Dr. Liz - What the Health

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Host: Okay? There's no easy way to say this. America's children and adolescents, even many young adults who are heading off to college, are dealing with a mental health crisis. There are, in fact, millions of these young people between the ages of three and 17 who suffer from anxiety.

Depression and behavioral problems. The Centers for Disease Control and Prevention report that almost 10% of children and adolescents suffer from anxiety and behavioral issues [00:01:00] while almost 5% deal with chronic depression. Not surprisingly, these conditions feed into each other. For example, three outta forward depression are also extremely likely to suffer from anxiety, and about half of these people also have behavioral issues.

Many of these mental health issues only get worse with age affecting a higher percentage of adolescents as they climb into their late teens and early twenties. The impact of depression on these aging adolescents also seems to connect to higher rates of drug and alcohol abuse. Perhaps worst of all is that the combined impact of the growing mental health crisis is a dramatic rise in suicidal thoughts and actions among the young, as we've reported on in WellWell usa.

The University of California noted that suicidal thoughts among children in adolescents jumped by 50% between 2016 [00:02:00] and 2021. Related emergency room visits and hospital stays jumped by almost 60% during this time. Other reports indicate that close to 10% of people between 15 and 24 have attempted suicide at least once.

Dr. Candace Odgers, a psychologist with the University of California, recently brought this crisis into focus when she told the New York Times. Young people are more educated, less likely to get pregnant, use drugs, less likely to die of accident or injury. By many markers. Kids are doing fantastic. They're thriving.

But there are these important trends in anxiety, depression, and suicide that stop us in our tracks. Dr. Augers got it right. The rising trend of mental health issues and its drastic ramifications should stop us [00:03:00] all cold. It not only has serious consequences for those suffering from mental health issues, but it also affects parents, caregivers, families, schools, and communities at large.

There are a lot of reasons fueling this growing crisis. Too many to really deal with adequately. In this loan episode of What The Health, however, we're going to shortly explore how the pandemic helped exacerbate the crisis with a renowned child psychologist who specializes in the field. This may surprise some because the US government and the World Health Organization have both just declared an end to the national and International Pandemic emergencies.

And they're undoubtedly right, but the pandemic's lingering impact on the mental health wellbeing of America's children and adolescents is still being felt and it is likely to continue [00:04:00] causing mental health issues for the foreseeable future.

Welcome! Today we're going to be talking to Dr. Liz Nissim-Matheis, who among other things, is a licensed clinical psychologist, certified school psychologist.

She's worked in public schools for many years on child study teams as well as coordinating child study teams. And she also has a private practice where she works with students young children and adolescents and their parents on really how to deal with various issues development and mental health issues. We're gonna deal with what we see as the level of problems. Why are they growing, and maybe how we can deal with them. So, Dr. Liz, welcome to our What the Health Podcast.

Guest: Thank you so much for having me today.

Host: Did I describe your background correctly and your private practice efforts. If not, please clarify them before we start. Cause I wanna make sure everybody knows exactly [00:05:00] how adept you are at these issues.

Guest: Oh, that's awesome. Yes. So a little backstory. I started this private practice full-time once I left the school system after having my third child, and I started in my di. Room and I had seen, I had seen patients here for years, about five. And as my three kids were getting older and requiring more and more of my time, I decided that I needed to make a change.

And so I was either gonna shut down the practice or I was gonna bring on someone to take my evening work. And you know, I guess the timing was right and it was meant to be. So I found a therapist who came and took all the evening. Therapists. And, you know, slowly over time I've had additional therapists join me.

And so now I have a team of six therapists and I'm working out of my office in Livingston, New Jersey. This year marks my 11th year doing private practice work full-time. I love [00:06:00] that we're able to reach children, adolescents, young adults, adults with special needs, working with their families focusing on adhd, anxiety learning disabilities autism and behavioral challenges. So we cover a big gamut and each of the therapists on my team has their area of specialty, their age of specialty.

So we're a really well versed team and we can handle a lot, which is nice.

Host: Okay. That, that sounds great. And the name of your practice is Psychological and Educational Consulting, correct?

Guest: Correct.

Host: All right. Well, and we'll give everybody some contact information a little bit later, and we'll also have it on our site so you can reach out to Dr. Liz afterwards with any questions or concerns or insights you might have. Mental health issues and problems for children, adolescents, young adults. Is there a way to get a handle on how wide the issue is or challenge is when we take that description and [00:07:00] is it, even fair to use a description like that?

Guest: I think in the history of this practice and the history of my working in private schools and public schools, a lot of these areas, anxiety, adhd, autism, learning disabilities, behavioral disabilities have always been. There. Right. I think what has happened is through the pandemic, a lot of these situations and experiences became highly, highly exacerbated.

And so right now, for the last three years are the most prominent thing we see is anxiety and learning disabilities that have gone undetected. Learning struggles as children are getting older, which then results in maybe some behavioral struggles and anxiety and depression. You know, a lot of families change their dynamic, whether they somebody lost a job they had to move, family had to move in divorce separation, all of that [00:08:00] co-parenting.

So a lot of dynamics have changed. In our homes, and as a result of the pandemic, our kids have lost a lot of time learning, socializing. They've lost a lot of milestones in their development, and I think that's what's been contributing to what we've been seeing so predominantly.

Host: Is it fair to use the term mental health issues or should we be defining this in some other way, or, or does it not matter?

Guest: I think the term mental health is now more widely used and more widely accepted. Like I'll hear my own children saying, I need a mental health day. I think that the concept and the term of mental health has been used again and again and again, and it's becoming a little bit more commonplace and a little bit more accepted.

Whereas before, I feel like maybe there was a little bit of a stigma. Now I'm in the field every day, so I'm the biggest proponent of it all and I wanna talk about it all the time. So to me there is no [00:09:00] stigma. But I understand that there, you know, the truth, the truth in the reality is, yes, there has been a stigma, but I think there's more awareness now.

And, you know, children, adolescents, young adults are, are using that language on a regular basis, which is nice.

Host: So you mentioned of course, the impact of the pandemic and what that did to structure, whether that's academic structure, schools, social familial, structural, that sort of thing, and this heightened problems. Are there other reasons why we see we are able to be more comfortable dealing with mental health issues or we're more aware of them.

Was there a growing problem before this, before the pandemic and that certainly impacted education or is it a matter that we're just more aware of these problems? So maybe the level was the same. We're just recognizing and willing to deal with these more openly, these problems.

And again, I recognize that there's a wide range of issues that come under [00:10:00] this umbrella.

Guest: From my experience, there was a great deal of steadiness in what we were seeing in the practice up until the pandemic. And then things kind of blew up and changed course a little bit. Like I said, there was you know, a lot of child study teams in schools were shut down and were virtual.

So children who had learning struggles, Couldn't really be evaluated and school was done very differently. Not, and then there's absolutely zero blame or anything like that being placed on anyone because we didn't know what we were doing. We were doing the best we can. We don't have a protocol for how to function in a pandemic when there has to be a shutdown.

So I think every school and every family did the best that they could. However, we didn't know what we were doing. You know, school was different, school looked different. Virtual school was different kids. We're not engaged, kids were not attending class. And I, I know that for a lot of students I [00:11:00] was contacting schools and working with parents on, you know, finding ways to help our children to stay engaged in the learning process.

But having your face on a screen when you don't usually see your face on a screen, especially for an adolescent who's already very self-conscious about what they look like. Just it. I took a bad situation, you know, in terms of the, the developmental phase and made it really difficult. So a lot of kids didn't go to class, a lot of kids didn't listen.

The level of instruction was different. The, the demands and the expectations were different in schools. Again, everybody did the absolute best that they could, but sadly, we missed a lot of education. We missed a lot of socialization, and it's having an impact.

Host: How do you see it specifically manifesting itself or has manifested itself? Is it anxiety? Are there some issues that are more prevalent than others, I guess, and we're talking about relating to the impact of the pandemic.

Guest: So a lot more [00:12:00] anxiety and a lot more depression. Kids social skills, declined and social cliques and groups changed depending on how the child who went to school versus the child who remained virtual. The child who, you know, and there was a lot of, and again, no judgment, everybody wanted to do this differently based on the information they had and how it impacted them and their family.

So some families were okay with their children socializing either in their home or outside of their home, and some parents were not. So it created a lot of isolation. Friendship groups changed, you know, a lot of milestones that would have been hit during those times weren't. And so, you know, I saw a lot of students who said, you know, I'm graduating high school and I, I don't have any friends.

And I encourage 'em to find other groups of friends. But what had happened is if people, the kids who went to school and the kids who maintained contact continued in their interactions and in their friendships and those who stayed home or stayed home primarily stayed [00:13:00] home, kind of came out of the loop.

And with teens, if you're not there, then you, you know, You don't get invited if you're not there. During those spontaneous times, plans aren't being made where you're getting included. And again, there was such a wide gamut of comfort with socializing inside the home, outside the home, with masks, without masks, you know, with social distancing or not.

And all of that had an impact on our kids. And let's not forget how quickly everything happened and how the whole world shut down. We'd never experienced that before. And a lot of kids became a agoraphobic, a lot of became germophobic. And we're still working on helping them to work through that because it was sudden, it was quick.

We'd never experienced it before, and our kids were scared.

Host: Just recently, the last week of April the World Health Organization and uh, the US government. [00:14:00] Downgraded the pandemic.

So now we're in a quote unquote post pandemic environment. Do these challenges go away naturally? How do we deal with them? What are the next steps with sort of the lingering impact of the pandemic on mental health issues for these young people?

Guest: I think we need to acknowledge it and treat it and work with it. It's not going to go away on its own. I think there, there was a, that was a a whole world that went into a panic mode and literally shut down. It's a big deal because it wasn't like, oh, we just did that here in this neighborhood or this community.

It was everywhere. And it was scary. And I think for a lot of our kids, they're thinking, well, how do we know there isn't gonna be another shutdown? How do we know that there isn't gonna be another virus that's gonna come around? And there's a lot of the, you know, if you have a child who was already anxious, this just took that anxiety and,

really magnified it, but I think it's really addressing whatever [00:15:00] our children are struggling with and helping them to build coping resources and to understand what's in their control and what's not in their control. Because for all of us, you know, how many of us. Really thrived on making plans and going out and planning parties and gatherings and making vacation plans.

And when you think about that, we couldn't do that for a very long time. So it was like, what are we looking forward to? And it was the same thing over and over again.

Host: Mm-hmm.

Guest: were just doing the same thing over and over again, trying to find any sense of normalcy. And then when it, you know, when it, it did change, we were all wanting to go back to normal, but you can't come out of an experience like this.

And just go right back to where we were, Jan, you know, excuse me, March 16 or 15, whatever it was. You can't go back to then and just resume. Like we've all changed. We've all changed in some ways.

Host: So how do schools initially deal with this and then maybe family members. [00:16:00] What should they be doing?

Guest: I think a lot of schools, from my perspective and working with a lot of school-aged children is there is a heightened level of anxiety. There have been a lot of undiagnosed learning disabilities and learning challenges. Curriculums still stand as they were not really accommodating the fact that a year and a half of instruction was lost.

And so we're still expecting our kids to live up to those standards. And yet they can't. So there's, again, from my perspective, kids need a lot of academic support. There is a lot more mental health awareness and, you know, I've seen at my son's high school three times a year, they create a half a day for all the students to be able to go to teachers and get extra instruction or make up work.

So that they're caught up. So they're building in days for Catchup. And I think there's more awareness. There's more just everyone. I, I feel like I. [00:17:00] Moore's teachers and Moore's school staff are aware that our kids may be struggling with mental health and offering opportunities for them to talk about it.

Having people in the building to talk about it, the school counselor, the guidance counselor, school social worker, the school psychologist to make those people available. Sometimes it's also the school nurse or the principal or the vice-principal and just. Understanding that at times when our kids are acting out, it's not necessarily, they're just acting out for the sake of acting out.

Cause no kid wakes up in the morning and decides, I'm gonna go to school today and flip a table And they're acting out. It's, they're trying to communicate to us. In an alternate way, because they may not have the awareness, they might not have the insight. They might not even have the language to be able to say, I'm anxious, or math is really hard, or I can't keep up.

The pace in the classroom is really fast, you know? And so it takes, and it's hard because we're asking our teachers [00:18:00] to do a lot and to really be able to notice what a child is struggling with. Or a child being able to advocate for themselves. And a lot of kids can't and won't, they're embarrassed by it.

And so then that's where then the parents come in and parents, you know, noticing like, my child's grades are declining in this area, and asking questions. And offering times, and especially with teens. Teens don't love to talk when you wanna talk to them.

But just keeping the lines of communication open consistently. Trying to have as many family meals together. And it doesn't have to be a time of in-depth conversation. It could just be light conversation, what's going on, stay aware of what's going on in your children's lives. Who are they friends with?

What are their struggles in those areas? How are they doing in their classes? What's going on with their teachers? It's a lot of work on our end and it has to be initiated through us to create. This relationship and the openness of you can [00:19:00] come to me, you know, and offering a place of low judgment and low blame.

Because the minute our teens feel like they're being blamed, they're not gonna come back. They're not coming to you. And so, you know, listening and validating and asking questions like, do you wanna problem solve or are you venting? And then if something is going on, communicate with your school. Let the school counselor know, Hey, this is going on.

They're really struggling. You know, ask for support plans if our kids need IEPs, or 5 0 4 plans. A lot of, you know, I'm finding that the school's personnel is not bringing forth those areas of concern to the parent, but rather, it's more the responsibility of the parent now because everyone's inundated. So it takes a lot of, on our end, as parents to be aware, take note, monitor grades, have conversations, spend one-on-one time with your kids and just keep the doors of communication open with, [00:20:00] you know, little judgment. And then, you know, if, if having that conversation on a consistent basis is helpful, great.

And if it's not and they need to speak to someone who's maybe a little bit more neutral. Then that's when you, you know, seek out therapy through a professional.

Host: It seems like there's a few things on the school end the schools have to recognize. Both the impact on academics and the impact that the pandemic had on social development of, the students in their systems and how that may be affecting academics.

Is that a fair assessment?

Guest: Yeah,

Host: And on the parent's end, obviously you want to keep open the lines of communications and really just connect to your kids in all sorts of different ways. What are some of the signs that parents need to look out for, that something may not be right. Are there specific signs that parents should look out for?

Guest: My go-to is if you see a change in functioning, you know, if you have a child who's now sleeping more, Or sleeping less, or [00:21:00] eating more or eating less

Host: Mm-hmm.

Guest: has really gained a lot of weight or lost a lot of weight. You know, their grades are declining. And it maybe it's gradual. Maybe it's sudden, you know, maybe they used to talk to friends and see friends and now they're not.

So any change that you're seeing gradual or sudden, take note of it because that's telling you something. Again, our children, And our adolescents and our young adults as well, they're, they may not always know what they're feeling. They just know I don't feel right, or I don't like the way I feel, or I'm trying to avoid this feeling of whatever it is.

And so they, they're not gonna be forthcoming. And our kids do a lot of avoiding and distracting, distracting through social media, avoiding by not talking about things, not acknowledging things. And then sometimes they also like to numb, you know, numb through alcohol, through substances, through cutting, [00:22:00] you know, and self harm.

So, you know, looking for that kind of any change in functioning where you're seeing that a child is, is not functioning the way that they used to, whatever that norm was.

Host: And once a parent begins to see these changes what do they need to do? Obviously they should try and connect to their child. Do they reach out to the school system? Do they reach out to other professionals or some combination?

What are the first steps if a parent's concerned?

Guest: My go-to is always go right to your child and say, Hey, I noticed you used to talk to your friends more and make plans with your friends more, and now you're not. There's something happening. And it could be a change in dynamic in the friendship group. It could be that the child just is overwhelmed by, you know, maybe there's some social anxiety, maybe there's a new peer in the group to ask questions.

That's my, that's my go-to. If you don't know what's going on with your child, ask them. And if, you know, they don't want to talk because they, again, they don't [00:23:00] always want to talk. It's, you know, I'm here. I, I love you. I care about you. And when if you, when you're ready to talk, I'm here. So just making yourself available.

Teens are in that really unique place in their development where they wanna be in control, they wanna dictate, they wanna call the shots, and. So creating that space for them to make their decisions as opposed to, we're talking about this now, is the minute you say that to a teen, that's it. Shut down mode.

We're not talking about anything at all. Sometimes when my kids are having a hard time putting things in words, I'll say, did you want to email me? Do you wanna send me a text?

Do you wanna call me? You know, you can go upstairs and I can go downstairs and we can speak by phone, we can go for a car ride. You know that face-to-face interaction can sometimes be very overwhelming, but you know, the car rides are great cuz you're not looking at each other. Oh, you know, something is happening with this child. [00:24:00] You're telling me that this person's been bullying you or picking on you or making you uncomfortable, let me call the guidance counselor, the principal or the vice principal, and let's problem solve.

You know, and let's you know, and especially with a teen, you wanna problem solve together when it's appropriate so that they have an equal part in it and they can begin to use their language to advocate for themselves. And those are some of the main skills that we do want our kid, our teens, and our kids to develop is, you know, building more awareness into how do I feel and what do I want and how do I advocate for myself.

Host: Okay. What type of problems if, this anxiety level or whatever it may be isn't addressed effectively? Can it morph into something, perhaps more dangerous.

Guest: I think when an, when a child doesn't feel seen, doesn't feel heard, doesn't feel validated, you know, and there's consistent issues around them that are not being resolved or addressed. You know, we think, think about this from E, even us as [00:25:00] adults, when we feel like, oh my gosh, there's nothing I can do to make this better.

No one is even noticing and I'm putting out the signs and no one is seeing used to begin to develop that sense of hopelessness and helplessness, which can turn into. Severe anxiety and severe depression where children sometimes start refusing to go to school or they stop functioning or, you know, they stop doing the things that they once liked.

That, you know, again, that change. And, you know, we ultimately don't want our children then to, to completely try to mask their feelings by using substances to numb and avoid because I, I. Like I said to a lot of my teens, you know, whatever you're struggling with, it's not gonna go away. If you, we need to address it.

We need to look at it, we need to talk to it, we need to think about it. We need to problem solve cuz it's not going away on its own. You know, we need to help you find outlets. We need to help you find was to relieve stress. To, for you, self-care [00:26:00] is a real big one with a lot of kids and teens and like, When you feel overwhelmed or over stimulated, that's when you wanna be able, you know, and even at school, letting teachers know when this child is feeling overwhelmed.

Let them go to the counselor, let 'em go to the nurse's office, let 'em go to the principal so that they can take a walk, decompress, and then ultimately return.

Host: Okay, this is an issue that, that we really should maybe discuss at another time. Older teens 17 and 18 year olds or 16 year olds who went through the pandemic faced all of these challenges, maybe dealing with some issues. And guess what? They're, they're about to go off to college now.

I know colleges certainly offer facilities and stuff like that, he's. Young people are about to go into a totally different environment where they're not gonna have their usual social support structure. They have to build a new one on top of all of this anxiety.

Or am I misreading as this something that will just naturally take care of itself?

Guest: No, and, and listen, [00:27:00] college transition has always been huge, enormous. Because, you know, our children do go from having a very structured class schedule and they know where they're gonna be from 7 45 to two 30 and they have their activities afterwards, and mom and dad are driving them around, or they're driving themselves around.

Laundry gets done, you know, they take 'em to the doctor's appointment, make doctor's appointments. A lot of that stuff then now changes. They go to college and they have to do their own laundry. They have to figure out what time they're gonna wake up. They have to figure out what time they're gonna go to bed and when they're going to, you know, what they're gonna do when they have a big gap in between classes and how long does it take if I have to take a shuttle or I have to walk to get to class and when do I go to eat?

You know? And there's a lot that goes now in their hands and I've been working with. Of those college students who transition from high school and the change is huge and offering that support to help them organize their days and organize the things that they need to do so that they can get it all [00:28:00] done.

Because it is a very huge transition and for a lot of our coll, our high school students who are ultimately going to be in college or hard now, there. A lot of them weren't prepared, and especially the college kids who went to college and then their classes were virtual, so they're either sitting in their dorm rooms doing virtual classes and not permitted to interact with each other, or who went home and were doing college classes online.

And so they lost a lot of that experience. The experience, you know, the experiences of networking and collaboration and going on internships and just forming friendships with. Their peers and forming relationships with their professors, a lot of that was taken away. So, no, this is something that has to be absolutely be addressed.

And one thing I encourage a lot of parents to do, especially during senior year, is I. Having children take more and more responsibility for their things, making their doctor's appointments doing their laundry, understanding their [00:29:00] schedule because these are all things that they're going to do. So if they're gonna struggle, let them struggle now while they're under your roof, rather than going off to college and struggling.

And they may be embarrassed, they may not call 'em to tell you and you're not gonna see it, and you can't see their grades, you can't see their attendance. A lot of that stuff is all that access that we had, it just all of a sudden ends and you know, I keep seeing this gif or meme or whatever it is where someone says, you know, here we are expecting 18 year olds to go off to college and to be able to manage themselves when only a few months ago they had to ask to go to the bathroom.

Host: Yeah. Yeah, yeah, yeah. And, and then you add in the potential for the increased level of anxiety coming out of the pandemic and what the ramifications of that. Maybe it makes it, I assume it makes it even more challenging for these young people.

Guest: Yep. And listen, some kids can naturally kind of adjust and are a bit more resilient and some kids aren't. And I see the full gamut and I even, you know, see the full [00:30:00] gamut in my own children.

Host: We've covered a lot of ground, and, and I thank you for all your time.

I know there's so many more subjects and areas that we could get into, but understanding the impact academic and social, and mental health impact of the pandemic on young people that they're still dealing with. And also trying to help parents understand how they can. Better identify problems and deal with 'em.

This has been incredibly valuable. I know there's so much more to talk about and I suspect there are a lot of parents and maybe even young adults who have tons of questions. So, Dr. Liz, please , tell people how they can reach out to you and your group.

Guest: So the name of my practice is Psychological and Educational Consulting in Livingston, New Jersey. The website is psych ed consult.com. On there you'll find in my phone number, which is (973) 400-8371. I can also be reached by email. So if anybody has any follow up questions or anything like that Dr. liz@psychedconsult.com is my email.

I also do wanna mention that I have what's called a psych [00:31:00] packed license, meaning that for states that will have given permission for New Jersey licensed psychologists to practice telehealth in, there's a whole list of approved states, so it's right on the front page of my website.

So, you know, if telehealth is something that we'd like to do as long as you're in an approved state, I can absolutely provide that level of support as well.

Host: Okay. And we of course anyone can reach out to us at What the Health or our parent company, WellWell USA and, we will list Dr. Liz's contact information on our site. And if you email us or contact us in any way, we will of course pass on your contact information.

So, Dr. Liz, I cannot thank you enough. We look forward to having you on one of our What the Health podcasts again, and thank you for your time and your insights.

Before we move on to Health Hacks for this episode, we wanted to again, encourage listeners to take advantage of the hundreds of exclusive discounts WellWell offers on a range of [00:32:00] health and wellness products and services.

These range from fitness and athletic equipment to dietary supplements, personal care products, organic foods and beverages, and more. Signing up is easy and it's free. Just visit us at wellwellusa.com. Go to Milton's Discounts on the top menu bar and the signup form will appear. Signing up will take seconds, but the benefits can last for years.

Okay, now onto some health hacks. As always, we want to pride guidance on how to deal with the issues we've identified in our podcast. Admittedly, mental health issues, for the young or the old are both challenging and serious. So we obviously recommend dealing with medical professionals if you suspect a problem, but here are some considerations.

Monitor your child's behavior, and as Dr. Liz pointed out, if you see a significant change in behavior and issue may be at hand, this could [00:33:00] be anything from a drastic change in diet or sleeping patterns to social withdrawal from family and friends. Outburst or extreme irritability can be another warning sign as is self-harming changes in academic performance and obviously talk of suicidal thoughts.

The particular reasons causing these issues may be difficult to get a handle on immediately, let alone correct, but it is always wise to support your child's continued socialization with friends and family. It's also critical to find time to talk to your child or adolescent, even if it seems like a tough nut to crack at times.

If possible, find a place where they're comfortable opening up about what's going on in their life, and this place might be away from home Finally. If you think your child may be dealing with some serious issues, reach out and get professional help. This can start through their personal physician, a school counselor, or a child [00:34:00] psychologist.

There is no good reason for waiting If you think something is amiss. That's gonna wrap up this edition of What The Health. I want to thank Dr. Liz for her time and powerful insights. We want to encourage everyone and anyone to reach out to her directly if you have questions or you may need support. I also want to thank everyone for listening.

We appreciate the support and obviously hope you come back. Thanks.