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Mental Health for Children, Young Adults and Families

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Anshu Bahanda: This is Anshu Bahanda on Wellness Curated. Thanks for joining me on this podcast. My mission is to empower you with health and wellness, so that you can then go and empower others. Today, we’re talking about mental health in children, young adults, and families. We have today a therapist called Anjali Singh-Mitter and she’s trained in Cognitive and Behavioural Hypnotherapy. Not only does she work with cognition and behaviour, but she also works with hypnosis. And she’s a big believer in combining Eastern meditative techniques with Western hypnotherapy. There is so much in this podcast. Listen to this. 

So tell me, Anjali, in the last decade, it seems like the number of mental health issues, especially in the case of young adults, teenagers, and children have gone up a lot. Why do you think that’s the case? 

Anjali Singh-Mitter: Things like generational trauma and patterns being passed down, so the current generation are being born with so much more on their plate than previously. If you also think about little things like stimulation, it’s so much more natural now for children to be very stimulated all the time. 

AB: Okay.

ASM: When I was younger, homework from school was a piece of paper, and I would fill out my sheet and I would hand it back to my school teacher. Nowadays, it’s open this tab, download this app, fill out this form, everything happens online. So, the amount of stimulation that children are getting just by default, forget the games, forget the television, forget the iPad games, all of that, just natural life is much more stimulating than it was for my generation and generations before us. So that’s the first reason I think, if we’re thinking long term. Slightly shorter term, we are in a post COVID world and the post COVID world, children missed out on two years of exploring the world. So, infants who were born in COVID or just before COVID missed out on their playgroups and interacting with other children their age. And so developmentally, that’s really going to stunt them and cause some degree of stress when they’re then thrown back into the world, which is operating almost as it once was. And they’ve missed out on those two years. Teenagers who should have been out exploring the world and finding their feet and figuring out how to operate independently didn’t get that opportunity. So now they’re suddenly two years older than they were. So let’s take someone who was 13 pre-pandemic and is now 16. At 16, you’d expect that they’re pretty independent, they can move around the city on their own, but because they had two years of not being able to go out there and explore that in a very organic, natural way, as the generations above them have done, they are somewhat stunted in that. So I think that the cumulative stress of their generation is much more than it has been in the past. 

AB: What are the most common mental health issues that you’re seeing? 

ASM: I think it varies a lot. So I’m going to sort of without wanting to make this entirely about COVID which I won’t do, but at the moment the most common thing is all the anxieties that COVID brought to the surface. Now, that’s all sorts of different things because COVID acted as a pressure cooker, but COVID definitely expedited that process. It acted as a bit of a catalyst. So when you’re asking what are the most common things I see, depending on age, I’m seeing a lot of stress about exams. And that’s particularly bad post COVID because during COVID, no one did exams.

AB: So that’s the main one. What about life stresses? Did you see any other life stresses, social stresses? 

ASM: Absolutely. So let’s talk a little bit about family dynamics. Take a family that is operating where parents are working or parents at home, kids are going to school and so on and so forth. And then you put everybody in the same house for two years and don’t let them out. Even the most coordinated, well put-together families are not used to sharing their space 24 hours a day, bar their one walk or trip to the grocery store. But without the external stimulation of our individual lives, those family dynamics started to rupture because everyone was taking everything that was going on internally out, on the people around them who were their family, rather than having their sports activities, for kids having sports extracurriculars school etc and for adults going to the office, it’s a really important thing when we get up in the morning and put ourselves together and go to work, even if going to work is going to meet someone or having to go to your home office, whatever that process is, it changed over the last couple of years. So that changed the patterns and it changed the way that we consider our day to work. And that is, again, very stressful to someone. That is a very difficult process to go through. 

AB: So Anjali, tell me, I’m a big believer, I’m someone who believes prevention is better than cure. I mean, how can we help children and teenagers so that they don’t develop mental health issues? 

ASM: So different people operate to different rhythms. A teenager or a child would not go through any stress would be some false because every adult as you grow up, every adult, you’re going to encounter something stressful, even normal things, moving house or you get someone who is particularly worried about a particular social dynamic and you get people who try the social dynamic. I don’t think there’s a scenario in which we can completely prevent a child from feeling stressed because the stress response is a human natural animalistic response. The way I would answer your question is saying, how can we best equip a child to deal with stress in a way that doesn’t feel like what we are now perceiving as anxiety? So ongoing stress and how can we be preventative for ongoing stress, long term stress rather than a stress response? A stress response is “oh, something is happening. I’ve got adrenaline running through my body”, that something is over and my adrenaline finishes. That’s what we want. We want a little burst of adrenaline because that’s what it’s designed to be. What we don’t want is weeks and weeks and weeks of anticipation, then weeks and weeks and weeks of decompression and for it to be a whole few months of anxiety. So that’s vis a vis what we are actually preventing. Now how to do that? Children firstly need to be taught, and I’m a big believer of this, that children need to be taught that stress does happen in life, because we’re not exactly what I just said, but if we teach a child that you should never be stressed or you should never feel upset, you should never feel pain. When it happens to them, they both get upset because they’re upset or for whatever reason has upset them. And then they get stressed that they’re stressed because this shouldn’t be happening. So you’ve compounded the stress by presenting them with a situation in which their emotions are not supposed to be happening, they’re not validated. So when a child is stressed, the first thing I say to them is you’re stressed for a reason. Let’s figure it out. 

AB: Amazing. 

ASM: My three pillars are sleep, nutrition and movement. And I say this to every single teenager child client, I say it to my adult clients as well. When those three things are in place, you’re setting the physical body up to be able to deal with whatever we have going on in the day.

If we’ve slept properly, if we’re eating properly, and if we’re doing some degree of movement, we’re getting some degree of exercise, the body is well equipped to then deal with stress. So again, the stress response becomes shorter, the stress response becomes more manageable. We also are operating in a healthy enough, balanced enough way that we can properly comprehend what’s happening to us and reach the solution that we want. 

AB: So you’re saying if you take care of what you call your three pillars, which is sleep, nutrition and movement, that should be a big help in preventing or dealing with mental health issues. 

ASM: And we build on three pillars. Three pillars is just what I call the foundation. On top of that, we build, so we say, on top of that, are you appropriately dressed for the day? Now, this is something that I’ve actually encountered a lot of in the last couple of months, which is retraining people in a post COVID world that actually it is a very important process to be appropriately dressed for work, appropriately dressed for sports, appropriately dressed to go out in the evening, and those three things are not the same dress code. We shouldn’t be working out in the same clothes that we’re going to work in the same clothes that we go out in the evening. There’s a big psychological component to putting on a blazer and getting ready for work. There’s a big psychological component saying, I’m going to do exercise now, which means I’m putting on my exercise and I’m going to exercise. There’s a getting-ready process and a decompression from that which psychologically tells your brain to get into action and tells your brain to switch on. Again, all of this adds to the three pillars. 

AB: And tell me, how can we possibly prepare families and parents to support their kids? 

ASM: A two fold answer here as well. First is educating parents in the difference between their generation and the generation growing up at the moment. The number one question I’m getting from parents is about electronic use with their children- “When do I take their devices away? They’re on their phone too much, they’re on their PlayStation too much.” It’s ongoing. I’m sure every parent can relate to that in some way. And my answer is always do not strip them of all their devices. If they’ve misbehaved, it’s a consequence, fine, that’s a different matter. But do not strip them of all their devices because that’s the generation in which they’re growing up. They have to learn how to handle it and how to be balanced with technology in their lives. So any parents who have 10 to 17 year olds, I would say, the generational gap is the biggest it’s ever been. The generational gap is not what it was , say for me and my parents, my parents, you know, they still understood homework as paper, they still understood technology as limited. I wasn’t on social media, it didn’t exist. Whereas now parents are saying to me, I don’t know what my child is on, I don’t know, I don’t know the language. Educating parents on what their children are doing and how best to monitor it, that’s an important stage. Two, educating parents on what constitutes stress for their child, that is also something so you get. I see a lot of children who are very, what I call hypersensitive, which means that certain aspects of the world are incredibly stimulating for them and it can become overwhelming. This can be via any of the senses, so there’s children whose audio senses are massively inflated and so they become very, very stressed when the sounds around them are overwhelming. When that happens, the parent often gets frustrated because the child starts misbehaving or the child can’t focus and the parent needs education that their child is not misbehaving. Your child actually cannot process their surroundings and you need to tailor that appropriately. The child needs to be given the appropriate solution. And this is something that happens more with current young people than it did for adults. There’s a whole difference in mental health dialogue at the moment. So children are growing up, firstly, more sensitive and secondly, with less of an ability to process their world, with less of an ability to go and talk to people because everyone is busier, everyone is more wrapped up in their own thing. Family dinners are much less common now than they were generations ago, that is both a sad fact and also a fact of life. So we have to adjust and adjust our expectations and say well, children are getting more stressed, so we need to offset that stress in better ways. And so parents need to have an education. If a parent really wants to be invested in their child’s mental health, the key is to start understanding your child’s world, not your world. Don’t try and get your child to fit into your world because your world is different. Your world is of a different generation and your child exists in a different space.

AB: Anjali, I’m really enjoying this conversation, I guess because you’re also part of that generation. That’s why it’s so different from what we’ve heard previously. 

ASM: I understand the child’s world and I understand the parents’ world because I’m exactly in the middle. I’ve got 50%, my clinic is under 18 and 50% are adults, so there’s a really good balance. But children, they can’t put me in a box. I’m not a teacher and I’m not a parent, so they don’t know where to put me. So I’m in my unique box. Parents and adults don’t really know where to put me because I’m not an employee, I’m not a boss, not a child. I’m a student. So they also don’t know where to put me. And that gives me a unique insight into what’s going on.

AB: How do we know when to look for external help in the case of our children or in the case of family members? 

ASM: Okay, so there’s lots of different kinds of external help. I think that if we divide that into something holistic and then something medical, the two are very different answers. So let’s first address the holistic approach. Firstly, maintain a dialogue with your kids. Your kids won’t always want to cut, they won’t seek you out and open up. And your children are as uneducated about the stress as parents are. In the first instance, the first time a child experiences stress, they have no idea what’s going on, so they just try and offset it or process it in a way that their subconscious tells them to do. This is not always a constructive thing. So the thing that I ask parents when they first ring me up and I ask about what led them there. Usually it’s a drastic change in behaviour, so a sudden change in behaviour. So a child who has always been perfectly sort of calm, et cetera, is suddenly throwing furniture across the room saying, so well, something’s going on. Sudden change in demeanour, so the child suddenly goes from being outgoing and happy talking to people to wanting to remain in their room to wanting not to engage, that’s also a marker that I would look for. But these are all markers of when to spark a conversation with your child about what you are feeling. If the child, you can say to the child, you’re angry, I can see you’re angry because you’re throwing furniture across the room, so why? And the child would likely say, I don’t know, I don’t know what’s going on, because they don’t, they’re not lying. They don’t know. So that’s when the parent can plant the seed of, “okay, maybe we should get someone to help you understand why you’ve suddenly got so angry”. There’s nothing wrong with it. It’s a big important factor. The child doesn’t feel sent to therapy because something is wrong and needs fixing. That’s an important factor that therapy is there to help with whatever’s going on and whatever’s going on is perfectly natural. The first instance, seek out help therapeutically or holistically is a sudden change in your child’s demeanour, so a big behavioural change. That’s the first model. Okay. Now, psychiatric care, very different answer when it comes, particularly when it comes to children. So I’ll give you a broader answer that I would also apply to adults, which is when therapeutic care serves the purpose of what I call firefighting and nothing else, then you’re going to look perhaps at psychiatric care as well to help with that fire fighting process. Now let me explain that. Firefighting in therapy is what I call when the client comes and they’re very, very stressed and they just need to get the stress off. Best in that situation is just to help decompress that anxiety and put a bandaid over it. That’s the best I can do in that situation. Client comes in really, really upset, a child or an adult will come in very upset because of whatever it is that’s happened or however it is they’re feeling. They’re spiralling, they’re anxious, they’re this, they’re that. And so in that therapy session, the only thing you can achieve is to whittle down that anxiety. And that’s great if you can achieve that, but you’re not solving anything. The hour is used just to calm down. That’s when I would recommend to someone, particularly an adult with children, I would be much less inclined to do this. With children, I would find other ways of doing this. But for adults I would be inclined at that moment to say okay, “why don’t we consider psychiatric care?” Now, I’m not a doctor, so I’d always send them to a psychiatrist. I would never prescribe anything myself, but I’d say why don’t we consider psychiatric care so that this edge is taken off, so that you and I can get to the bottom, we can start digging because at the moment in therapy we can’t dig anywhere. We’re just trying to solve what’s on the surface. When you consider psychiatric care, it’s not a solution, it is an aid. It’s a very important aid for some people. It’s an aid that just takes the edge off, that allows the therapeutic care to really get to the root of the issue, start changing things, start adjusting things and so on and so forth. But it’s not a solution in itself. 

AB: When people should look at psychiatric care, when there’s continuous anxiety, the child or the adult is not able to make progress in any form because they’re consumed by anxiety? 

ASM: Sometimes, they’re consumed to the point that they can’t implement the tools that I’m giving them, so we call in to behavioural hypnotherapy. We go through certain things and I’ll often give little tasks. And if the anxiety is so much that even those tasks are too much of an ask, even the smallest, smallest task, you’ve got to consider how we can help the mind just cope with the process of therapy. I don’t consider psychiatric care to be a solution to the problem, so to speak. It’s not the solution to anxiety, it’s the aid that allows therapy to see the solution to anxiety.

AB: So again, a very important point. Psychiatric care is not the solution, but it’s an aid. Tell me Anjali, do you often see a pattern between parents and children, or families and children? 

ASM: There is not a single case that I’ve had where there is no pattern whatsoever. Okay, I can write you a whole thesis on this. There are reasons for this sort of beyond what we can go through in a podcast. But the nutshell is that firstly, the baby can’t talk, your baby can’t talk to you and articulate how it’s feeling. So the baby just learns to absorb everything that is going on around. So the baby is observing, the baby picks up body language, the baby picks up mentality, the baby picks up micro expressions in the face and the baby becomes an expert at reading emotion off their parents. Obviously a lot of parents don’t want to show their children stress and if they have an argument behind closed doors, I’m very much in favour of that. Children should be exposed to everything. But your child can still read to you that stress still exudes off the parent. I see a lot of cases. I’ve actually got a lot of cases where the child has gone through something major as quite young. And the focus has been obviously in that moment on the child because the child is going through whether it’s school change or illness or something fairly major where the child is really being put through their faces. The focus tends to be on the child from the doctors or the teachers or whatever it is. What is forgotten is how stressed the parents get in that situation. And it is traumatic, as traumatic for parents as it is for the child and that stress from the parents. If a parent doesn’t deal with that stress at that time, the child will also absorb that. And this is nothing that can’t be undone. There’s nothing that can’t later be undone. Nothing I’m very a strong believer in. There is no situation that cannot be undone or rebuilt in the way that you want it to be rebuilt. So nothing is too far gone in that respect. Children are experts in reading their parents and absorbing what their parents are feeling because that’s what we learn to do. That’s how we communicate as infants. As a parent, you’ll learn how to read your child’s cry. There’ll be five different kinds of cry. The hungry cry, the tired cry. Every parent will say that about their baby and that is the same sound to anyone who’s not that child’s parent. They won’t know the difference between the cries, but the parent will. So it works both ways. We don’t lose the ability to read the emotions of other people, but we mask it because we learn language. And language is much easier and harder in that respect because language you can say the truth and language you can mask the truth. So it becomes harder to read what children read so instinctively off their parents. 

AB: That’s amazing. 

ASM: So generational patterns exist, something that we inherit from both parents with different degrees of significance. 

AB: We always try to leave people with tips, tools and techniques. Can you share something that will equip children and young adults with some sort of help for mental health issues?

ASM: Number one tip would be to engage with your kids about emotion as a perfectly normal thing. Things that made you happy that day, things that made you if you’ve got little kids, you’re sitting at dinner, get them to see the best thing that happened to them and the worst thing that happened to them that day. There will be an up and a down in the day and it has to be involved in normal conversation. Tip number two is to really instil healthy habits, the three pillars, preparing yourself for the day, every day. A child should know that in the morning they get up out of their pyjamas and into their day clothes. Even if it’s a Saturday, right? Even if it’s the day where they’re going to be at home, they should be productive on that day, even if their productivity is just going to be a very relaxed day. Teach your child, get up, get ready for the day, take care in what you’re wearing. And it’s not about appearance. It’s about feeling put together. It’s about preparing your mind to get ready. And then equally at night, switching off properly. So decompressing properly. Teach your child to take the time to decompress in the same way that I say to someone in the morning, no matter what, even if you have a flight at 06:00 a.m. And you have to wake up, do not wake up at the last minute. Do not be in a rush. Wake up with enough time to do the things in the morning that are important to you. Similarly, leave enough time at night to do the things that are required to decompress. And if you can instil those two things in your children, you’re off to a good start for sure.

AB: And the last question I want to ask you is, do you have any other advice for the people listening in? 

ASM: If I had to choose one piece of advice, do I have one piece of advice, it would be to talk more. There’s a huge culture, particularly in the west, over either things being inflated, everything being problematic, so when people do talk, everything’s a problem, or people just don’t talk about mental health at all. So mental health needs more of a spotlight than either nothing, so we’re not going to talk about it or a huge problem. There’s an in between.

AB: Okay, that was lovely. Thank you, Anjali. That was such a useful conversation. Thanks for joining us. Hope you enjoyed the Wellness curated podcast. Please subscribe and tell your friends and family about it. And here’s to you, leading your best life.