Pediatric Meltdown

https://swiy.co/WhatAreYourThoughts

Physicians rely on our mental health colleagues to provide comprehensive behavioral health treatment, but we often speak different professional languages. Today’s guest leads us through the mental health alphabet soup of therapies and explains what we can expect when we make mental health referrals. Sheryl Lozowski-Sullivan, MPh, LP, PhD, is a clinical psychologist specializing in evidence-based interventions and psychological assessments for adults and children.

Dr. Lozowski-Sullivan founded the Integrated Behavioral Health Psychological Services, which provides talk therapy, testing and assessment, feeding, toileting, and parenting support, cognitive behavioral therapy for insomnia, hypnotherapy, occupational therapy, and intuitive art therapy.

Building collaborative relationships with our mental health colleagues benefits our patients and families and improves our skills as well. I am delighted to welcome Sheryl to the podcast and she has been a trusted colleague in the development of interprofessional partnerships.

[00:01 - 05:55] Opening Segment

• Introducing today's guest, Sheryl Lozowski-Sullivan, MPh, LP, PhD
• Expertise and work 
• Sheryl gives some background on her story 
• Personal battle against cancer
• External practicum program with me
• Integrated behavioral health  
• Health interventions on pediatric conditions

[05:56 - 17:55] Why You Should Not Always Believe Your Thoughts

• Choosing a specific type of therapy
• Sheryl talks about mental health in the United States
• Clinical psychology and social work 
• Mental health as a discipline
• Behavioral therapy 
• Referral source rates  
• Combination of behavioral therapy and medication
• Cognitive Behavior Therapy
• Automatic thoughts
• Counter thoughts
• Thought-restructuring 
• Need for a coach

[17:56 - 33:50] 7 Things to Feel Better 

• We talk about “selling” therapy to the child’s family
• Recognizing that whatever the child experiences is real
• Listening to the child
• Dealing with anxiety disorders
• Sheryl walks us through the Activation Therapy
• Experiential
• Determined by and dependent on the patient
• She talks about not needing to know the diagnosis always
• Changing behaviors in therapy
• We talk about how to feel better, especially during the COVID-19 pandemic

[33:51 - 43:01] Collaborating with our Mental Health Colleagues

• Sheryl shares how to increase visit rates to therapy 
• Mind-body dichotomy is artificial, not real
• Educating parents and guardians about pediatric conditions
• The importance of a mental health professional near you
• Can we separate the mind from the body?

[43:02 - 49:38] Closing Segment

• I give my thoughts about the role of mental health professionals in therapy
• We need to address low patient referral rates
• Final Takeaways
• Types of therapy
• Areas of expertise of therapists
• Integrated behavioral health
• This should be advocated and funded
• Mental health has long been waited by psychologists

Tweetable Quotes:

"Don’t believe everything you think … Just because a thought pops in your head doesn’t mean you have to believe it.” - Dr. Sheryl Lozowski-Sullivan

"Make sure, if you’re suspecting anxiety of any sort, of which OCD is one, please make sure that you’re referring to someone who’s doing evidence-based practice. Talking about anxiety doesn’t fix anxiety.” -

https://swiy.co/WhatAreYourThoughts

Dr. Scheid is a practicing Child and Adolescent Psychiatrist and Associate Professor at MSU whose primary research interests are in the area of mental health services and public policy for children and adolescents with limited resources and multiple needs. Dr. Scheid’s work encompasses the full scope of child and adolescent psychiatry including disruptive behaviors, mood, and anxiety disorders, and eating disorders and much of her focus is on improving the health and well-being of the youth served by the Michigan Department of Health and Human Services. She welcomes collaboration with primary care providers to promote optimal care to some of our most vulnerable children. 

Let’s dive right in and hear Dr. Scheid’s thoughts about improving psychiatric care for all children and particularly those in the child welfare system.

[00:01 - 09:13] Opening Segment

• Introducing today's guest, Dr. Jeanette Scheid 
• Expertise and work 
• How we know each other 
• Dr. Scheid gives some background on her story 
• Started in pediatric hematology 
• Always wanted to work with kids 
• First rotation in psychiatry 
• First mentors at MSU
• Dr. Scheid talks about shifting careers 
• What is it that excites you
• Look around and look at your colleagues 
• Thinks about the day to day aspects 

[09:14 - 24:45] Dealing with Child Trauma in the Welfare System

• Dr. Scheid talks about her consultancy with the Child Welfare System
• Interests in trauma 
• Working in Pittsburgh 
• Open doors to become a consultant 
• Dr. Scheid’s training focuses 
• Understanding the other point of view 
• Foster parents lack empowerment
• You can’t assume 
• Everyone brings in their own experience 
• Experiences and lessons with children in bio-families 
• Everyone has a unique experience 
• How can we support the parent 
• Strengths and weaknesses analysis 
• All or nothing may not be the answer 
• Dealing with gaps in background information
• How do you find out the best practices for the individual 
• Acknowledge what we don’t know 

[24:56 - 36:56] Deprescribing and Polypharmacy

• Dr. Scheid’s insights on polypharmacy 
• The presence of other problems 
• Hard to know a single diagnosis 
• Take a step back and look at the history
• Is there evidence of benefits 
• Back away based on risk 
• Start slow as you go down 
• I summarize my own experience 
• Dealing with dependency 
• Depression example 
• Gauging this impact of symptoms 
• Aggressive behavior assessment 
• Psychosocial intervention
• Links you can find below 
• The issues of diagnosing 
• The levels of confidence 

[36:57 - 44:12] Building Relationships with Psychiatry Colleagues 

• Dr. Scheid’s thoughts on relationships with colleagues in psychiatry 
• It all requires time and energy 
• Getting the most recent documentation and records 
• Having open communication 
• Dr. Scheid’s example 
• Getting to know your colleagues 
• It’s fun and informative 
• Making friends and connections

[44:13 - 53:19] Closing Segment

• Dr. Scheid talks about resources that can help 
• Links below 
• Dr. Scheid’s advice to her younger self
• Dealing with the answer no 
• Don’t be afraid to name your lack...

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Let’s have some tough conversations around special needs, race and disabilities in school. I’ll be discussing this with today’s guest and my friend Rikki Saunders. Rikki is the director of special education at Kalamazoo Public Schools. She has also worked as a social worker in school and the community. Her role today is to find and identify children with disabilities who are enrolled in public schools in the Kalamazoo district and in need of special education and related services. She also helps educate staff to ensure they have the capacity to fulfill their responsibilities to execute Child Find under the Individuals with Disabilities Education Act. 

I’m excited to learn more from Rikki on meeting the educational needs of children, and how to collaborate with colleagues in the schools.

[00:01 - 08:45] Opening Segment

• Introducing today's guest, Rikki Saunders
• Expertise and work 
• Rikki gives some background on her story 
• Always had a love for children 
• Time and degree at UMich 
• School social work 
• Passionate about special education 
• Preparing them for life 
• We can do better 

[08:46 - 14:54] Changing Our Thinking of School

• Rikki talks about needing to change our approach 
• We are here to serve 
• We don’t turn people away
• People come in with trauma 
• Some are even homeless
• Consistency is key 
• This system has everything the kids need 
• The impact on children 
• It’s their day to day existence 
• Teachers spend as much time with kids as parents 
• It goes beyond reading and writing 

[14:55 - 26:56] How Schooling Involves the Medical Community 

• Rikki talks about kids coming into school with disabilities 
• Qualifying for 504
• Diabetes example 
• The options you have 
• Teachers are responsible to accommodate needs 
• Qualifying for IEP covered through IDEA
• The school has to show qualifications 
• The issue of behavior 
• Determining if behaviors are a disability 
• Can you progress?
• Response to an Intervention RTI 
• Burden of proof 
• The autism example 
• It has to impact education to qualify 
• The social side of disabilities 
• Rikki’s procedure
• Can they do what their peers are doing?
• Social is part of the disability 

[26:57 - 53:56] Speaking to Bias and Race and Asking the Questions

• Rikki talks about her responsibility 
• The main mission 
• Environmental vs. eligibility 
• The African American Male example
• Rikki talks about analyzing the race and social climates of certain communities 
• Diversity is in the school 
• Home is separate 
• Cultural relevance training 
• Being culturally aware 
• We need to be included in the conversation 
• It’s not the answers, it’s the discussion 
• It’s uncomfortable but we need to talk about it 
• What Rikki does to enter the conversation 
• What do you know for sure, and what do you think? 
• Challenging certain ideas 
• Be clear on what you know for sure 
• You can’t ignore the issues 
• How Pediatricians should go about talking about police safety 
• Having The Talk 
• Know that it can be stressful for families 
• How certain areas are affected over others 
• Ask the questions 
• Do you feel safe?
• Giving the feeling of

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Maybe it’s not ADHD, maybe it’s something else we’re not seeing. I’ll be discussing this with today’s guest Dr. Arthur Lavin. Dr. Lavin was educated at Harvard (BA) and Ohio State (MD). At Harvard, Boston Children’s Hospital, and MIT, he completed training, became board-certified in general pediatrics and the subspecialty of newborn medicine, taught, and published original research in such journals as Science. He has been in pediatric practice for more than 25 years and has served on several national committees of the AAP, as president of the Northern Ohio Pediatrics Society. Dr. Lavin is also co-author of the book, “Who’s the Boss? Moving Families from Conflict to Collaboration.

Let’s dive into Dr. Lavin’s incredible insights on school struggles, childhood experiences, and ADHD. 

[00:01 - 07:57] Opening Segment

• Introducing today's guest, Dr. Arthur Lavin
• Expertise and work 
• Dr. Lavin gives us a bit of his background 
• Experience in Harvard training 
• Passionate to work with people through relationships
• Dr. Lavlin’s experience in the Neo-Natal ICU 
• Building trust with families  
• Dr. Lavin’s thoughts on psycho-social 
• It’s our entire experience 
• Connecting with people 

[07:58 - 19:05] Let Them Solve the Problems They Started 

• Dr. Lavin talks about writing his book 
• Meeting the co-author 
• The collaboration process 
• Dr. Lavin shares about speaking on struggles and family dynamics 
• Most intense discussions 
• It’s not the parent’s job 
• If the child creates the problem let the child solve it 
• Person A can’t solve the problem that person B started 
• The adolescent makes the choices 
• Looking at yourself as the parent 
• What makes you care so much about this issue 
• It may not be all about the child 

[19:06 - 34:32] Impairing Childhood Behaviors; Is it Really ADHD?

• Dr. Lavin shares his insights on ADHD 
• Coming at ADHD like it’s a fever 
• Why do you have a fever? 
• It is a symptom of underlying issues 
• When you treat the better explanation 
• A 3rd of the kids coming in for ADHD didn’t actually have it
• AAP article - link below 
• Understanding the underlying issues 
• My own analogy 
• Do the drugs work? 
• Learning disabilities, anxiety, messy family 
• How relationships come into play 
• An opportunity to help 
• These issues tend to be mutually exclusive 
• What is the engine driving the issues? 
• Good relationships get answers 
• The diagnosis is in the history 

[34:33 - 40:50] The AAP Guidelines 

• Dr. Lavlin talks about the changes in the AAP 
• The two papers on the guidelines - links below 
• Differential Diagnosis 
• Looking at all the possibilities and resources 
• We talk about other helpful resources
• Look at the resources below 

[40:51 - 52:03] Closing Segment

• What would you say to a younger Dr. Lavin? 
• Recognize that the MD carries a lot of power 
• Thoughts on burn out and relationships 
• The music analogy 
• Final Takeaways
• It’s all about relationships 
• Child behavior problems take reframing 
• Think bigger to include other issues 
• The fever analogy 
• Use your title 
• Do...

https://swiy.co/WhatAreYourThoughts

As a pediatrician screening for suicide, it’s not about the ones you find positive for suicide, it’s about the ones you may miss. Today’s guest Dr. Horowitz is a Staff Scientist and Pediatric Psychologist at the Nation Institute of Mental Health Intermural Research Program at NIMH and for years she has been helping health care professionals not let kids slip through the cracks. She excels in Suicide Risk Detection and is head PI in several ‘Suicide Prevention Protocols’ using the ASQ Toolkit. She assists hospitals, schools, and pediatric centers in implementing Suicide Screening of patients.  

Let’s dive in a learn how we as busy professionals can incorporate this suicide screening in our practices. 

[00:01 - 10:01] Opening Segment

• Introducing today's guest, Dr. Lisa Horowitz
• Expertise and work 
• Dr. Horowitz gives us a bit of background on his story 
• How Dr. Horowitz got into her field of work 
• Late 90’s, mental health patients flooding hospitals 
• Saw the need for a suicide screening tool 
• Used as a Fellowship Project 
• Push back from nurses 
• Moved to DC to get a job at NIH
• Dr. Horowitz story developing screening for the hospital 
• Creation of ASQ

[10:02 - 15:56 How To Implement Screening Even if You’re Not an MH Expert

• Dr. Horowitz talks about how doctors who aren’t mental health experts can ask screening questions
• Pilot study results 
• 60%-80% response rate
• Asking parents to step out
• Nurses asking the kids without parents in the room 
• Creating a Script to model 
• Most parents responsive 
• Are there risks to the screening?
• Studies show that you can’t plant the idea of suicide if it’s not there
• Asking the questions help, they don’t hurt

[15:57 - 22:07] Getting Comfortable with the Whole Script for the Busy Practitioner 

• Dr. Horowitz talks about giving the whole script
• A fear for busy doctors 
• Don’t change the questions 
• Getting comfortable with the language 
• Getting over the worry of screening positive 
• Positive screenings are very rare 
• When you have one, you can save a life 
• It’s not one size fits all, not everyone has to go to the emergency room 

[22:08 - 41:38] Translating From Emergency Room to Primary Care 

• Dr. Horowitz talks about how this can translate into Primary Care
• Suicide is the second leading form of death 
• Training that pediatricians receive is very little towards what actually kill kids
• The problem of don’t ask don’t tell 
• The facts of fighting suicide
• We haven’t made a dent in rates in over 50 years 
• Dr. Horowitz story of Pediatrician using the screening 
• Worried about the ones you miss, not the ones you don’t 
• A lot of people go to health care before their death 
• The difficulties of these screenings 
• Are they safe?
• What to do if you get a positive 
• What is included in the ASQ toolkit 
• Screening vs. assessment 
• BSSA for Pediatricians 
• Very rare if you need to get them to an emergency room 
• The value of having MH experts in your practice 
• My own experience in risk assessment 
• Clinical pathway 
• Using the guide is not as hard as you think 
• Other ways to learn and work with families at risk 

[41:39 - 55:07] Closing Segment

• Alternative measures to preventing risk
• Ex: safe storage of...

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It’s apparent now more than ever, our children need advocacy. Today I’ll be speaking about this with Dr. Robert Saul. Dr. Saul completed his pediatric training at Duke University Medical Center. He deeply cares for all children, and after seeing the need for child advocacy in society he was led to write several books for parents. Dr. Saul believes we need constant reminders about the optimal nurturing of children, and his work provides a multi-dimensional approach to parenting that is refreshingly new. 

Let’s dive in and learn the art of conscious parenting for our own family, and for the parents of our patients. 

[00:01 - 07:03] Opening Segment

• Introducing today's guest, Dr. Robert Saul
• Training and studies 
• Author of several books - links below
• Dr. Saul gives us a bit of background on his story 
• Finished residency in the mid-’90s
• A need to connect to the community 
• Devoting resources to be the solution 
• The impact of Columbine on Dr. Saul
• Wrote articles in the newspaper to educate 
• The 5 steps to community improvement  
• Inspired to write books to teach himself

[07:04 - 14:59] My Children’s Children 

• Dr. Saul’s own experience from childhood
• Parents divorced at the age of 9
• Verbally abusive household 
• Read back on his mother’s journals when she passed 
• Becoming the evil parent for your parent 
• Dr. Saul’s insights on parenting and pediatrics 
• The paternalism and maternalism of pediatrics 
• Child advocacy project 
• SSNR vs. SSRI 
• You need both, but SSNR will create lasting change
• Identifying and boosting SSNR’s 

[15:00 - 24:15] The Art of Conscious Parenting 

• Dr. Saul talks about the basis of Conscious Parenting 
• Dr. Saul’s story with his own child 
• Based on forgiveness 
• The model of the Parental Awareness Threshold 
• Dr. Saul’s story of Conscious Leadership 
• Above the line vs. Below the line 
• Being conscious of where you are on the line 
• Parenting works the same way 
• How to make a conscious effort as a parent 
• Pause, assess, and choose 
• Example 

[24:16 - 33:06] Being and Raising a Good Citizen 

• Separating approaches by age range 
• The value of having a partner along the journey 
• Another point of view
• Safe stable relationships are for parents as well
• Dr. Saul talks about how his book aids parents 
• Short read 
• Step by step approach 
• From someone who is also learning 
• Raising a good citizen 
• Don’t become elderly, become an elder
• Getting socially reconnected 
• Get involved and stay involved 
• Practice forgiveness personally and communally
• Be part of the solution 

[33:07 - 46:45] Closing Segment

• A word for parents in hard living environments 
• 3 levels of intervention 
• Active integration and support for these families 
• Advocacy can be part of the solution 
• Engaging the well-being of pediatricians 
• Seek out people who share your values 
• Don’t do it alone 
• Refuse to become discouraged 
• How Dr. Saul stays engaged 
• Dr. Saul talks about his book for children 
• Growing in wisdom
• Final...

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Have you ever looked at your child or a patient and just thought, ‘oh my God, I don’t know how to fix this’? You’re not alone and we’ll talk about this today with our guest Sandy Fowler, host of the Mighty Parenting Podcast. Sandy is a stress relief and wellness coach, a wife, mom, and business owner whose passion is teaching people to make powerful choices that impact their lives in the best possible way and help them take back their life from the busyness and stress of modern-day living. 

Let’s get right into the episode and learn from Sandy how we as pediatricians don’t always have to know everything, and what it looks like to partner with parents to learn together.  

[00:01 - 08:13] Opening Segment

• Introducing today's guest and my friend, Sandy Fowler, and what we will be talking about
• Met on her podcast to talk about the topic of suicide prevention for parents
• Listen to my guest appearance on her podcast here
• Sandy gives us a bit of background on her story 
• Help parents learn emotional wellness tools 
• Why this age group 
• You don’t have to know the answer, just understand that you’re not alone

[08:14 - 13:01] Shhhh, Just Listen and Check Yourself 

• Sandy talks about common themes she finds on her show 
• Our teens still need us, but it needs to look different
• Listening - a safe place to talk
• Coaching
• Modeling what it is we want them to do 
• Listening and coaching for kids 
• Parents need to be willing to check themselves 
• Pediatricians should help, not judge 
• Recognize and acknowledge things in yourself 
• Self-regulation 
• Try not to blow up 

[13:02 - 24:56] We Don’t Always Have to Know 

• Sandy shares her experience with pediatricians 
• Expectation of partnership 
• Sometimes the doctor just doesn’t know what to do and end up doing the wrong thing 
• Be okay not knowing as a pediatrician 
• Be honest with the parents 
• Explore options as partners 
• Sandy talks about a positive story with her daughter and her doctor 
• Non-disclosure 
• Gave the option to speak directly 
• There is help 
• I talk about our training as a pediatrician 
• Acting on things you may not know 
• A parent wants to know they have help, not just an answer 
• Sometimes it’s a skills issue 
• “I don’t have a pill for a messy family” 
• Chaos impacts behavior 
• Sometimes we can’t just fix the kid 
• Sandy talks about what we can do to help the family 
• Non-judgmental 
• Partnership and options  
• Realize that the issues can connect to a still-developing brain 

[24:57 - 30:07] Calmness is Key 

• Communication with the child is key
• Don’t panic 
• Our calmness helps the child 
• Pause and let the silence sit until the child is ready   
• I give an example with a code lead manager 

[30:08 - 39:34] Closing Segment

• A word for parents
• Your kids will be okay 
• Accept what you don’t know 
• We can be there for parents 
• The silence is...

https://swiy.co/WhatAreYourThoughts

Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I had the honor of speaking with Dr. Allek Scheele. Dr. Scheele is currently doing her pediatric hospitalist fellowship at the Helen DeVos Children’s Hospital in Grand Rapids. Her research focuses on pediatric and adolescent substance abuse and exposure.

Let’s dive into Dr. Scheele’s expertise so we can learn the hard truths behind child substance abuse and what we can do to arm ourselves, the children, and parents with tools and strategies to prevent problems in their lives.

[00:01 - 04:24] Opening Segment

• Introducing today's guest, Dr. Scheele, and what we will be talking about
• Dr. Scheele talks about how she got into her field 
• Opioid epidemic conference sparked her first interest 
• Led a project on marijuana exposure 
• Became addiction medicine certified 
• Reflected on her passion and decided to do a Pediatric hospitalist medicine fellowship in her second year of residency

[04:25 - 17:53] The Shocking Truth Behind Substance Use and What To Do

• Dr. Scheele talks about the truths behind adolescent and adult addictions
• The average age of addiction starts around 12
• Preventative pediatrics can make a difference 
• I talk about my experience with a 9 year old patient
• Monitoring the Future Study
• “You can’t tell who’s a good kid”
• Anyone can have a use disorder
• Dr. Scheele breaks down how to deal with prescriptions 
• Talk with the family
• Don’t over-prescribe 
• Not all pharmacies take back opioids 
• Promote putting out notices for when there is an event 
• Dr. Scheele talks a bit about vaping 
• The last two to three years has shown the largest substance increase we’ve ever had
• These vaping products are obviously geared towards children 
• All Juul products have nicotine and most teens are being tricked into getting hooked 
• One pod equals a pack of cigarettes 

[17:54 - 32:55] What We’re Seeing in the ER

• Dr. Scheele talks about the dangers of marijuana vaping
• Increase in accidental ingestion  
• Decreasing stigma 
• Marijuana ingestion is getting more creative causing kids to take in higher volumes 
• Kids coming in with altered mental status 
• What to screen for
• Dr. Scheele talks about preventative pediatrics 
• Work asking about substances into your check with the adults
• The Vapors in the house can cause an infant to test positive for THC
• This can also be absorbed into their skin affecting long term brain development 
• ADHD
• Schizophrenia 
• Substance Abuse Issues 
• I talk about promoting awareness 
• How to work with adolescents 
• Get to know who their friends are 
• Make it nonchalant 
• Be non-judgmental
• Ask what it is they like about what substance they’re taking 
• Know stopping smoking weed will stop cyclical vomiting 

[32:56 - 37:28] How to Deal With Alcohol Abuse

• Dr. Scheele talks about the current state of AA 
• Know that it is part of the culture 
• Fortunately there is a decline in binge drinking 
• Gear...

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In today’s episode, I have the pleasure of speaking with my amazing friend and co-chair of the Kalamazoo Perinatal Mood Disorders Coalition, alongside myself, Kristina Ledlow ICCE, CD, CPD. After two very challenging pregnancies and postpartum periods, Kristina became especially passionate about educating families and other healthcare professionals about Perinatal Mood and Anxiety Disorders. Kristina holds certifications as a Childbirth Educator, Birth Doula and Postpartum Doula in Kalamazoo, Michigan. She also works for OB-GYN, P.C. as their Patient Educator, and teaches classes for Bronson Methodist Hospital. 

Let’s dive into Kristina’s story and expertise so that, whether you are in pediatrics, a parent, or someone who knows a parent, you can be well equipped to help moms or even yourself get connected and be okay.

[00:01 - 07:50] Opening Segment

• Introducing today's guest and my friend, Kristina Ledlow, and what we will be talking about
• Certified in Postpartum Support International (PSI)
• Doula
• Patient educator
• Kristina talks a bit of journey to expertise in PMAD and prevention
• Severe depression and anxiety during two births
• Several Risk factors going into both pregnancies
• Manifested OCD tendencies 
• Connected with a therapist and put on medication 
• Went into childbirth education and perinatal mood disorders

[07:51 - 12:44] The Effects of PMAD

• I talk about my shared experience with postpartum depression
• Kristina talks about the impact on partners and babies
• Mothers mood affects everyone
• Losing function
• 1 in 5 moms affected, 1 in 10 dads affected
• Dad’s can also break down from the stress and exhaustion 
• Each baby comes with their own personality and challenges 

[12:45 - 25:30] Ask Mom’s if They’re Ok

• Screening moms during pregnancy and postpartum 
• Worry of opening a pandora's box
• Kristina talks about the importance of asking 
• Using the Edinburgh tool 
• Negative hormones in the mom affect the baby during pregnancy 
• Social workers and network to work with patients 
• Asking is therapeutic 
• You’re not crazy, this happens, let me get you connected 
• PMAD Virtual Care 
• Get them connected
• Have a plan 
• We need to get moms connected to the right people 
• Use  Postpartum Support International and get a coordinator involved
• 94% of moms have ‘scary thought’
• 1: OCD thoughts 
• 2: Postpartum psychosis (rare but dangerous)
• Believing the thoughts to be true and acting on it 
• It’s common to feel like this, it’s ok and there is help
• Putting strategies in place
• Getting good sleep by chunking 

[25:31 - 34:46] Practical Advice and Actions to Face PMAD

• These disorders can last up to two years
• The strongest moms can feel like a failure 
• Postpartumstress Instagram
• Don’t tie your self worth to social media
• It’s ok to feel the way you do
• Kristina shares self care tips
• Reach out and ask for help
• Support is key
• Ask: how can I help? 

https://swiy.co/WhatAreYourThoughts

Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I brought in Dr. Mark Sloane. He is a board-certified pediatrician and an adolescent medicine specialist.

Let’s dive into Dr. Mark’s story of how important it is to build a safe space for kids with mental illnesses and how to get involved in your community to help with kids’ healing process. This is a movement that is not restricted to medical practitioners alone, everybody can make an impact on kids’ lives and we are all in this together.

[00:01 - 11:02] Opening Segment

• Introducing today's guest, Dr. Mark Sloane
• Dr. Mark talks about his career
• He wasn't ready to practice because of limited training
• He did ADHD-related work
• Worked in a Trauma Center
• Most moms were exposed to drugs, alcohol and domestic violence
• How can we help kids with their functional outcomes?
• Working across different systems
• How do we achieve better outcomes and success?

[11:03 - 28:11] Building Safe Spaces for Kids’ Emotions

• Dr. Mark talks about continuing to improve the medication process dealing with kid's mental illness
• Looking for a holy grail pay off
• How do we make things safe for kids with trauma?
• Dr. Mark talks about using the same med-model on kids of different ages
• Some families have no problems with their older kids but struggle on the younger ones
• Kids being traumatized by the system
• Getting compared to their siblings
• Where do kids feel safe?
• With school, teachers and their doctors
• Helping them remember somebody they trusted
• The Power of Adult's Resilience
• If a kid has an adult that is crazy about them, this will help them big time with their healing process

[28:12 - 38:36] Collaborating with Other People

• Medicine and Prescriptions are just not enough
• Medicine only works to a certain extent
• Anybody can make an impact on kids' recovery process
• You don't have to be a psychiatrist
• Dr. Mark talks about bringing in different people to help with primary care work for kids
• Making connections
• Schools need to work with doctors and vice versa
• How do you get everybody on the table?
• Having the right infrastructure buildings and personnel
• We will all benefit from doing it. It's hard but worth it!

[38:37 - 44:40] Closing Segment

• There are so many ways that we can help and support these programs
• We are all in this together
• Final words from me and Dr. Mark

Tweetable Quotes:

"If a kid has one adult that's irrationally crazy about them that can matter and that's enough." - Dr. Mark Sloane

"Primary care has been traumatized and the answer is relational change by reaching out to other people to help us mend our own trauma" - Dr. Lia Gaggino

Resources Mentioned:

• Thinking Developmentally  - Andrew Garner
• Children's Trauma Assessment Center - WMU Kalamazoo
• Bruce Perry, MD, PhD – www.bdperry.com
• Ross Greene, PhD – www.drrossgreene.com

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