Welcome back to the Healing Pain Podcast with Dr. Nicole Beurkens
If you are the parent of a child with chronic pain, anxiety, mood or behavior challenges, you may have wondered if the struggles you and your child are facing will ever get better. Too often you may hear things from your child such as, “My stomach hurts, I got a headache today, my lower back hurts, or my neck is stiff,” or maybe you’ve even heard, “I just don’t feel like going to school today.” One out of every four children in the US struggles with chronic pain and those numbers are growing. Combine this with the fact that half of all mental illness occurs before the age of fourteen and anxiety is the most prevalent mental health challenge that children face, we know that kids are suffering and parents are looking for solutions.
Joining us today is Dr. Nicole Beurkens who has over twenty years of experience supporting children, young adults and families with mental health concerns. She is the Founder and Director of Horizons Developmental Resource Center in Caledonia, Michigan where she leads a team of clinicians dedicated to the evaluation and treatment of a wide range of mental health concerns including autism, ADHD, learning disabilities, anxiety, bipolar disorder, behavioral disorders, brain injury and other neurodevelopmental conditions.
Dr. Beurkens has a unique combination of having earned Doctorate in Clinical Psychology, a Master’s in Nutrition and Integrative Health and a Master’s in Special Education. She’s also the best-selling author of a book called Life Will Get Better: Simple Solutions for Parents of Children with Attention, Anxiety, Mood and Behavior Challenges, which of course you can find on her website at DrBeurkens.com.
Tips for Parenting a Child with Chronic Pain & Anxiety with Dr. Nicole Beurkens
Dr. Nicole Beurkens, welcome to The Healing Pain Podcast.
Thanks so much for having me, Joe. Great to be here.
I’m excited to talk to you because you are the first person I have on The Healing Pain Podcast where we will be talking about children. So far we’ve talked a lot about adults and the chronic pain that adults experience and how we can lead them toward a path of help and healing. Today, we’re going to be talking about kids, both with chronic pain and anxiety. The first thing, I love your bio because I love the degrees you have. You’ve put a lot of time into learning about kids and the things they face and weave that through your practice and everything you really do. Can you tell us about your story of how you’ve come to those three really incredible degrees that you have?
My story has taken a winding path over the last twenty years. I started out actually in education, studied to be a teacher, got a Bachelor’s and a Master’s Degree in Special Education. I started my career as a classroom teacher. I was working with kids with more severe emotional and behavioral kinds of disorders, autism, those kinds of things. I loved doing the work and I loved being in schools, but what I found is that I really could have a limited impact on kids in the six or seven hours a day that I have them. I really began to see a huge need for parents to be more in the loop and for parents to have more resources and education in how they can improve the development of their children impact these symptoms. I didn’t see a lot of people doing that. That really led me to get a Doctoral Degree then in Clinical Psychology because I was really fascinated about the interaction between parents and children and how that impacts symptoms.
I did research on that as part of my Doctoral and Post-Doctoral work. In my work then as a clinical psychologist primarily working with families and kids, what I began to see is that this distinction that we make in medicine between mental health and physical health is really pretty ridiculous. It’s this historical idea that medicine deals with everything from here down and psychologists deal with here up. What I started to really notice in a lot of my patients and even in their families is that there are a lot of physiological things that seem to go along with the symptoms they were having, so a lot of nutritional-based things, a lot of sleep-based issues, lifestyle-based issues. That got me really interested in the role of nutrition and functional medicine and integrated health. I went back and got another degree in that to help me incorporate those kinds of things into the work that I do with families and with kids.
We can do all of the cognitive behavior therapy or family-based therapy or traditional mental health sorts of interventions. We can do those all day long, but if kids are not having their needs met from a nutritional standpoint, if they’re not getting good sleep, if they’re not moving throughout the day, if there are health issues, broader health issues aren’t being addressed, then we’re really limited in terms of the impacts that we can have with the more traditional psychological approaches. I weave all of those things. I take all of my experience from various things and weave them together in the work that I do. I think we get better results from doing that.
I’m excited to talk about kids and the connection between chronic pain and anxiety because, as you noted, it’s a growing concern. There are more and more kids with chronic pain issues and certainly more and more kids with anxiety. I’ve had experience with that in treating kids both in hospital setting with kids with more significant medical kinds of needs, and then also in the outpatient setting. I think it’s a growing area of interest and a lot of parents are really looking for resources around this, so I’m excited to talk about that.
I love the combination of psychology and nutrition, integrated health and special education. I think a lot of clinicians, teachers and parents will definitely benefit from this podcast and your work. Let’s talk about kids with anxiety. When people first think of anxiety, they think anxiety is something that happens to adults when they have a life stressor like a change in a job or maybe a death in the family or a stress in their life of some sort. What do we need to know about kids with anxiety?
I think the first thing is to recognize that anxiety can and does occur in kids of all ages. We know that even very young children can develop a sense of anxiety even in their first year of life. Anxiety is a pretty normal emotion that we experience in certain types of circumstances. It used to be thought that kids didn’t really experience anxiety and that it wasn’t until they got older. We know now that actually young children can experience anxiety. For some of them that anxiety doesn’t just occur in typical situations where we’d experience anxiety. A typical one for young kid would be suddenly looking around at the store and realizing that they can’t see where their mom or dad is. You should feel anxious in a situation like that.
For some kids, that anxiety becomes perpetual, it becomes chronic, it becomes something where they’re not just experiencing it in situations where you should have anxiety. They’re experiencing anxiety or heightened stress or angst in all different things across the day that shouldn’t register that kind of anxiety response. We know that kids, especially who come from backgrounds where maybe there is trauma when they were young, something really catastrophic happened to them, or where there’s a lot of difficulties or upheaval in the family situation or things like that. Those kids tend to be much more prone to chronic anxiety. We also know that there are kids who haven’t been through traumas who either because of genetic predisposition or the environment that they’re raised in or just their own personality, tend to be a lot more prone to having that heightened sense of fear response.
I really talk with parents about it as anxiety is really a heightened fear of uncertainty. Any time we feel like we don’t have control over something or there’s something uncertain in the environment or in a situation, we can experience some anxiety. Some kids become stuck in a really chronic loop of experiencing any kind of uncertainty and then they get really anxious. Their central nervous system gets really activated and they get stuck in that loop of feeling really scared about things that kids that age shouldn’t feel scared of. That can happen to kids all the way along. I think just recognizing that that’s a thing that happens for kids is important as far as figuring out what we need to do to treat it.
Have we gotten better at diagnosing kids with anxiety? I think for so long, just like with chronic pain, we haven’t’ given a lot of attention to this and may have slipped through the cracks of the primary care provider or it may not have been on the radar of the elementary school teacher. Have we gotten better at recognizing this in our whole system, so to speak?
I’d love to say that we have but I think the reality for anxiety is that we’re not quite there yet. Anxiety can present in a really wide range of ways in kids. Often what I find especially for younger kids and elementary-age kids, unless they have a very classic presentation of anxiety, for example, really classic like separation anxiety. Crying every day when mom or dad has to bring them to school or anytime mom or dad leaves, that’s more of a classic presentation, or some kids who have very classic obsessive-compulsive disorder kinds of symptoms. I think we are better at recognizing some of those very obvious types of anxiety issues in kids. Many kids with anxiety who have just generalized anxiety or heightened fear response to things, I think they’re still slipping through the cracks and/or getting misdiagnosed.
A lot of the kids that I see in practice, when they come in they’ve actually been diagnosed by their pediatrician or the school has suggested that they’re ADHD. Really, what’s going on is they have significant underlying anxiety that people have not been aware of and addressed. In kids, inattention and spaciness and daydreaming and not getting work done and all of that stuff, the first instinct is to say, “This kid has an attention problem.” Actually that can be a really big red flag for anxiety issues. I think there are still a lot of kids where their anxiety is not being recognized and addressed early enough. It’s being misdiagnosed or it’s just being putting off as some kids worry or some kids are more nervous or shy than others. That certainly is true, but when you notice that your child’s anxiety symptoms are starting to impact their ability to function, whether that’s at school, going over to friends’ houses, making friends, doing normal activities of daily living, then it’s really time to look at is there something more going here beyond just personality. Is there something more that needs to be treated?
What’s the research telling us, what’s clinical practice telling us as far as why is anxiety showing up in kids more these days than it used to?
I think there are a lot of hypotheses about that. I don’t know that we’ve got definitive answers from the research at this point, but certainly some of the issues have to do with just increased stress in our culture in general. Children back when we were young and certainly when our parents and generations before us were young, the pace of life was slower, parents weren’t pulled in as many directions, just everything was slowed down. Kids had more of an opportunity to go through the developmental process of early childhood in those elementary years without so much stress and pressure.
One of the things that has dramatically shifted, especially over the last 25 to 30 years, is the pace and the pressure of everything in our culture, at least here in the US, has really increased. Kids are starting school much younger than they did. We started school when we were in kindergarten, we went for half a day and we still took a nap, we had play time. That was what kindergarten was. Now, kids are starting school at three years old, four years old. By the time they get to kindergarten, in many states it’s mandated that it’s all day every day. They are not playing and taking naps. They are doing science. They are being taught reading. They are doing math. It’s a much more pressure-filled environment. For many kids, they are just developed mentally not quite at a level where they’re ready for those things. When they’re pushed into an environment like that, it can really increase their uncertainty response, their stress and anxiety response.
I think the shift in education is part of it. I think families are busier, parents are more consumed and pulled in multiple directions and less attentive maybe at times to what’s going on with their kids. As a parent of four kids, I can certainly say that I have noticed that even for myself at times. With an increase in technology and those kinds of things, we just tend to be working more and pulled in more directions. That can impact kids’ development and their resilience and those kinds of things. I think the food that we’re eating has shifted. Kids who may be were not as prone to developing full-blown anxiety issues 20, 30 years ago, now when you factor in the amount of sugar that they’re eating in a day, the amount of processed foods, things that we know make these kinds of symptoms worse in kids, that’s having an impact.
I think technology too. Technology is a great thing but the fact is kids are spending a lot more time with their face in the screen. We know that for many kids, while that can be a retreat and a way for them to feel like they’re soothing themselves in the moment, in the big picture they are not receiving the movement, the physical movement they need each day. They’re not engaging in face to face relationships and developing the resilience that comes from going outside and playing and having to engage with the neighborhood kids or things like that. I think those are some of the hypotheses that we have about why we’re seeing such a massive increase in the amount of anxiety. Those are certainly all areas that to a certain extent we have control over and can improve then from a treatment standpoint.
There are so many great nuggets in there. You talked about nutrition, you talked about movement, you talked about sleep, you talked about all the devices that we’re all currently using. I want to get back to a whole bunch of those, but before we do, for a parent who’s maybe starting to notice or maybe already has noticed that their child has anxiety and now they’re starting to notice, “Now my child also is complaining of pain.” In order to make the connections for the parents or anyone, what is the connection between pain and anxiety in children?
There are a few different paths that this can take. One is obviously for children who have had some kind of medical procedure or medical condition or an injury or something where it started with pain and now has transitioned into chronic anxiety about the pain. That certainly is one path that it can take. You can see how that happens. It’s just what you talked about all the time for adults. Our child starts having some kind of pain issue, maybe it’s a surgery or a procedure they needed. Maybe they fell and broke their arm on their bike or they have a chronic health condition that causes pain, and their central nervous system becomes really sensitized to that. It becomes really hyper-vigilant and aware of that and really honed in on, “How am I feeling? Am I feeling twinges in my body? Am I feeling headachy? Am I feeling sick to my stomach?” those kinds of things.
What can happen for some kids is they get stuck in a loop then of their central nervous system, gets hyper-vigilant and over-activated with those things. Then we pay attention to that. Kids are paying attention to, “How am I feeling?” As adults we ask all the time, “How is your pain? How are you feeling?” especially after an injury or something. That just keeps them more focused on it. That can lead to a lot of anxiety in the bigger picture where now they’re anxious about pain and what they’re feeling in their body, but they’re also avoidant and anxious about anything around them that they think might increase that pain. That’s one pathway.
The opposite pathway that can happen with the connection between pain and anxiety is that you may have a child who, for a variety of reasons, is just more anxious about things in general, more wary of things, just feeling anxious. Then they may start to have physical symptoms that manifest as a result of that. That same thing of, “I’m really worried about what’s going on around me and within me. Then I notice that my stomach starts to hurt a little bit. My stomach’s hurting. Then I tell mom or dad that my stomach’s hurting, and then they’re asking me about my stomach. Then I’m thinking about my stomach and it’s getting worse,” and before you know it, that anxiety now starts to get stuck on these physical symptoms. Very, very commons ones for kids is headaches and stomach aches are the big ones that can be manifested from a pain standpoint.
I would encourage parents, even if you didn’t necessarily notice that your child was having anxiety symptoms, if you’re starting to see recurrent patterns of complaints of headaches, of stomach aches, of those kinds of things especially around certain times like having to go to school or having to go to bed or things like that, obviously you want to have that medically checked out. Most of the time if you’re seeing patterns with that, that’s a physical manifestation, a pain manifestation of what’s going on emotionally. The underlying issue there is going to be anxiety that’s driving that.
It makes me think of being in elementary school where the kids at the school nurse always were the kids that had stomach aches or they had headaches. I think oftentimes the school nurse sees this kind of stuff and they’re screening for it. Hopefully they are referring to the proper practitioner to get treatment. Kids are so observant. They’re like those sponges that really just take in everything around them. What kind of advice can we give to a parent where they have to deal with a kid, they have to advice the child or teen? What should their behavior be like and what should their response be like when they’re trying to live a life with their child and make their child’s life better?
I think this is a great thing to talk about because parents actually have a lot more potential to positively impact these symptoms in their kids than I think most of them realize. Kids are sponges and they learn how to make sense of themselves and their feelings and other people in the environment around them by watching what adults do; particularly adults they’re in close relationships with, parents, teachers, babysitters, that type of thing. One of the big ways that kids start to learn how to understand their physical pain and their emotional anxiety is through the lens of how adults are responding to that.
When kids are in a situation where parents are also very hyper-vigilant and very anxious about every little thing that’s going on with the child, what that does for the child is it teaches them, “These are things I need to be really concerned about and really focused on and really worried about.” Whereas when parents can step back and just be more calm and not so anxious and hyper-vigilant in their approach, kids then learn to say, “Maybe this isn’t that big a deal. I’ve got a tummy ache but I can go get a drink of water, I can take a walk, I’ll feel better.”
Parent responds in two ways. Parent responds to their own things that come up in life because remember your kids are watching you all the time. If you as a parent tend to be very anxious and very attuned to everything that’s going on with your pain or your anxiety, like every time you have a headache you make a big deal out of it, “I have to lie down and I can’t go to work,” and all of these things, that’s going to teach your child to think the same way about their pain. You want to be really careful and just aware of your response with your own stuff that you’re experiencing, but then also how you respond to the child is important too. If your child comes to you and says, “I’m having this headache,” what you want to try to avoid is overreacting to that, “Oh my gosh, you have a headache. How long have you had it? How bad does it hurt? Let’s get the Tylenol.” You want to try to just stay really calm and maybe ask some questions, “I’m really sorry you have a headache. Let’s think about that. How much water have you had to drink? Maybe it would be good to just get some fresh air for a little bit. I know you’ve had a really stressful day, talk to me about what’s been going on.”
When you approach it in that way, a curious way but a calm way, and you don’t plant ideas in their head, you let them tell you what’s happening, that’s going to really help the child to develop much less anxiety around physical symptoms and pain they’re experiencing. They’ll mirror what the parent is doing and the response. If you want your child to learn to stay calm and cope better and problem solve through pains and anxieties, then you have to model that as a parent.
Modeling behavior is so, so important. As a licensed psychologist and also a nutritionist, I think a lot of parents as well as psychologists are really becoming aware of nutritional influences on the brain and behavior, how do you start to address nutrition with the children and the parents that you see that come in to your clinic? When you go see a psychologist, you know some of the things that are going to happen. You know you’re going to be talking about life and stress and things like that but you don’t expect them to ask you, “What did you have for dinner yesterday?”
I think it’s one of the things that makes people like me unique in that we combine those two. I’m starting to see that happening more in the field of mental health. I’m hoping that the next ten and twenty years that’s going to be a standard of practice in psychology, social work, all of these kinds of mental health fields where people are recognizing the connection between the foods that kids are eating, their nutrient levels, those kinds of things, and how they are feeling and how they are functioning because there is so much research coming out that supports that; that there is a huge connection between food and nutrient status and depression and anxiety, chronic pain, all of those kinds of things. I’m hoping that that’s going to become more of the standard.
Nutrition is one of the first places I start to intervene with kids and families with anxiety and chronic pain because we can see a difference so quickly. I use psychotherapy techniques, mindfulness techniques. I teach them breathing. I very quickly start to teach kids some good coping tools for them to have. Nutrition is an area where we can quickly see a change without the child needing to do a whole lot of things that are different. I look at areas like stabilizing blood sugar is a big one. When I have a kid who’s presenting with anxiety or panic, having chronic pain complaints, it’s not uncommon when I look at what they’re eating that I see that basically they’re going through huge sugar spikes and crashes all throughout the day. They’re having a bowl of frosted flakes for breakfast with chocolate milk. Then for snack time, they’re having a granola bar, which nowadays tends to be more of a sugar bar. Then for lunch, they’re having maybe a peanut butter and jelly sandwich on white bread and they’re drinking strawberry milk in the cafeteria and they’re having M&Ms with that.
Basically what’s happening then for kids who are eating that amount of sugar-processed foods, refined carbohydrates, they’re spiking their blood sugar which registers for many people who are experiencing chronic anxiety as anxiety. When we have a spike in our blood sugar, our heart rate starts to increase, our blood pressure increases, our temperature can increase, our body revs up. For kids who are very prone to feeling anxious, those feelings in their bodies as their blood sugar rapidly rises feels to them like anxiety. They begin to go into a very anxious, very hyper-vigilant state and then they’re crashing. That sugar burns through and then they’re crashing and now they feel sluggish and moody and irritable and all of that.
One of the best ways that we can start to stabilize that for them is to reduce the amount of sugar, make sure they’re having protein to start their day. Parents, this is a huge one for your kids with anxiety and chronic pain complaints. Start the day before school with some protein, not with the sugary cereals or the Pop-Tarts or those kinds of things. Protein and healthy fats are really great whether it’s a protein shake or even meat. People have weird ideas in this country about what’s breakfast food. In Europe like the patients that we treat overseas are like, “We eat meat and eggs and all that kind of stuff for breakfast.” Those are the kinds of things that help stabilize kids’ bloods sugar and helps reduce the amount of ups and downs that they’re having physically and emotionally then based on that. That’s a big one and just making sure that they’re not having a ton of sugar, caffeine, artificial things throughout the day.
There’s a big connection now in the research between things like artificial flavorings and chemicals in food dyes. Artificial sweetener is a big one, things like aspartame and sucralose, high fructose corn syrup. The research is showing us that kids who consume diets that are high in those kinds of things do tend to have heightened anxiety, mood issues and those types of things. I really help parents to think about swaps that they can make. Sometimes parents will say to me, “My kid’s not drinking caffeine. I don’t think they’re getting caffeine,” because caffeine is a big one for stimulating kids and making them feel anxious. When I start having them look at the labels of stuff that their kids are ingesting throughout the day, they actually are getting caffeine without them realizing it through some of the beverages that they’re doing even through some of the foods. You want to be careful with that.
This is a big one I see more in the last couple of years with teenagers as energy drinks have become more popular and they’re in the vending machines at schools. I’ve got these kids coming in, these thirteen-year-olds, sixteen-year-olds, eighteen-year-olds and they’re like, “I’m anxious. I’m having panic attacks all the time. My headaches are through the roof. I’m nauseous.” When you have Red Bull regularly throughout the day, that’s what’s going to happen. It’s really educating them and educating parents of the connection between those things, and why drinking water in a water bottle is a better choice and how that is going to very, very quickly reduce the anxiety symptoms, reduce the headache symptoms, those kinds of things. Those are some of the dietary things that we tend to start with.
I love the nutrition part. I think it’s amazing that you’re bring it into your practice and I’m sure a lot of psychologists will be interested in hearing more about it. Of course they can read about it in your book, Life Will Get Better. There’s a local high school near me and on their football stadium, it has a big Red Bull sign. So you know that this stuff is being marketed to kids at a very young age and it has an impact on them both physically and mentally. I have a friend who has a young child and the kid is about two years old. I was amazed that the kid can pick up an iPhone and start to use it at the age of two. I’d like to know what kind of impact all of this screen time on iPhones and big screen TVs and computers and iPads, and all the types of screen time that kids are coming across, how does it impact their health?
It’s a blessing and a curse. On the one hand, technology’s great. It gives us access to things that we wouldn’t have access to and it certainly can be a valuable learning tool for kids. The curse part of it is that it has become so predominant in society that even infants now are learning how to swipe on a tablet before they’re learning how to turn the page of a book or how to put shapes in a shape sorter. Certainly, just like everything else, moderation is key and I don’t think we’re there yet.
Technology is so new that I often talk about people who are parenting right now. I’ve got kids who are eleven to seventeen years old right now. Those of us who are parenting kids right now are really on the forefront of this. We’re really the first generation of parents that has had to deal with technology issues from birth through our kids’ childhoods. We haven’t figured out that moderation piece yet, at least lots of people haven’t. What studies are showing is that kids are spending far above the amount of time that’s recommended that’s safe and healthy for them in front of these devices. That can be for a variety of reasons. It’s an easy thing to stick your kid in front of, put the baby in front of the iPad to watch shows or games or things, same for toddlers. You can hardly go into a restaurant or a grocery store without seeing babies and toddlers and pre-schoolers in the cart with their iPads and their iPhones and things. What the research is showing us is that when kids spend an increased amount of time like that in isolated activities, they’re in isolation. They’re not engaging with other human beings or with the environment around them. They’re engaging in something that’s going on on a screen in front of them. It can have very detrimental effects for their communication and language development. It can have detrimental effects on their social skills, their ability to read people and situations and relate to people.
Physically, it’s a problem because kids are much more sedentary now as a result of technology. We know especially in those birth to first, second grade years, kids’ brains develop through movement. Their bodies develop their movement but people often don’t realize that brain development happens as a result of physical movement and engaging in physical activity. We’re seeing now changes in kids’ brain development as a result of passive stimulation from these devices and a sedentary lifestyle. I’m a huge proponent for all parents to be aware of these issues and monitor and regulate use of these devices for their kids. Especially if you are a parent who has a child with anxiety or mood issues, behavior problems, learning issues, any of those types of challenges, it’s an area that you really have to be concerned about and paying attention to. The research is just becoming clearer and clearer that it’s unhealthy for our kids and a lot of cases can be exacerbating the symptoms that they’re experiencing.
It’s a great advice. This may be specific based on the patient or their diagnosis, maybe their age even. Do you have a recommendation as to how many hours per day or how many hours per week that your child should be on or off something that’s electronic?
Yeah. I tend to use The American Academy of Pediatrics Guidelines as a good general guideline for parents to think about if they don’t have kids with problems. In general the recommendation is that babies should not be exposed to screens at all, or in that birth to two-age range, if they are going to use it like something like FaceTime to be able to see grandparents or family members at a distance. If they are using devices it should always be in the context of a parent or a caregiver using it with them. There is person to person engagement with the technology. Then from two to about four or five years of age, the recommendation is an hour or less of exposure. After five, once kids get into school, it becomes a mercurial issue because of how much time they’re spending in school on these things. What the American Academy of Pediatrics has moved towards now is helping parents to think about how much use and access their kid is having across the day and making sure that they’re getting all of the other things in to their life and their day before prioritizing technology. What I talk about with parents for elementary-age kids, for example, is do they have all their chores done? Those need to be a priority. Have they played with friends? Have they gone outside or gotten physical movement for at least an hour a day? Have they done the things that they need to do? Then the technology use becomes something that happens after all of that. That’s a good way to try to find some balance there.
For kids who are having more chronic or intense mental health or behavioral symptoms, that does need to be tailored depending on how they’re doing. Some kids really need a full detox and complete abstinence from use of those things for a while. Some kids really would benefit from that, but we have to very gradually over time decrease their use because they’re so obsessive and entrenched in technology use that it becomes dangerous actually. They become physically dangerous if you try to take that away from them. For kids with more significant kinds of symptoms, it helps to work with a practitioner who understands these issues and can help you develop a plan for that, but that gives people some general guidelines.
It’s a great guideline for parents and teachers alike. I think it’s important that we at least touch on psychiatric medication for children and maybe where we are and what you’re seeing in practice and how that feeds into what we’re seeing happening with opioids in the United States and perhaps globally?
I think this is such an important issue for kids with any kind of mental health issue, but particularly when we’re talking about pain medication for kids with more substantial chronic pain. There has been this 30 to 40-year, maybe even a little longer than that now, history in mental health of we have these pills that can address these symptoms. We have Prozac. We have Xanax. We have all these different things that can address this. While it was really appealing initially to think about there are pills that can help with this, the research over the longer term has shown us that actually these medications tend to cause a lot more problems for people than they solve. A lot of the theories and the ideas behind why these medications work have now been shown by the research to not be true. We know that patients both children and adults who have been treated with psychiatric medications don’t have much greater chance of being better in the long run than people who have never used them.
There are a lot of concerns around them. I think particularly for children, one of the things that parents need to understand is there is very, very little research on any of these kinds of anti-depressants, anti-anxiety medications, any of these kinds of things in a pediatric population. It’s basically using the limited research we have for adults and then saying, “Kids are like little adults.” Kids are not like little adults. We don’t have really any good research to support our understanding of what happens over the long-term with kids on these medications. We’re starting to see some of that come out and it’s not good. There are lots of reasons to be concerned about short-term and long-term side effects, especially when we have research showing that teaching kids coping skills, using mindfulness-based stress reduction, using nutritional intervention, using Cognitive Behavior Therapy, these kinds of approaches are equally or more effective than prescription medication. They should certainly never be a first-line treatment.
Where I start to get really concerned about this in the context of kids who have anxiety and present with chronic pain symptoms, is the message that we embed in these kids from early on about the origin of their symptoms, how much control they have, and what can happen for them. This idea that a kid isn’t paying attention in class and we say, “There’s something biologically wrong with your brain. Here’s the pill to fix that. You can’t control that. We have to give you medicine for that.” Or a child who presents with anxiety and some headaches, for example, and we say, “You’re having headaches. You can’t control that. That’s something physically wrong with you. Here, we’re going to give you a medication for that.” What we start to embed in kids’ minds then over time is this idea that these symptoms are things that happen to them that they have no control over and no matter what they do, they won’t be able to make them better. That really flies in the face of what we know about why all these other interventions work. I think we set kids up to develop into teenagers and adults then who really feel like they have no control over what happens to them and who feel like every problem that I have in my life, the best thing I can do is just take a pill to make that better. As you and I know, that becomes really problematic when we start looking at things like opioid pain medications where it’s like, “I’ve been having this pain. I get put on Norco or something like that. I have to keep taking that because if I don’t, I have pain and there’s nothing else that can be done for it.” We open the gate early on in kids’ lives to set them up as adults to be people who just really believe that that’s the best that they can do and then develop secondary addiction issues and other kinds of problems as a result of that.
I think there are a lot of reasons to be cautious and concerned about that, and all the more reason to identify these kinds of issues as early as we can and to teach kids and parents healthy adaptive coping skills, how to modify their nutrition and their lifestyle, and use strategies that really can help them feel more in control and get them on a better path so that we hopefully can avoid some of those kinds of problems with medication dependence and substance use and those kinds of things later on.
I love the fact of being cautious and concerned. Before you decide to maybe place your child on medication, I’d love for you to check out Dr. Nicole Beurkens’ work. You can find her on her website at www.DrBeurkens.com. Dr. Beurkens, can you tell everyone else where they can learn more about you and all the amazing things that you’re up to?
The website has everything. For parents who are interested in the things that we just touched on briefly today, the Life Will Get Better book will really give them a lot more in-depth information and really give them techniques that they can start using right away with their kids. They can find that on Amazon, they can find it at LifeWillGetBetterBook.com. That’s a little easier for people. I know my last name is tricky to spell. Also on my website, there is an online program that parents can go through to really step by step take them through these different areas to address these symptoms for their kids. That really came out of my desire to be able to help more people with these things than what I can do daily in my clinic. That online program takes them through that, and lots of blog articles and lots of resources for them on the website as well, so they can check that out.
Make sure you check out DrBeurkens.com and LifeWillGetBetterBook.com. She has tons of great resources there whether you’re a practitioner or whether you’re a patient or someone who’s looking for resources for children with chronic pain and anxiety. I want to thank Dr. Beurkens for being on The Healing Pain Podcast this week. Please make sure you share this information with your friends and family and give us a five-star review on iTunes. We’ll see you next week.
About Dr. Nicole Beurkens
A unique combination of psychologist, nutritionist, and special education teacher, Dr. Nicole Beurkens, has 20 years of experience supporting children, young adults, and families to improve behavior naturally. She is an expert in evaluating and treating a wide range of learning, mood, and behavior challenges including ADHD, autism, anxiety, mood disorders, and brain injury.
Dr. Nicole has a doctorate in Clinical Psychology, masters degrees in Special Education and Nutrition, and is a Board Certified Nutrition Specialist. She is the Founder and Director of Horizons Developmental Resource Center in Grand Rapids, Michigan; and is a best-selling author, award-winning therapist, and published researcher. When she isn’t working, Dr. Nicole enjoys being a mom to her four kids who teach her new things every day.
Link to speaker: https://www.drbeurkens.com/
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