Now Available: Because They’re Kids Podcast

Anne Baum (00:00):

How can you support your child’s mental health and wellness? Are there warning signs that your child may be struggling? What are some ways to help your child cope with anxiety or depression? All that and more on this episode of Because They’re Kids. Kids aren’t little adults. They’re built differently, physically and emotionally. That’s why we launched a podcast built just for kids and their parents. As a parent myself, I know how important it was, as my children were growing up, to prioritize their mental well-being. Today, we’re diving into mental health in kids and how you can support your child’s mental health and wellness. Here to talk about children’s mental health are my guests, Dr. Monica Lancellotti, a pediatrician with LVPG Pediatrics–Pond Road, and Thes Godshalk, Director of Children’s Hospital’s School-Based Behavioral Health program. Monica, Thes, welcome to the show.

Monica Lancellotti (00:59):

Thanks for having us.

Thespina Godshalk (01:00):

Thank you for having us. Happy to be here.

Anne Baum (01:03):

Why do mental health and well-being of our youth matter?

Monica Lancellotti (01:06):

I think, as parents, we certainly want our children to be healthy, successful adults, and supporting their mental health and well-being is vital to have that.

Thespina Godshalk (01:15):

Absolutely. And I think that mental health is just an integral component of well-being. And so, it’s important to start those conversations in the family home as early as possible.

Anne Baum (01:28):

That’s great. So what’s the difference between mental health and wellness and mental illness? I know that’s something that we hear a lot about, but what really is the difference between them?

Monica Lancellotti (01:40):

So mental health refers to our overall emotional, psychological well-being. Mental illnesses are diagnosable mental health conditions. Everyone has mental health, but not everyone receives a diagnosis involving mental illness.

Thespina Godshalk (01:56):

Right. I would agree with that.

Anne Baum (01:59):

How does one go about getting those answers? As a parent, is your child just unruly? Are they having a bad day? When do you know that you need to reach out for that additional help and advice?

Thespina Godshalk (02:14):

Well, that’s a really great question, and I think that can be complicated by youth itself and a child who’s moving through the stages of development. But if you’re sensing some changes, you’re seeing your child maybe doing different things, maybe retreating, withdrawing, or just making choices they wouldn’t normally make, I think that, then, you can really start to look at maybe consulting a professional.

Anne Baum (02:40):

And then, how do you impact your child’s health and well-being? What are some things you can do to promote mental health, but also be on the lookout for some of those changes or challenges?

Monica Lancellotti (02:54):

I think, as a parent, it’s really important to have an open conversation with your children, to be there, available, one-on-one, to kind of be their advocate and also to support them in any changes that are going on in their lives. So keeping that open conversation, I think, is vital to support their mental health.

Anne Baum (03:14):

That’s great. I think being a great listener is important, but as a parent, you kind of want to solve the problems that your children have. So how do you balance that, be a good listener, but not try-and-solve the problems that they’re teeing up to you?

Thespina Godshalk (03:33):

Again, that’s a really big challenge, I think, for parents. We want to try to solve the problems, like you said, before they happen or as they’re happening. And so, when I talk to parents, I’ll often say, “Listen nonjudgmentally as much as you can.” Your brain may be working and thinking of solving problems, but it’s really important, in that moment, to just listen and listen attentively. So nodding your head, making eye contact, putting aside distractions that you may have, like cellphones or work, if you can put that aside and devote the time to the conversation, that’s very helpful.

Anne Baum (04:12):

And as you’re being that nonjudgmental listener, what if they say something that’s startling or worrisome? What do you do next, when you hear something like that?

Monica Lancellotti (04:26):

I think trying to compose yourself in the moment is really difficult as a parent, but is really important, to try to take a deep breath and acknowledge their feelings, acknowledge what they’re saying to you, and tell them that you want to help them and that you know ways to help them.

Anne Baum (04:45):

So how do you know when your child is struggling emotionally?

Thespina Godshalk (04:49):

I think you might see big changes, changes in mood, changes in behavior. You can see self-harming behavior sometimes, and again, some kids are doing that already. Again, not that it’s a healthy behavior, but some kids are already in that. So you may be seeing some self-harm behavior, unexplained changes in weight, unexplained changes in eating patterns or sleeping patterns. All of those things become very important. But I would also say trust your gut. So if you’re looking at your child and you’re thinking, “I think something’s different, I think something’s wrong,” even if you can’t put your finger on it, it’s a good time to have a conversation or maybe seek out professional help.

Anne Baum (05:38):

So that’s really, when something is different enough, that’s when you reach out for that extra help?

Monica Lancellotti (05:46):

Yes, absolutely. So you know your child best, and certainly, if you feel like your child is just not acting like the way they normally would, having a conversation with that child to start, and then seeking help if you feel like there are some warning signs.

Anne Baum (06:01):

And if you feel that, you feel like you need help, where do you get that help? Where do you go? Is it the emergency room? Is it your pediatrician? Where is that help available?

Monica Lancellotti (06:11):

So if your child is not in an active suicidal threat, then starting with your child’s doctor or pediatrician is a great first step. If there’s a concern that they have an active suicide risk, then they should be seen in the emergency room at that time.

Anne Baum (06:28):

And is that a 911 call? Is that a get in your car and drive call?

Monica Lancellotti (06:34):

It depends on the degree of threat, I would say. Use your judgment in that moment, but if you’re really concerned for your child’s safety, you can utilize 911.

Thespina Godshalk (06:44):

Yeah. There’s also the 988 Suicide Prevention Lifeline. So if you are uncertain or feeling like you need a little more help to even make that decision, you can call the 988 lifeline or your local county crisis [office] can also be helpful in that way. So calling them, you don’t have to be the suicidal person calling. You can be a person who’s helping that person. So as a parent helping a child, you can call and just talk about the situation with them and maybe get some help in that moment for that judgment call.

Anne Baum (07:23):

That’s great. And is that a 24-hours-a-day, seven-day-a-week number?

Thespina Godshalk (07:27):

Yes. That is 24 hours a day, seven days a week.

Anne Baum (07:30):

Great. That’s wonderful. So how often should you talk to your children about mental health, mental wellness? I know, I would often get like, “Mom, I know, I know.” So where do you draw that line between being too pushy, talking about it too much, or not enough?

Monica Lancellotti (07:52):

I think it’s important to talk often. Certainly, you don’t want to be asking them multiple times a day how they’re feeling, but having one-on-one conversations with your child on a regular basis is important, and making sure that they know that they can always come to talk to you, if they need to talk about something. One activity we do in my household is just, at the dinner table, sitting around and talking about a sunshine or positive experience that we had that day and a cloudy or not-so-positive experience. And that really helps foster conversation in our household.

Anne Baum (08:25):

Oh, I love that. Sunshine and cloudy. That’s great. That’s great. So how can you nurture your child with their mental health and their well-being? What are some of the activities or things, like the sunshine and cloudy day, that you can do to really nurture them, help them grow, help them be mindful and well?

Thespina Godshalk (08:49):

Monica, I love that as well. Such a great activity and just fostering communication. And I think it’s more activities like that. I often say modeling is important. So recognizing, as a parent or a caregiver, your own mental health, seeking help for yourself, if you need it, or in moments of stress, seeking out activities that help you, just modeling that can be a wonderful thing for your children to see. And also, how you approach mental health and your perspective on mental health. So even without talking directly, you can encourage maybe a child to feel comfortable with that conversation.

(09:31):

I say, as an example, if your child has a friend who’s struggling, your perspective on that, saying, “Boy, I really hope your friend gets help. It’s really important to get help if you’re struggling with your mental health,” that opens the door for conversations, so that, if they are feeling or experiencing difficulty in the future or at any point, they’ll feel comfortable coming to you to have that conversation. So I think that’s a really important piece. And then, again, Monica, I go back to your activity, that incorporating mental health discussion into everyday discussion. So just like you’d say, “Did you sleep well? Are you hungry? How are you feeling emotionally? How are you doing today? Did anything stressful happen today in your day?” All of those things can be great ways to bring mental health into the conversation without really being very on point and direct, which can sometimes be uncomfortable, if it’s the first time you’re having that discussion.

Anne Baum (10:31):

So that sounds like some really good ways to support your kids, emotionally, really help them feel comfortable with the topic. What are some other ways that, whether they’re struggling or even if they’re not struggling, how do you continue to provide that support to them?

Monica Lancellotti (10:51):

I think just being present, present to them, having those moments where we take away our electronic devices and give each other attention is very, very important. Offering support, but also fostering independence, is very important for children. As parents, we set the boundaries in our household, but we also can offer that sense of independence and safety to them as well. So I think all of those factors can play a big part in how parents can play a role in fostering that well-being.

Anne Baum (11:23):

That’s great. And I liked how you said, “Really be present,” because you could be on your phone or writing or cooking or doing different things and you’re not really present if you’re doing that. So you’re saying, “Stop what you’re doing,” which is probably good for us too, “and actually sit and pay attention.”

Thespina Godshalk (11:45):

I feel like there are many times where, if you do that and you have that pause, everyone comes out of that feeling like they’re really happy that that happened. “I’m glad we took this break. I’m glad we had this conversation.” So it really is a good thing, even if it seems, in the beginning, it can be difficult to put things down, when you’re in the middle of everything, especially as a parent, but that time is always going to have positive return, I would say to you.

Anne Baum (12:14):

For everybody.

Thespina Godshalk (12:15):

For everybody, yeah.

Anne Baum (12:17):

Right. Yeah. We can all use a little downtime, right?

Monica Lancellotti (12:20):

Yep, absolutely.

Thespina Godshalk (12:21):

Always.

Anne Baum (12:23):

So let’s talk a little bit about mental illness. How does mental illness affect mental health?

Thespina Godshalk (12:34):

Mental illness, when you’re talking about mental illness, I would say mental health is like being on the road. We’re on the road, on this road of our mental health, and sometimes, we get off of that road, we kind of start to veer off and get into the bumps and get into maybe the brush. And that’s really what I feel like mental illness is. … There’s negative impact on your mental health, to the point where it’s impacting your daily life, in ways that are pretty intrusive. So in kids, I think we see sometimes school avoidance, lots of anxiety. I think we see some self-injury. So all of those can start to lean into, “My mental health is negatively impacting my life, my ability to do things or interact with my friends or my loved ones.” That’s really, I think, when you start to go down the road of mental illness, interfering with daily life.

Anne Baum (13:35):

And for a kid, since they’re a kid, they may not even realize that this is impacting what should be their more normal way of living, right?

Thespina Godshalk (13:48):

Yeah.

Anne Baum (13:48):

So as a physician, how do you figure that out with parents and their kids when they show up? How do you know when it’s that mental illness versus just a bump in the road?

Monica Lancellotti (14:03):

Certainly, mental illness is something that should be persistent, should be something that’s really impacting everyday function, and, in many cases, should be present for at least a couple weeks to make a true diagnosis. I think, as pediatricians, we do a lot of screening tools as part of our well visits. And so, starting at age 12, at all well visits, we do screen for depression using existing tools. And so, that can kind of help us gauge whether your child does need some intervention or some assistance with handling mental illness. And if there’s any concern that a parent brings, we have other tools in place as well to address other mood disorders and to screen for them.

Anne Baum (14:49):

So you’re looking for it even if a parent hasn’t brought it to your attention?

Monica Lancellotti (14:55):

Absolutely. We look for it in everyone.

Anne Baum (14:57):

And in children and teens, what are the common mental illnesses and disorders that you do see?

Monica Lancellotti (15:04):

The most common ones would be ADHD [attention deficit hyperactivity disorder] or ADD [attention deficit disorder]. So issues with attention, focus. And then, we have the mood disorders, like anxiety, depression and bipolar disorder.

Anne Baum (15:17):

And do you often see many of them together?

Monica Lancellotti (15:22):

Yes, many of them can coexist, like anxiety and depression. Many children that have ADD or ADHD can also suffer from anxiety, so they can correlate together.

Anne Baum (15:35):

And what do you think is the most misdiagnosed mental illness in children?

Thespina Godshalk (15:42):

Well, I think that we see a lot in our school-based behavioral health program of kids that are labeled as defiant sometimes – or oppositional defiant disorder’s the technical diagnosis – but that they’re having some amount of defiance or they’re not listening or they don’t want to listen. And I think a lot of that often comes down to an undiagnosed attention disorder, sometimes an anxiety disorder or a depressive disorder. Sometimes even a learning disorder can make a child appear to be resistant. So I believe, really strongly, it’s diagnosing defiance or that oppositional defiant disorder, that really sometimes is overdiagnosed, when there are underlying issues that we’re not looking at.

Anne Baum (16:32):

Sure. As a society, I think we’ve gotten much better about talking about mental health and mental illness, but there still is a stigma that goes along with it. So when your child is diagnosed with mental illness or a disorder, how do you explain it to them, so that they understand that it’s something that they can work on and grow from and not take it as a negative label?

Monica Lancellotti (16:59):

I think I would look at it kind of like physical illness. So certainly, there is physical illness, we get injuries, or something just doesn’t work quite right in our body, and so, we have to go to the doctor to kind of address that issue. Well, the same thing with mental illness. There’s something not quite right with how we’re thinking or behaving, and we need some help to get us on the path again and to grow from this. But I think, just trying to keep a positive outlook on things, to be supportive, and to know that there’s a lot of people, there are a lot of kids that are dealing with this same issue and we will learn something from this experience and learn to grow through our childhood.

Anne Baum (17:45):

That’s great. So let’s talk a little bit about anxiety. That was one of the top ones on the list. What are signs of anxiety in kids and adolescents?

Thespina Godshalk (17:58):

I would say that we see a lot of fear, a lot of worry, and then, that can manifest itself in physical symptoms as well. So maybe nail biting, chewing on their fingers, or picking at their skin. Inability to focus or concentrate can also be another sign of anxiety, so in their head or just feeling so nervous that they really can’t concentrate on what’s in front of them. So those are all signs that we see. There can be difficulty with sleeping, maybe not being able to get to sleep, because of worry, or stay asleep. Maybe they’re having nightmares even, stress dreams. All of those, I think, can be signs of anxiety in kids.

Monica Lancellotti (18:44):

And I think, sometimes, for children in particular, they’ll present with somatic complaints. So more like bodily complaints, like headaches or belly pain or even chest pain, and trying to tease out where those symptoms are coming from.

Anne Baum (18:58):

And do you often see that that’s the reason they show up at your office with the physical symptom and then ...

Monica Lancellotti (19:06):

Absolutely. And then, you kind of talk more to the child, even one-on-one, and you uncover that there’s more behind that.

Anne Baum (19:13):

And I understand there’s lots of different types of anxiety. Can you talk a little bit about the different types that exist?

Thespina Godshalk (19:21):

Generalized anxiety disorder’s one form of anxiety disorder. So this can manifest itself in perfectionistic sort of behavior, just generally feeling like things are overwhelming or out of your control. There’s a separation anxiety. So this is obviously separation from a parent or a loved one, and that can come with upset, tearfulness. I think we experience a lot of kids who are coming to school for the first time, who are experiencing some of this, having that difficulty separating from a parent. Especially having just been through the pandemic, very scary times for some of our younger kids. And so, now, they’re feeling even more resistant to that separation. So that can promote a lot of anxiety. And then, social anxiety as well, so anxiety in social settings. So going into a classroom full of kids or having to give a speech or a presentation, those things can be really, really challenging for kids who have a social anxiety disorder. Selective mutism, just almost being mute in some situations, so not speaking.

Monica Lancellotti (20:36):

In situations where you’d expect someone to be able to speak.

Thespina Godshalk (20:39):

Yes, you would expect a response.

Anne Baum (20:41):

Like if you’re on a podcast?

Monica Lancellotti (20:43):

Exactly.

Thespina Godshalk (20:47):

That can be that, right.

Anne Baum (20:50):

So in kids, obviously separation, that would be something that would trigger the anxiety. The social anxiety, coming into a room with other kids. With the generalized anxiety, what are some of the triggers? And as a parent, if your child has one of these different types of anxiety, how can you think through how to best protect them in those situations or give them the tools to manage through?

Monica Lancellotti (21:23):

I think, certainly, those anxieties can be triggered by different transitions, like moments of transition, so changes that happen with just the school year or transitions from the school year to summertime can be difficult. Major life changes, like family structure, such as divorce occurring, the death of a loved one or some sort of traumatic experience, can trigger anxiety. And I think, certainly, coping mechanisms are important to have in place to help your child. And that can certainly come from a health care professional, like a therapist or a counselor, to give them strategies to help them through those times.

Anne Baum (22:03):

That’s great. And at what age? Is anxiety age dependent? Can you be 2 or 3 and have anxiety? Or does it only show up as you’re older? Is there an age where it starts?

Thespina Godshalk (22:18):

I wouldn’t say that there really is. I think the thing with anxiety, but I would say all mental illness, is that there’s no discrimination in who it’s happening to. And so, kids as young as 2 and 3 can really experience some measure of anxiety. You can see that in kids just that young. And then, certainly, as they’re getting older, you might see more of that perfectionistic behavior, tearfulness, nervousness, worry about doing things independently. I always say, for school-aged children, going back to what you said, Monica, lots of trips to the school nurse. So not feeling well. But yes, certainly any age, it can be any age.

Anne Baum (23:02):

And does the treatment vary by age? How do you treat anxiety?

Monica Lancellotti (23:08):

I think the approach is fairly similar. I would say, initially, I think an important step to incorporate would be some form of therapy. So that can be through a school-based counselor or a psychologist. It could be through just a behavioral therapist, and certainly talking to your child’s pediatrician or health care provider for a list of resources. One specific resource we have locally here at Lehigh Valley Health Network is a group of pediatric embedded therapists, that work through our pediatric offices, to provide just short-term therapy resources for children and their families. So that’s a great first step. And then, certainly, medication is something that we can always discuss, if necessary, as well.

Anne Baum (24:02):

So you start with therapy and then, work from there?

Monica Lancellotti (24:05):

Yes.

Anne Baum (24:06):

That’s great. Now, what if anxiety goes untreated? What does that potentially lead to?

Thespina Godshalk (24:14):

Well, I really think that you’re going to see more and more impact on daily life. So this is when you’re going to see major changes, I think. Again, we talk about that school avoidance, for school-aged children, maybe poor academic performance, they’re just not able to focus and concentrate. They may have difficulty with their interpersonal relationships, so maybe they’re being invited to a birthday party or a group activity and they don’t want to go, so they’re withdrawing from things. So all of those can be [the] impact of anxiety.

Anne Baum (24:52):

And what are some things, when your child is experiencing anxiety, what are some things that you could do to help them through it, help them manage through that moment when it’s actually happening?

Monica Lancellotti (25:06):

There are certainly grounding techniques that can be helpful to just kind of identify different things that you can perceive through your senses to help you ground yourself in that moment. And then, I really like just breathing techniques, taking three deep breaths to kind of help calm your bodily response during those anxious moments.

Anne Baum (25:27):

That’s great.

Thespina Godshalk (25:28):

And they have, if you even go on YouTube, they have lots of videos, Sesame Street videos, even for younger kids, to talk about how to breathe, taking a pause, or like those grounding exercises, Monica, you were talking about, maybe three things you see, three things you hear, and three things you smell. So you can ground that way, bring yourself back to the present, and kind of focus on the here and now. I think that also it’s helpful, especially in the beginning for parents or for educators, who’s ever in the environment with that child at the time, to help them almost co-regulate. So to help them to do that, to teach them how to do that, sometimes you’re doing that with them. So kindergarten, even younger than kindergarten, I’d say, you can co-regulate, you can sit with them and say, “Can you take a deep breath? Do you feel it in your tummy? Can you hold it there? And then, OK, now, let’s release our breath.” And you’re doing that with them to teach them that skill.

Anne Baum (26:30):

Oh, that’s great. Because you might say, “Take a deep breath,” but if I’m a kindergartner, I may not know what a deep breath really means. So that’s awesome.

Thespina Godshalk (26:39):

Yeah.

Anne Baum (26:40):

Great. All right, well, let’s switch our topic to depression, another one that was on your list. So as a parent, how do you know, is your child just sad and having a bad day or are they struggling with depression? What’s the difference? What are some of the signs?

Monica Lancellotti (26:58):

So certainly, everyone feels moments of sadness or feeling down at some point in their lives, but the concern would be if this is impacting daily function and, in the case of depression, if it’s been present for more than two weeks on a daily basis. And different signs of depression, most commonly, you can see disruptions in sleep, a lack of interest in doing things that they previously really enjoyed doing. They could have feelings of guilt, changes in energy level. So lack of energy and difficulty concentrating at school or at home, changes in appetite, and then, obviously, the warning sign of feelings of thoughts of suicide.

Anne Baum (27:46):

OK, so what are some things that can cause depression in youth? Is it something that happens to them, that really brings this on? What are some of the causes?

Monica Lancellotti (27:59):

I think, certainly, genetics can play a role in certain respects. If a parent or a family member has a mental disorder, a child can be at increased risk for developing that disorder as well. And then, certain life experiences, trauma in particular, bullying, I think, can be a big risk factor for bringing on depression, especially amongst teens.

Anne Baum (28:23):

And if you notice some of these signs, how can you help your child with depression? What are some options that are available?

Thespina Godshalk (28:33):

I think open dialogue, like we were talking about earlier, is very, very helpful. I say, sometimes to parents, “I noticed” is a great way to start. “I noticed, I noticed you’re not hanging out with your friends as often.” Or, “I noticed you haven’t been to soccer practice or you’re not really enjoying the things that you used to enjoy.” So you can start the conversation by just bringing up your observations in a gentle way. I also think it’s important, with people who are experiencing depression, they sometimes can feel a sense of burden that they are a burden. And so, it’s also, I think, really crucial that, as you’re having the conversation, you just try to really make sure that that person knows that you want to be there with them, that this is important, that you want them to be able to talk to you or talk to someone, because they’re an important person and because they’re loved.

(29:26):

So I think that can be a great starting place. And then, certainly, assuring them that help is available and that this is not a permanent feeling for them. That’s another thing that can happen with people who are experiencing depression, specifically adolescents, is that they feel it’s a very permanent situation. And it’s not. It’s treatable. And so, we want to give them that hope and then, help them seek out a professional. So along with them, let’s look at some therapists maybe. “Where would you like to see a therapist?” So Lehigh Valley has school-based behavioral health services in many schools, and many schools have services that can support a child who’s experiencing some mental illness or depression. So that would be my starting point for support. Or the primary care physician as well would be another place to start.

Anne Baum (30:17):

Yeah, that’s great. I love giving them hope and letting them know that they aren’t a burden.

Thespina Godshalk (30:22):

Yeah.

Anne Baum (30:24):

It’s got to be hard, as a parent, when you notice this and trying to reach out. How do you help the parents not feel like they did something wrong?

Monica Lancellotti (30:37):

Certainly, I think it’s important to let parents know that you support them as well and that you acknowledge that this isn’t their fault. Even if someone has an anxiety disorder or depression, as a parent, doesn’t mean that they necessarily cause this on their child, but it can help them in some ways. Because they understand what their child is going through, if they’ve dealt with the same issue.

Anne Baum (31:00):

Because they’ve experienced it?

Monica Lancellotti (31:02):

Yeah, absolutely. And so, I think they can use whatever coping mechanisms they’ve learned through their experiences to help their child.

Anne Baum (31:09):

That’s great. So let’s shift into the family, because your family is your support mechanism. It’s the place where you can go for help. So how does your family and your family environment impact mental health and emotional well-being?

Thespina Godshalk (31:29):

Well, certainly, being able to have an open conversation about how you’re feeling is helpful. So right there is a good starting place, so that we’re – like we talked about earlier – making sure that we’re open and available for that conversation, we have a supportive viewpoint of mental health, it’s something we freely discuss in our household and that we help each other. So I know I keep going back to your dinner table activity, but really, this is all of us sharing. And so, I think it can be empowering for a child when a parent says sometimes, “I experience sadness, so these are some things that I do to help myself. Why don’t we do this together? Why don’t we spend some time together? Why don’t we talk about it a little bit?” So I think family can really be supportive in that way, creating that safe and protective space.

Anne Baum (32:28):

And how does the family environment impact the mental health of kids? We’re making it sound so easy. “Oh yes, our home is beautiful, sunshine, lollipops, flowers.” But we know that there’s difficulty, there are challenges that families face that run the gamut. So how does that impact a child? And what can we do when these challenges come before us?

Monica Lancellotti (32:59):

I think recognizing that everyone’s family structure can be different. There are families with two parents, there are families with single parents, there are families with divorced or separated parents, and certainly, all of those different family structures can affect a child’s development and sense of well-being. I think just being consistent with trying to provide a structured home environment, whether it’s in one home or two homes, is the key, and trying to maintain that open relationship amongst all of the people who are helping raise that child.

Anne Baum (33:38):

That’s a great point, that routine and something they can rely on, even if they’re going from place to place and there’s change involved. That leads me to the question about the impact of divorce and the effects of divorce on a child, that we talked about how change is difficult on kids. That’s a big change. So what does divorce do to a child?

Thespina Godshalk (34:05):

Yes, divorce can have a major impact on a child’s well-being, on their mental health, as can other significant losses, [such as the] death of a loved one. Through COVID, we saw many parents who lost employment. So changes in income can be very stressful for kids. I think that it’s important we recognize that, sometimes, even when we don’t think that they’re paying attention or we think we’re having a secret conversation, they’re still listening. They’re still absorbing from the environment. And so, I think it’s important to point it out. “We’re experiencing this together. This is a stressful and huge change for our whole family, so how are we going to handle it together? How are we going to communicate through this?” So I think that’s very important, just the line of communication to establish that and really help that child to ensure that, or assure to them that they will be supported throughout.

(35:08):

So if it’s a divorce, “Maybe we’re separating. We’re going to have two households now, but we’re here and we’re going to help you through that. This is a big problem. It’s too big for one person to handle. So we’re going to do our best to handle it together and make sure that you’re taken care of and make sure that we’re supporting you through it. And any feelings that you have about it or any stressful thoughts you have about it, share them, so we can address them.” So I think communication and being open are very helpful through some of those really challenging experiences we have in our families, because it isn’t easy and it is not sunshine all the time. But even in the rain, we’re together in the rain.

Anne Baum (35:55):

I just love that. I think parents try and shelter their kids from trouble, especially if it’s something like the loss of a job or reduction of income or even things like food insecurity, that you’re just trying to support your family. So you want to hide it from your kids. But I love that, sharing it with them, making sure that they recognize that everybody’s in it together. That’s really, really great. So back to divorce, is there an age where it’s hardest on kids? When they’re younger? Older? Or is it just any age that’s a traumatic impact on their life?

Monica Lancellotti (36:38):

I sort of think it can affect all children at any age, but probably, cognitively speaking and developmentally speaking, the school-age children can be most impacted, particularly around age 11.

Anne Baum (36:51):

Oh, that’s interesting. And what is it about age 11 that has that biggest impact?

Monica Lancellotti (36:58):

I think, certainly, it could be just they’re at a certain level of understanding, developmentally, they’re cognizant of the world around them, and they’ve developed very close relationships with their caregivers, and certainly, that disruption can be quite impactful for them.

Thespina Godshalk (37:18):

Yeah, I feel like old enough to know what is going on, but “still too young to feel confident in taking care of myself maybe. So now, who’s going to take care of me? This is all happening around me.”

Monica Lancellotti (37:31):

Absolutely.

Thespina Godshalk (37:33):

“Who’s going to take care of me?” And I think that’s why it hits those kids at that middle age so hard.

Anne Baum (37:42):

Some parents think it’s better to stay unhappily married than it is to divorce. Do you have any thoughts on that? We talked about how kids are so observant and better to communicate with them. What are your thoughts on those that decide to stay unhappily married versus proceed with a divorce?

Thespina Godshalk (38:05):

I feel like one of the things to remember is, at every moment, when your child’s in front of you, you’re modeling, so they’re seeing what you’re experiencing and how you’re handling those things. And so, there are moments we all want to take back. I can certainly think of my own, but ...

Anne Baum (38:20):

It’s a long list.

Thespina Godshalk (38:24):

A long list. A long list. So I think that’s an important thing for everyone to hear too, is that there are always times that you want to take back or things that you think, “Well, maybe I could have handled that a little better,” but that’s OK. Because you can even say, “Well, I probably could have handled that a little bit better.” That’s an OK thing to say. Admitting or having your own accountability, I think, is also important for a child to see modeled. But certainly, in your relationship, that you’re modeling, you’re modeling that for your child, and so, they’re looking to you as to what’s normal or what is tolerated in a relationship. So sometimes, I think that handling a divorce in a healthy way and communicating along the way is the best option, because you really are modeling that growth and self-care and health for your child.

Anne Baum (39:23):

Oh, that’s great. That’s excellent. Thank you so much for being with us today. I'd love for you both to just share whatever you think is most important that you’d like our audience to remember from today’s discussion. And Monica, we’ll start with you.

Monica Lancellotti (39:40):

OK. So thank you for having me today. I certainly want parents to remember that we, as pediatricians, as health care providers, are here to help you. We’re here to help you support you as you raise your children, support you in helping them through physical and mental challenges, and providing resources to guide you along the way, so your children can grow to be healthy, happy adults.

Anne Baum (40:05):

Awesome. Thank you. And Thes?

Thespina Godshalk (40:07):

Well, that was wonderful, Monica, and I’m so thankful to be here with the two of you today. This is such an important topic, and so I’m so happy that we can talk about it. I think what I would leave everyone with is this matters. This matters very, very much. Your mental health, your child’s mental health matters. And so, any question you have, even if you’re thinking, “Oh, should I really ask this? Is this really important?” it’s important. And you have every right to ask it. And so, if you’re feeling like you need support or if you’re feeling like you notice something going on with your child, but you’re just not sure, it’s OK to come to the professionals, like your primary care or mental health services, and say, “I just have some questions. I want to make sure everything’s OK.” That’s always the good way to go, and it matters. So that’s what I’d lead with.

Anne Baum (41:05):

Great. Thank you. To learn more about children’s mental health, visit lvhn.org/childrensmentalhealth. For more kid-focused health tips, advice and must-know news about Lehigh Valley Reilly Children’s Hospital, follow us on Facebook and Instagram at LVHNChildren. And remember, every parent needs a partner through parenthood, so make sure to subscribe or follow Because They’re Kids wherever you get your podcasts, so you never miss an episode.