August 26, 2024 • 20 mins
Unlock a deeper understanding of ADHD and autism comorbidities in children and teens with insights from our special guest, Dr. Marie Dona. In this episode of Brain Power, Dr. Dona shares groundbreaking statistics and underscores the urgency of early diagnosis and treatment to prevent additional mental health issues like depression and anxiety. You'll learn why children who act out may not be doing so on purpose and how a compassionate, informed approach can make all the difference. We promise you’ll gain a new perspective on these complex conditions, helping you to better support the young ones in your life.
We also explore the often-overlooked aspects of ADHD such as impulsivity and emotional regulation, offering practical strategies for parents to reframe their understanding of ADHD-related behaviors. By recognizing these behaviors as more than just defiance or laziness, you can create a more supportive environment. Additionally, we discuss the significant role of parents in advocating for their children's mental health, especially during the challenging teenage years. From setting boundaries to ensuring proper care from healthcare providers, this episode is packed with actionable advice to help you navigate these intricate issues effectively. Tune in to equip yourself with essential knowledge and tools to support your child's mental well-being.
Connect with Dr. Dona:
donawellnessclinic.com
IG: donawellnessclinic
FB: donawellnessclinic
LI: https://www.linkedin.com/company/dona-wellness-clinic/
Listen to the full episode on your favorite podcast platform and check out the video version on our YouTube channel!
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If you want to schedule an ADHD/Autism appointment for your child, you may contact Glow Pediatrics:
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- info@glowpediatrics.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Hokehe Eko (00:00):
Hello parents.
Welcome to another episode ofBrain Power with Dr o.
I have an amazing guest today.
Her name is Dr Donna and I'mgoing to have Dr Donna introduce
herself, as always.
So, dr Donna, welcome to theshow.
Dr. Marie Dona (00:14):
Thank you so much for having me.
I'm so excited to be here.
So my name is Dr Marie Dona.
I'm a child, youth, adult,reproductive psychiatrist and
therapist, but I also gotadditional subspecialty training
in obesity medicine as well.
So that was an additionalcertification that I just got
within the last year or so.
Yeah and yeah, I have my ownprivate practice in Riverview,
(00:37):
florida, but I see patientswithin my practice all
throughout the state of Florida,new York, pennsylvania and
Washington DC.
Dr. Hokehe Eko (00:44):
Wow, that's amazing.
Thank you for coming on here,and it sounds like you have
quite the expertise.
Oh my gosh, I didn't know youhad the obesity and the
reproductive.
Dr. Marie Dona (00:57):
Wow, yeah, I mean I feel like it's a thing
Like when you you know, asdoctors, right, you're always
wanting to, you're always doingCMEs, continuing medical
education, and you're alwayswanting to learn, and I felt
like that was just kind of partof it.
So that's when I just kept liketacking things on, but I feel
like it's all beneficial andit's stuff that I can apply
towards my practice, you know,yeah, definitely.
Dr. Hokehe Eko (01:19):
I mean, it makes sense because you're an adult
psychiatrist and then you havereproductive, so if you have
mummies you can take them, andthen the adolescents, too, need
reproductive care as well, Imean from a mental health
standpoint.
So it all makes sense.
So, congratulations, I love it.
So today we decided we weregoing to talk about the
(01:40):
comorbidities around ADHD andautism, especially in kids and
even teenagers.
Teenagers is a big one, yes, solet's dive in.
Dr. Marie Dona (01:51):
Well, definitely , as a child youth psychiatrist
I will say so ADHD and autism.
They are, you know, mentalhealth conditions that
definitely I think are veryimportant to be properly
diagnosed and treated as youngand as early as possible, just
because you know, as you justmentioned, the comorbidity like
the likelihood of someoneeventually having another mental
(02:15):
health condition depression,anxiety, you know, mood swings,
you know all of the above itjust goes so much higher when
someone has a diagnosis of ADHDor autism.
So I mean, I can even give youstatistics so you know, for
someone who has been diagnosedwith ADHD, like as a child, the
(02:35):
comorbidity of both depressionand anxiety can be anywhere from
25 to 50% of them having dualdiagnosis.
And, as you can imagine, ifsomeone has depression, anxiety
as a young child and it goesundiagnosed or untreated for
years, like how the severity ofthat disorder can just continue
to manifest and potentially getworse as they're getting older,
(02:58):
into teenage years and adulthoodyears, so that comorbidity
actually goes up.
Like if you have ADHD or autismand have untreated diagnosis of
depression or anxiety, it goesup to like 50 to 75 percent of
comorbidity of depression andanxiety.
So there's definitely aninterplay between those
diagnoses and other mentalhealth conditions.
Dr. Hokehe Eko (03:19):
Yes, and I think that's important.
Those statistics are staggering, first of all.
So it's really important forparents to understand it and to
recognize that it's not thattheir child is willfully being
well, willfully not listening,willfully not wanting to go to
school and just being a brat.
No, because all of these thingscould be happening at the same
(03:43):
time.
If we don't recognize that,then we're just going to not
give them the help that theyneed.
Dr. Marie Dona (03:49):
Yeah, yeah, definitely.
So something I hear all thetime and I'll give an example
for ADHD specifically.
So you know, with ADHD, withinthe DSM it's diagnosed as, like,
the inattentive type, thehyperactive type or the combined
type.
So then you know, when peopleare thinking about ADHD they're
thinking, oh, super hyperactive,or, you know, very inattentive,
(04:09):
forgetful, daydreaming, etcetera.
But you know, what isn't reallytalked about as much, or you
know people don't find out untillater is that behavioral
component or the mood componentof ADHD.
So when I talk with parents ofkiddos with ADHD and they're
like, oh yeah, like not payattention or they're very hyper,
but I'll, like I think it'sjust laziness when they're not
(04:37):
listening to me.
Or you know they're doingthings without kind of thinking
about the consequences, like isthere something wrong with that?
I'm like, ok, well, with ADHD,while there is the inattentive
portion and the hyperactiveportion, like impulsivity, that
lack of impulse control is ahuge thing.
You know, with the brain, youknow the brain connection, like
there is that disconnect between, okay, let me actually think
through the consequences of myactions, behaviors, or oh, I
(04:57):
want to do this or I'm going toreact right now, I'm just going
to do it, and then that's whenit kind of leads to issues.
So I like to help parents tryto think of it and reframe it as
okay, not just forgetful, notpaying attention or hyper, but
just the way that they caninteract with the world.
Like impulsivity, I'm upset, I'mgoing to throw my toy across
the room and it might break theTV.
(05:19):
Oh, now you're acting out,you're in trouble, defiant, just
behavioral issue.
No, there's, it's a little bitmore nuanced than that.
Just because they are notunderstanding, like, ok, I need
to take a moment to understandwhere my emotions or anger is
coming from to maybe stop fromjust thinking I'm angry to
throwing the toy.
And that's where a lot ofbehavioral intervention comes in
(05:41):
when it's coming to ADHD orimpulsivity or these types of
behaviors.
Dr. Hokehe Eko (05:47):
Wow, that's wonderful.
Thank you for explaining that.
And so what do you tell parentswhen they come to you?
Dr. Marie Dona (05:52):
and their children have these issues so
when parents come to see me, Ilike to really get a good
background about their history,kind of how they do things like
basically from childhood tocurrent or birth to current,
like you know, birth history,medical conditions, family
psychiatric history, all ofthese, all of the above, because
(06:14):
these can definitely affect youknow a kiddo in their terms of
their behaviors.
If there is trauma, abuse,these are huge things that can
affect you know a kiddo andtheir behaviors.
So I get a really thoroughbackground, information, history
, and then, once that's obtained, then I'll kind of ask, ok,
like well, what is going onnowadays that's bringing you
into seeing me?
And I will say, as a childadolescent psychiatrist, a lot
(06:36):
of times it's either behavioralconcerns acting in a school,
acting in at home, or, you know,issues with attention, focus,
that it's actively contributingto them having issues with
performance in terms of school.
So then identifying what that,whatever that problematic issue
is, and then seeing how they'veaddressed it so far, a lot of
times they'll be like, oh,haven't really done anything, or
(06:57):
screen time.
So then that's when I wouldusually start talking about
intervention.
So, child adolescent,adolescent psychiatrists I am,
you know, an expert inprescribing medicine, but I will
always say, I always recommendbehavioral interventions.
First, you know therapy, youknow PCIT, play therapy, you
know other types of things youknow to come down to actually
(07:19):
find out the root or the causeof the behavior.
So that that's where you canpotentially, you know, do things
like reward charts.
Reward systems are things thathave a lot of evidence base for
being helpful for kids who havebeen struggling with behavioral
management, behavioralregulation, and a lot of times
parents just aren't familiarwith that.
There are things out there likethat that can be helpful with
(07:40):
their kiddo.
So those are all things that Iwould recommend as first, you
know, first-line treatment andthen typically when I would
start recommending medicines isafter they've already tried
behavioral interventions andthey haven't been working, or
it's kind of plateaued orbehaviors have really escalated
that you know it can progress tolike a safety concern, and then
(08:01):
that's when medicines reallybecome more of a topic of
conversation.
Dr. Hokehe Eko (08:11):
Right, right, that makes complete sense and
thank you for walking us throughthat.
And so what would you say forparents Like, how do they, how
would they handle things at home?
How do they talk to their childabout what's going on?
Because I think that's a bigissue that parents have.
Yeah, yeah.
Dr. Marie Dona (08:26):
So usually I would recommend for parents to
just have like an open andhonest kind of discussion, Like
sometimes parents might not givetheir kids enough credit to
have an understanding of whatthey're feeling and, like you
know, sometimes they might kindof just assume like, oh, they're
just angry or they just haveissues.
But then you know, justactually sitting down with your
(08:47):
child, Okay, like is theresomething going on?
Is there something botheringyou?
Like, are there issues atschool?
Is someone bullying you?
Are you having?
A big thing that I've noticedwith kids with ADHD and even
autism is that behaviors canmanifest when they are
frustrated with schoolwork, likethey're not understanding how
to do the schoolwork, they'renot able to focus, they're not
(09:08):
able to concentrate, so they getfrustrated.
And the only way that youngerkids are able to, you know, show
their, you know show thatthey're frustrated is by acting
out, getting angry, you know,throwing things, breaking things
, yelling, screaming, thosetypes of things.
And then, yeah, parents mightthink, oh, my kid is just being
a bad kid when underlying.
Oh, no, they're actually reallyhaving trouble reading for an
(09:32):
extended period of time, orthey're having a lot of trouble
with math.
So you know, just, I think youknow, I'm really being open to
discussing with their kids, likeif there is something bothering
them, and then taking their cuefrom there and then, you know,
getting input from the school.
I think is also reallyimportant.
Important too, if teachers arehaving any specific concerns and
then, yeah, trying to navigatefrom there.
Dr. Hokehe Eko (09:53):
Right, right and no.
Those are really importantpoints, because I think that
even a lot of the work that canbe done to help the children has
to start at home, and so it'sreally a kind of environment.
So when you're talking aboutteenagers and you ask them how
(10:14):
was your day, and they say fineso how, how do you recommend to
parents to get past the finething, fine answer and get to
the, to the real crux of thematter?
Dr. Marie Dona (10:26):
so I'm going to say teenage years, pre-pre-best.
You know, like pre-teen yearsare very difficult when it comes
to communication with kids.
Because I will say honestly andI have this conversation with
the parents all the time too andthat, like, as much as you want
to be that go-to, that personthat you know your teenager is
going to confide in and talk to,during that time period, it's
(10:49):
almost within developmentallynormal for friends like that
support group, to just kind oftop the.
You know the teenagers in termsof, like, who they're wanting
to open up to or talk to.
So this is where, okay, it isnormal that you know sometimes
your kids might not be wantingto go to you first, but this is
where I say willingness to openthe door to communication.
(11:09):
Okay, like, I know that youmight not be wanting to go to
you first, but this is where Isay willingness to open the door
to communication, okay, like, Iknow that you might be just
wanting to hang out with yourfriends or do this or that, but
I'm always going to be here foryou if you need anything or you
know, just let me know ifthere's any way I can support
you.
And I also think you knowwillingness, yeah, to open the
door to communication.
Being vulnerable too, like so,adhd is a diagnosis that there
(11:32):
is high likelihood that it'sheritable, like genetics.
So a lot of times kids withADHD might have a parent who had
ADHD.
So if a parent themselves hadADHD, saying, yeah, I've kind of
struggled with the same thingstoo.
So if this is something you'regoing through, let us know so
that we can try to help you, andjust kind of keeping the door
open like that, letting themknow that they will always kind
(11:52):
of have a support.
Boundaries are a thing too.
So you know as much as you wantto be support, like if someone
is obviously acting out, etcetera, like there still needs
to be boundaries in place.
But I think you know, justultimately letting your teen
know, or you know your kid knowthat you are there to be a help
or support if they're needinganything and just trying to
follow their cues essentially.
(12:13):
But it is a difficult time interms of communication, I think,
just worldwide and during thistime frame specifically.
Dr. Hokehe Eko (12:19):
Yes, I have one in my house, so I know.
I'm a 10-year-old and, yes, I'mlike what happened to my kid,
okay, but sometimes it's thefine.
No, yes, okay, so I get it.
And yes, parents, you're notalone.
There's resources to help youwalk through how it gets to your
(12:42):
kids, but just to get them thehelp they need.
But it's so important I think Ilike what you said about.
For me, I like to say it asspeaking life to your kid and
just reminding them who they are, who you see them as, who you
love them, even when it feelslike you can't reach them, they
are listening and I found my ownlimited experience, especially
(13:06):
when it's like when she, whenshe's acting like oh, she
doesn't need you, she reallythey still, they still need you
yeah yes, and and when you justkeep being consistent and
telling them that you love them,regardless of the behavior, it
doesn't mean you're condoningthe behavior, but they still
need to know their love, becausethat's like the bedrock
(13:27):
foundation, because if anythingis going to pull them out of
that, it's going to be that theyknow their love, because that's
like the bedrock foundation,because if anything is going to
pull them out of that, it'sgoing to be that they know their
parents love them.
So I think it's important.
Dr. Marie Dona (13:35):
Yeah, definitely .
So I've heard, you know, fromall ends of the spectrum.
So I've actually had familiesI've worked with that you know.
They've gone through theteenage years but then they've
seen the other side of it.
It's like I've had alsopatients that themselves like I
remember like oh, I actuallytalked with my mom and I was
like yeah, mom, dad, why, Idon't know why I didn't talk to
you for like four years but likeall of a sudden this like light
(14:00):
bulb goes off and they're likeI have no idea why I didn't want
to talk to you for four years,but I guess it's okay now and
then now they have a goodrelationship.
But I would say like this ishonestly where I think it is
within the realm of normal.
But like everything you said,showing that you love, care,
support them kind of regardlessif they need anything.
But you know, alsounderstanding that this is a
(14:20):
time that sometimes they arekind of wanting and needing
their distance to you.
But just know it's not anythingthat you are doing as a parent,
like it's just something thatdoes kind of happen within these
developmental years.
Dr. Hokehe Eko (14:30):
Yes, and so what would you say to those parents
who they go to the health careprofessional and they're not
quite able to get the help orsupport that they need for their
kids?
Maybe it's oh, it's just normal, They'll get through it.
What are the questions or whatkinds of things should they be
saying to their providers to getthe help they need?
Dr. Marie Dona (14:52):
So I guess this is where a lot of times it can
be normal but at the same timetoo, you know, some of these
things might not be as normal.
So I know that a lot of timeswhen they when you know kids,
teenagers, might be seeing theirpediatrician or PCPs, they'll
do kind of screening exams likeGAD-7 for anxiety, phq-9 for
depression, like those types ofthings.
(15:13):
So this is where you know,taking those questionnaires
seriously and if they're scoringhigh enough on the threshold,
talking, you know, having thekid talk with their PCP or their
pediatrician about these issues.
And I will say so, I work in alot of different, so I have my
own private practice, but I alsodid a lot of like emergency,
like child, child, adolescent,teen, er work and it's kind of
(15:35):
funny how, like sometimes theteens won't want to talk with
their parent about the issuesbut then they will meet me a
complete stranger and they'llfeel like because this is, like
you know, someone who iscompletely unbiased outside of
the relationship that they canbe open and honest.
So if this is where you know aparent is concerned, they can
always I think I would stillencourage them, you know, to
(15:57):
bring them in for an evaluationand like you know, if they're,
you know preliminary screeningPHP 9, gad 7, you talk isn't
raising any red flags, that'swhere you know pediatrician, pcp
, psychiatrist can provide thatreassurance.
But you know, if after aconversation with their kid
there are additional concerns,that's where it might be worth
warranted for a furtherevaluation and potentially
(16:19):
having their kiddo talk withanother mental health provider.
Dr. Hokehe Eko (16:23):
Yes, and parents , I want you to know that you're
the first and best advocate foryour child.
So, even if there's a screeningform and, based on the way you
answer it, it doesn't quite,your child doesn't meet
threshold.
It's important for you to behonest with the doctor and see
exactly what's going on, becausethat's the only way you're
going to be able to get thereferrals as need.
(16:45):
I mean, depending on what'sgoing on, what's your insurance
and all of that is to get thehelp that your child needs.
So it's just don't be ashamedof it.
It's nothing to be ashamed ofyou.
It's important that your childgets the help they need yeah and
like.
Dr. Marie Dona (16:59):
so, while you know, while we're talking here,
like we are both, you know,medical professionals, right,
we're kind of familiar with,like within norman, what's not,
but parents, like, it's okay ifyou don't know exactly what is
normal.
That's why it's okay to reachout for help, you know, touch
base with your doctor, touchbase with your pediatrician, pcp
, and ask the questions, bringup behaviors, and that's where
(17:22):
they can.
You know, not every case is thesame, right, so there's
different scenarios, differentsituations and that's where your
medical professional can adviseyou one way or the other.
Right, absolutely.
Dr. Hokehe Eko (17:33):
Wow.
So I like to ask all my gueststo give us last minute brain
health tips for both the parentsand the kids.
So do you have any you'd liketo share?
Dr. Marie Dona (17:47):
Last minute brain health tips.
So do you have any you'd like toshare Last minute brain health
tips?
So I'm all about so.
Psychiatrists prescribemedicines, but I'm all about,
you know, the holistictreatments as well too, like
nutrition, like good, you know,making sure that someone is
getting healthy nutrition, sleep, sleep hygiene as much as
possible.
And I'm going to say the teenyears are especially hard.
It's a conversation I have allthe time with my patients and
(18:08):
clients, right, and physicalactivity.
These are all huge, foundationalthings that there's so much
evidence that like and I'm allabout homeostasis too that if
one of these things are off,like bad nutrition, poor sleep
habits, you know, limitedphysical activity these are all
things that will, you know, canimpair mental health.
(18:29):
Yeah, physical, medical, mentalhealth, brain growth and
overall development.
So this is where, you know,people are seeking help,
behavioral interventions,therapy, medicines.
But I always go back to thebasics first and like how's your
sleep, how's your?
You know, how's your diet?
Okay, what are things that wecan do to tweak here to make
them just that much better?
(18:50):
And you know, these are thingsthat, like, they might seem so
small, and you know, minuscule,but can make a world of
difference in overall helpingsomeone with any and basically
anything right, Like any mentalhealth condition, autism, adhd,
like basically everything.
Dr. Hokehe Eko (19:06):
So so that's my basic, fundamental go-to from
here I love it so before thelisteners, where they can find
out more about your practiceokay, yeah, so my practice name
is uh donna wellness clinic, soyou can reach me through.
Dr. Marie Dona (19:22):
Our website is www.
donawellnessclinic.
com.
We have a bunch of social mediathat handles it's all dona
wellness clinic likecom.
We have a bunch of social mediathat handles it's all Donna
wellness clinic like facebook.
com slash Dona wellness clinic.
Instagram.
com slash Dona wellness clinic.
I am physically located inRiverview, florida, but yeah,
I'm able to see patientsvirtually all throughout the
state of Florida, pennsylvania,new York and Washington DC, and
(19:44):
we are taking new patients now.
Dr. Hokehe Eko (19:46):
Yay, wonderful.
So thank you so much, Parents,go check out her YouTube page.
If you need her services, reachout.
And so thank you so much againfor coming on here.
Dr. Marie Dona (19:57):
Dr Dona, Thank you so much for having me.
Dr. Hokehe Eko (19:59):
This was great Everyone until the next episode,
have a wonderful day.
Please share this with somebodythat you feel needs to hear
this.
Take care.
Hello parents.
Welcome to another episode ofBrain Power with Dr o.
I have an amazing guest today.
Her name is Dr Donna and I'mgoing to have Dr Donna introduce
herself, as always.
So, dr Donna, welcome to theshow.
Dr. Marie Dona (00:14):
Thank you so much for having me.
I'm so excited to be here.
So my name is Dr Marie Dona.
I'm a child, youth, adult,reproductive psychiatrist and
therapist, but I also gotadditional subspecialty training
in obesity medicine as well.
So that was an additionalcertification that I just got
within the last year or so.
Yeah and yeah, I have my ownprivate practice in Riverview,
(00:37):
florida, but I see patientswithin my practice all
throughout the state of Florida,new York, pennsylvania and
Washington DC.
Dr. Hokehe Eko (00:44):
Wow, that's amazing.
Thank you for coming on here,and it sounds like you have
quite the expertise.
Oh my gosh, I didn't know youhad the obesity and the
reproductive.
Dr. Marie Dona (00:57):
Wow, yeah, I mean I feel like it's a thing
Like when you you know, asdoctors, right, you're always
wanting to, you're always doingCMEs, continuing medical
education, and you're alwayswanting to learn, and I felt
like that was just kind of partof it.
So that's when I just kept liketacking things on, but I feel
like it's all beneficial andit's stuff that I can apply
towards my practice, you know,yeah, definitely.
Dr. Hokehe Eko (01:19):
I mean, it makes sense because you're an adult
psychiatrist and then you havereproductive, so if you have
mummies you can take them, andthen the adolescents, too, need
reproductive care as well, Imean from a mental health
standpoint.
So it all makes sense.
So, congratulations, I love it.
So today we decided we weregoing to talk about the
(01:40):
comorbidities around ADHD andautism, especially in kids and
even teenagers.
Teenagers is a big one, yes, solet's dive in.
Dr. Marie Dona (01:51):
Well, definitely , as a child youth psychiatrist
I will say so ADHD and autism.
They are, you know, mentalhealth conditions that
definitely I think are veryimportant to be properly
diagnosed and treated as youngand as early as possible, just
because you know, as you justmentioned, the comorbidity like
the likelihood of someoneeventually having another mental
(02:15):
health condition depression,anxiety, you know, mood swings,
you know all of the above itjust goes so much higher when
someone has a diagnosis of ADHDor autism.
So I mean, I can even give youstatistics so you know, for
someone who has been diagnosedwith ADHD, like as a child, the
(02:35):
comorbidity of both depressionand anxiety can be anywhere from
25 to 50% of them having dualdiagnosis.
And, as you can imagine, ifsomeone has depression, anxiety
as a young child and it goesundiagnosed or untreated for
years, like how the severity ofthat disorder can just continue
to manifest and potentially getworse as they're getting older,
(02:58):
into teenage years and adulthoodyears, so that comorbidity
actually goes up.
Like if you have ADHD or autismand have untreated diagnosis of
depression or anxiety, it goesup to like 50 to 75 percent of
comorbidity of depression andanxiety.
So there's definitely aninterplay between those
diagnoses and other mentalhealth conditions.
Dr. Hokehe Eko (03:19):
Yes, and I think that's important.
Those statistics are staggering, first of all.
So it's really important forparents to understand it and to
recognize that it's not thattheir child is willfully being
well, willfully not listening,willfully not wanting to go to
school and just being a brat.
No, because all of these thingscould be happening at the same
(03:43):
time.
If we don't recognize that,then we're just going to not
give them the help that theyneed.
Dr. Marie Dona (03:49):
Yeah, yeah, definitely.
So something I hear all thetime and I'll give an example
for ADHD specifically.
So you know, with ADHD, withinthe DSM it's diagnosed as, like,
the inattentive type, thehyperactive type or the combined
type.
So then you know, when peopleare thinking about ADHD they're
thinking, oh, super hyperactive,or, you know, very inattentive,
(04:09):
forgetful, daydreaming, etcetera.
But you know, what isn't reallytalked about as much, or you
know people don't find out untillater is that behavioral
component or the mood componentof ADHD.
So when I talk with parents ofkiddos with ADHD and they're
like, oh yeah, like not payattention or they're very hyper,
but I'll, like I think it'sjust laziness when they're not
(04:37):
listening to me.
Or you know they're doingthings without kind of thinking
about the consequences, like isthere something wrong with that?
I'm like, ok, well, with ADHD,while there is the inattentive
portion and the hyperactiveportion, like impulsivity, that
lack of impulse control is ahuge thing.
You know, with the brain, youknow the brain connection, like
there is that disconnect between, okay, let me actually think
through the consequences of myactions, behaviors, or oh, I
(04:57):
want to do this or I'm going toreact right now, I'm just going
to do it, and then that's whenit kind of leads to issues.
So I like to help parents tryto think of it and reframe it as
okay, not just forgetful, notpaying attention or hyper, but
just the way that they caninteract with the world.
Like impulsivity, I'm upset, I'mgoing to throw my toy across
the room and it might break theTV.
(05:19):
Oh, now you're acting out,you're in trouble, defiant, just
behavioral issue.
No, there's, it's a little bitmore nuanced than that.
Just because they are notunderstanding, like, ok, I need
to take a moment to understandwhere my emotions or anger is
coming from to maybe stop fromjust thinking I'm angry to
throwing the toy.
And that's where a lot ofbehavioral intervention comes in
(05:41):
when it's coming to ADHD orimpulsivity or these types of
behaviors.
Dr. Hokehe Eko (05:47):
Wow, that's wonderful.
Thank you for explaining that.
And so what do you tell parentswhen they come to you?
Dr. Marie Dona (05:52):
and their children have these issues so
when parents come to see me, Ilike to really get a good
background about their history,kind of how they do things like
basically from childhood tocurrent or birth to current,
like you know, birth history,medical conditions, family
psychiatric history, all ofthese, all of the above, because
(06:14):
these can definitely affect youknow a kiddo in their terms of
their behaviors.
If there is trauma, abuse,these are huge things that can
affect you know a kiddo andtheir behaviors.
So I get a really thoroughbackground, information, history
, and then, once that's obtained, then I'll kind of ask, ok,
like well, what is going onnowadays that's bringing you
into seeing me?
And I will say, as a childadolescent psychiatrist, a lot
(06:36):
of times it's either behavioralconcerns acting in a school,
acting in at home, or, you know,issues with attention, focus,
that it's actively contributingto them having issues with
performance in terms of school.
So then identifying what that,whatever that problematic issue
is, and then seeing how they'veaddressed it so far, a lot of
times they'll be like, oh,haven't really done anything, or
(06:57):
screen time.
So then that's when I wouldusually start talking about
intervention.
So, child adolescent,adolescent psychiatrists I am,
you know, an expert inprescribing medicine, but I will
always say, I always recommendbehavioral interventions.
First, you know therapy, youknow PCIT, play therapy, you
know other types of things youknow to come down to actually
(07:19):
find out the root or the causeof the behavior.
So that that's where you canpotentially, you know, do things
like reward charts.
Reward systems are things thathave a lot of evidence base for
being helpful for kids who havebeen struggling with behavioral
management, behavioralregulation, and a lot of times
parents just aren't familiarwith that.
There are things out there likethat that can be helpful with
(07:40):
their kiddo.
So those are all things that Iwould recommend as first, you
know, first-line treatment andthen typically when I would
start recommending medicines isafter they've already tried
behavioral interventions andthey haven't been working, or
it's kind of plateaued orbehaviors have really escalated
that you know it can progress tolike a safety concern, and then
(08:01):
that's when medicines reallybecome more of a topic of
conversation.
Dr. Hokehe Eko (08:11):
Right, right, that makes complete sense and
thank you for walking us throughthat.
And so what would you say forparents Like, how do they, how
would they handle things at home?
How do they talk to their childabout what's going on?
Because I think that's a bigissue that parents have.
Yeah, yeah.
Dr. Marie Dona (08:26):
So usually I would recommend for parents to
just have like an open andhonest kind of discussion, Like
sometimes parents might not givetheir kids enough credit to
have an understanding of whatthey're feeling and, like you
know, sometimes they might kindof just assume like, oh, they're
just angry or they just haveissues.
But then you know, justactually sitting down with your
(08:47):
child, Okay, like is theresomething going on?
Is there something botheringyou?
Like, are there issues atschool?
Is someone bullying you?
Are you having?
A big thing that I've noticedwith kids with ADHD and even
autism is that behaviors canmanifest when they are
frustrated with schoolwork, likethey're not understanding how
to do the schoolwork, they'renot able to focus, they're not
(09:08):
able to concentrate, so they getfrustrated.
And the only way that youngerkids are able to, you know, show
their, you know show thatthey're frustrated is by acting
out, getting angry, you know,throwing things, breaking things
, yelling, screaming, thosetypes of things.
And then, yeah, parents mightthink, oh, my kid is just being
a bad kid when underlying.
Oh, no, they're actually reallyhaving trouble reading for an
(09:32):
extended period of time, orthey're having a lot of trouble
with math.
So you know, just, I think youknow, I'm really being open to
discussing with their kids, likeif there is something bothering
them, and then taking their cuefrom there and then, you know,
getting input from the school.
I think is also reallyimportant.
Important too, if teachers arehaving any specific concerns and
then, yeah, trying to navigatefrom there.
Dr. Hokehe Eko (09:53):
Right, right and no.
Those are really importantpoints, because I think that
even a lot of the work that canbe done to help the children has
to start at home, and so it'sreally a kind of environment.
So when you're talking aboutteenagers and you ask them how
(10:14):
was your day, and they say fineso how, how do you recommend to
parents to get past the finething, fine answer and get to
the, to the real crux of thematter?
Dr. Marie Dona (10:26):
so I'm going to say teenage years, pre-pre-best.
You know, like pre-teen yearsare very difficult when it comes
to communication with kids.
Because I will say honestly andI have this conversation with
the parents all the time too andthat, like, as much as you want
to be that go-to, that personthat you know your teenager is
going to confide in and talk to,during that time period, it's
(10:49):
almost within developmentallynormal for friends like that
support group, to just kind oftop the.
You know the teenagers in termsof, like, who they're wanting
to open up to or talk to.
So this is where, okay, it isnormal that you know sometimes
your kids might not be wantingto go to you first, but this is
where I say willingness to openthe door to communication.
(11:09):
Okay, like, I know that youmight not be wanting to go to
you first, but this is where Isay willingness to open the door
to communication, okay, like, Iknow that you might be just
wanting to hang out with yourfriends or do this or that, but
I'm always going to be here foryou if you need anything or you
know, just let me know ifthere's any way I can support
you.
And I also think you knowwillingness, yeah, to open the
door to communication.
Being vulnerable too, like so,adhd is a diagnosis that there
(11:32):
is high likelihood that it'sheritable, like genetics.
So a lot of times kids withADHD might have a parent who had
ADHD.
So if a parent themselves hadADHD, saying, yeah, I've kind of
struggled with the same thingstoo.
So if this is something you'regoing through, let us know so
that we can try to help you, andjust kind of keeping the door
open like that, letting themknow that they will always kind
(11:52):
of have a support.
Boundaries are a thing too.
So you know as much as you wantto be support, like if someone
is obviously acting out, etcetera, like there still needs
to be boundaries in place.
But I think you know, justultimately letting your teen
know, or you know your kid knowthat you are there to be a help
or support if they're needinganything and just trying to
follow their cues essentially.
(12:13):
But it is a difficult time interms of communication, I think,
just worldwide and during thistime frame specifically.
Dr. Hokehe Eko (12:19):
Yes, I have one in my house, so I know.
I'm a 10-year-old and, yes, I'mlike what happened to my kid,
okay, but sometimes it's thefine.
No, yes, okay, so I get it.
And yes, parents, you're notalone.
There's resources to help youwalk through how it gets to your
(12:42):
kids, but just to get them thehelp they need.
But it's so important I think Ilike what you said about.
For me, I like to say it asspeaking life to your kid and
just reminding them who they are, who you see them as, who you
love them, even when it feelslike you can't reach them, they
are listening and I found my ownlimited experience, especially
(13:06):
when it's like when she, whenshe's acting like oh, she
doesn't need you, she reallythey still, they still need you
yeah yes, and and when you justkeep being consistent and
telling them that you love them,regardless of the behavior, it
doesn't mean you're condoningthe behavior, but they still
need to know their love, becausethat's like the bedrock
(13:27):
foundation, because if anythingis going to pull them out of
that, it's going to be that theyknow their love, because that's
like the bedrock foundation,because if anything is going to
pull them out of that, it'sgoing to be that they know their
parents love them.
So I think it's important.
Dr. Marie Dona (13:35):
Yeah, definitely .
So I've heard, you know, fromall ends of the spectrum.
So I've actually had familiesI've worked with that you know.
They've gone through theteenage years but then they've
seen the other side of it.
It's like I've had alsopatients that themselves like I
remember like oh, I actuallytalked with my mom and I was
like yeah, mom, dad, why, Idon't know why I didn't talk to
you for like four years but likeall of a sudden this like light
(14:00):
bulb goes off and they're likeI have no idea why I didn't want
to talk to you for four years,but I guess it's okay now and
then now they have a goodrelationship.
But I would say like this ishonestly where I think it is
within the realm of normal.
But like everything you said,showing that you love, care,
support them kind of regardlessif they need anything.
But you know, alsounderstanding that this is a
(14:20):
time that sometimes they arekind of wanting and needing
their distance to you.
But just know it's not anythingthat you are doing as a parent,
like it's just something thatdoes kind of happen within these
developmental years.
Dr. Hokehe Eko (14:30):
Yes, and so what would you say to those parents
who they go to the health careprofessional and they're not
quite able to get the help orsupport that they need for their
kids?
Maybe it's oh, it's just normal, They'll get through it.
What are the questions or whatkinds of things should they be
saying to their providers to getthe help they need?
Dr. Marie Dona (14:52):
So I guess this is where a lot of times it can
be normal but at the same timetoo, you know, some of these
things might not be as normal.
So I know that a lot of timeswhen they when you know kids,
teenagers, might be seeing theirpediatrician or PCPs, they'll
do kind of screening exams likeGAD-7 for anxiety, phq-9 for
depression, like those types ofthings.
(15:13):
So this is where you know,taking those questionnaires
seriously and if they're scoringhigh enough on the threshold,
talking, you know, having thekid talk with their PCP or their
pediatrician about these issues.
And I will say so, I work in alot of different, so I have my
own private practice, but I alsodid a lot of like emergency,
like child, child, adolescent,teen, er work and it's kind of
(15:35):
funny how, like sometimes theteens won't want to talk with
their parent about the issuesbut then they will meet me a
complete stranger and they'llfeel like because this is, like
you know, someone who iscompletely unbiased outside of
the relationship that they canbe open and honest.
So if this is where you know aparent is concerned, they can
always I think I would stillencourage them, you know, to
(15:57):
bring them in for an evaluationand like you know, if they're,
you know preliminary screeningPHP 9, gad 7, you talk isn't
raising any red flags, that'swhere you know pediatrician, pcp
, psychiatrist can provide thatreassurance.
But you know, if after aconversation with their kid
there are additional concerns,that's where it might be worth
warranted for a furtherevaluation and potentially
(16:19):
having their kiddo talk withanother mental health provider.
Dr. Hokehe Eko (16:23):
Yes, and parents , I want you to know that you're
the first and best advocate foryour child.
So, even if there's a screeningform and, based on the way you
answer it, it doesn't quite,your child doesn't meet
threshold.
It's important for you to behonest with the doctor and see
exactly what's going on, becausethat's the only way you're
going to be able to get thereferrals as need.
(16:45):
I mean, depending on what'sgoing on, what's your insurance
and all of that is to get thehelp that your child needs.
So it's just don't be ashamedof it.
It's nothing to be ashamed ofyou.
It's important that your childgets the help they need yeah and
like.
Dr. Marie Dona (16:59):
so, while you know, while we're talking here,
like we are both, you know,medical professionals, right,
we're kind of familiar with,like within norman, what's not,
but parents, like, it's okay ifyou don't know exactly what is
normal.
That's why it's okay to reachout for help, you know, touch
base with your doctor, touchbase with your pediatrician, pcp
, and ask the questions, bringup behaviors, and that's where
(17:22):
they can.
You know, not every case is thesame, right, so there's
different scenarios, differentsituations and that's where your
medical professional can adviseyou one way or the other.
Right, absolutely.
Dr. Hokehe Eko (17:33):
Wow.
So I like to ask all my gueststo give us last minute brain
health tips for both the parentsand the kids.
So do you have any you'd liketo share?
Dr. Marie Dona (17:47):
Last minute brain health tips.
So do you have any you'd like toshare Last minute brain health
tips?
So I'm all about so.
Psychiatrists prescribemedicines, but I'm all about,
you know, the holistictreatments as well too, like
nutrition, like good, you know,making sure that someone is
getting healthy nutrition, sleep, sleep hygiene as much as
possible.
And I'm going to say the teenyears are especially hard.
It's a conversation I have allthe time with my patients and
(18:08):
clients, right, and physicalactivity.
These are all huge, foundationalthings that there's so much
evidence that like and I'm allabout homeostasis too that if
one of these things are off,like bad nutrition, poor sleep
habits, you know, limitedphysical activity these are all
things that will, you know, canimpair mental health.
(18:29):
Yeah, physical, medical, mentalhealth, brain growth and
overall development.
So this is where, you know,people are seeking help,
behavioral interventions,therapy, medicines.
But I always go back to thebasics first and like how's your
sleep, how's your?
You know, how's your diet?
Okay, what are things that wecan do to tweak here to make
them just that much better?
(18:50):
And you know, these are thingsthat, like, they might seem so
small, and you know, minuscule,but can make a world of
difference in overall helpingsomeone with any and basically
anything right, Like any mentalhealth condition, autism, adhd,
like basically everything.
Dr. Hokehe Eko (19:06):
So so that's my basic, fundamental go-to from
here I love it so before thelisteners, where they can find
out more about your practiceokay, yeah, so my practice name
is uh donna wellness clinic, soyou can reach me through.
Dr. Marie Dona (19:22):
Our website is www.
donawellnessclinic.
com.
We have a bunch of social mediathat handles it's all dona
wellness clinic likecom.
We have a bunch of social mediathat handles it's all Donna
wellness clinic like facebook.
com slash Dona wellness clinic.
Instagram.
com slash Dona wellness clinic.
I am physically located inRiverview, florida, but yeah,
I'm able to see patientsvirtually all throughout the
state of Florida, pennsylvania,new York and Washington DC, and
(19:44):
we are taking new patients now.
Dr. Hokehe Eko (19:46):
Yay, wonderful.
So thank you so much, Parents,go check out her YouTube page.
If you need her services, reachout.
And so thank you so much againfor coming on here.
Dr. Marie Dona (19:57):
Dr Dona, Thank you so much for having me.
Dr. Hokehe Eko (19:59):
This was great Everyone until the next episode,
have a wonderful day.
Please share this with somebodythat you feel needs to hear
this.
Take care.
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