44. Anxiety Disorders in Children: Treatment Pearls

My guest today is Dr. Jeffrey Strawn, a Professor of Psychiatry, Pediatrics and Clinical Pharmacology at the University of Cincinnati and at Cincinnati Children’s Hospital. He is the Director of the University of Cincinnati Anxiety Disorders Research Program and the Associate Vice Chair of Research in the Department of Psychiatry & Behavioral Neuroscience at the University of Cincinnati.

In his clinical practice, he works with youth with anxiety and related disorders and with their families and supervises residents and fellows. Dr. Strawn has authored more than 160 peer-reviewed publications and co-authored two textbooks on the treatment of children and adolescents and on contemporary psychotherapy. He is a distinguished fellow of the American Academy of Child & Adolescent Psychiatry and has received multiple awards for teaching, mentorship and research.

 

[00:01] Dr. Jeffrey Strawn Shares His Story With Us

  • Dr. Strawn shares how he landed in the child psychiatry space 
  • The potential of over-screening patients
  • Dr. Strawn shares his thoughts 
  • Dealing with different levels of anxiety per Dr. Strawn’s experience 

 

[06:54] The Severity and Frequency of Anxiety

  • The criteria that Dr. Strawn uses to determine the level of anxiety of his patients 
  • The  questions to ask to tell how severe the anxiety is and how frequent it happens 
  • What parents should expect in assessing their kid’s anxiety 
  • The factors that can affect moods, not necessarily anxiety disorders 
  • Does your child need medications?
  • Listen to Dr. Strawn’s explanation  

 

[16:35] The Right Medication for Anxiety

  • Dr. Strawn shares his approach to giving medications on anxiety 
  • Giving medications is one thing, managing the dosage is another 
  • Avoid making the patient expect they will have problems with this simple statement 
  • Overlaps between anxiety and depression symptoms 

 

[26:18] Side Effects of Medications

  • How do we know if the medicines are working?
  • Mania vs. difficulty in sleeping and bipolar disorder 
  • Dr. Strawn talks about boxed warnings 
  • Managing insomnia and sleepiness 

 

[36:25] Managing Panic Attacks

  • Taking medications with or without food
  • Dr. Strawn shares his thoughts 
  • Dr. Strawn shares his thoughts about managing anxiety among young adults 
  • His clever strategy to handle panic attacks among young adults 
  • He shares his thoughts about cannabis use 

 

[47:29] Marijuana Use Among Young Adults

  • The difference between alcohol and marijuana users 
  • Dr. Strawn’s parting advice for listeners 
  • The impacts of anxiety about the growth of a child 

 

 [52:46] Closing Segment

  • Final takeaways:
  • The question, “How often do you worry?”
  • Treatments for different levels of anxiety 
  • Severe symptoms of anxiety we should watch out for 
  • The SCARED tool for anxiety 
  • SSRIs are safe as first line of medication for anxiety and depression in children
  • “start low and go slow”
  • The time to onset of actions of different medicines
  • Side effects of medications that we should know
  • Managing side effects 
  • Monitoring can be done in person or via televisits 
  • A more strategic approach to handle panic attacks
  • The adverse effects of selected medicines we should not forget
  • FDA boxed warnings 
  • Be prepared with false positives 

 

Key Quotes:

“Don’t ask, ‘Do you worry?’ Ask, ‘How much do you worry?’ or terms of a younger child, ‘How good are you at worrying?’” – Dr. Jeffrey Strawn, MD

“Spend as much time as you can with your family.” – Dr. Jeffrey Strawn, MD

Email [email protected] to connect with Dr. Strawn or check out Cincinnati Children’s Hospital to know more about his work.

Resources Mentioned:

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Dr Lia Gaggino

Dr Lia Gaggino Host of the Pediatric Meltdown Podcast

Dr. Lia Gaggino has worked as a pediatrician for over 30 years on the west side of Michigan. During her career as a primary care physician, she has been privileged to care for children and adolescents, and know that their success is closely tied to mental wellness.

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Dr. Lia Gaggino has worked as a pediatrician for over 30 years on the west side of Michigan. During her career as a primary care physician, she has been privileged to care for children and adolescents, and know that their success is closely tied to mental wellness.

Recent Episodes

  • All Post
  • ADHD
  • Advocacy
  • Aggression and Disruptive Behaviors
  • Anxiety
  • Autism
  • Building Better Workflows
  • Depression
  • Genetics
  • healthcare disparities and inequalities
  • LGBTQIA+
  • Medications
  • Mental Health
  • OCD
  • Other
  • Pain
  • Parent/child
  • Physician Well-Being
  • Schizophrenia
  • Sexual Trauma
  • Sleep
  • Social Media
  • Substance Abuse
  • Suicide Prevention
  • Trauma

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