Anxiety in kids doesn’t always look like worry. Sometimes it shows up as stomachaches, sleep struggles, irritability, or even constant visits to the school nurse. As pediatricians, we know this is one of the most common challenges families face today and parents are often left wondering: Is this normal? Do I need to be worried? What do I do next?

In this episode, I’m joined by pediatrician and author Dr. Natasha Burgert, who just released Managing Childhood Anxiety For Dummies. We talk about how anxiety can look different in kids, when parents should reach out for help, and the many supportive steps families can take before medication is even on the table.

We cover:

• The many faces of anxiety in children (it’s often a chameleon)

• How to talk to your child about anxiety without making it scarier

• Why early screening matters and what those forms really mean (spoiler: not a label)

• Common myths about medication and how SSRIs actually work

• How school transitions (hello, September stomachaches) can trigger anxiety

To connect with Dr. Natasha Burgert check out all her resources at ⁠https://kckidsdoc.substack.com/⁠. Follow her on Instagram at ⁠@kckidsdoc⁠. Buy her “Managing Childhood Anxiety For Dummies” book here: ⁠https://l.instagram.com/?u=http%3A%2F%2Famzn.to%2F4dYyaim&e=AT16kIumYZsC0TK4slk9a-qlSR7mzOsrHwpM4fOhdheESkam-cNuVmg2csHv-v6wgf8dHsUidIsW79nQA45rMXUvzxKmwOktxXr63UcHi-2Fxwq2⁠ 

Another great listen: ⁠What is the gut-brain axis and how does anxiety play a role⁠

We’d like to know who is listening! Please fill out our ⁠Listener Survey⁠ to help us improve the show and learn about you!

0:00 – Understanding Childhood Anxiety: The Great Mimicker
01:21 – Welcome & Why Anxiety Matters for Kids Today
03:19 – Recognizing Signs: What Anxiety Looks Like in Children
08:00 – Talking to Kids About Anxiety in a Supportive Way
09:51 – Screening, Diagnosis & Why Rates Are Rising
17:33 – First Steps After a Positive Screen (Beyond Medication)
21:28 – Medications, Myths & How SSRIs Actually Work
30:17 – Parental Mental Health, Myths, and Back-to-School Anxiety

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00;00;00;02 – 00;00;20;15

Dr. Natasha Burgert

Well, I call it. I call anxiety the greatest moniker. It is truly a chameleon because it can look like so many different things, and that’s why it is easy to miss. So I think parents need to give themselves a little bit of grace that this is not hard for good nutrition to diagnose. So certainly for parents to immediately recognize, I see anxiety that looks like inattention, like ADHD.

 

00;00;20;23 – 00;00;44;14

Dr. Natasha Burgert

I see it look like OCD and compulsive behaviors. It can look like temper tantrums. I can see I’ve seen anxiety look like appendicitis with severe abdominal pain and so understanding the anxiety has three components. It has behavioral. It has physical and it has emotional. And parents can see behaviors behavior change. They can see physical symptoms. But we can’t read our kids mind.

 

00;00;44;16 – 00;01;14;29

Dr. Natasha Burgert

It’s very hard to find that third component. So identifying anxiety is going to take some time. It’s watching for patterns. It’s watching for situational patterns, reaching out for help if you need it to help define it further. But most importantly, it’s addressing and validating that feeling that they’re having. It’s directly managing pain, the pain or discomfort they may be experiencing, all while continuing to observe and watch and then bring it to your pediatrician or mental health provider.

 

00;01;14;29 – 00;01;21;16

Dr. Natasha Burgert

If you’re worried.

 

00;01;21;18 – 00;01;43;08

Dr. Mona

Hello, and welcome back to the show. I’m Doctor Mona, your online. Pediatrician mom friend. And I’m so glad that you’re here. We’re debuting this episode right as the school year kicks off. A time when so many kids feel nervous. New classrooms, new teachers, new friends. It’s normal for children to feel jitters. I mean, I felt it too, but here’s the important question.

 

00;01;43;11 – 00;02;09;05

Dr. Mona

When is it just nerves and when is it actually an anxiety disorder that needs more support? As parents and caregivers, we want to support our nervous children while also recognizing when anxiety has taken the driver’s seat and is interfering with daily life. That’s when compassion and guidance really matter. Anxiety disorders are some of the most common mental health concerns in kids, affecting about 1 in 12 children and nearly 1 in 4 adolescents.

 

00;02;09;08 – 00;02;40;27

Dr. Mona

And the earlier we recognize it, the better the chance the kid has to thrive. That’s why I’m thrilled to welcome doctor Natasha Berger, pediatrician, author of the new book Managing Childhood Anxiety for dummies, a Wiley brand, and a national spokesperson for the American Academy of Pediatrics. Together, we’re going to unpack why anxiety is called the Great Mimiker The three key components to watch for why patterns matter more than one offs, and how to explain anxiety to your child in a way that makes them feel understood and not scared.

 

00;02;41;00 – 00;03;02;15

Dr. Mona

And before we dive in, don’t forget to subscribe and download this episode and any of your favorite episodes. It helps more families find these important conversations, and it helps keep the show in the top 20 parenting podcasts in the United States. Thank you so much. And if today’s episode really resonated with you, please share it with another parent on your social media channel.

 

00;03;02;17 – 00;03;19;25

Dr. Mona

Tag PedsDocTalk, the PedsDocTalk podcast and Doctor Natasha at KC Kids Talk, because supporting our kids mental health is just as essential as supporting their physical health. Let’s get into it.

 

00;03;19;27 – 00;03;26;27

Dr. Mona

Marsha, I’m so happy that you’re finally on the show today to talk about this. Thank you for joining us, and congratulations on your book.

 

00;03;26;28 – 00;03;29;01

Dr. Natasha Burgert

Thank you so much, doctor Mona, it’s great to be here.

 

00;03;29;03 – 00;03;50;28

Dr. Mona

I know that the work that goes into this is something that is not often talked about enough. People don’t realize the time, the sweat, the thought process, the editing. Really, I’m so happy. And for anyone who’s not familiar with who you are and what made you write this book, why did you, as a general pediatrician, choose that this book on anxiety is what you needed to put out into this world?

 

00;03;51;00 – 00;04;26;11

Dr. Natasha Burgert

Well, any pediatrician today knows that the a large chunk of our pediatric practice is mental health and and helping families navigate emotional and behavioral disorders. And so it kind of came at a great time for me because as anxiety was rising for my patients individually and as a nation, I really wanted to create a tool so that parents could reach for a book that gave them evidence based information about what anxiety was, but also things that they can do at home before they even talk to their pediatrician, and to give them very important details, to know when they need to reach out for help.

 

00;04;26;11 – 00;04;32;01

Dr. Natasha Burgert

And if they do get a diagnosis, what exactly they need to do in order to support their child.

 

00;04;32;03 – 00;04;57;28

Dr. Mona

Well, absolutely. Very timely. I’m so excited that I could get you on the show and release this fast. People don’t know this, but I don’t always release my recordings within a week. But I’m like, I want to get you on. Also, for anyone who’s interested, I had recorded an episode with a GI psychologist about the gut brain connection and anxiety, and it was that episode that prompted so many questions from parents about a deeper dive into anxiety and maybe just more about.

 

00;04;57;29 – 00;05;22;25

Dr. Mona

And I was like, well, guess what? I have this amazing pediatrician who wrote this book, so why don’t I get you on and just bump up this episode so that we can actually talk about the questions that my, my followers had? And, you know, I also get in my office and it is really important, like you said. I mean, we’re I think people forget that pediatricians are not just booboo fixers or not just people that you come to for, you know, a cold.

 

00;05;22;26 – 00;05;46;13

Dr. Mona

We actually are dealing, by and large more with this anxiety, depression, school avoidance, whatever it may be. Mental health concerns from toddlers and up than people realize. And so I think one of my first questions that I wanted to ask you, because parents are often wondering what you know, what anxiety looks like in children because it doesn’t always show up just as worry.

 

00;05;46;18 – 00;05;55;25

Dr. Mona

Sometimes it can be stomach aches, trouble sleeping, irritability. So in your book, how do you help parents recognize the signs of anxiety, especially the ones that might be easy to miss?

 

00;05;55;27 – 00;06;16;20

Dr. Natasha Burgert

Well, I call I call anxiety the greatest moniker. It is truly a chameleon because it can look like so many different things. And that’s why it is easy to miss. So I think parents need to give themselves a little bit of grace that this is not hard for pediatricians to diagnose. So certainly for parents to immediately recognize, I see anxiety that looks like inattention, like ADHD.

 

00;06;16;22 – 00;06;40;15

Dr. Natasha Burgert

I see it look like OCD and compulsive behaviors. It can look like temper tantrums. I can see I’ve seen anxiety look like appendicitis with severe abdominal pain. And so understanding the anxiety has three components. It has behavioral, it has physical and it has emotional. And parents can see behaviors behavior change. They can see physical symptoms. But we can’t read our kids mind.

 

00;06;40;16 – 00;07;12;06

Dr. Natasha Burgert

It’s very hard to find that third component. So identifying anxiety is going to take some time. It’s watching for patterns. It’s watching for situational patterns, reaching out for help if you need it to help define it further. But most importantly, it’s addressing and validating that feeling that they’re having. It’s directly managing pain, the pain or discomfort they may be experiencing, all while continuing to observe and watch and then bring it to your pediatrician or mental health provider if you’re worried.

 

00;07;12;09 – 00;07;31;14

Dr. Mona

I love it. And again, the book is so well structured and I love it that it goes into again how to understand the signs. And we’ll get into more about, you know, obviously how to talk to the children about it and treatment plans and all of that. But it’s something that you’re really going to want to get. I, I love this because I think it’s just going to help me better understand my patients as well, you know?

 

00;07;31;14 – 00;07;47;27

Dr. Mona

So thank you for writing it. I always love learning about mental health, and I’m sure I’m going to even learn something more from this conversation that we’re about to have, but also from your book. So I say that as someone who’s a lifelong learner, that I am just so grateful that you, got this out and that we’re going to be talking about.

 

00;07;47;27 – 00;08;00;13

Dr. Natasha Burgert

This awesome and I think that that’s really important. That’s why I learned even more when I was writing it. I mean, that’s that’s the part of being a parent. It’s part of being a professional is constantly being open. So thank you.

 

00;08;00;16 – 00;08;19;14

Dr. Mona

And anxiety can feel overwhelming not just for kids, but for parents too. I have it myself, so I’m very well aware of how that can feel in my body. Parents often ask, and I was asked this after I debut the other episode about functional abdominal pain. How do I even talk about anxiety without making it scarier for the child?

 

00;08;19;14 – 00;08;28;19

Dr. Mona

So how do you guide families to explain anxiety in a way that helps children feel understood and supported, and not scared of what’s going on in their body? In their mind.

 

00;08;28;22 – 00;08;52;06

Dr. Natasha Burgert

Anxiety is normal. There is nothing to fix and their child is not broken. They have a very special brain that has a superpower. Yeah, anxiety is a superpower. Their brain is extra good at noticing things and thinking about things. And so when those symptoms get too much to handle, it’s just practicing and teaching our brain what to pay attention to and what to relax.

 

00;08;52;06 – 00;08;54;26

Dr. Natasha Burgert

And when to relax. When I love.

 

00;08;54;26 – 00;08;55;05

Dr. Mona

That.

 

00;08;55;05 – 00;09;13;15

Dr. Natasha Burgert

Yeah, when I’m talking to parents. I also love the smartphone analogy. I don’t know if you’ve heard this one, but when I have my smartphone going, I have it set so that I’m only getting important notifications things for my kids. Weather alerts. When Taylor Swift drops an album, I mean things that are going to be really important to me, right?

 

00;09;13;18 – 00;09;33;16

Dr. Natasha Burgert

Yeah, because every time my phone alert goes off, it excites my nervous system. I jump to my phone, I grab it, I want to look. It distracts me. It guides my attention. What would happen if my phone had every single notification on for every single app, and every single new service that I subscribe to? It would be so overwhelming.

 

00;09;33;16 – 00;09;51;22

Dr. Natasha Burgert

I’d be constantly engaged, be constantly worrying what’s important, what’s not, and being in the state of alert that becomes distracting and tiring and annoying, quite honestly. But I’m not going to throw my iPhone away. The iPhone is not the problem. We need to learn how to manage those notifications and that is managing anxiety.

 

00;09;51;24 – 00;10;10;00

Dr. Mona

And this month, the app released a new report recommending that pediatricians screen for mental, emotional and behavioral health concerns at every checkup starting at six months. Why is this such an important step for families? And what does effective screening actually look like in practice? And parents might be like, what does that mean for a six month old?

 

00;10;10;00 – 00;10;16;18

Dr. Mona

When do you think that we should really start be, you know, starting to ask these questions or be on lookout for anxiety symptoms?

 

00;10;16;25 – 00;10;40;18

Dr. Natasha Burgert

Pediatricians are all about prevention, right? So the earlier we identify problems with mental, emotional or behavioral issues, the early we can give support to families. And that’s why this is important. So this clinical report is redressing really what we’re already doing. We’re looking for maternal and paternal anxiety and depression during the early months. We’re looking for autism autism spectrum disorder during early childhood.

 

00;10;40;18 – 00;11;03;14

Dr. Natasha Burgert

And then beginning at age three, we’re annually now screening for other issues in my office. You’re looking for in my office, you are screening by asking questions. Do you have a problem? Right. That’s the first thing. We certainly ask. I’m also asking the kids directly. Do you have problems with headaches? Do you have problems with stomachaches? How are friends at school?

 

00;11;03;17 – 00;11;28;05

Dr. Natasha Burgert

How how are things going? And then as kids get older, they can actually fill out forms and do screening tests on their own, which can often reveal some challenges that they’re having. It’s important for parents to know that just because they have a positive screen doesn’t mean they have a diagnosis, right? And so I don’t want families to feel like we are doing this to find something wrong.

 

00;11;28;08 – 00;11;32;12

Dr. Natasha Burgert

We are doing this to find them help and support where they may need it.

 

00;11;32;14 – 00;11;57;28

Dr. Mona

And you know, you mentioned already and I love the way you talked about that, that anxiety can be this great marker, right? That it can be other things. And then obviously, our role as a pediatrician, which I know you do, I do, is always thinking about mental health components in our differential. Right. So using the example example of abdominal pain if a child’s coming in with abdominal pain just started school dealing with it on the weekdays we are asking the questions.

 

00;11;57;28 – 00;12;19;28

Dr. Mona

We’re obviously ruling out anything organic, but we’re also having the conversations around mental health, emotional well-being. And so we can screen this a little bit earlier. And I love that you mentioned that the forms don’t always mean mean everything. And they always don’t they don’t always mean a diagnosis. I think parents have an interesting phobia of getting these labels put on their children.

 

00;12;19;28 – 00;12;27;26

Dr. Mona

And I don’t know if you felt that as a pediatrician. And what would you say to those parents who are like, scared to bring up that their child has anxiety? What would you say to those.

 

00;12;27;26 – 00;12;46;14

Dr. Natasha Burgert

People again, screening and asking questions is not a diagnosis. We’re helpers. We’ve always been helpers and that’s our job. And so so we’re here just to give you support that you may need or to ask you more questions to tell you that this is normal. And maybe you’re worrying about something that you don’t need to worry about. So we’re not here to label kids either.

 

00;12;46;14 – 00;12;51;23

Dr. Natasha Burgert

We just want to make sure that kids and families get the support that they need.

 

00;12;51;25 – 00;12;59;23

Dr. Mona

Now let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show.

 

00;12;59;25 – 00;13;17;26

Dr. Mona

I’m happy that we’re talking about this because obviously you talked about your inspiration of the book. You talked about how we’ve seen this rise. We’ve seen that 13 to 20% of children have a behavioral or emotional disorder at any given time, and anxiety seems to be on the rise. Why do you think anxiety’s climbing? I don’t know if you go into that in the book.

 

00;13;17;26 – 00;13;30;07

Dr. Mona

Or do you have your own, you know, from your own research that you’ve done or clinical experience that you see this sort of pattern that we’re seeing it? Is it more awareness? Is it more of societal expectations? What is it in your opinion?

 

00;13;30;09 – 00;13;54;04

Dr. Natasha Burgert

It’s it’s all of it. I think we still have a pandemic effect. I think we can’t ignore screens in the room. I think parental stress is is at a high. And when we’re stressed, our kids get stressed. And it’s hard to be a kid. Like there’s insane academic pressures. The, youth sports machine is causing a ton of anxiety and pressure with these kids.

 

00;13;54;07 – 00;14;01;11

Dr. Natasha Burgert

But just like we mentioned through the Academy, also better science, better screening. We’re talking about it more, and we’re getting these kids the help they need.

 

00;14;01;13 – 00;14;16;29

Dr. Mona

You brought up a lot of the things that I’m seeing. And I love that you have that in your book as well. But yes, the the ever ending need to do things and lack of boredom and the need to constantly be on. I mean, how is our brain ever going to be able to close down those windows?

 

00;14;16;29 – 00;14;47;27

Dr. Mona

You know, using your smartphone analogy, it literally is like something’s always ticking in the brain, I got to go to this sport or I got to do this and I think it’s so nice that if a child’s passionate about something, but it is, it is on a per parent to kind of look at, is this borderline too much for the child, or is this something that is serving them well and so with so many different things, I mean, in terms of younger children, I love that you brought up the parental mental health because I’ve always felt that even in the postpartum period, you know, I’ve talked about postpartum mental health, the importance of both partners

 

00;14;47;27 – 00;15;14;13

Dr. Mona

taking care of their mental health in a time that it can be hard to because you have to now take care of a newborn. And parents often want to know with anxiety or behavioral or emotional disorders. Did I pass this on? So how much of anxiety is genetic or nature versus nurture? How much of it is observed, and what other factors can put children at greater risk of developing an anxiety disorder, knowing that there’s so many factors to it?

 

00;15;14;13 – 00;15;16;01

Dr. Mona

I know this is a loaded question.

 

00;15;16;03 – 00;15;34;23

Dr. Natasha Burgert

Well, genetics play a role, there’s no doubt. But it’s very, very clear that parents do not give their children anxiety. Kids have developing brains. They have periods of time in their life when they’re just going to be more prone to being more emotional versus a cognitive thinker, which is going to be a setup for a time of life.

 

00;15;34;23 – 00;15;55;07

Dr. Natasha Burgert

And they may be more anxious. Kids have innate temperaments or the way they perceive the world that makes them more prone to anxiety. And I really enjoyed when I was writing the book, learning about epigenetics or, yeah, the study where, the study of how genes are turned on and genes are turned off. And that’s why I devoted so much of the book to environmental factors.

 

00;15;55;09 – 00;16;19;09

Dr. Natasha Burgert

These are things that are important to optimize the mental wellness of our kids and turn those anxiety genes off or down there, things like sleep and nutrition and play, not being overscheduled like you mentioned, management like calming our own nerves. That affects their genetic expression. So if you have a kid that is prone to anxiety, my mom was anxious.

 

00;16;19;09 – 00;16;29;24

Dr. Natasha Burgert

I’m anxious, I have a kid who’s anxious. I want to set up that environment the best I can to turn as many of those genes off and make their experience of anxiety easier for them to handle.

 

00;16;29;26 – 00;16;50;09

Dr. Mona

I love that I, I’m very fascinated with nature, nurture and obviously what you said about epigenetics, and I love that you’re talking about the environmental factors and very foundational things. I mean, you didn’t bring up anything that’s outlandish, right? The importance of sleep, the importance of not over scheduling, the importance of nutrition play. I mean, children need that in their lives for healthy emotional well-being.

 

00;16;50;09 – 00;17;09;06

Dr. Mona

And also, you mentioned parental mental health. I think is obviously something very important as well. And, you know, I think a lot of parents that I feel you know, come into the office and we had alluded to the labels and like, you know, filling out the forms and sometimes the forms don’t match what I’m seeing in my office.

 

00;17;09;06 – 00;17;33;03

Dr. Mona

For example, I do believe that a lot of my teenagers sometimes will fill out the forms just to fill it out, or a parent will fill it out for them. And one of the feelings that I’ve I’ve heard, or one of the sentiments I’ve heard, is that I’m afraid to bring up anxiety because my pediatrician is just going to suggest medicine right away, or I don’t want to go see a therapist because I don’t want my kid on meds.

 

00;17;33;09 – 00;17;59;14

Dr. Mona

You and I both know that that is not how this works. And neither of us, and many of my pediatricians that I know are not going to always go to meds as first line for anything. Usually we like to do, other approaches first, but can you walk us through what actually happens when a child screens positive for anxiety, whether it’s through conversation, which is how most of my diagnoses start to happen, the forms and what are the first steps a family can expect?

 

00;17;59;17 – 00;18;03;20

Dr. Mona

If there’s a concern and why it’s important to bring it up in the first place.

 

00;18;03;23 – 00;18;19;22

Dr. Natasha Burgert

Yes. I couldn’t agree more with you, doctor. Mona, meds are never the first thing that we’re thinking about. And if you do walk into a place, quite honestly, and that’s the first thing they suggest for typical child anxiety, I’m going to turn around and run because that’s not evidence based, and that’s not what we’re wanting to do with these kids.

 

00;18;19;25 – 00;18;39;27

Dr. Natasha Burgert

If you screen positive, that doesn’t mean you need that does not mean that your child has a diagnosis. So it is going to be more questions, more questions, more questions in order to determine what symptoms that they are describing or affecting their life function. So how is this affecting your family? How is this affecting school? How’s this affecting growth and development?

 

00;18;40;00 – 00;19;03;11

Dr. Natasha Burgert

How is this interfering with the things that kids want to do or need to do or love to do and since anxiety is normal, you can have anxiety and thrive with anxiety and not need any additional supports. But we have to ask those questions to see how it interferes with their life and what they love and want to do, and that will determine a comprehensive treatment plan for these kids.

 

00;19;03;13 – 00;19;19;26

Dr. Mona

And I love that you already you mentioned how to to talk to the child about their anxiety. You know, obviously like making it very normal. One of my favorite movies of all time is Inside out to. That’s at the scene with anxiety and really normalized. Like how anxiety can be a very good thing unless it takes control, right?

 

00;19;19;26 – 00;19;40;24

Dr. Mona

Unless it takes control of the control system control center. But like any other emotion we have, anxiety can be protective and it can be helpful. But you said it beautifully that if it starts to overtake activities of daily living, how that child showing up in school, peer relationships with their parents, that it’s something that we want to to evaluate and get get them help for.

 

00;19;40;27 – 00;19;41;29

Dr. Natasha Burgert

Absolutely.

 

00;19;42;01 – 00;20;13;17

Dr. Mona

And you know, it’s it’s still sad to me that we live in 2025. I have been very vocal about the fact that I see a therapist. I’ve been on medications for anxiety and depression in the past, and just like we would want any child to get help for their diabetes or for anything else that they’re dealing with, we would want that same level of care for their anxiety and their mental health, and whether that means needing a medication down the line, being open to having the conversation and having the parent on board is the first step.

 

00;20;13;22 – 00;20;37;17

Dr. Mona

And I think you’ve probably been in those situations, too, where I feel like the child is dealing with anxiety or depression or some sort of mental health concern, and the family is giving me pushback. And I just really want to say that in order to allow this child to live their full potential and be happy in their skin and feel content with their feelings, we have to address the elephant in the room, which doesn’t have to be the elephant in the room.

 

00;20;37;20 – 00;20;44;29

Dr. Mona

Anxiety does not have to be a thing that we push down, and it’s sad that even in 2025, it’s still something that’s so stigmatized.

 

00;20;45;02 – 00;21;11;16

Dr. Natasha Burgert

Now it’s true. And I think thankfully, a lot of, families are just a lot more willing to talk about it. But it is kind of myth busting. And that’s where I try to do, especially when you’re talking about medicines and early diagnosis. We have to kind of get those myths out of the way so that we can come to the table with our pediatrician, our trusted health expert, and be able to ask educated questions and really get to the matter of what’s worrying you, because we are here to help and navigate.

 

00;21;11;16 – 00;21;28;16

Dr. Natasha Burgert

We’re never going to recommend something for your kids that we wouldn’t do to our own. And so bring those questions, have that have that framework of what you’re trying to ask and what those concerns are, and help us and we can help clarify and kind of clean that windshield a little bit for you so you can make a good decision for your family.

 

00;21;28;18 – 00;21;45;09

Dr. Mona

And I have prescribed SSRI for teenagers and children in the past, and I think you have as well. But I do want to talk a little bit about medications, because SSRI are often in the headlines and parents have a lot of fears, and a lot of these fears can come from social media creators that aren’t well versed in the field.

 

00;21;45;11 – 00;22;00;06

Dr. Mona

How do you address questions like, do kids really need medicine for anxiety? If it gets to that point, are these medications safe and what do you want parents to understand before making these decisions? Whether it’s with a pediatrician, whether it’s with a therapist or whoever is the prescriber?

 

00;22;00;08 – 00;22;18;29

Dr. Natasha Burgert

Sure. You know, I devoted a whole chapter of my book to medicines because I think it’s really important for us to get facts over fear. And I think whenever we’re talking about giving a medicine to our kids, it can be scary, whether that’s an ADHD med and anxiety med or even an antibiotic. We want to know what it’s doing in their body and how it’s changing things.

 

00;22;19;02 – 00;22;38;27

Dr. Natasha Burgert

But I think it’s important to recognize that most SS our eyes are simply tools. We’re already trying to use different tools in order to get their symptoms into remission. We are trying to do therapy. We’re trying to do environmental and social supports, and sometimes that’s not enough. Their emotional brain is simply too strong and so we can use those meds as a tool to help.

 

00;22;38;27 – 00;23;03;10

Dr. Natasha Burgert

The work of therapy and the work of environmental supports worked better. Sometimes our kids need medicines when they’re unable to participate in therapies or when symptom severity gets super high. But it’s important to know that there’s been decades of research here. There’s been decades of clinical work with these. When we prescribe medicines of all type, we’re doing that in partnership.

 

00;23;03;13 – 00;23;33;18

Dr. Natasha Burgert

We’re doing that with a common goal of getting symptoms under control, knowing that we can change course if things are getting uncomfortable. And the most kids don’t need SSRI forever, they need it as a tool to make the therapy work better so that they can strengthen the brain parts they need to control those anxiety symptoms. So again, partnership and getting facts from people who actually prescribe these medications and our current with the updated guidance.

 

00;23;33;21 – 00;23;46;08

Dr. Mona

Briefly, do you want to explain to anyone who’s not familiar how an SSRI works on a biochemical level, like what it stands for and why it can help in something like anxiety? Or, you know, obviously, mood disorders like depression.

 

00;23;46;10 – 00;24;15;17

Dr. Natasha Burgert

Sure. So, yeah, what I tell my family is, is that serotonin is responsible for our emotional tightness, our emotional responsiveness, and the emotional centers of our brain. And so when we take SSRI, what it’s doing is it’s just boosting that level of that natural hormone that our brain is already making. It’s not giving you any extra. It’s just boosting what you already have and optimizing that so that you can use that hormone in that emotional center.

 

00;24;15;20 – 00;24;38;20

Dr. Natasha Burgert

So maybe you only go from 0 to 50 instead of 0 to 100. And so in that moment you can use your calming mechanisms, the tools, your Co regulation or self-regulation techniques that you need to learn in order to change that pathway. And over time, the goal is to increase that serotonin level. So that we can reinforce that good, healthy pathway, which does take time.

 

00;24;38;23 – 00;24;53;09

Dr. Natasha Burgert

But once that good neuronal pathway is established, then we can back off on that SSRI support. There should be a good entrance plan, a good exit plan while we’re trying just to support the natural hormones and that natural brain growth that happens over time.

 

00;24;53;12 – 00;25;11;07

Dr. Mona

Yeah. Bringing back the point again, that in order for us to make changes for your child, we have to know that they have this issue. So that’s going back to the importance of knowing signs, having the conversation with your pediatrician, because that’s usually going to be the first line to either get the diagnosis or, you know, refer you to someone who may be more well versed in medication.

 

00;25;11;12 – 00;25;26;05

Dr. Mona

I do want to add, and I think you would agree that not all pediatricians are as well versed in anxiety as others. So it’s important to ask your pediatrician what the next steps are, right? Like what? In terms of if they have a diagnosis, is it going to be you that helps me through this? Who am I going to need someone else?

 

00;25;26;05 – 00;25;47;00

Dr. Mona

And finding the best referrals that are going to be that sort of holistic approach of what can we do environmentally, what can we do behaviorally? And then when will medication need to be in the picture so that it supports the parent and the child? Now let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show.

 

00;25;47;02 – 00;26;11;27

Dr. Natasha Burgert

Oh, absolutely. The kids require a team. Yeah, society needs a comprehensive approach. And so it’s not just one thing that’s going to help. It’s a combination of many. And that’s what kids deserve. So yes, ask your pediatrician questions because there are some that don’t manage mental health. Choose not to. But they will have resources locally in your community that they can refer you to.

 

00;26;11;29 – 00;26;32;28

Dr. Mona

Yeah. And I going back to the medication thing and what you just described, I didn’t realize that until it happened to me. And I am very much that type of provider that does a very like very low med approach initially. Right. What can we do in terms of behavioral therapy? What can we do in terms of terms of therapy, not only for things like anxiety but also things like ADHD?

 

00;26;32;28 – 00;26;51;27

Dr. Mona

Right. That same thing that you mentioned. A lot of my parents have the fear of ADHD medications and having had anxiety and still having it, but having needed XYZ, I remember saying I don’t need it. I pushed it away. There was a stigma that existed culturally for me to need any sort of pill to help me with my mental health.

 

00;26;52;00 – 00;27;14;21

Dr. Mona

And like you said beautifully, I was doing the therapy. But it wasn’t easy to get into therapy every week because I was busy postpartum mom, working clinically in a pandemic and getting on that SSRI in my life saved me because it was that bridge to get the tools, get the therapy, have the therapy start to work, and then I was able to come off of it.

 

00;27;14;23 – 00;27;35;18

Dr. Mona

And in my reality, I want to share this because I love being personal on this podcast. I now only have to be on an SSRI in the summer in Florida because I get reverse Sad, which is reverse seasonal affective Disorder, which is a thing guys. And I say this because I shared it on my stories the other day and someone had said, you know, you’re on an SSRI and I’m like, ill.

 

00;27;35;25 – 00;27;53;11

Dr. Mona

I’m like, I’m, you’re saying, you know, I’m saying I’m living my best life because I am in therapy. I’m so happy. But I have this thing that helps me for the season when I need it, and I’m able to taper off of it with the guidance of a clinician and get off of it and feel happy. And there’s no shame.

 

00;27;53;11 – 00;28;10;10

Dr. Mona

And I say this because it’s not always going to be that your child needs the medication. But when you have the right doctor and the right therapist, you’re it’s going to make sense when that needs to come into play and maybe when it’s going to need to be weaned off. And we our goal here is to support your child.

 

00;28;10;10 – 00;28;30;25

Dr. Mona

And that means also supporting the family because we know that anxiety affects everybody, right? Mental health disorders can affect everybody in the household. And we want that to be better for everybody and especially the person who’s dealing with it. So they don’t feel like they have to struggle in silence because that’s more risky than being on an SSRI, in my opinion.

 

00;28;30;27 – 00;28;57;26

Dr. Natasha Burgert

I mean, and how many times have you heard Doctor Mona, after you quit, after you work with a medication to get symptoms into remission, what are the parents always say? I should have done this six months. Yes, I should have done this a year ago. And I think we fight, fight, fight. But this is a this is a safe and effective tool, as long as it’s in partnership with a prescriber who understands your family, understands your goals, understands your child’s physiology and their symptoms, what they need to accomplish in their life.

 

00;28;57;28 – 00;29;11;03

Dr. Natasha Burgert

It I’ve certainly, as you have experienced, I have certainly also seen kids whose lives are changed. Their trajectory of their anxiety is changed permanently and in some cases XYZ have saved their life.

 

00;29;11;06 – 00;29;38;08

Dr. Mona

Yeah, absolutely. And I can’t go back. I can’t repeat it enough. The importance of the team and I, I wish we had better mental health resources out there that do that for us, you know, like have. And that’s why I think your book is so important that has the education but also the empowerment, also the understanding of the holistic approach to this that isn’t shameful, that isn’t like, well, I can’t believe you’re on unnecessary that hey, this may be the tool that you need to get this under under control so that you can live the life that you want, right?

 

00;29;38;08 – 00;29;54;22

Dr. Mona

That anxiety isn’t taking that control. The control, tower in inside out too, because we we’re fine with having it, but we don’t want it to be in the driver’s seat at all time. The other the other thing that, you mentioned was, you know, and I love that you brought up that, that you you have anxiety.

 

00;29;54;22 – 00;30;17;07

Dr. Mona

Your mother had it. Your you see, your your child have it as well. You make the important point also that a parent’s own mental health and anxiety can influence how well they’re able to support their child sometimes. Right. Maybe they’re nervous about what how they were dealt with, or maybe they are unsure what’s going to happen. How do you encourage parents to reflect on and address their own mental health, while also trying to help their kids in this?

 

00;30;17;07 – 00;30;18;27

Dr. Mona

In this situation.

 

00;30;19;00 – 00;30;51;15

Dr. Natasha Burgert

Parenting when you have anxiety is so much harder, and I do think it’s reciprocal. So if you anxiety you can put the gas on your kids anxiety. But also a child having anxiety can also make you anxious like it’s a, it’s a very, important cycle to recognize. And I know we’ve always heard the adage that anxiety is contagious, which I think has some elements of truth, because kids do pattern our behaviors, but anxiety also interferes with our parenting in a few ways that most parents maybe don’t recognize.

 

00;30;51;18 – 00;31;18;06

Dr. Natasha Burgert

And that is, it decreases our parenting effectiveness. It increases our willingness to do accommodation and increase it changes our parenting style. Anxiety, will and anxiety will change our emotional interpretation. So we often overreact for things that we shouldn’t overreact to. It also interferes with our relationships. I mean anxious person. I know when your anxiety is uncontrolled, you’re irritable.

 

00;31;18;14 – 00;31;45;12

Dr. Natasha Burgert

You don’t want to be around people. You feel drained and that does not help with the relationship with your child. But I think most importantly, anxiety can really steal joy. So if I have a child where we have a really nice comprehensive medical plan for them and things are not changing, we have a frank conversation that something in the environment is not allowing your kids symptoms to go into the remission, into remission.

 

00;31;45;15 – 00;32;13;08

Dr. Natasha Burgert

And is this a space where getting your own anxiety under control is the best thing that you can do for your child’s anxiety, and that can often make all the difference in the world. It’s not an easy conversation. It does require a relationship which fortunately, most general pediatricians have with their families to know them well. But I think it’s a point of honesty when things are not going in the direction that you want them to, that we need to reflect on.

 

00;32;13;10 – 00;32;30;29

Dr. Mona

And I think your point is valid, that it’s not a blame or shame thing. I think, you know, I as someone who does have anxiety and can see not even just my anxiety, but when I’m irritable, when I’m overstimulated, all of the manifestations of my anxiety, when I see how that impacts my child, that’s not blaming myself. I don’t feel like I’m a bad mom.

 

00;32;31;04 – 00;33;00;22

Dr. Mona

I don’t tell myself, well, Mona, you’re horrible. I just it’s insight, right? It’s understanding that. Yeah, when I’m when I’m running around my house with, like, my like a chicken with the, with the head cut off that doesn’t bring energy into my home. My kids start feeling that. Right. And I, I think it’s important for parents to hear that, that we neither of us and neither any of our colleagues have ever felt like this is a blame or shame game, but it’s having the understanding and the insight to saying like, how am I showing up for my kid in this moment, right?

 

00;33;00;22 – 00;33;28;21

Dr. Mona

If I have anxiety, if I have ADHD, if I have whatever I’m dealing with, my kid is going to absorb that because it’s very contagious. I mean, energy is palpable. I mean, you don’t have to be this. You don’t have to like, people think that you have to be a certain type of personality to feel energy. But I know when you walk into a room and you feel that sort of stress, you’ve been in those visits, Doctor Natasha, or the moment you walk in, everyone, is this the baby’s crying?

 

00;33;28;21 – 00;33;45;22

Dr. Mona

You know that that situation, the baby’s crying, they’re passing the baby around. Everyone’s stressed. And I just sit down and all of a sudden we’re all relaxed. The bodies calm down and the baby stops crying. Is that going to happen? Every moment a baby cries? No, but it goes to show you how palpable and how strong that emotional connection is.

 

00;33;45;22 – 00;34;05;15

Dr. Mona

And just having that self-reflection, saying, am I bringing anything to this? Maybe or not? And if I am, what can I do to better provide for my child in this situation? Maybe it’s my partner bringing them to visit, maybe it’s my partner or someone else helping them, with other things. You know, it’s not a I’m not a good mom or I’m not a good dad.

 

00;34;05;15 – 00;34;10;02

Dr. Mona

It’s a understanding of self. And I think that’s a huge thing that I wish parents would understand.

 

00;34;10;06 – 00;34;36;15

Dr. Natasha Burgert

I think that that’s such a great point and so eloquently spoken. I think it’s also just a reflection of being a human. Right, right. We’re changing and growing just like our kids are. And I think we don’t stop to self-reflect because we’re so busy in their life and making sure that their life is okay, that putting putting those steps to reflect on our own lives as we’re changing as an adult is equally important and is going to serve us well when our kids leave the house, right?

 

00;34;36;20 – 00;34;49;11

Dr. Natasha Burgert

Yes, we we need to keep building and growing as an as an individual. And that includes our mental health, our interests. What we prioritize, even beyond what’s happening in our kids lives.

 

00;34;49;13 – 00;35;03;12

Dr. Mona

It’s so, so beautiful. And I’m just so, again, excited about people getting their hands on this book. What would be any other myths that you’d like to debunk right now regarding things in your book, anxiety in general, that we didn’t cover yet that you wish our listeners would know?

 

00;35;03;15 – 00;35;23;05

Dr. Natasha Burgert

Parenting is a verb. We’re constantly changing. We’re constantly growing. And it’s and even though our kid may have anxiety and that’s not necessarily what we planned for, we don’t wish anxiety on our kid. We have this great opportunity to grow and adapt with them in order to learn how to parent. And anxious kid kids can absolutely manage their anxiety.

 

00;35;23;05 – 00;35;40;19

Dr. Natasha Burgert

They can do it on their own. We just need them. We just need to give them the validation, support, the love that they need in order to be able to learn how their brain works and learn how they are going to independently function in their lives. And there’s a lot of tools and resources out there that are going to be able to help them.

 

00;35;40;22 – 00;35;56;14

Dr. Mona

Like your book. Thank you. Not Doctor Natasha. I really appreciate you coming on today. I know we’re debuting this episode at the start of a school year. What is it about the start of a school year that you feel like. I mean, I notice a lot of my anxiety concerns come in September, October? November?

 

00;35;56;14 – 00;36;08;12

Dr. Mona

What is it? Is it the relationships? Is it the workload? I mean, we already kind of alluded to it, but I know that it was important to get this episode out now because I see anxiety skyrocket a little bit now. But what do you think it is that’s happening for our kids?

 

00;36;08;19 – 00;36;30;01

Dr. Natasha Burgert

Oh my gosh, it’s everything right? And it’s also just the it’s also just a transition because kids love the summer. I know stressed out that school is starting. So it’s anxiety. And those physical symptoms can come from great things too. It’s just they get sad that summer is over. So I call this anxiety. I call this season abdominal pain season because that’s like kids always get stomach ache.

 

00;36;30;01 – 00;36;50;05

Dr. Natasha Burgert

Some God bless the school nurses. They’re angels out there because they’re dealing with all of these kids coming to coming to the school nurse with abdominal pain and headaches this time of year. It’s normal. Or just like you had a great guest on that explained the gut brain connection. This is a very real change to their physical body when they start to have stress and transition.

 

00;36;50;08 – 00;37;00;23

Dr. Natasha Burgert

Pain deserves to be appropriately recognized, directly treated, and then continuing to work forward to get the keep those kids in school and to get their symptoms better.

 

00;37;01;00 – 00;37;20;17

Dr. Mona

And that episode I will be linking that in the show notes as well. I released a week a couple of weeks ago, but me and Doctor Ali, Ali, Naveed, he’s a psychologist. We talked about how to talk to the kid about their abdominal pain, what we say to the kid, so that they understand that the pain is real and how it’s obviously impacted by their emotional being, so that it’s not gaslighting your child.

 

00;37;20;17 – 00;37;39;03

Dr. Mona

It’s not saying that the pain’s not real. Get over it. It’s like, hey, this is a real thing. But thank you so much, Doctor Natasha. This was an amazing conversation. Where can people go to get this book? I’m holding this up for anyone who’s not who’s not watching the YouTube. But again, it’s managing Childhood Anxiety for dummies, a wily brand which is obviously their series of the For Dummies series.

 

00;37;39;03 – 00;37;42;11

Dr. Mona

But where can they get that? And where can they go to stay connected with your work?

 

00;37;42;13 – 00;37;54;14

Dr. Natasha Burgert

Sure, you can get the book wherever books are sold, so I would love for you to check it out. And then I also share things on Instagram and Substack. And you can connect with me at KC kids, Starcom.

 

00;37;54;16 – 00;38;18;08

Dr. Mona

What I loved about this conversation with Doctor Natasha is that she is a pediatrician, a mom. She was transparent about her own anxiety, her mom’s anxiety, her daughter’s anxiety, and she wrote this incredible book to guide parents in their anxiety journey with their child. I hope this conversation gave you both insight and reassurance, and maybe a tool if you need a book to support yourself as you support your child.

 

00;38;18;11 – 00;38;37;23

Dr. Mona

I also appreciate her talking about parental mental health and anxiety, that cyclical situation where our anxiety can cause our child to be anxious and our child’s anxiety can cause us to be anxious. It’s something that we see. It’s something that’s in literature, and it’s important to be aware so that we can better support our child. Remember, kids can feel nervous.

 

00;38;37;23 – 00;39;03;20

Dr. Mona

That’s normal. That’s a human emotion. But when worry and anxiety starts to interfere with daily life, school, sleep, friendships are eating. That’s what we need to look at. Deeper anxiety is real. It’s normal and it’s common. But when it takes over us, we need to get our kids support. If you found this episode helpful, remember share it with a friend or post it to your stories on social media and tag PedsDocTalk, the PedsDocTalk podcast, and KC kids doc.

 

00;39;03;27 – 00;39;25;25

Dr. Mona

The more we talk openly about anxiety, the less stigma there is and the more kids get the support they need. And don’t forget, subscribing and downloading really helps our show continue to grow and reach more families. So if you haven’t already, hit that subscribe button. So you never miss an episode. Thank you for tuning in. Thank you for showing up for the kids in your life, and thank you for being a part of this growing community.

 

00;39;25;29 – 00;39;42;27

Dr. Mona

Supporting kids mental health is just as vital as their physical health. And it’s something that I’m so involved in body, mind and spirit. And that’s what I’m all about. And that’s what this episode was all about. I’ll see you all next week on the show, and I cannot wait to chat with another guest for another amazing conversation.