Child and Adolescent Mental Health – Podcast

child therapist
By LifeStance Health on October 1, 2020

Dwight Thompson (00:00):
Hi, welcome to Reset your Mindset by LifeStance Health. Myself, Dwight Thompson, and my cohost Nicholette Leanza we’ll bring you conversations with leading LifeStance health professionals who will help guide you on your journey to positive mental health and wellbeing. At LifeStance, we believe in the three pillars of mental health, mental flexibility, mindfulness, and resilience.
Dwight Thompson (00:32):
Welcome back everyone to another episode of Reset your Mindset. My hosts, Nicholette Leanza and myself, Dwight Thompson are really excited to be joined today by Dr. Jennifer Shoenfelt. Nikki, please do the honors of introducing and getting some more information from Dr. Shoenfelt about her
Nicholette Leanza (00:50):
Sure thing, Dwight. Dr. Shoenfelt, we’re very excited to have you on our episode today. And I know you work out of our Dublin office. So can we start by you telling us a little bit about yourself?
Dr. Jennifer Shoenfelt (01:02):
Sure. I am a child and adolescent psychiatrist. I graduated from Wright State University school of medicine. I’ve been practicing about 17 years. And I see patients in a private practice setting in Dublin. But I do have experience in multiple other kinds of practice settings, like inpatient and community mental health in various outpatient settings. And some of my passions with child and adolescent psychiatry are working with kids who have depression, anxiety, bipolar disorder. But I do have a special place in my heart for children who have autism and coexisting mental health conditions.
Nicholette Leanza (01:53):
Wow. That’s great. May I ask, have you seen an increase in clients struggling with mental health issues in your time working as a child psychiatrist, have you seen an increase in mental health issues with children?
Dr. Jennifer Shoenfelt (02:10):
Yes, I would say I really have. Obviously in the present situation of our global pandemic, we’ve definitely increased mental health issues. And for those who didn’t have mental health concerns in the past, new ones have developed. For those already diagnosed, they are worsening. Children have become depressed and anxious with the lack of social work, the quarantine with family. Trying to live in their home without the same access to teachers and help to do their schoolwork. And that’s created unprecedented stress. But however pre pandemic, there still was an increase in childhood mental health issues.
Dr. Jennifer Shoenfelt (02:56):
I personally believe this stems from and academic pressure and decreased strength and focus on the family unit. This topic pretty much needs its own podcast, honestly.
Nicholette Leanza (03:09):
Oh, right. Right.
Dr. Jennifer Shoenfelt (03:11):
But briefly we have become a really busy society. Children and parents are constantly running around and doing things. Everyone is going a different direction. Not only is this overwhelming and exhausting for children, but it does not allow them enough downtime to relax or just play outside. It doesn’t allow time for parents and kids to talk to one another and bond. I feel like school has become a huge stressor. Students are being told they have to work harder, take more classes, get all A’s or else they’ll never get into college or have a productive life.
Dr. Jennifer Shoenfelt (03:53):
And competition is really very fierce in our society. Teenagers are staying up until the wee hours of the morning doing homework and going to school absolutely exhausted every day. And lastly, I think screens and video games pull many children into imaginary worlds. Some of which are filled with violence. And hours of time playing games eats up time that could be spent in much healthier activities. It impairs face-to-face communication skills. Creates tension in a child. It erodes the precious focus that’s needed for schoolwork. So many children become irritable from playing video games. And this ends up getting looked at as a mental illness also.
Dwight Thompson (04:47):
Yeah. Well, if there was any question as to why we thought you’d be perfect for this episode, you’ve answered it with all of that information. You really do. One thing that’s special sort of about our practice is that we have providers that focus on different populations in different mental health disorders. And you sort of encompass that with your work with child and adolescent patients and especially kids that have been diagnosed with autism. You touched on a lot, but one thing that you mentioned was us kind of becoming a really busy society. And in a busy society, a lot of the folks that are so busy are parents of these kids that have been struggling with managing their child and also managing their child’s mental health. Why is it important for parents to be mindful of not only their child’s health and wellbeing overall, but specifically their mental health?
Dr. Jennifer Shoenfelt (05:47):
Yeah, that’s a great question Dwight. A child’s mental health is really just as critical as their physical health. And I think that gets lost in the shuffle a lot. Many parents don’t realize or acknowledge this. And many children are great at hiding their feelings so that family and friends are unaware of how they feel. And you wonder, why would they do that? But most kids are afraid of disrupting their parents’ happiness or making them overly concerned when they’re not feeling well. So for most children and adults, ones mental health is really kind of the foundation for their physical health in my opinion. Without both mental and physical wellbeing, no one can really truly say they’re actually well. And if you have an interest in spiritual health, this also plays an integral part in overall wellbeing. But it’s important for parents to stay connected as much as possible with their children. So they can notice a change in their child’s mental health early in the course of a disease.
Dwight Thompson (07:01):
Nicholette Leanza (07:09):
So Dr. Shoenfelt, how can parents tell if maybe their child or their teen are struggling with mental health issues? Are there some signs they should be looking for?
Dr. Jennifer Shoenfelt (07:20):
Yeah, most definitely. First of all, I do want to qualify this with saying that sometimes it’s really hard to see the initial signs of a mental health condition until they become actually a change from the child’s baseline. So first and foremost, if you see a child’s mood change, there should be some cause for concern. If they’re not their usual self, whatever that may be, you want to start thinking twice about what’s going on. Like I said, though, many children are adept at hiding their feelings and a majority of patients who have depression can go unnoticed for quite some time. So well you want to be looking for children who are isolating themselves more than usual, becoming irritable or overly quiet.
Dr. Jennifer Shoenfelt (08:20):
If you notice your children’s schoolwork is kind of slipping or their hygiene is leaving something to be desired, they may be depressed. Noticeable changes in behavior like sleeping or eating are also red flags. Decreased interest in activities they would normally enjoy. Decreased motivation. And of course at the extreme end of the spectrum would be self-harming behaviors or suicidal thinking or actions. Lots of times in younger kids, the first thing you might see is them making comments that are sort of self-deprecating, I’m just stupid, I’m ugly. You don’t love me. People don’t like me. I shouldn’t be around. Things like that. Sometimes parents just kind of pass that off. It’s distressing to them, but they do kind of let it go. And we don’t want to do that.
Dwight Thompson (09:23):
Yeah. I mean, and it also seems to… I mean, this is really helpful because parents, a lot of times don’t know exactly what to look for. And then once they do see some of these things that you are referring to as sort of red flags, it’s sort of the alarming response of that worries me, but I genuinely don’t even know where to start to address it. So where do you start to address it?
Dr. Jennifer Shoenfelt (09:48):
Well, I think there’s a couple places. I mean, your pediatrician would be probably the number one person to go to at that point in time to talk to them. But you might also consider talking to the child’s school counselor, to their teachers. Oftentimes, kids friends will reach out to the child’s parent and say, hey, Susie said something to me the other day and it kind of upset me, or I was really kind of worried about her or something to that effect. But I feel like going to your pediatrician or your family practice doctor is the place to start. And then also maybe bringing in the school counselor,
Dwight Thompson (10:35):
Dr. Jennifer Shoenfelt (10:36):
Dwight Thompson (10:37):
Yeah. And so what can… So that’s sort of, bringing in a third party to assist with it at home and sort of in the family unit. What can be done on the parent’s behalf to kind of support the kid that might be struggling?
Dr. Jennifer Shoenfelt (10:55):
Well, I think for sure, the biggest thing you need to do is try to open the lines of communication. But that’s also the most difficult thing to do because oftentimes kids just really don’t want to talk to their parents about this stuff.
Dwight Thompson (11:09):
Dr. Jennifer Shoenfelt (11:11):
But I think if you just sort of increase your face time with the child, make yourself more present, be there for them. Sit down and have a snack with them and start up a conversation. Or take them on an errand with you in the car and just listen to what they’re saying. And show them that you’re available and that you’re concerned.
Dwight Thompson (11:38):
And why is that important? Why is it important to have that face time?
Dr. Jennifer Shoenfelt (11:42):
Well, I think it’s hugely important because right now I don’t think kids have face time a lot with their parents.
Nicholette Leanza (11:48):
Right. I agree. I agree.
Dr. Jennifer Shoenfelt (11:51):
I mean, everybody’s running different directions. It’s like, there’s this huge hamster wheel that everybody’s stuck in.
Nicholette Leanza (12:01):
You know what I find, I find that the parents, I know you were speaking earlier about kids and the screen time they have. I’m finding parents, same thing. Maybe, at the end of their workday, they’re just going on their phone and just scrolling and just kind of like, that’s their thing to decompress. And so they’re just maybe scrolling through Facebook or whatever. And that could be time of… Just I love that you said being available to your child. Because I think that is so important. So if the parents just kind of sitting there scrolling through and there may be getting mad at the kid that they’re just on their social media. Well, it’s role modeling it too, of making that time for one another. Show your available to your child as well so. It’s really important.
Dr. Jennifer Shoenfelt (12:40):
Yeah. The role modeling is an excellent point. Yeah. Do what you want your kids to do.
Nicholette Leanza (12:47):
Exactly. Exactly for sure.
Dwight Thompson (12:56):
So, so far, kind of talking about what can be done to support the kid from a family unit, from all the different perspectives. And Honestly, more of the adults in the child’s life. What can, if there’s a kid listening to this that wants to know what can be done on an individual basis, what would you recommend to someone to be doing, have some self initiative to kind of cope with some of this?
Dr. Jennifer Shoenfelt (13:18):
Yeah. Well, my number one prescription is actually sleep.
Nicholette Leanza (13:28):
Oh yes.
Dwight Thompson (13:29):
Nicholette Leanza (13:30):
Like that you said that.
Dr. Jennifer Shoenfelt (13:30):
Yeah. That’s the number one prescription I give patients is, I stay on top of their sleep because sleep, if you do not have sleep, you are not going to feel good.
Dwight Thompson (13:42):
That’s exactly right.
Dr. Jennifer Shoenfelt (13:42):
Whether it’s physical or mental. And that is something that kids now have a horrible time getting onto a good sleep schedule that they can maintain so.
Dwight Thompson (13:55):
Adults too. Adults too.
Dr. Jennifer Shoenfelt (13:55):
Oh yeah.
Nicholette Leanza (13:55):
Dr. Jennifer Shoenfelt (13:56):
You’re right. Definitely. So I tell kids and parents, you have to have good sleep. And right alongside that, my second most prescribed intervention is nutrition. You would be so surprised at the kids, when you change their nutrition and you just feed them healthier foods, you just take out junk food and things like that, that are not good for them. And you put them on sort of a schedule of eating when their body can expect food. I’ve had parents be absolutely flabbergasted at how their child’s mood changes once they have sleep and good nutrition. So those are my two big things to manage,
Dwight Thompson (14:48):
That is insightful.
Dr. Jennifer Shoenfelt (14:50):
Stress and anxiety. But the next big thing would be to allow kids to have some break time, some free time, just-
Nicholette Leanza (15:01):
Oh gosh. Yeah.
Dr. Jennifer Shoenfelt (15:04):
Even if you have to schedule it. I do tell parents to limit the child’s screen time to about two hours a day at maximum. I certainly don’t prescribe taking your cell phone to bed with you. But anything they could do also to stay physical, go on walks, do some chores.
Nicholette Leanza (15:28):
Dr. Jennifer Shoenfelt (15:30):
I think physical and then mental calming like meditation or yoga or something. But I do want to put in a plug for one thing,
Dwight Thompson (15:41):
Yeah, please do.
Dr. Jennifer Shoenfelt (15:42):
That really, really is a major player in kids mental health and family dynamics. And that is eating together in the evening. Having dinner together.
Dwight Thompson (15:54):
Very uncommon.
Nicholette Leanza (15:54):
Dr. Jennifer Shoenfelt (15:56):
It’s very uncommon. You’re absolutely right. But it is so, so critical. I mean, we have actual research backing this up. That the kids are healthier. They do better in school. The family dynamics are better. Everybody’s happier. I know most families now can’t do it every single night. But if you can do it a few nights a week where you can all sit down together, everybody sees each other, gets to talk, gets to enjoy a meal together. I mean, maybe you even prepare and clean up the meal together.
Nicholette Leanza (16:33):
I agree. Those are all great points Dr. Shoenfelt. Really important stuff.
Dwight Thompson (16:38):
I mean, we could do a whole podcast simply on sleep hygiene.
Nicholette Leanza (16:40):
Oh god yeah.
Dr. Jennifer Shoenfelt (16:41):
Oh absolutely.
Dwight Thompson (16:43):
We might have to have you back for that because that is something. And I think a lot of adults are it’s honestly kind of nuanced to some of the people raising kids right now, because sleep hygiene is something that just recently and still very minutely, has been stressed. Yeah. So we appreciate that information.
Nicholette Leanza (17:05):
My gosh, Dr. Shoenfelt, you are a wealth of knowledge. Thank you for sharing all these important tips for parents, for children. And I think my biggest takeaway is going back to the roots as a family coming together. Parents making themselves available to their children. Sitting down together for meals. Getting outside, exercising. Taking time away from screens. I think those are all so integral to mental health in kids. And I think another thing you really emphasized was, mental health is just as important as physical health. And I think we definitely are moving more towards recognizing that with our children as well. So I appreciate you sharing all of those tips with us. What about you Dwight? Anything that really stood out for you?
Dwight Thompson (17:50):
Several things. Honestly, the biggest thing for me was Dr. Shoenfelt, your specific prescriptions as you referred to it. Right now, I think we’ll extend an invite for you to come back and do an episode with us on sleep hygiene, because I just think that is so important. I think that we could talk a lot more about that. And just kind of like family dynamics in general. So I hope you will be willing to come back and join us because we really appreciated your insight.
Dr. Jennifer Shoenfelt (18:17):
Well, thanks very much to both of you. I’ve really enjoyed doing this. And I’m very passionate about child and adolescent psychiatry. And I just want to get things out to people, information that’s easy and implementable. And I would love to come back and talk some more.
Dwight Thompson (18:37):
Nicholette Leanza (18:38):
Great. Thank you.
Dr. Jennifer Shoenfelt (18:40):
You’re welcome.
Dwight Thompson (18:41):
We will make that happen. Dr. Shoenfelt, Thanks again.
Dr. Jennifer Shoenfelt (18:42):
Yep, my pleasure. Thank you.