Transcription:
Assessing Your Family's Mental Health

Melanie Cole: There's no handbook for your child's health, but we do have a podcast featuring world-class clinical and research physicians covering everything from your child's allergies to zinc levels. This is Kid's Health Cast by Weill Cornell Medicine. I'm Melanie Cole and today we are discussing how to assess your family's mental health. My guest is Dr. Andrea Temkin. She's an Instructor of Psychology in Psychiatry at Weill Cornell Medicine. Dr. Temkin, this is such an important topic right now, as families around the world are under so much stress and anxiety due to the pandemic. Children of all ages are experiencing strong emotions. They really are, and they don't often know how to cope with this challenging time. Parents are struggling with their own fears and stressors. It's kind of all coming together. What do you see happening with the mental health of families right now?

Dr. Temkin: We definitely see that stressors related to COVID or taking a toll on families. And there are a lot of different reasons. You know, first and foremost, we have these huge concerns about safety and job security and finances and housing, and all these factors that really tie into our fundamental needs. And that's going to have a huge impact on stress and mood for parents and their kids. You know, we also know that COVID disproportionately impacts minority populations who are already battling with a lot of stressors and other aspects of their lives. So that's something that we're seeing a lot too coming out. And then on top of these concerns, you know, COVID is really forcing families to withdraw and avoid parts of their life that have a lot of meaning for them. And that's going to have an impact on how many positive experiences that families can be engaging in, and that's going to really impact mood as well. And then of course, we have all these new factors that nobody's ever struggled with before. So remote learning, remote work, new responsibilities with childcare, we don't have our normal stress relieving outlets. So all in all, you know, I think most clinicians are really noticing an uptick in low mood, increased anxiety and just sort of overall tension and conflict within households right now.

Host: Well, I can certainly understand that. So as a parent, how do we check in on our kids? How do we start that conversation? Because many teenagers I'm fine, mom, or they lock themselves in their room. I know so many parents whose kids are doing that right now. And of course they're doing it for school as well, but how do we go about assessing our family's mental health? What are we looking for?

Dr. Temkin: Yeah. Great question. So I think it's helpful to start with general questions. Like, how are you, how are you feeling? And some kids are going to be happy to spill the beans. And some, like you said, are going to pretend it's all fine and not want to want to share. So in those cases, I think it can be helpful to bring up more specific topics and normalize what a difficult time this is. So, you know, for example, you know, I was talking with your, your friend's mom and they said that, you know, your friend has been feeling kind of sad about not being in person this year for school. You know, what are some of the things that you're going to miss? Or you know, I always look forward to our summer trip to your grandparents. It was hard not being able to see them this year. How are you feeling about staying home this summer? So really sort of opening up the door to different sort of areas that you think your child might be struggling with and just letting them know that, Hey, even if you don't want to talk about it now it's on my mind. We're having a hard time too. We're here to talk about it if you want to. And they might not take you up every time, but at least they know that you're there and hopefully will be able to sort of approach you and open up when they're ready to.

Host: As you're giving us this great advice on what parents can do, what are we looking for, Dr. Temkin? What are some red flags and signs that our kids are suffering as we ask them, and maybe they don't want to share, or maybe they do, as you say, want to spill the beans? What are we looking for in them to know that they are having issues and having trouble?

Dr. Temkin: I think we want to be on the lookout for any noticeable changes in behavior or functioning. So what I mean by that is if you notice that a family member is, you know, their mood is consistently different. If their sleep is different, if their eating habits are different, if they can't concentrate, if their energy is really low, we're really just looking for signs that something from their typical pattern is off. And that could be in either direction. So, you know, a child who's typically sleeping seven hours is suddenly sleeping 12 every day, or your partner who usually gets a good eight hours is now only sleeping four. You know, that's a sign that something is going on and we want to be paying attention. We also want to look for how long these things are lasting. So everyone has little changes in their behavior and mood, you know, sometimes, but is it persistent? Is it lasting, you know, most of the day, almost every day for more than, you know, a week or two at a time. And then we also want to see, you know, how are they doing in the parts of their lives that are important to them? So if they're starting to have a hard time interacting with friends, you know, they're not enjoying things they normally enjoy. They seem not to be doing well with school or work. You know, those are times that we really want to be on the lookout for more than just a temporary dip in mood or a temporary increase in anxiety. And that's why we might want to consider getting some outside, help

Host: What about the kids themselves, what can we expect from them, our teens specifically, how can we help them deal with this? How can they help themselves, Dr. Temkin deal with these things? And even if we have tweens or younger ones, you know, there's always ways we can work with younger ones and playtime and things. But as they get into the tweens and teen years, they don't want so much of that. What can they to help themselves?

Dr. Temkin: That's right. They're not so interested in mom and dad's suggestions anymore. So I think it's helpful for parents to set up just sort of overarching guidelines of here are the types of things we expect you to be doing. And then they get to fill in the blanks. So when we think about improving mood and we think about, you know, wellbeing, there are a couple of different categories. We care about being social, being physical, giving back things you enjoy and building mastery or building a skill in something. So I think it's helpful to sort of let your kids know, Hey, we want you to be filling these buckets in different ways and you can pick what ways those are. So when we're talking the social bucket, it might be having zoom Hangouts. It might be having a distance picnic. It might be for younger ones, having a virtual ice cream tasting party. You know, this is a chance to be creative. It can be a Netflix party if you want. When we're talking about the physical bucket, they can go for a walks.

They can do 50 jumping jacks. They can watch a yoga video, they can download a workout app, anything that feels accessible to them. And then when it comes to things like giving back or building mastery, you know, finding the things that they already care about and building off of that. So if you have a kid who's creative, awesome, they can work on, you know, honing their drawing skills or their painting skills. If you have a kid who really likes animals, they can organize a little fundraiser amongst their friends and everyone chips in a few dollars and they send it to the local animal shelter. So, you know, finding the areas they already care about and encouraging them to think of creative ways to build that. And then again, you, as the parent consider set some expectations. So you, we expect you to do each of these buckets every week and you can pick what that looks like. So they get a lot of choice and control and, you know, mom and dad are still there to sort of scaffold for them.

Host: Well, I love that you brought up giving and gratitude because we've always learned that that's a way that you can kind of put into perspective when you're feeling down, when the family's feeling anxious, but knowing that that family, that you're safe, that you're protected and using gratitude. Can you share some resources for families that may be struggling with their mental health and why it's so important to reiterate, to use gratitude, to look at the good things that we have?

Dr. Temkin: Yeah. So gratitude, super important. There's a lot of research that shows that, you know, being thankful, and giving back can improve our mood. So thinking of ways to do that within the family on the regular basis. And that can be little things like, you know, everyday at dinner, everyone shares one nice thing that somebody else did, or one great thing that you noticed mom did, or the kid did for little kids. You could have a gratitude jar, and each time someone does something nice, you fill the jar with a cotton ball, and once it's full, the family gets a reward. So it can really be small ways to just point out things that are going well. In terms of resources, you know, I think there's a lot of stuff out there at Cornell, we have a handful of podcasts for families or webinars series. You know, you can look up the Weill Cornell Specialty Center or the New York Presbyterian Youth Anxiety Center. And we have a whole webinar series that includes different sort of skills and tips for families, but also one on making meaning, you know, how do you find ways to make meaning and have joy and gratitude within your family at this time when it's not always so easy to do so on a day to day basis?

Host: Well, it certainly isn't and some kids are headed back to school in person Dr. Temkin, and that's making both parents and the kids pretty nervous about that. Do you have some advice about ways that we can manage the anxiety and hope that things are being taken care of and that everyone is safe? Do you have some advice about that?

Dr. Temkin: Yeah, so I think it can be helpful to come up with a cope ahead plan ahead of time. Right? So we all know these changes are coming. It's really hard to know exactly what it's going to look like, but identify a few activities or tools that you can use preemptively that help you feel calm. Right? So when we start to get anxious, our body sort of kicks into fight or flight, and it makes it really hard to focus and pay attention and think clearly. So anything you can do that helps your body just take calm, deep breath, you know, relax that tension. And it could be as simple as deep breathing, playing with a stress ball, looking at a picture of your cat, playing with your puppy. You know, we're talking about small little things just to help you reset and also making sure you're starting to do those things as you're getting nervous about the upcoming changes.

So, if your child is starting to get worried about what their school is going to look like, and if it's going to stay open, or if it's going to be all remote or what have you, you know, remind them, Hey, this is a good time for those deep breaths. This is a good time to go play with fluffy. It can also be helpful to practice using coping thoughts. So what I mean by that is, you know, remembering that there are some good things going on right now, if you're nervous about returning to school or the safety remind yourself of all the precautions that you, your kids in school are taking to keep your child safe, keeping those facts really sort of front and center in your mind can help you focus on the helpful proactive steps we're all taking, rather than getting caught up in the spiral of anxious thoughts, which, you know, can be really powerful right now.

Host: Well, it certainly can be. And this is such important information, Dr. Temkin for families to hear, as we wrap up, give us some advice on how to cope with these stressors of this pandemic in these unprecedented times. How can we go about setting realistic expectations for what may happen as things are changing every single day, there's so much uncertainty. And give us some tips for strengthening those family ties. So both the parents and the kids can really find strength in each other?

Dr. Temkin: Yeah. So a few great questions in terms of, you know, how do you just cope with the overall stress? I think there's sort of two factors. One you want to build your overall reserves. If we think about just stress on a thermometer, you know, we all have our boiling point where we sort of spill over and we want to try and keep our distress as low on the thermometer as we can. So identify some of the things in your life that make you feel good, that lower, that stress level. So exercise, sleep being social, and each week just do one thing that helps you prioritize that. So it could be a smallest texting your back's best friend, at least once it could be going to bed 10 minutes earlier, just small changes that can make a difference. The other piece is to not get caught up in the what ifs or the, if onlys, you know, I think it's easy right now to sort of, you know, be sad about the things we're missing out on, and wonder what it's going to be like. So I have a little two minute rule that I think is helpful to use. If you've been thinking about a problem for two minutes and you either feel better or you have a new perspective or you're coming up with solutions, great, keep going.

But if you aren't, if after two minutes you're feeling worse, you don't seem to have any new ways to think about it, or you're stuck about what to do. It's no longer that helpful. And we probably need to take a break. So give yourself permission to find something distracting, return to the problem later when you might be in ahead of better headspace. And you know, to that last question, what do families do to strengthen the bond? Use your families in this, right? There are a lot of wonderful things about being in a family right now. And one of the silver linings of the situation is you are home with each other. You do have a little more time. So making it a point to find activities that the family likes to do together, rotating, who gets to pick the activity on Saturday night and reminding yourself to the things that you are grateful for and can appreciate, can really go a long way at decreasing the overall stress that everyone is experiencing right now.

Host: Absolutely such important information. Dr. Temkin thank you so much for coming on and sharing your expertise at a time when so many families need to hear your message. Weill Cornell Medicine will continue to offer video visits for consultations and discussion to minimize travel, and you can be confident of the safety of in person appointments if needed. Thank you to our listeners. That concludes today's episode of Kid's Health Cast. Please remember to subscribe, rate, and review this podcast and all the other Weill Cornell Medicine podcasts. For more health tips and updates. Please follow us on your social channels. I'm Melanie Cole.