Sara Nudd (00:00)
let's just take away all the weight from all the shoulders of worrying about being perfect because it's, it's just not gonna happen. And we're all just trying our best, right?
Courtney (00:15)
Welcome back to Kids These Days, insights for every stage of child and family development. I'm Dr. Courtney Lynn, founder of Integrated Behavioral Health and your host. So we live in a culture that tells us if we just try hard enough, eat the right food, stay consistent enough, we can optimize our parenting and our children's mental health. But for many of us, that pressure to be a perfect parent actually keeps us stuck in a state of high alert.
Our fear can take over and we start viewing our child's struggles or our own as a personal failure. Today, I am joined by someone who is dedicated to taking that weight off your shoulders. Sarah Nudd is a psychiatric mental health nurse practitioner and the founder of the Mama Co-op. With over 20 years of nursing experience, Sarah specializes in pediatric and maternal mental health.
Helping families navigate everything from ADHD and anxiety to postpartum depression and PTSD. What I love about Sarah is her in the trenches perspective. She's a mom who has navigated the complexities of medical crises and the shifting landscape of parenting over the last 27 years. Today, we are having a refreshingly honest conversation about why good enough parenting is actually the gold standard. The science behind neurotransmitter balance,
and how to let go of the shame often associated with medication. Sarah, I'm so glad you're here. Let's dive in.
Dr. Courtney (01:45)
Hi Sarah, how are you?
Sara Nudd (01:46)
I am well. Thank you for having me.
Dr. Courtney (01:49)
Yeah, I am so excited for our talk today. And I feel like you have a lot of diverse background in all sorts of different areas, not only professionally, but as a parent, that you have lots of expertise to share with us today. Right. Yeah. Can we start there? Actually, I'm so curious. And I think our listeners, after reading your bio to them of all the different things that you've done,
Sara Nudd (02:06)
That's a true story.
Dr. Courtney (02:18)
Can you share with us just your path and how you've come to be really passionate about mental health, passionate enough to go back to school when you already had kids and all the things? So yeah, I would love to hear more about that. Yeah.
Sara Nudd (02:32)
What was I thinking? Oh my goodness.
So I will do my best to be very succinct in the long story short. long story short, I got pregnant when I was super young. So I was 21. I was still in college with my first. And so had him, he was born with a congenital heart defect. Now, this was back in the 90s where, A, the internet was literally just.
beginning, like was Netscape and Dial-Up and all that stuff. So there wasn't like a lot of resources online. So he was born with a congenital heart defect. He had to stay and then he was flown a flight for life from Greeley down to Children's here in Denver, stayed there for a bit, was on oxygen for the first six months. And I am just like a 21 year old, ignorance is bliss, new mom. My ex-husband at the time, same thing, right? So then at that point,
I kind of knew nothing. didn't know like the medical land. I certainly didn't know the cardiology land. I 100 % had undiagnosed postpartum depression PTSD, but that wasn't really a thing, of course then. And then, so family history for me includes, you know, family history of anxiety and depression. And then myself, I personally have depression where I've taken Prozac for years. So once Zach was home, he's my oldest,
He's 27 now, just in case you're curious about that. So then once he was home, as I think some folks do, right, you start to kind of self-treat. So was a super young mom, 21, when you are starting to have those like feelings of depression and anxiety. What do we have on hand? Most of the time it's very culturally like encouraged, right, to drink. And so then I found that for, know, kind of that time, a lot of like self-treating depression and anxiety.
Dr. Courtney (03:58)
Yeah.
Sara Nudd (04:27)
I was also super disappointed in my kind of delivery, wanted to do a natural delivery, wanted to breastfeed. Also, you know, with his pregnancy, I didn't even eat chocolate. I was so strict with what I consumed and didn't consume. So then when he was born with this pretty significant birth defect, it rocked my world. So then next kiddo was born, she was totally fine. Then...
Dr. Courtney (04:33)
Yeah.
Mm-hmm.
Sara Nudd (04:54)
got a divorce, right? So now I'm in this like kind of what do I do with my lifetime frame? So then because I had just really kind of dug in so deep into like being able to advocate for Zach's needs, my needs, our family's needs to be able to communicate with like specialists, cardiologists, surgeons, I really got into the medical scene. So then went back to nursing school. My ex-husband and I got a divorce. So now I'm a single mom in school to be a nurse.
figuring out myself a little bit as we do in our like late 20s early 30s. I worked as a health and counseling nursing manager for the University of Denver. Their health center is integrative so there's both
mental health and like physical health. So that was also a great introduction into like mental health and physical health how they can connect. So then went to work as a triage nurse for Children's Hospital Colorado and then within that work there's so much partnering, so much education, so much advocation, so much just like
Dr. Courtney (05:37)
Yeah.
Sara Nudd (05:56)
empathy when you're working with families who are in these super high stress situations who may not have a lot of the tools and the coping strategies. So then, there was a little seed there.
And this is so silly to say that it was like an aha moment for me. it's anyway. So one summer, I think like I had three or four clients. Babies were, you know, within the first year of life, but either the birth giver or the non birth giver.
we're having significant postpartum depression, anxiety, PTSD. And I was like, you know what? I just don't have the tools. Like, yes, like I can facilitate the management of all the things for this baby and kind of help to coach the parents a little bit. But as far as like specific mental health strategies, interventions, tools, I didn't have that. So then that's when I went back to school to become a nurse practitioner.
Dr. Courtney (06:47)
Mm-hmm.
Sara Nudd (06:52)
And so now in my current practice, I'm a nurse practitioner for a local practice here in Denver. And then I specialize in pediatric and maternal mental health. So I will see whether it's like kids five and older for like anxiety, depression, ADHD, and then same for, you know, women, non-birthgivers, birthgivers.
And so it's the best job and I'm so dang lucky and I feel so honored for every client that I have because I also recognize honestly every time, right? Like I am just some stranger that they are coming to seek for help, right? And these clients are so brave and so courageous to be like, you know what? I'm struggling with this or I need help with this. Like that takes just so much like internal power to a stranger.
Dr. Courtney (07:16)
Yeah.
Sara Nudd (07:43)
So I think that my clients are amazing. I feel like I made that long story long. So, okay.
Dr. Courtney (07:50)
No, it's
so great. was totally following along and locked in and also just thinking about, wow, what a unique opportunity, To like be able to look back at your own life and, know, okay, I had kids, when I was younger, when the internet is around, we have a like joke in our house where like, did you ask Jeeves? And, you know, of course my deaf sons have no clue what we're talking about, but.
Sara Nudd (08:14)
You
Dr. Courtney (08:18)
Yeah, there was so much information that you didn't know compared to when you had a kid later on in life and now when you're supporting, you know, all of these families and just the education that you've had. Yeah. Wow. I mean, it's, yeah, it's amazing to be able to compare those two things within your own life and not just, you know, with families that you work with. I think that's pretty special.
Sara Nudd (08:39)
know and it's so funny looking back right to the 90s right that was when we had um bumpers in the cribs we had like the big like fluffy blankets to put on top of the baby we had like stuffies in the cribs and then you know Zach was on ox oh this is a good story so Zach was on oxygen for the first six months right so he had the little nasal cannula and we had this big oxygen tank in in our apartment which was kind of teeny tiny but because of his heart defect he
Dr. Courtney (08:41)
Yeah.
Yep.
Sara Nudd (09:06)
he has what's called Epstein's anomaly. So he had on his the right side of his heart. It doesn't necessarily pump blood to his lungs to get that oxygen very well. So he at that time always had kind of like a blue hue about him, especially like like his perioral area, right? He's like lips, his gums, his tongues. And as a new mom, I just after we left the hospital, I just wanted to pull socks. I just wanted some objective
machine to tell me if his oxygen was good or if it wasn't good, then I could turn up the oxygen thing at home. Back then, I should do like the cost comparison now, but anyway, back then, the cost to buy a home pull socks was $750. And so obviously we didn't have that money. And now it's like $10 from Amazon. like I just, yes, I think like, you know, it's just so funny.
Dr. Courtney (09:51)
wow.
Sara Nudd (10:01)
just it's a different time in a different world and we have like more tools that we have now and then who knows what we'll have in like another 30 years.
Dr. Courtney (10:04)
It is.
Right,
right. Yeah, no, that touches on a, I think, bigger overarching thing too with parenting. And I know with a lot of the medication stuff that we'll dive into a little bit more too, it's always going to change, right? And our parents did the best that they could. And we know different things now. And we do things differently now than we did then. We have more information then. And.
A lot of it, I think letting go of that, being the perfect parent idea or doing it perfectly, right? Like, I'm not going to take any medication because I'm going to figure this out. I'm going to exercise more and eat right, and I'm going to figure this out. We don't have to do that. We know more now. We don't have to do things perfectly in order for ourselves and our kids to be OK.
Sara Nudd (10:41)
Yeah.
Yes. And let's take out like the, you know, right if we could, let's just take away all the weight from all the shoulders of worrying about being perfect because it's, it's just not gonna happen. And we're all just trying our best, right?
And I can also guarantee you 100 % that as parents and or as kids, we're gonna make mistakes. Like no matter how much we prep and read and practice and do all the things, mistakes happen.
And the best and coolest thing about mistakes is you just learn from them. So then that's your opportunity to look back, man, next time I'll do it like this or like that.
Dr. Courtney (11:41)
Right.
Yeah, exactly. And I know, I think that mindset of, all right, well, fix it, we'll kind of move on is so great. And I think it can be hard for a lot of people. Even when you were saying the Pultoc thing, I shout out to Ollie's branch. Do you know Ollie's branch? Yeah. Shout out to Ollie's branch. I see many parents who have kids with heart defects through that nonprofit. I feel like a lot of medical conditions, or just honestly, kids in general, right?
Sara Nudd (11:57)
Yes!
Dr. Courtney (12:10)
all of the checking and let me make sure that their numbers are right and let me, you know, check their A1C or their blood sugar, right? For kids with diabetes, you know, when we have all of these tools and we know so much information, it can also almost like cause more anxiety, right? Because, you know, back then you're like, all right, we don't have the money to buy a pulse ox. So I'm just not going to be able to do that. Whereas now it's like, no, okay, I will buy one on Amazon and I will check 500 times a day.
Sara Nudd (12:14)
Yes.
Mm-hmm.
percent.
Mm-hmm.
Dr. Courtney (12:40)
to make sure everything's okay. Yeah.
Sara Nudd (12:40)
Literally, right?
And then I think you're so right. I'm like, data as parents now is so helpful. It can be so helpful, right? But literally at the end of the day, look at like what your baby or what your child is telling us, right? ⁓ So looking back to that time, we'll just use as an example, right? So if he was crying and becoming like more kind of cyanotic, right? Then that is his body's indication to me, right? Like he's...
probably not oxygenating as well as he could versus like now I think that there's so many things. Fever, for example. I think fevers for parents can be super, super, super scary because your child not only like feels crummy, but they feel so hot to the touch and they're probably like achy. And so then, right, we've got like the thermometer, whether it's across the forehead or in the ear, armpit, rectal, whatever. And so we're going by this reading of whatever number the thermometer said.
You may have this internal freak out because the number says 103. But your child is running around happy as a clam, just living their best life. And so really, it's more than focusing on whatever number, whatever device we're talking about. Let's look at what your child is telling us. ⁓ That data number can represent information, but at the end of the day, it's literally what your kiddo is sharing.
as in the sleep world, right? There's so many very well-meaning apps where you can track sleeps and naps and wake periods and light sleep and REM sleep and deep sleep. And if you are in a sleep deficit, all of these things, right? And again, it can provide like cool information, but I think when those numbers start to prevent like you from being able to fall asleep,
or your baby, it's not gonna prevent your baby from falling asleep, but if it's preventing you from falling asleep, right, or centering, then that data, let's see what we can do to maybe recognize that that data has a place, but it's not paramount. Yeah, but it's hard.
Dr. Courtney (14:51)
Yes, yeah.
It's so hard and especially in the medical world and with social media now, I cannot, as you were saying that I was just thinking of and like holding close so many parents that I've seen who rather when they were pregnant or right after they had the baby knew something was not right. mean, especially through all these brands, right? I've seen so many parents, I worked at children, saw so many parents who had kids with.
chronic medical issues and they felt like something was wrong or off and they're being told from a medical provider that it's okay. I feel like, yeah, there is this kind of give and take, this balance of being able to trust yourself, right? My kid has 103 fever and you know, we're fine, we're doing good versus like this is the number that.
Sara Nudd (15:24)
Mm-hmm.
Yes.
Okay.
Dr. Courtney (15:44)
need
to stick to. Yeah, it's a dance and I think it is really hard, especially when we're getting so much information, to trust that part of ourselves and it's really easy to lose track of it.
Sara Nudd (15:54)
Yeah.
Mm-hmm. And then, you know, I look to like the new mom, and she doesn't even necessarily need to be a new mom, right? She could be a mom to a toddler and it's like her third kid. ⁓ If you are in like a high stress situation and in fact, you could be like in the medical field, but your kid is sick, all rational thought goes out the window, right? You are just so worried about your kid and you want for someone to hear you.
Dr. Courtney (16:21)
I'm done. ⁓
Sara Nudd (16:28)
that you are worried and concerned and let's look maybe like let's, you know, assess and reassess and or evaluate to see, you know what, like, let's, I don't know. I just think that this also gets my goat actually in medicine, whether you're in physical medicine or mental health, like whatever, right? So many times there's whether it's gaslighting or people just aren't listened to or they're rushed, but folks will report.
something, whether it's a symptom or a side effect or a worry and their concern is either like not heard, it is just not addressed, it's poo pooed, it's you're not feeling that way when really each of us are like our own experts, right? Every mom, every parent is the expert of their kid. They know their responses to whatever.
more than I do if I'm just walking in the room. Right. And so we really. ⁓ It's super hard, I know, and like kind of our ⁓ the rhythm of how we are now. Right. But like as providers again, no matter what kind of realm you're in, to slow down and maybe just really listen to what that parent is telling you. And maybe it's not even about like maybe there's something kind of deeper.
Dr. Courtney (17:25)
Right.
Sara Nudd (17:52)
So one thing I encourage all of my clients, there's literally no question that is like off the table or silly. our, you know, sometimes I will use this example, right? So medication side effects is certainly something that we want to avoid. Or, you know, if we are experiencing side effects, we want to know about it. So if like we are starting you on a new medicine or if you've been on a medicine forever and all of a sudden you're noticing that you're getting more hangnails and you're thinking.
Would these hangnails be related to my Prozac? Absolutely ask me that question. Like you might think that it's a silly question and let me just tell you, no, the hangnails are not related to the Prozac, but let's talk about this, right? Like let's take away that barrier to being like educated and just, I really want for my patients and my clients to have that autonomy to advocate for themselves. And then with that, right? Like you can ask me the same question.
Dr. Courtney (18:31)
Yeah, just clear it up. Yep.
Sara Nudd (18:51)
10 times over, like keep asking me about that, hang on. If whatever I explained, however I explained it, if it didn't make sense, if you forgot, maybe you're feeling really anxious at the time and it just, you know, just didn't stick. Keep asking until you feel like you know whatever that answer is. Yeah.
Dr. Courtney (19:10)
curious and just so much was hitting me as you were saying that in terms of medication, which I appreciate. Thank you for sharing your journey with medication as well. And now this is one of the many areas of expertise that you have. I can just picture in my mind a parent late at night scrolling on Instagram. Their child's not sleeping. They are having, you know.
thoughts about wanting to harm themselves, like, why did I even do this? This is too much. I can't handle it. And they come across someone who's like, I, you know, this is what I do to take care of myself. You know, I, I don't know. I'm not saying exercise is bad. Exercise is good. You should exercise. That's not what I'm saying. But like, you know, my whole life turned around exercising and I'm just imagining the person thinking like, I do exercise and it's not working for me. Like something must be wrong.
Sara Nudd (20:05)
Yes.
Dr. Courtney (20:06)
with me,
I'm not doing it right, I must not be doing the right type of exercise, I'm not doing it enough, any of those things and plug in whatever for exercise. Like how do we, there's just such a big comparison game, right? How do we allow parents to know even when it comes to their kids being on medication or them being on medication that you know, right? When something does not feel right and when, and you can trust that.
Sara Nudd (20:21)
Mm-hmm.
Dr. Courtney (20:36)
There was no question in there, just a lot of rambling, but I'm curious. I'm sure you have something to say. Yeah.
Sara Nudd (20:37)
Yes.
Yeah, but let me get,
so, social media, right? It's a great tool for feeling connected and meeting others who may be going through similar kind of life stages and it can be great for education. Like, oh, it's not up here, but I learned to crochet from TikTok. I know, super fun, right? But it can be super not healthy for us, right? The comparison game, the shame game is ridiculous.
Dr. Courtney (21:02)
Yeah.
Sara Nudd (21:14)
And so how do we also, right, in a time of a lot of...
Untruths being shared also on the internet, I think it's really difficult too for people to understand like is this a true fact or is this ⁓ untrue in it, but though it's being shared as a fact, right? It's super, super hard to decipher that. And then when you're reading that content, just like you were saying, right? If I am doing XYZ and XYZ is not solving the problem why I'm taking XYZ for, it's me, it's my fault. There's something wrong with me, I'm a failure here.
And then I think we'll just kind of go like for the new mom, right? So the new mom, she not only like is a new mom, so she's got a new role, new responsibilities, she's figuring herself out, she might have a new kind of role with her partner, right? She may have like kind of new friendship roles. So there's that piece, which is super complex in itself. Then we've got hormones, which are just always
unpredictable and we can just kind of do our best there. Plus, we've got the science that shows, really that first 12 months, but I would argue the first three years after having a baby, right? The neurotransmitters or like the chemicals that are in your brain, they are still rebalancing. And so there's just so much weight on our shoulders right now as a society, whether it's good or bad, it's just what it is. And so it's just really tipped.
difficult to navigate and to know what's what's truth and what's not and to know what to do to help you to feel better. Whether it's you or your kid or anyone that you're worried about too, right?
Dr. Courtney (22:59)
Yeah. What
would you say to the parent or to, I mean, to the parent either for themselves or for their kids who feels like, you know, if my kid needs to be on ADHD medication, I'm a failure because I must not be, you know, doing good enough parenting. Or if I need to be on medication, I must've done something wrong, you know, during the birth process or I must've...
Sara Nudd (23:11)
Mmm.
Dr. Courtney (23:24)
You know, I must not be eating all of the right things in order, yeah, because I have to take medication or because I'm thinking about maybe I want to take medication or that might be a route to go down.
Sara Nudd (23:31)
Yeah. Yeah.
I love this question so much and I actually answer this question a lot in my everyday life. Okay. So let's just go with the five-year-old with newly diagnosed ADHD. And we'll just go with the very wiggly, very fidgety, very hyperactive and inattentive five-year-old who's like frequently distracted and forgetful and really has a hard time starting a task and completing a task.
So we have, right, he's, we'll just go with a he, right? He's very eager to please and he wants to love school, but he, like his body is just wiggling, his mind is just wiggling. And so, you know, let's also go with a parent who's definitely tried all the things natural. They've, you know, done dietary changes, they've done sports and like soccer and jujitsu and all the things to keep this little hyperactive body entertained.
Dr. Courtney (24:05)
Good night.
Sara Nudd (24:28)
but still the reports from the school, from the teachers are like, he's really distraughtful to his peers and he's struggling with peer relationships. he tried really hard on a math test and he didn't do so well. So now we've got this kid who's wiggly and struggling. And during these first primitive years, primary years of school, we were wanting to build their confidence.
We want to also support their love for school because school is so fun, right? We want to support their relationships and their peers and their perception and relationship with their teachers too, because we don't want them to see them as a punitive person. This should be a person that they're excited to learn from and engage with. So with ADHD medications, ⁓ Methylphenidate is a family of stimulants that a lot of the time
is like first line for kids with ADHD. So common brand names would be like Concerta or Focalin or Ritalin. And basically, right, how, so it will balance the neurotransmitter dopamine. And I'm just super, I'm like super simplifying this, right? Like just, so dopamine and norepinephrine. And then this isn't to say we are changing the brain structure, right? We are just supporting what's already there.
Dr. Courtney (25:36)
know this is great.
Sara Nudd (25:48)
So that your five-year-old who was normally unable to like start a puzzle with his best friend is now playing quietly because the neurotransmitters in his brain are allowing his body to have those executive functioning skills. This goes for everyone with like anxiety or depression or OCD.
lot of times with those mood disorders, and I hate the word disorder, but it is what it is, We will use like an SSRI. So that's a selective serotonin reuptake inhibitor. So common examples would be like Prozac or Sertraline. And there will be parents that are like, I'm really worried because my 11 year old is so anxious that they can't do their homework.
or that they don't want to go to school because when they are around their peers, they just freeze. They have like pretty intense social anxiety and they don't want to put something artificial or a chemical into their kiddo's body. But they also don't want them to be experiencing like this super turmoil. ⁓ And so the cool thing again, kind of with a lot of the medicines that we use in mental health. So SSRIs, they are not changing the brain chemistry or the neurotransmitters.
Basically, they are creating an environment where what you have that's already there is now being used properly, right? We're kind of just like strength, well, just depending on the medicine, but we are modulating, balancing the serotonin that's in there, right? And so it's not gonna change your child. And if it does, it may offer them a breath to realize, all right, so like I...
I can now do whatever it is that I couldn't before because I was too anxious to do it or if you're kidding with your ADHD, I was too fidgety to do it because now that my neurotransmitters are balanced, I can learn and I'm excited to learn and I'm confident and I love school. Anyhow, that was also a long winded answer.
Dr. Courtney (27:45)
Right.
No, I think it's so
great and it's so spot on with a lot of things that I talk to families about. know, parents can trust themselves. And so, you know, when, I see a family, the child was diagnosed with ADHD and they want to talk about medication or not, it's totally, of course, totally up to them. I'm also no expert like you are and don't prescribe medication, but parents know, right? If
You see them at soccer practice and none of the kids want them to be in their group because they're not going to follow directions. They're going to kick the ball across the field and they're not following the rules or whatever it is. Or you see that at school they're being left out during recess because other kids are finding their behaviors annoying. Those, me, are some indicators. Maybe.
Sara Nudd (28:32)
Bye.
Dr. Courtney (28:41)
And especially if I'm already seeing them, then that means we're implementing behavioral strategies. Parents are really doing a lot of things at home. We're really changing the environment to be supportive, but we don't want them to then have negative impacts, low self-esteem, or like you're saying, not enjoy school, any of those things, whether it's anxiety, ADHD, anything that you just mentioned.
Sara Nudd (29:04)
100%. And there is a study, and I wish at this minute I could tell you who it was by, but it was recently released that showed who kiddos who have ADHD and are started on medication younger, and it's like effectively addressing and turning the ADHD symptoms are less likely to need medications as adults.
And so again, I think like as parents, right, we're all just doing our best and we don't want to put anything like that we don't need to in our kids' bodies. And so it can be a tough balance. But I also really love the point that you brought up, right, about like, are like the behavioral interventions that we can do? Because isn't just as simple as throwing a pill at somebody? Heck no, never, right?
And it depends on so many things, but I would say number one, before like all else or maybe at the same time as all else, it's so important to work with like a therapist or psychologist or provider, right? That where you get to practice and maybe like learn new skills on how to either like cope or just all the strategies, right? That you will take with you literally for the rest of your life. Then...
If we do need to add a medication on, okay, but I don't know. I could go on and on.
Dr. Courtney (30:25)
Yeah, yeah,
Well, and like you said, the medication is like supporting, you know, the neurotransmitters and things that are already there. Similarly, you know, it's not going to fix the uncertainty of life or fix the overwhelming nature of parenting or life in general. so, yeah, medication and therapy both can just support those things so that, you know, it's just so hard. It's so hard already.
Sara Nudd (30:37)
Mm-hmm.
It's so hard already. Like life is bananas. And then it sounds like such an old person thing to say, but I'm just going to say it like kids these days, they have to deal with so much more than we had to. And it's so true. Like it's, it's tough to manage. It's tough to manage as a parent. and so we just, we, have all these amazing tools.
Dr. Courtney (30:56)
Yeah, right.
Sara Nudd (31:18)
Sometimes it's difficult to decipher which tool to use because there's a plethora of tools at our disposal and are that are marketed to us. That is the cure all. But we do have tools. And so then if you like talk to an expert, right, then that can be helpful for you to decide this is the tool or nope, that is a tool that I don't need or want and like save your money in time, right?
Dr. Courtney (31:36)
All right.
Yeah, right, and everyone's so different. The tools that work for one person that you see on social media might not work for another person. And that is OK. Like you said earlier, everyone's the expert on themselves and the expert on their child.
Sara Nudd (31:44)
Mmm!
preach that and
like what may work for one kid doesn't work for the other. That happens all the time and sometimes too it makes me laugh. But I feel like for families who have more than one kid, sometimes the siblings are just so different, right? And the parent will be like, ⁓ we just never experienced this with the other kid. Because you get to experience all the things. ⁓ So that's just a funny little anecdote.
Dr. Courtney (32:18)
Right. Yeah, it is different.
Yeah. What are the risks, would you say, because I know we've talked a lot about new parents and kids. What are the risks for, I think you probably hear this often, right? Like, I don't want to take any medication during pregnancy because I'm scared of what it's going to do to the baby. But then also they're very anxious or have, you know.
Sara Nudd (32:28)
Mm-hmm.
Yeah.
Dr. Courtney (32:44)
postpartum
OCD or whatever that looks like. And then same thing for kids. We kind of touched on it in terms of the shame cycles, but yeah, what would you say some of the risks are of not using medication as a tool in your toolbox that could potentially be helpful? I think that's the question. Yeah, what are the risks? No, you're good.
Sara Nudd (33:04)
Yes. Okay. And then if I leave a part out, like circle back or
whatever the anyway. Okay. So this definitely gets my goat. So I'm certified in perinatal mental health through Postpartum Support International, which is a nonprofit that specializes in perinatal mental health. Right. So it's an amazing organization. If you have a chance, if you're listening, take a peek. All right. So within that, right.
The perinatal population is like a subset of a subset of a subset special population. And for emphor, right, if you are on any medication that you don't need to be, once you find out that you're pregnant or if you're trying to get pregnant, the advice was stop whatever you're doing. Do not take any medication. Period. What we've recently found out that no, that's so the wrong answer. Right. So if let's say you are a mom.
and you've been taking ADHD medication for eons, you are wanting to get pregnant and you're very well intentioned, OB-GYN says, nope, stop taking your Adderall or stop taking your Concerta because you're trying to get pregnant. So now, okay, you're doing your best. Like you were listening to this medical advice and then, but now you are so distracted when you're driving, you may run through a red light because you're just not even, you know, it's, you're just super distracted.
you may be getting in trouble at work because you're not completing your tasks or you might be making these like impulsive choices that you're like, I don't even know why I did that. So stopping all medications during the perineal timeframe is no longer science-based, evidence-based. It is actually, it can cause more harm than good, right?
So let's also go to depression and or anxiety and or OCD, right? So typically, historically, those have been treated with SSRIs. We talked about those a little bit earlier. So like your Prozac or Sertraline, those have been, Prozac specifically and Sertraline have been studied at length. I can't even, I don't even know the number, but anyway, they've been very well studied for use in the perinatal period.
Data says it is safe, it is not harmful to the pregnant mom, nor is it harmful to the pregnant baby. If though you stop taking your SSRI or your medication that you're using, Moms can have a higher incidence of preterm birth. We can have a higher rate of low birth babies. We can have higher rates of maternal suicide. We can, like all the things, right, that these very well-intended moms are
Dr. Courtney (35:49)
Mm-hmm.
Sara Nudd (35:53)
trying to avoid are going to be happening. like, we can go back to ADHD, right? If you have pretty significant ADHD and you aren't taking your ADHD med and you forget to eat, like everything gets thrown off, right? the science shows that for the most part, but check in with your provider. For the most part, it's okay to continue taking your meds that you've been stable on and taking.
There are a few though that are outliers, but even, so for example, lithium is an amazing medication that gets a real bad rap. It has been shown to potentially cause birth defects, right? And they are showing now though at like low doses, it may not be as risky.
Because some people are really stable like if you have bipolar disorder and you are on lithium Do I want to take mom off of her lithium when she's been stable and she's thriving and she's doing so great Do I want to take her off of that lithium and so it just becomes a balance so check with your provider make sure that your provider is an expert and well-educated and it do your own research like again WWW dot World Wide Web is amazing
Dr. Courtney (37:02)
Totally.
Sara Nudd (37:13)
And let's see here. feel like there was, I, what?
Dr. Courtney (37:16)
No, think that
you're spot on. I asked about kids too, but I think this is so important. I'm even thinking, because I know you were talking about these are all the things that can change, right? If you're really stable and then you get off your medication and it's going to throw things off. I was thinking, yeah, even your relationship with your partner, potentially, if you have a partner, right? And you're getting ready to enter into an extremely stressful time of life.
Sara Nudd (37:29)
Mm-hmm.
Yeah, 100%.
Dr. Courtney (37:41)
whether it's your first child, second, whatever number child it is, it's going to be stressful. It's all different. Every single time you have a child, right? It's a different experience. And to throw that off when it's already gonna be a huge life change, yeah, just might not be the best route for everyone to go down.
Sara Nudd (37:44)
Mm-hmm.
Mm-hmm.
Right,
right, and like one plus two or A plus B doesn't always equal C. like, I mean, wouldn't it be super easy if like we could just say, don't worry about taking this while you're pregnant, but it's not like that. And so I would just encourage everyone to check with their provider, if even your provider, because there are a lot of, again, well-meaning folks, I would say, you know, like 95 % of those who are in the field to help others are doing it because they are well-meaning.
But if you have a provider where they are telling you to cold turkey, stop all of your medications that you've been taking for mental health because you are considering pregnancy or and or are pregnant, ⁓ maybe pause and absolutely. I have a client who's 20 weeks pregnant. She's been.
Dr. Courtney (38:43)
Get a second opinion. Yeah.
Sara Nudd (38:48)
very stable on an atypoclantysychotic. And again, we need to like rebrand that family of medications because it sounds like a scary family, but really these medications just help to balance dopamine and serotonin. So we should just call them the dopamine serotonin balancers, but I'm not in charge of that. Yeah. So she's been doing great. She's on a medication called Abilify. It's an awesome medication and
Dr. Courtney (39:04)
Right. Call them what they are. Yeah, exactly.
Sara Nudd (39:15)
her, she went in for the ultrasound and her GYN has told her it's safe. I've told her it's fine. She's stable. She's doing well. The ultrasounds texted. Oh my gosh, what are you doing? Why are you taking this medication? You are harming your baby for being on this medication. I know, right? And so as a, like as a mom who's wanting to do all the right things, how scary. So.
Dr. Courtney (39:33)
no.
It makes me want to cry
even hearing it. like, my gosh, that, I can't even tell you the number of parents that I work with that have one sentence stuck in their mind, right? And I do EMDR and we're like, all right, we'll reprocess this traumatic experience. One sentence stuck in their mind of something a provider told them. Yeah.
Sara Nudd (39:49)
Yeah.
100 % and they will listen to that right because you hear it because it's like yeah so and if you do meet a provider and they're like they're telling you something you can always literally every single time ask what can I do know the evidence behind why you are recommending this ⁓ you can always ask for that right and
Dr. Courtney (40:06)
Yeah.
Sara Nudd (40:24)
you know, the provider may be like, well, I do have to like pull up some things, which is OK. Like they may not be able to tell you like the study and when it occurred, but they can go back and look. That's always OK to advocate for yourself.
Dr. Courtney (40:32)
Right.
Right, which is like a general theme of everything that we've been talking about. Being able to trust yourself, trusting, you know, your parenting abilities for your kids. And if you feel like medication could be helpful, it does not mean that you're a failure or that you're not doing something right or that you're not doing enough of something. It's simply another tool in your toolbox to be able to support yourself and your kids.
Sara Nudd (41:01)
Absolutely. And I know we're running out of time, but one thing that I will tell families who may feel just that kind of internal shame, I don't know if shame is the word, but we'll just go with it, for giving their kiddo a medication, whether daily or as needed, right? If your child has asthma and they have an intermittent, nonstop cough, maybe they have intermittent wheezing that occurs, ⁓ they may take a daily steroid to help prevent the inflammation.
There's not like a negative stigma with that, right? Again, we are balancing like the bronchodilation there. And then if we do like come up with like, you know, a wheezing episode or like a viral illness where wheezing occurs, we've got our inhaler on hand and there is no shame in giving your kid the support that they need there. ⁓ So, you know, I don't know. Sometimes I feel like kind of that comparison is helpful for some folks and then sometimes.
I think that there's just so much heavy negative stigma around mental health that it's just like comes down to like test talking about it. so, yeah.
Dr. Courtney (42:05)
Right.
Yeah, well, I really appreciate our dive into this and for you sharing so much about your experience and life experiences. And I hope that people listening have, I'm sure they've taken away a nugget, if nothing else. Is there one last thing that you would like to tell parents who are...
You know, hearing this and thinking, yeah, I've really been thinking I should probably try medication, but I'm just not sure.
Sara Nudd (42:39)
I would say there's never harm in asking, right? If you have a provider that you trust, talk with them about it and see, you know, like what their thoughts are, or if their thoughts maybe don't like, even if their perspective is like, that's not really like the answer that I was hoping for, continue, right, to look at like the evidence or connect with maybe someone else who, again, is an educated person on the subject, perhaps with certifications or and or degrees.
And it's always okay to like ask to look for the science and just know that you are not alone in any of this. Like you may in the moment feel so isolated and like you're the only parent that is dealing with like a kiddo, right? Who has to turn like the light off and on maybe like 75 times before bed and who can't use one towel. They have to like their hands on another towel you are not the only person.
Dr. Courtney (43:32)
Mm-hmm.
Sara Nudd (43:34)
And there's a community of people who can offer support and guidance, but it's just getting you to that community and finding that support and the right medication to help balance the neurotransmitters. We're not changing them. We're just balancing them.
Dr. Courtney (43:49)
I love that. Yes, the balance. Balance in life, balance in neurotransmitters. You know, we need balance. I have a friend who calls it the B word, balance. you're like, ⁓ no, back to the B word. Finding that balance. So well, thank you so much for your time, Sarah. This was so wonderful. And I will link all of everything so people can find you in the show notes. And yeah, I appreciate your time.
Sara Nudd (43:58)
haha
⁓ no.
Well, thank you for having me. This was so much fun. So I just, I appreciate you and thank you for sharing.
Dr. Courtney (44:18)
Yeah, I appreciate it.
Yeah, of course.
Courtney (44:25)
I think my biggest takeaway from Sarah today is her reminder that we aren't changing who our children are when we seek support. We are simply helping their systems find balance. Her comparison of mental health medication to an asthma inhaler is such a powerful reframe. We wouldn't feel shame for giving a child a tool to help them breathe. We shouldn't feel shame for giving them a tool to help them regulate. As parents, we often feel like we have to do everything perfectly to be good enough.
But as Sarah mentioned, the real magic happens in the repair and in the connection, not in the compliance. This week, I want to challenge you to look at one area where you're holding yourself to a standard of perfection, whether it's your child's behavior or your own mental health journey. Can you give yourself permission to be good enough? If you want to learn more about Sarah's work or the parent coaching offered at the mama co-op, please check the show notes for all the links.
Thank you for listening to Kids These Days. Remember, you don't have to be perfect to be a great parent. We are all learning about how to raise kids these days.