41. Taylor Swift: In my child mental health era

In honor of the release of Taylor Swift’s 11th album, The Tortured Poet's Department, this is a special episode where I am joined by my tween daughter Julia, to share highlights from Swift's albums as well as from PsychEd4Peds episodes.  I bet you never thought about how the album, Red, is related to ADHD meds. 

#childmentalhealth #swiftie #tsttpd #adhd #anxiety #parentmentalhealth

Check out our website PsychEd4Peds.com for more resources.
Follow us on Instagram @psyched4peds

Transcript

Dr. Elise Fallucco: 0:21

Welcome back to psyched for Peds. I'm your host, Dr. Elise Fallucco child psychiatrist and mom. And I'm your cohost, Julia Fallucco, Swifty and daughter. You may note that Friday Taylor swift released her new album, the tortured poets department. In all our Taylor NES, she made it a double album, just like we're making this episode a double host, I'll bring the Swifty and I'll bring the child psychiatry. I'll ask Julia questions about Taylor swift and her music and albums.

0:54

She'll ask me child mental health questions related to our recent psyched for paeds episodes.

Dr. Elise Fallucco: 1:00

So let's get started. Starting with Taylor Swift's debut album and your debut podcast episodes. What are the best ways to screen for anxiety and kids? Excellent question. Julia, as screening is recommended for kids 12 and up by the us preventative services task force. And it's really important to ask both kids and parents about signs of anxiety. So my favorite screening tool is this scared, which most of our friends and colleagues have heard me talk about. Has 41 items with a child report and parent report. And most recently we've talked about an abbreviated version of the scared, which only has five items. And it's called this scared five. And both of these screening tools for anxiety are available on our website. Psyched for Peds.com. So Juul, what's your favorite song from Taylor Swift's debut album? I really like our song. I don't really have a specific reason. This is just a fun song to sing along to. I think you like the slamming screen doors, part of it. Oh, yeah, that's pretty fun. Okay, let's move on to Taylor fifth, second album called fearless. What questions can you ask to find out if someone might have an anxiety disorder. So in episode 31, About ADHD and anxiety with Dr. Jeff Strawn, he gave us some great interview questions to help distinguish types of anxiety. He said, we should ask kids, how good are you at worrying? And then ask what would happen if this thing that they fear occurred? And try to see if they have some sort of catastrophic answer for that. And then ask yourself. When you're trying to distinguish between clinical anxiety. Is the thing that they're worried about reasonable, like an upcoming test or. A big assignment. Yes, or something like that. And is the anxiety proportional to the stressor? So are they a little worried before an upcoming test and then it goes away or is their amount of anxiety really? Disproportionate to the type of stress. But back to Julius. So Taylor swift second album is called fearless. How does the song fearless relate to anxiety? Well, I think the song fearless relates to anxiety because she doesn't have anxiety in this relationship and she just drives it as being fearless and just want to go dance in her best dress in the pouring rain. And it brings up the question, if it's a good thing or a bad thing, that she's fearless that is a good question, Julia, about whether it's good or bad to be fearless, because we know that anxiety is actually something that's normal and that it can be really helpful. And so sometimes being fearless might not be a good thing. Yeah, because like he one, thing's it to not jump off cliff. Cause that might save your life. Exactly. Okay. The next album she released is speak now. And one of my favorite songs in that album is never grow up, which is basically a song telling you to treasure your early years as a preschooler and an elementary school. Speaking of elementary school. Two of the most common mental health problems in kids in elementary school are ADHD and anxiety and episodes 32 and 33. You and Dr. Strawn. Talk about how do we approach treatment for kids with both ADHD and anxiety? What were some key points from that episode? Very briefly. We talked about a lot of things, but the key points would be treat ADHD first when you have ADHD and anxiety, and then once the ADHD is treated, then you can address any residual anxiety. Unless, of course the anxiety is so severe and then you'd want to rethink that. I was glad to hear that Dr. Strawn also recommended starting with methylphenidate type stimulants because the research and the data say that they are much less likely to cause mood and anxiety symptoms and less likely to cause appetite suppression. Then the mixed amphetamine salts. But enough about salts. Let's go back to. Your favorite song from speak now, which was called, never grow up. Tell us what is your favorite line from that song? Easy. I like the line where it goes and don't lose the way dance, rounding. PJ's getting ready for school. Just because of that line. I added that as my alarm so that I would be dancing around in my PJ's getting ready for school. When it said that line. Oh, my gosh. I was not even aware of that. onto her fourth album red. I saw this thing on Pinterest the other day. It was telling you that red dye number 40 can lead to ADHD symptoms like hyperactivity. Can you tell me about when you would use alpha agonist to treat ADHD? It is totally unfair that I'm making you ask questions that involve words like alpha agonists in them. Which I didn't think about until just now. Okay. When would you use alpha two agonists? We would use them as adjunctive treatment for kids who are having trouble tolerating stimulants. Or who have residual impulsivity. When they're being treated with stimulants. And of those Clonidine is the one more likely to affect blood pressure and cause sedation. So it's good for sleep. Whereas guanfacine tends to be less likely to cause those problems and guanfacine XR is a really nice one for impulsivity it's dosed once daily and the magical dosing formula that Dr. Strawn talked to us about. Is dosing guanfacine XR at 0.1 milligrams per kilogram per day. Enough about milligrams per kilogram, per ninom? Ah, but, and back to the fun part, the Taylor swift part. So background information. Julia's favorite Taylor swift song probably of all time is the 10 minute version of all too well from the red album. Jay, what do you like most about that song? I'm sure my brothers love it. When I play all 10 minutes in the car. When I get to request a song that is true. I think that's partially my favorite reason because they play very annoying songs and it's my little revenge. And also the lyrics are just masterpieces. Excellent. Okay. Taylor Swift's fifth album 1989 is my favorite album Now let's wrap up our questions about ADHD and anxiety. Can you tell me what to know about one of the newer ADHD meds on the market? Violin Zach's teen or Kelly? Whew. That's mouthful. It's actually philoxenia. Dezeen or Calvary, but I also have trouble pronouncing it. So I think this may be genetic. I could not survive a Dane med school. So the Luxe Dezeen is a norepinephrine re-uptake inhibitor. And I bet you're relieved that I did not ask you to say norepinephrine re-uptake inhibitor. Very relief. So it's similar in its mechanism of action to Adam oxytocin or Strattera. Tara, it works more rapidly than Straterra does. And even within the first couple of weeks, you can notice an improvement in symptoms of ADHD. And the one thing to know about it is that it's a potent cytochrome P 4 51, a two inhibitor. And why that's important is that's also the enzyme that metabolizes caffeine and energy drinks. And so if you have somebody who's on Viloxazine you have to warn them. To really be careful about how much caffeine they take, because the medication can increase caffeine exposure and increase the blood level over time. About six fold. No Starbucks for little Timmy. Timmy's not the only one who takes the Lux ezine but, okay. So back to 1989, your favorite album, what are your top three favorite songs from 1989? In order of appearance on the album, cause I'm just a super Swifty welcome to New York. How you get the girl and new romantics. Wait. Hang on. I'm getting a phone call. I'm sorry, but the old anxiety medications can't come to the phone right now. Why. Oh, because they've changed. Welcome to reputation psych for PV listeners. Are you ready for it? It's not so much that the meds have changed, but the approval for them has somewhat changed. Since I recorded our most downloaded episode of psyched for paeds to date, episode five on anxiety meds with Dr. John walkup we have had an additional FDA approval for the treatment of anxiety in kids. Both Duloxetine which is Cymbalta and the more recently approved med Escitalopram or Lexapro are both approved for generalized anxiety disorder in kids seven years and older. And if you want dosing guidelines or information about the SSRI for anxiety, depression, you can check out our free downloadable card on our website. And for Julia, a little trivia. Which reputation song has a music video that involves bank robbery and cats? Easy. The look, what you made me do. Music video. Next one is such a fun album lover. In fact episode 35 of yours was titled how to help kids love sports. With coach Peter veer, Hoff, what are some key things that you've learned from that episode? So two key things I learned about youth sports. One. Was that almost 70% of kids drop out of youth sports by age 13? And I think I didn't realize that. And I was also surprised by how few kids go on to play sports in college. And I think sometimes as parents, we may have overinflated ideas about our kids going on and playing sports in college. So that was a good reality check. Be helpful hints that coach Peter shared. We're excellent. Basically he said in a much nicer way, we should stop trying to coach our kids as parents and just let the coaches, coach and our job as parents is to focus on cheering them on and helping them know that we love them. Regardless of their performance, whether they win, they lose, they go a best time or not. And Julia, when we went to the Taylor swift concert, you made a big dazzled silver guitar and wore a costume based on the album called lover. What exactly did you wear? You basically said it with the potassium silver guitar, but I wear a blue shirt, like she wore on the album cover. Also Taylor swift famous quote, my favorite colors glitter. Oh, that is a good quote. Next is my second favorite album folklore. What exactly is a folklore of crying and waffles from the same episode of before. Oh, I loved this story. Coach Peter really talked about the hardest time for a student athlete. And you told this story about a kid whose mom called him before early morning practice saying that her son couldn't attend practice because he was crying in his waffles. And he used that story to illustrate that. That child had just recently gotten his. Driver's license and was driving to practice on his own. It had been about a month or so that he had not had his mom pick him up. From practices and that, that time in a teenager's life. Is usually a time when a lot of his student athletes break down because they no longer have the support of their parents driving them to and from practice or just that little space and zone to process how they're feeling. That was a cool factoid or folklore OID, if you will. What do you like so much about folk Lord? That it makes it your second favorite? First, I would just like to say. Crying in French toast is bad, but crying in waffles. That's where we draw the line. But I like folklore because I don't know. It was just like the album that helped us all get through COVID if you know what I mean. But anyways, evermore is next and evermore is also a COVID album. And during COVID. It was pretty hard to sit still and look at an iPad all day. My little brother was in pre-K four at the time, and it was extra hard for him to pay attention. We had to bribe him with Dunkin donuts. Okay. So maybe it's not okay to be talking about bribing kids with doughnuts on a child, mental health podcast.. We all did things that we're not proud of during COVID. So let's move on. Anyways in episode 38, you talk about behavioral problems in preschoolers. What is one way to tell if a preschooler may be experiencing these behavior problems? One of my favorite screening tools is the brief ECSA or the brief early childhood screening assessment. It's a 22 item. Caregiver report that assesses for symptoms of child emotional behavioral problems. And it also looks at caregiver stress and caregiver, depression. And the brief ECSA is also available free for download on our website. Psyched for paeds. So back to a quick trivia time, which song on evermore is about Taylor's grandmother. That one would be Marjorie. It's actually a very sad song. But we only have two areas to go, which are midnight. And tortured post department. So get ready for some unreleased content relating to midnights. Mom. I know that you're an early bird and you'd like to wake up early, but not stay up late. It is a horrible sign if I'm up at midnight and I can guarantee that no one will be happy the next day, if that happens, I highly value my sleep. And I think that was part of why it was so hard when dad and I were taking care of you guys, when you were little. The sleep deprivation. Can you tell us a factoid about how sleep deprived parents do we, young kids are at risk for depression. In the first four years of a child's life, one in 10 dads, experienced depression and one in four moms experience depression. And so just for all of you who are parents out there, and for all of us who are taking care of parents out there, this is something to keep in mind and something to remind parents about that in this time where we're all just trying to hold it together. We're all at increased risk for potential depression. And we also know depression is incredibly treatable. Please encourage parents to get help and seek support. Because we also know that depression in parents can increase the risk of emotional and behavioral problems in kids. One last bonus. Taylor swift trivia question. When were all of her songs written on the album? Midnight. They were all about her dreams and she woke up at midnight. For our final torture poets department era, we hope that we don't torture you with any more mental health trivia. And I want to give a special shout out and thanks to Julia for coming up with the idea of this episode and for having an encyclopedic knowledge of Taylor swift music to make it happen. And for being a fantastic cohost. Thank you guys so much for listening. We hope that this was a helpful recap and also a fun review of Taylor swift trivia. Check us out on our websites. Psyched the number four paeds.com. And please send me a chat or add your email list to the website so you can get our weekly newsletter. And if you're just like, wait back, girl was just like so much fun to have on a podcast. You can make this the most popular episode instead of episode five. How could they do that? Julia? They would listen to it. Oh, tell your friends, tell your family, tell everybody. All right, we'll see you next week. Bye.