Welcome back to ADHD, Autism and Chronic Disease Parenting Summit. I am here with the phenomenal doctor Jihan, who is a pediatrician in Oklahoma City.

Thank you so much for joining us and chatting with us about anxiety today. Thank you so much for having me. It's a real honor. And, it's a very important topic.

You know, stress is probably, I would say, at an all time high or it's certainly up there. People are more anxious than ever. And I guess I just wanted to start with maybe talk about the landscape a little bit with anxiety, what you're seeing and what we're seeing in the community and out there in society these days in terms of anxiety, because I feel like it's really, you know, anxiety disorders, a lot more diagnosis.

And it's ever been before. I feel like. Definitely, definitely I, I feel like post Covid, everything changed and there's so many different factors that played into that.

But one of the things was, you know, we were indoors, you know, for the majority time. We we are seeing a lot more like vitamin D deficiency because we were inside.

Also that socialization, which helps many of us thrive. We we lack that. But one of the biggest things was just that fear and uncertainty, which cause more stress and also anxiety became a result of that.

So in the pediatric population, we typically say about 8% of children. But when we start to see this new data, because, you know, research always lags, I'm sure it's going to be much higher than that.

And for some children, it's not a true diagnosis of like an anxiety disorder, but just that consistent worry or anxiousness or fear, which we're definitely seeing in much larger numbers as well.

Yeah I mean I've seen an 8% number as well. And you know, even if that is the true number that's still way too high. I mean 1 in 10 kids almost and it's probably way underreported.

And just like you said, everything in medicine is very slow to change or catch up. So it's probably I would guess it's even higher, like maybe 15%, 1,015%.

And then it's probably a lot higher if you take into account people that wouldn't have anxiety disorder clinically diagnosed. But, you know, kind of on the borderline, I would bet.

Right. And then the reality is, is that a lot of clinicians do not test or screen for it. So if you just come from a well-child check and you have an eight year old and you haven't noticed anything, then you may not bring it up.

I make sure that I screen every child at well-child checks for mental health disorders so that we can bring it to the parents attention so that we can, you know, help those children live their live their best lives.

So many children are so anxious and their parents have no idea. And then once we open up that conversation, the parents are like, I had no idea you felt this way.

They're like, yeah, mom, I don't sleep. Yeah, mom, I don't do this. You know, all of these different things or I hate going out in public. That's why you see me, you know, go to the, you know, to this area or this corner or.

That's why I'm always sick or I get a headache in those types of things. But the parents just think, oh, you know, he's sick again. Probably got that stomach bug.

But the reality is it's it's more anxiety than that. I agree, and I bet you it's also that a lot of people, it's just their normal state. They stay so they don't even call it anxiety.

It's just like this is how things are. I guess. And and parents who have anxiety are more likely to have a child with anxiety. And they really don't know to say because they've lived their whole lives in this state.

And so they're just like, they're just like me. But but as we know, living in a state of chronic stress, anxiety, worry is, you know, detrimental to your body over time.

And so I know people say, well, that's how I've always lived. But I'm like, well, you're still young. You know, we want to see, you know, make sure that your child doesn't develop, you know, high blood pressure and, you know, other chronic illnesses in the future.

And so that's why it's so important as pediatricians, that we are stepping in and screening and educating parents so that we can help prevent disease.

So it's very, very important. I couldn't agree more. And that's one of the biggest, you know, reasons why I want to do this, this, you know, summit and also write the book that I wrote.

It is really prevention, right? Because medicine is so focused on treatment these days. And it's great. I mean, we need to treat diseases. That's important part of where we come with medicine.

But but there's this whole other side of chronic disease. And we're really not that great at prevention. We didn't train a lot in any of that. And the problems that we had 100 years ago when they were creating modern medicine are not the same that we have now.

So it's very different issues. And, you know, even with anxiety and there was stress, there was always stress, but not the same kinds of stresses that we had today.

So what would you say are some of the big, big causes of anxiety? So I see a lot of children, it's decreased socialization. And so when they're put in these situations, then they're developing the anxiety because they haven't actually been exposed.

Other aspects are unfortunately social media. It causes you to be quite anxious, especially as a child. If you're on TikTok and or Instagram and, you know, of course, as adults were on these things.

But as a child, if you're constantly going through these rules and you have these unrealistic expectations of your life or how you look or what you should be able to do, it actually causes more anxiety.

And we have studies to prove this. And so I, I see that the social media has just made it so much worse. And so I have patients who, you know, may stay at home all day, you know, and then all they're doing is looking at social media and they have no social interaction.

So that's one of the big things that I'm seeing. Our food and what we eat is a huge plays a huge role. There are actual certain foods that are worse for people who have are more prone to anxiety or foods that can actually trigger it.

And so, for example, most people know caffeine can trigger a little bit of anxiety, right? But we're putting it in all types of foods and drinks and even things that children will consume.

And people forget things like sweet tea has caffeine in it, you know. So it's it's like we're seeing even what people are eating is triggering more anxiety.

And then also a lack of certain foods in our diets are causing it to stay even more ramped up. Why it's so important for us to pay attention to that I, I, I have all these books that I love to share with parents about, you know, eating for your anxious child or yourself.

Right? If you have anxiety and have those foods will help you to subside some of that anxiousness. But also, I mean, just helps with digestion anyhow, right?

But we see so many illnesses associated with anxiety like irritable bowel syndrome or things like that. And it's like, well, how much of that is our digestive system?

And we actually we're able to intervene there. We would actually lessen anxiety. And I personally my personal story was during Covid, my anxiety was horrible because I was a private practice owner, got no instructions of how to run my office, but couldn't close my office because children actually needed to be seen, right.

And I didn't want them in the air getting Covid. So I had to figure out the whole set up. Everything that I needed to do so was very stressful. But then also, how do I not get myself and my staff sick and my children in my family?

So it's very stressful time and I had never had anxiety and then kind of coming out of it, it wasn't going away. And then I didn't want to take trips, I didn't want to fly.

I with my stomach and other things. And it wasn't getting better. And then finally I started to researching more, right? And realized I was eating all this junk food and things that I didn't.

Highly processed foods, right? Because I was stress eating. And then as I realized, as I decreased those and I also did some gut tests and things like that and, and was able to heal my gut, I don't now have that problem.

And so for me, I'm very passionate about it because yes. Do I sometimes have to use medications in children? I do, but the reality is, is that I'm able to see so much improvement, which is very minimal steps.

Of course it takes effort, but it's just powerful to see. And we do have data and studies showing, you know, when you use medications for anxiety versus placebo, you see a slight increase, but it's not the same as with, you know, other studies that they've done for other mental health disorders with anxiety.

Many people will get better on their own. I agree. And it's interesting also you know especially with with diet we don't talk about but also exercise too.

I mean there's so much research on the both of those and I think that people just don't make that connection between the gut and the brain, and exercise and the brain and.

Yeah, I mean, and any integrative practitioner at all knows that the research now where it's like, hey, you know, the exercise gets you better results than a lot of the medications doesn't mean the medications don't help in certain situations.

But we have to be mindful of these things. We have to take note of it. And we have to realize that just the basic foundations are such a huge part of what we're lacking, and that will get you a long way.

And some people will need a medication. Some people, it's very severe. But but many, many, many people can work towards being in a better place with their mental state by just some of these simple things over the long run.

So I, I love hearing that. Yeah, that's the thing that we lost in Covid as well was the sports. And the activities. I, I. Agree that physical activity and so that thank you for, you know, just bringing that up because that's huge.

And that's one of my prescriptions for my patients is you have to move, have to increase all of those good neurotransmitters in your brain for with nothing else.

Right. Just a movement and exercise. And it's just it's wonderful and powerful to see how the body, when you give it what it needs, then it responds how it should.

Definitely. And then outside of food and exercise, what are some of your other big go tos, whether you know, talking about therapy or stress reductions and then you know, and then supplements and other herbs and things like that after.

Yes. So I am a big advocate of cognitive behavioral therapy. We have tons of research showing that it's very effective in children and adults. And unfortunately, it's hard sometimes to find a therapist that do it.

But there are resources like one for younger children. It's called coping cat. It's actually a CBT workbook that they can work through with maybe a regular therapist or even sometimes a parent.

And I find that when I have parents work with the children, sometimes they realize, you know what? I also had a little bit of that issue, and now I'm kind of working through that.

But I love presenting to my families something called stair steps to Bravery and just helping them look at, you know, what are our future goals and what is each step and how many days do we send in each thing to help us get over this fear?

And I have found that that is very effective and it's also a visual. So you actually see your progress along the way, which is very rewarding. For those children, there are other types of therapies that can be done for, especially for younger kids, like play therapies and things like that.

But in my, my practice, most of the children are a little bit older. And so we're focusing on the cognitive behavioral therapy. I also really love mindfulness exercises.

There are so many apps out there now, that you can just listen to it. I know Stanford recently released a, one online and they can actually it's called Imagine Action and they can listen to it even before a procedure.

Or if you have a child with chronic illness and they often have to go into the hospital and they can actually listen to it before they're poked or before they have to do something scary.

And it's they also have it for teenagers. And so I really like that because they can hear an older voice in. Sometimes we only focus on the younger children, but now they can hear an older voice similar to theirs.

And so when they walk in that room, they're not as fearful because I have plenty of teens or a fearful of a blood draw. Definitely. So I really like that one.

But the mindfulness exercises are so huge, and if children actually practice them every day and they're prepared when they actually encounter the scary thing.

And so for my younger patients, I'm just teaching it to them. And they're and they're listening and they're understanding mindfulness and they're getting it.

And the other thing is course is breathing exercises, you know, deep breathing. Box breathing. We do butterfly breathing. Those those humming sounds that really help to, you know, stabilize our vagus nerve, you know, which can help control that lighter, fight or flight and anxiety and all these different things.

And so I love teaching, especially the younger kids, breathing exercises, sometimes with the older teens, like, nobody's going to sit here and, you know, I'm going to be breathing.

They're going to notice and things like that. So as you will have them step into a corner or step into a space or just just breathe, making sure you're counting, but you don't have to make a big deal out of it.

But it's so important because so many of us hold our breath and make ourselves more anxious, especially children, during test taking. And so that's one of the big things and reminding them to breathe.

So those are a few of my approaches that have nothing to do with taking anything by mouth, that are, you know, definitely important. And of course, that was combined with the exercising regularly and getting time outside.

Yeah. Which is fresh air is huge. So that's the exact list that I give to my patients as well. It's always great to hear, you know, echoing back and forth.

And one thing that I did want to add to the therapy, the, discussion that that you mentioned that I find helpful for parents is I feel like, you know, the stigma is decreasing in terms of therapy, but it's still there.

And I think people get their impression of therapy from watching TV and like, sitting on a couch and talking with a therapist. And I always just try to remind parents, it's like, it's not really like that for kids especially, you know, and especially when you're going in with, with your, you know, for anxiety for kids, a lot of it is just talking strategies.

I mean, there is some kind of behavioral therapy, but certainly a lot of it is just talking through the stuff like you just mentioned, like a lot of therapists now work with mindfulness and breathing and teaching you, you know, if you're starting to have these thoughts, well, maybe these are some things that you could do or helping kids to understand while you're having these thoughts. But do you need to be this worried?

What what are you feeling and kind of connecting their body with their mind and making them even just be more present and aware, and you can call it mindfulness or whatever you want to call it.

But I think that's a lot of what they're what they're doing is just bringing them back to, you know, what are you worried about? Why are you worried about playing it out?

And that sometimes helps families, you know, a lot. So I think that and definitely and I where I live there is a shortage of therapy, any type of therapy.

And so that's why I personally went and got some additional training because I was like, I have to implement something in the in this room. And so I find that it's it's so helpful and so, so important.

But I also love I'm not sure if you're familiar with the Eli Lebowitz, book. It's, breaking free of, of child anxiety and OCD, and it actually has like a workbook with it, but it's for the parents to better understand what anxiety is, how their accommodations can also impact the child, and you know, how they can break some of those bad habits that may be worsening the anxiety due to their accommodations.

So that's another thing that's very important is, making sure that parents are involved with this treatment as well. And love it. And then we're mentioning alluding to some oral stuff.

So what are some of the things that like supplements, herbs, anything that you, you like? To use in general, for obviously every patient is different, every situation is different.

But some of the things that that seem to work for you. Every child is very different. But, in terms of some of the things like we have, you know, research, discussing like magnesium, it's great for sleep.

It's also great for anxiety. It also has some, you know, help with ADHD and things like that as well. And so I often will recommend, you know, different different types of magnesium depending on what the other issues are going on with children.

There's a lot of, you know, discussion about ashwagandha, right? And some certain ages and using it, I do take, you know, I'm often cautious with just using, you know, multiple things.

But I do take care if someone's already on a medication about, you know, what things we're adding as well as one because one of those, it can have a slight, interaction with SSRI.

So of course be careful in any time. You know, obviously we're saying what we might use, but you have to make sure you're under the care of someone who understands your child.

All of their, you know, ailments and things like that, sensitivities. And then they can make those best options. So let's see. Magnesium, I do like five HTP.

In children, it is, it it's a amino acid and it bypasses and you just go straight to the area where we increase serotonin. Right. And we know that low serotonin can add up, cause anxiety.

And more recently, I'm not going to go into it in detail, but looking at things like inositol, and I really like Trudy Scott's book where she goes over several of the amino acids and things that can be used to help with anxiety.

And so, those are some of my go to, initially. And, yeah, try to see what a flat. Forget it. Oh, that's a good list, I like it. I mean, those are the things that I use along with maybe like essential oils, lavender, things like that.

But and so those. Yeah. So by mouth I by mouth. And then we do a, I love aromatherapy and and so or especially the sprays, the lavender sprays. And then for some of my patients I have them where the necklaces especially during testing.

And then we, we will sniff certain mixtures and things like that. And then what about parents. So how do you feel is, you know, what is their role in this?

Because I think like most things, it's kind of practice what you preach. And parents are also stressed and anxious as well. So do you find that it's really helpful to have a group conversation and everyone can kind of work together?

What do you what do you how do you think that plays in? I mean, definitely whenever we can have the parents on board, it's going to make things easier.

And then that also lets the child see like they can see that example. They can also see the parent getting better. Right? If the parent has anxiety, or they can just see that it's normally that these things that we're asking you to do are things that we all should do honestly.

And so if the parents can be on board and go for that outside, walk with the child, if the parent can exercise with the child or encourage it, but also the parents have to realize that their own anxiety plays such a huge role in a child with anxiety.

And so if you are willing to get your own treatment, you both will start to improve at the same time. And so I have some parents who started therapy and their child starting therapy.

And there's, you know, they're swapping techniques and things. And then and it's been very beautiful to see when the child is like, well, mom, you're afraid to x, y, z and you should use this coping skill or you should do this.

And I'm like, wow, this is amazing. You know? And they're both they're all getting better at the same time. And so as, as a mother, I actually have a child who has like some worry and things like that.

Like I have to completely change my thought process instead of saying, you need to just get over it, right. That's not how these kids are built nowadays.

They're not getting over like this kid internalize things and they just keep it. And you're like, what? When I was your age, I just got over it. But that's not how they're built.

And so as parents, we just have to re focus and say, okay, let me address the situation. Let me actually acknowledge your fear and your worry. So I'm acknowledging it.

But then I'm going to help you figure out ways around it. Right. So we have to make sure that we're not that parent who says, well, they don't like going to x, y, z.

So we don't go. That's not the answer. Right. It's I acknowledge that going to eat sushi makes you fearful because you don't like the smell of fish. However I love sushi.

So we will look at the menu and see what else you can order. Or maybe we can get you some plugs. I love it, but I tell I couldn't agree more and I think that's very, very actionable and practical and, you know, kind of working with, with kids and being mindful of where they are today.

And it's a little bit different than, than when we were growing up. So I really, you know, I appreciate everything that you have said and all the actual tips that that you've given.

And maybe we can just finish off by telling people, you know, where they can find you, and use your social media and all those things. Yes. So, my website is doctor g.com.

And then I also on Instagram, Doctor Jihan oh eight and also on Facebook as Doctor Jihan. And, you know, feel free through my website if you have, you know, what to sign up or have questions or things like that, or work with me at any time, I will be doing some other things later.

So just stay tuned. And I think it's really important that we are able to start preventing and helping children who have anxiety so we can really make a difference in the lives of children.

I agree and I thank you for all of the the difference that you're making and how you're helping kids with their their health and discussing this and bringing in the kind of integrative approach to anxiety and help, which I think is super important.

And really the way that we can move forward and help things get to a better place. So I really appreciate you being here, and thank you for everybody for listening.

And we'll we'll see you in the next episode. Thank you very much for having me.

Jihan Abdul-Haqq

From Panic To Freedom: Empowering Your Child To Overcome Anxiety