole (Host): Welcome to Mom Docs, the podcast from St. Louis Children's Hospital. I'm Melanie Cole, and we're talking today about maintaining mental health during this holiday season for parents and kids. Dr. Boland, it's such a pleasure to have you join us today.

My first question is really about what used to happen and what is happening now. Do you think that kids are more stressed around the holidays than we were as kids? I don't know how old you are, but I'm in my late 50s and I don't remember worrying about anything and just being really excited. But do you think that today kids seem to have more pressure plus what's going on in the world today is, you know, kind of crazy? What do you think?

Dr Kelly Boland: Yeah, I think that's a great question that I think I've also been getting a lot from patients' families that I've worked with. And I think you're absolutely right with some of the events that are going on in the world today, definitely can contribute to stress levels for kids, but also just how connected they are to the internet, to seeing content that maybe is not developmentally appropriate always for young developing minds to fully comprehend. And I do think, yeah, we tend to see a lot of stress during the holidays that maybe is a little bit increased than what we had back in our day as kids.

Melanie Cole (Host): Well, I think that we are really seeing a mental health epidemic among our kiddos, whether they're tweens or up into their early 20s. It seems like there's a different sort of feeling. Can you discuss some of the negative physical consequences of stress that not only surrounds the holidays, but all the times for our kids? What have you seen sort of as the results of all of this stress that we've had, whether it's because of COVID, viruses, school, social media, everything, all of it together?

Dr Kelly Boland: I'm glad that you brought up COVID. You know, we're still in the midst of the COVID pandemic and we're certainly still dealing with ramifications of shutdowns and of pretty intense times in a lot of young people's lives of being isolated from friends, isolated from a lot of in-person communication and opportunities, and thinking about how that impacted their parents' ability to maintain their own stress, which definitely can rub off on kiddos. So physically, there is a huge link between children's mental health and their physical wellbeing. That's something that definitely pops up around the holidays too, I think. In part, for those older kiddos with studying, cramming last minute for finals at school and things like that. And just not getting enough sleep, not getting enough nutritious foods in their bodies. And we do see an increase here at the hospital in cases coming in that have different illnesses because maybe their immune system has been weakened by chronic stress, but even kind of mundane things that build up over time, like increased stomach aches, increased headaches. And those aches and pains can, by themselves, lead to more stress, and more just confusion on how to manage those things, especially over the holidays.

Melanie Cole (Host): So then, let's get into the really important stuff here, ways that we can manage and healthily manage our stress ahead of the holiday season and even after. I'd like you to start, Dr. Boland, with tips for parents to maintain our mental health in the holiday season because there is budgeting and shopping and hosting and cooking and all of the things plus COVID plus... I mean, I've got a bunch of people coming and I can tell you I've had headaches. Give us some really good tips for parents and how we can start, because obviously, we've heard this credo before, but we have to put on our own masks before we can put on the masks of our loved ones. And we cannot care for our loved ones unless we practice some self-care and take care of ourselves. So, start with us.

Dr Kelly Boland: Yes. And just to echo that, just the idea of the best way to teach your child about self-care and their own mental wellbeing is being a role model to that yourself. And part of that is making sure that us as parents, that we're taking care of our own mental wellbeing and giving ourselves breaks and just the mental space to recover.

Part of winter break should be having a break from cognitively challenging activities and just different things that stress us out at work or at home. But you're absolutely right. Like some of the things you had mentioned with throwing parties and all of those things can be taxing, they can be so much fun, but they're work, they're stressful. So, just keeping that in mind, how are you role modeling to your kids' self-care? So if you're feeling like your stress level is coming up, you're noticing yourself getting more irritable or more frustrated with people, modeling to your kids, "Hey, mommy's going to go to the bedroom and take a half hour break. If there's any emergencies, go to your other parent. You've got grandma or grandpa on speed dial. But mom needs a break right now. I'm going to go take this half hour for myself." Or thinking about just your own basic needs.

So during the holidays, it's great to socialize more, hang out with people more, but it's just as important to make sure that you're eating nutritious foods, not just that amazing candy corn and candy canes and all the treats that go along, but really like nutritious foods, making sure you're getting enough sleep at night and keeping your body's basic functions going because we know physically taxing your body can lead to more stress. It can lead to more mental fatigue and vice versa. We know that mental stress can also lead to feeling more exhausted and physical symptoms. So making sure you're covering your basics, you're covering your sleep, your nutrition, and then also thinking about just small ways that you can remember what the holidays are all about. So, remembering what you feel grateful for and trying to help yourself put things in perspective. So, is your family going to remember that dinner went off without a hitch that all of the sides were warm at the same time that you had, you know, mashed potatoes? Probably not. What they are going to remember is having memories with you, laughing with you at the kitchen table. So if some of the other stuff needs to come out cold, then it comes out cold because a year from now, 10 years from now, that's not what your kids remember. They remember the joyful times in there.

Melanie Cole (Host): What great advice that we don't sweat the small stuff and that we use gratitude and we think about how lucky we are and all of those things, which I try and do every single day. But now, give us some tips for our kiddos, how we can help them because as we're doing all of these things for us and putting up our hands and saying, "I got to walk out for a minute," what about them? I'd like you to speak about how we can help them. Obviously, you said role modeling, that's the first best thing. But also, we want to give them those joyous times, but they need to use gratitude too. They need to have that appreciation for it all as well. So, give us some tips for those kids that are feeling this extra stress around this time.

Dr Kelly Boland: One of the common complaints that I get around the holidays from parents is kind of that idea of we're doing so much for them, they've got all the toys they could ever want from the holidays. We're bending over backwards to have all these fun activities planned. And yet, my kid is not expressing gratitude. They're throwing tantrums. They're being a moody teenager and staying in their bedroom. And I think one thing to just to keep in mind, again just going back to like basic needs, especially for young kids, but those teenagers too, they need adequate sleep. They need nutritious foods, and the holidays is definitely a time where those things get disrupted.

And so, when your kid is maybe acting out, just trying to remind yourself during this time, it's usually less about what you're doing wrong that's causing those behaviors and more about what of their basic needs maybe isn't being met right now. Especially young kids, they crave schedules, they crave routine, and we've got holiday parties, we're staying up late, and that's wonderful. And again, those are the things they're going to remember a year from now, 10 years from now in the future. But in the immediate term, it has consequences. It has less time to revamp for the day, get that rest that they need to reset those little minds and those little bodies. And so, it's probably going to come out in some anger, irritability.

So, I think the number one thing is making sure that they get those basic needs met, that we're balancing the fun activities with sometimes just having them go to bed closer to bedtime if necessary. Also, just thinking about ways to make sure that they're staying socially involved because, especially those adolescents and teens, they might have a very clear idea in their mind of how they want their break to look. So, making sure that you guys are sitting down talking about like what is the schedule of events. If the family really wants to do something on Friday or on Saturday, making sure your teenager didn't already have a big party with friends in mind or was going to see somebody that they liked in mind.

So, really helping to set expectations with your kids of, "Here are the times that we'll have some downtime and not over-schedule things, so that you can hang out with friends, do what you want. But here are the times that mean a lot to mom and dad to have you there." And so, just thinking about, yeah, ways to fill that need as well.

Melanie Cole (Host): What great advice. I literally just did that with my kids. I'm like, "Listen, Friday night, we are here. Nobody goes out. We're here. I mean, we're supposed to have a storm, so nobody's going to be going out." But that's such a great point because the kids make their own plans. They have their own ideas of what their vacation will look like. And one of the things that you mentioned was, you know, the bed thing and getting a little earlier and sleep. I mean, it's vacation. They're going to stay up until three on Snapchat and TikTok and all of that. But what are some of the warning signs? Because that's the teenage brain. That's normal stuff. But what should we be looking for that would signal to us, "Hey, you know, this is a little bit different."

Dr Kelly Boland: One of the things that really sticks out to me is, when you start to notice self-care is markedly getting worse because with most teenagers, you know, they're not always putting on deodorant, not always taking the time to shower in the morning, and that's pretty typically normal. But if you notice like this is a couple days on end where they're not showering, they're not combing their hair, they're not getting out of their PJs all day, when everyone else in the family has been doing those things, that might be a clue that your kid might need a little extra prompting to get re-involved with those things. Or, like you had mentioned, like warning signs, that could be a warning sign maybe something's wrong, maybe something's going on and they're feeling less motivated, they're feeling more fatigued than usual.

Also, things to look for is if they're withdrawing from others. So, again, most teens around the teenage years, high school years, even middle school years, they tend to pull back from family a little bit and they have more worth in friendships at that point in their lives, and that's completely normal. But what we don't want to see is that kids are even withdrawing from friends, so they're not spending time with people. Like you mentioned, TikTok, Snapchat, they're on their phones all day, but they're not really having meaningful interactions with people on those platforms. So, they're not wanting to spend time with friends.

It could also look like excessive sleeping. So if kids are napping all day, if they seem fatigued, even when you know they're getting plenty of hours of sleep at night, those are all things that you might want to check in with a mental health professional or your doctor about just to see if, yeah, something else might be going on.

Melanie Cole (Host): Well, those are all really interesting points that we need to keep an eye on in this. As we get ready to wrap up, I'd like you to summarize, Dr. Boland, this time of year, right after this time of year, just kind of all year round, our kids are feeling this stress, there's kind of a global stress going on. We're all sort of feeling it, and what you would like parents to know about helping our kids through this about looking at their sleep and their nutrition and their social media use, all of those things. Our kids want expensive gifts at Christmas time. We have to run from relative to relative. There's just so much going on. Give us your best advice here for parents listening because it's so important that we hear this from a professional like you to tell us really, really what we need to do to tamper it all down, to bring down the temperature just a little bit.

Dr Kelly Boland: So, I think just summarizing some of those points, so just remembering the basics, remembering that from young toddlers up into the teenage years, kids need basic needs met with adequate sleep, adequate nutrition, and adequate downtime, whether that be a consistent schedule or something that you guys build into what is probably sure to be a drastic change in your normal day-to-day schedule during the holidays.

So, making sure too with younger kids that you try to keep up their schedule as best you can and giving them some grace if you see behavioral outbursts. But especially as we move into adolescents and teenager, really thinking about how to be collaborative with them, how to set expectations for what different days of the week are going to look like, to make sure that that is also meshing well with their ideas of what they want their break to look like.

And regardless of the age of your kid, keeping in mind that you are their best role model for how to practice self-care. So role modeling, if you are feeling stressed, if you are feeling down, giving yourself a short time period where you can have time to yourself, away from everyone else to recoup and then rejoin the family.

Melanie Cole (Host): Great information and so helpful all year round. Dr. Boland, what a great guest you are. Thank you so much for joining us. And for more advice and articles, check out the Mom Docs website at childrensmd.org. That concludes another episode of Mom Docs with St. Louis Children's Hospital. Parents, share this show with your friends and your family on your social channels because we are all learning from the experts at St. Louis Children's Hospital together, and they're really helping us to keep our kids safe, healthy, and happy. I'm Melanie Cole. Thanks so much for listening.