Both my husband and I have anxiety. So yeah, we are two anxious people raising kids and watching closely for signs of anxiety in them. The irony is very real. But it also means I am deeply invested in understanding where childhood anxiety comes from, and how much of it we as parents are actually influencing.

In this Follow Up episode, I brought back child psychiatrist Dr. Helen Egger to break down the nature vs. nurture of anxiety, what it actually looks like in kids and parents, and how we can interrupt the cycle without losing our minds trying.

In this episode we cover:

• Why having anxiety as a parent puts your child at 4-6 times higher risk for anxiety, and what that actually means
• The difference between normal anxiety and anxiety that needs support
• How fear can be “contagious” in a family environment, even without realizing it
• The genetic component of anxiety explained as risk, not destiny
• Why anxious kids often also have heightened empathy and sensitivity (the strengths side of the coin)
• How to address your child’s anxiety while managing your own
• The different types of anxiety: generalized, social, separation, and phobias
• Why getting mental health support as a parent is one of the most powerful things you can do for your child
• How modeling help-seeking behavior actually breaks the anxiety cycle

Want more? Listen to the full, ⁠original episode⁠.

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00;00;00;03 – 00;00;27;13

Dr. Mona

Hey, it’s Doctor Mona and you are listening to the follow up. Where we bring back a past episode of the PedsDocTalk podcast. In less time than it takes your brain to convince you something is definitely wrong at 2 a.m.. I know you’ve been there. True story. Both my husband and I have anxiety, so we are literally the anxious parents anxiously monitoring our kids for anxiety.

 

00;00;27;16 – 00;00;53;19

Dr. Mona

The irony is not lost on me so far. Our kids are doing great, but I’m very aware of how our own worry and anxiety can quietly shape theirs. And I’m genuinely fascinated by how much of this is nature versus nurture. Remind you anxiety is not a bad thing. It’s when it consumes us and overtakes us, which is sometimes what happens to me and my husband.

 

00;00;53;22 – 00;01;17;05

Dr. Mona

I invited Doctor Helen Eggar, a child psychiatrist who breaks all of this down in an original episode called How Parental Anxiety Impacts Childhood Anxiety. And remember, this is a follow up episode, so we take the best little tidbits from that full episode. So if you like this conversation, make sure to download it, but also download the full conversation in our show notes.

 

00;01;17;12 – 00;01;39;02

Dr. Mona

And if you love it, please make sure to share it! Tag the PedsDocTalk podcast and at PedsDocTalk. It really helps the show continue to grow because you are all about to learn. Nature. Nurture. Anxiety. Who is causing it? Is it a cycle and hint? It’s a vicious cycle that we can break.

 

00;01;39;05 – 00;01;51;12

Dr. Mona

So do you see a cyclical effect of childhood anxiety and parental anxiety? More so is it that the child’s anxiety can cause parents to get anxious or vice versa? Or both? Do you see that?

 

00;01;51;14 – 00;02;22;20

Helen Egger

So we absolutely do. And it goes in both directions. But let’s pull the lens back a little bit first. It’s important to understand that anxiety, particularly clinically significant anxiety, comes from multiple sources. And one of those is genetic and biological. So that is a parent or a family member has an anxiety disorder. The child is 4 to 6 times more likely to also have an anxiety disorder.

 

00;02;22;22 – 00;02;44;27

Helen Egger

So that’s really the first thing that we need to think about. And if you are a person experiencing anxiety as a parent, you want to be very aware and alert to your children’s level of anxiety and fears. But I think the other thing is something that’s familiar to all of us that fear in some ways can be contagious.

 

00;02;44;29 – 00;03;00;28

Helen Egger

Right? If someone is scared, you’re expressing worry in your environment and people around you can also become worried and afraid. And so that dynamics between parents is something that it’s so important to be aware of.

 

00;03;00;29 – 00;03;01;19

Dr. Mona

Absolutely.

 

00;03;01;20 – 00;03;31;02

Helen Egger

And I think it’s also really important for us to talk about what anxiety is, right. Because anxiety is something that everybody feels and everybody experience. And that’s a good thing. It protects us from danger. It helps us identify us and be aware of our environment so that what we want to think about is not sort of what is typical anxiety.

 

00;03;31;02 – 00;03;49;00

Helen Egger

But when is a person, whether it’s a parent or a child, when is their anxiety so pervasive and uncontrollable that it is impacting their ability to function or it’s impacting other people?

 

00;03;49;02 – 00;04;15;05

Dr. Mona

Oh, this is so important. And, you know, going back to your comment about genetics, right? Obviously, yes, I agree that there is some genetic component like we’re talking about. But what I’ve always wondered. So with something like anxiety, do you find that it could be hard to determine if it’s genetic or environmental? Giving an example. So if I grew up with a dad who had anxiety, right, I grew up seeing how he responded to certain situations, and I also started to respond the same way.

 

00;04;15;06 – 00;04;34;05

Dr. Mona

Now, if I was removed from that home and was raised by parents who did not have those tendencies, I’m talking about the physical mannerisms that can come with anxiety, right? The pacing, the biting of the nails, the nervousness that you’re seeing in that environment. So is it that it’s truly genetic, or is it that there’s also that environmental component?

 

00;04;34;05 – 00;04;36;23

Dr. Mona

It’s hard to know because it’s both. It’s both.

 

00;04;36;25 – 00;05;02;23

Helen Egger

It really is both. When we think about the genetic component, that’s not like we know what’s going to happen. Think about it as a risk. Yeah. So it means the way that your nervous system is built, the way that your brain is wired gives you the propensity to be able to react in a more anxious or fearful way.

 

00;05;02;25 – 00;05;25;22

Helen Egger

But what you’re describing is that what happens to us and what our experiences are, both in terms of modeling, as you’re describing with your dad, but also other kinds of experiences that we have are going to shape, whether our anxiety gets expressed in a way that has a negative impact.

 

00;05;25;25 – 00;05;39;26

Dr. Mona

Yeah, absolutely. It’s so fascinating to me because it’s this whole nature nurture. Like if you removed from an environment and raised by people who weren’t having those anxiety tendencies, you know, just by watching, like, could you not present that like the child? It’s just an interesting conversation.

 

00;05;39;28 – 00;06;11;05

Helen Egger

But I think it’s important to realize when people talk about, is it this or that? These are really different components that are contributing really to people’s emotional makeup, right? Yes. And I think the other thing that’s important to recognize is that children who are anxious often also have a heightened sensitivity to other people. They have increased empathy, they have real attention to their environment.

 

00;06;11;05 – 00;06;30;06

Helen Egger

So like anything like, you know, it’s not like anxiety is bad. Anxiety is part of life. And children who are at a higher risk for anxiety will also have strengths and capacities that are going to help them in life.

 

00;06;30;07 – 00;06;42;19

Dr. Mona

I think one of my biggest questions, and I’m sure we could do a whole hour long more episode about this, but how can we address our child’s anxiety while simultaneously managing our own fear?

 

00;06;42;26 – 00;07;18;24

Helen Egger

Okay, so I think there’s a few things that we need to talk about here. I think the very first thing is that if a parent is experiencing anxiety, that’s really causing them a negative impact or they think is impacting their child. Please get mental health care because we have such good treatments and interventions for clinically significant anxiety. I mean, I don’t know if you want to talk about the different kinds of anxiety, but people can have anxiety.

 

00;07;18;24 – 00;07;54;20

Helen Egger

That’s we called generalized anxiety. And that’s a lot of worrying, particularly worrying about things that will happen. There can be social anxiety, which is anxiety about social interactions and being with people. We see separation anxiety, which is really prominent we see in children, but we’ve actually learned that adults can experience separation anxiety also. And that’s when you feel overwhelming fear and worry when you’re separated from a loved one and they’re, you know, phobias and some other kinds of anxiety.

 

00;07;54;20 – 00;08;12;05

Helen Egger

But I think what people don’t recognize is that you don’t have to suffer. Yes. And that there is help and there is such strength when parents seek out help for themselves.

 

00;08;12;05 – 00;08;33;10

Dr. Mona

Thank you so much for that, because it is. I mean, we can’t focus only on saying, okay, the child has anxiety. It’s not anything to do with me. Like, right. It obviously is a family unit, especially with mental health. I mean, you know, physical health is also something like we talk about if you’re eating something, then your child will model, but also how we cope with fears and stress is also something that our children are always looking at.

 

00;08;33;10 – 00;08;53;08

Dr. Mona

And it’s so important to always recognize that. And somehow, some way, mental health always gets put in the back burner. You know, we tend to focus more so on physical health. Okay, I need to exercise, which obviously helps with mental health with anxiety. So yes. But like you know, there’s so much focus on that. But not like, hey, I need to be in tune with myself.

 

00;08;53;14 – 00;09;23;14

Helen Egger

I so agree with you because we’re talking about anxiety, but this is also about how do we teach children to develop their emotional and social capacities in life, and how do we really enable our children to know that we really we really see them, we hear them, we really understand what they’re experiencing. That’s where the true connection can be between other, you know, adults.

 

00;09;23;14 – 00;09;33;19

Helen Egger

But it’s where there’s really that true connection, where growth and also a feeling of security comes from for kids.

 

00;09;33;21 – 00;09;35;06

Dr. Mona

And it’s such a beautiful thing.

 

00;09;35;06 – 00;10;09;16

Helen Egger

And, you know, I also want to sort of bring into this part of the discussion that families mental health challenges, whether it’s depression or anxiety or other things, are common. Many parents are going to experience their own anxiety or depression or other mental health challenges. And part of our job is to be able to get the help and have the social supports we need to be able to function as parents and in other ways.

 

00;10;09;18 – 00;10;37;26

Helen Egger

But it’s not shameful to have a mental health challenge. And I don’t think it is like, let’s say there’s a mom who really is struggling with her own anxiety, maybe has OCD or something like that. Being able to acknowledge this as a challenge that you’re experiencing and working on is one of the ways that you can break the cycle with your child, right?

 

00;10;37;29 – 00;11;26;11

Helen Egger

Because if you can say, yeah, I sometimes have these worries, and if your kid is saying, I’m sick and mommy has a doctor who’s giving her help with this, and that really opens up the idea that if your child needs help at some point, it’s okay to get help. Yeah, you know, you can get helping your family, but they’re also special feelings doctors who can help moms and dads and kids and I like to think of this not as anxiety or depression, but it’s really about how do we live as fully as possible in being able to understand ourselves and our children and those we love emotionally, and connect with them in healthy ways that

 

00;11;26;11 – 00;11;33;08

Helen Egger

help everybody in the family thrive.

 

00;11;33;10 – 00;11;54;20

Dr. Mona

And that’s your follow up. Just a small dose of the real, relatable and eye opening conversations we love to have here. If you smiled, nodded, or had an moment, go ahead and download, follow and share this episode with a friend. Let’s grow this village together for more everyday parenting wins and real talk. Hang out with us on Instagram at the PedsDocTalk podcast.

 

00;11;54;27 – 00;12;10;11

Dr. Mona

Want more? Dive into the full episode and more at PedsDoctalk.com. Because parenting is better with support. And remember, consistency is key. Humor is medicine and follow ups are everything. I’m Doctor Mona. See you next time for your next dose.