Episode Transcript
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Dr. Elise Fallucco (00:21):
Welcome back
to psyched for Peds.
I'm your host, Dr.
Elise Fallucco childpsychiatrist and mom.
And I'm your cohost, JuliaFallucco, Swifty and daughter.
You may note that Friday Taylorswift released her new album,
the tortured poets department.
In all our Taylor NES, she madeit a double album, just like
(00:42):
we're making this episode adouble host, I'll bring the
Swifty and I'll bring the childpsychiatry.
I'll ask Julia questions aboutTaylor swift and her music and
albums.
She'll ask me child mentalhealth questions related to our
recent psyched for paedsepisodes.
So let's get
started.
Starting with Taylor Swift'sdebut album and your debut
(01:05):
podcast episodes.
What are the best ways to screenfor anxiety and kids?
Excellent question.
Julia, as screening isrecommended for kids 12 and up
by the us preventative servicestask force.
And it's really important to askboth kids and parents about
signs of anxiety.
So my favorite screening tool isthis scared, which most of our
(01:28):
friends and colleagues haveheard me talk about.
Has 41 items with a child reportand parent report.
And most recently we've talkedabout an abbreviated version of
the scared, which only has fiveitems.
And it's called this scaredfive.
And both of these screeningtools for anxiety are available
on our website.
Psyched for Peds.com.
(01:49):
So Juul, what's your favoritesong from Taylor Swift's debut
album?
I really like our song.
I don't really have a specificreason.
This is just a fun song to singalong to.
I think you like the slammingscreen doors, part of it.
Oh, yeah, that's pretty fun.
Okay, let's move on to Taylorfifth, second album called
(02:11):
fearless.
What questions can you ask tofind out if someone might have
an anxiety disorder.
So in episode 31, About ADHD andanxiety with Dr.
Jeff Strawn, he gave us somegreat interview questions to
help distinguish types ofanxiety.
He said, we should ask kids, howgood are you at worrying?
And then ask what would happenif this thing that they fear
(02:33):
occurred?
And try to see if they have somesort of catastrophic answer for
that.
And then ask yourself.
When you're trying todistinguish between clinical
anxiety.
Is the thing that they'reworried about reasonable, like
an upcoming test or.
A big assignment.
Yes, or something like that.
(02:53):
And is the anxiety proportionalto the stressor?
So are they a little worriedbefore an upcoming test and then
it goes away or is their amountof anxiety really?
Disproportionate to the type ofstress.
But back to Julius.
So Taylor swift second album iscalled fearless.
How does the song fearlessrelate to anxiety?
(03:14):
Well, I think the song fearlessrelates to anxiety because she
doesn't have anxiety in thisrelationship and she just drives
it as being fearless and justwant 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 thatis a good question, Julia, about
whether it's good or bad to befearless, because we know that
(03:37):
anxiety is actually somethingthat's normal and that it can be
really helpful.
And so sometimes being fearlessmight 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 isspeak now.
And one of my favorite songs inthat album is never grow up,
(03:57):
which is basically a songtelling you to treasure your
early years as a preschooler andan elementary school.
Speaking of elementary school.
Two of the most common mentalhealth problems in kids in
elementary school are ADHD andanxiety and episodes 32 and 33.
You and Dr.
Strawn.
Talk about how do we approachtreatment for kids with both
(04:19):
ADHD and anxiety?
What were some key points fromthat episode?
Very briefly.
We talked about a lot of things,but the key points would be
treat ADHD first when you haveADHD and anxiety, and then once
the ADHD is treated, then youcan address any residual
anxiety.
Unless, of course the anxiety isso severe and then you'd want to
(04:39):
rethink that.
I was glad to hear that Dr.
Strawn also recommended startingwith methylphenidate type
stimulants because the researchand the data say that they are
much less likely to cause moodand anxiety symptoms and less
likely to cause appetitesuppression.
Then the mixed amphetaminesalts.
But enough about salts.
(05:00):
Let's go back to.
Your favorite song from speaknow, which was called, never
grow up.
Tell us what is your favoriteline from that song?
Easy.
I like the line where it goesand 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 thatI would be dancing around in my
(05:22):
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 Pinterestthe other day.
It was telling you that red dyenumber 40 can lead to ADHD
symptoms like hyperactivity.
Can you tell me about when youwould use alpha agonist to treat
(05:42):
ADHD?
It is totally unfair that I'mmaking you ask questions that
involve words like alphaagonists in them.
Which I didn't think about untiljust now.
Okay.
When would you use alpha twoagonists?
We would use them as adjunctivetreatment for kids who are
having trouble toleratingstimulants.
Or who have residualimpulsivity.
When they're being treated withstimulants.
(06:04):
And of those Clonidine is theone more likely to affect blood
pressure and cause sedation.
So it's good for sleep.
Whereas guanfacine tends to beless likely to cause those
problems and guanfacine XR is areally nice one for impulsivity
it's dosed once daily and themagical dosing formula that Dr.
Strawn talked to us about.
(06:25):
Is dosing guanfacine XR at 0.1milligrams per kilogram per day.
Enough about milligrams perkilogram, per ninom?
Ah, but, and back to the funpart, the Taylor swift part.
So background information.
Julia's favorite Taylor swiftsong probably of all time is the
(06:45):
10 minute version of all toowell from the red album.
Jay, what do you like most aboutthat song?
I'm sure my brothers love it.
When I play all 10 minutes inthe car.
When I get to request a songthat is true.
I think that's partially myfavorite reason because they
play very annoying songs andit's my little revenge.
(07:05):
And also the lyrics are justmasterpieces.
Excellent.
Okay.
Taylor Swift's fifth album 1989is my favorite album Now let's
wrap up our questions about ADHDand anxiety.
Can you tell me what to knowabout one of the newer ADHD meds
on the market?
Violin Zach's teen or Kelly?
(07:26):
Whew.
That's mouthful.
It's actually philoxenia.
Dezeen or Calvary, but I alsohave trouble pronouncing it.
So I think this may be genetic.
I could not survive a Dane medschool.
So the Luxe Dezeen is anorepinephrine re-uptake
inhibitor.
And I bet you're relieved that Idid not ask you to say
norepinephrine re-uptakeinhibitor.
Very relief.
(07:47):
So it's similar in its mechanismof action to Adam oxytocin or
Strattera.
Tara, it works more rapidly thanStraterra does.
And even within the first coupleof weeks, you can notice an
improvement in symptoms of ADHD.
And the one thing to know aboutit is that it's a potent
cytochrome P 4 51, a twoinhibitor.
(08:07):
And why that's important isthat's also the enzyme that
metabolizes caffeine and energydrinks.
And so if you have somebodywho's on Viloxazine you have to
warn them.
To really be careful about howmuch caffeine they take, because
the medication can increasecaffeine exposure and increase
the blood level over time.
About six fold.
(08:29):
No Starbucks for little Timmy.
Timmy's not the only one whotakes the Lux ezine but, okay.
So back to 1989, your favoritealbum, what are your top three
favorite songs from 1989?
In order of appearance on thealbum, cause I'm just a super
Swifty welcome to New York.
How you get the girl and newromantics.
Wait.
(08:49):
Hang on.
I'm getting a phone call.
I'm sorry, but the old anxietymedications can't come to the
phone right now.
Why.
Oh, because they've changed.
Welcome to reputation psych forPV listeners.
Are you ready for it?
It's not so much that the medshave changed, but the approval
for them has somewhat changed.
Since I recorded our mostdownloaded episode of psyched
(09:12):
for paeds to date, episode fiveon anxiety meds with Dr.
John walkup we have had anadditional FDA approval for the
treatment of anxiety in kids.
Both Duloxetine which isCymbalta and the more recently
approved med Escitalopram orLexapro are both approved for
(09:34):
generalized anxiety disorder inkids seven years and older.
And if you want dosingguidelines or information about
the SSRI for anxiety,depression, you can check out
our free downloadable card onour website.
And for Julia, a little trivia.
Which reputation song has amusic video that involves bank
robbery and cats?
(09:56):
Easy.
The look, what you made me do.
Music video.
Next one is such a fun albumlover.
In fact episode 35 of yours wastitled how to help kids love
sports.
With coach Peter veer, Hoff,what are some key things that
you've learned from thatepisode?
So two key things I learnedabout youth sports.
One.
(10:17):
Was that almost 70% of kids dropout of youth sports by age 13?
And I think I didn't realizethat.
And I was also surprised by howfew kids go on to play sports in
college.
And I think sometimes asparents, we may have
overinflated ideas about ourkids going on and playing sports
in college.
So that was a good realitycheck.
(10:37):
Be helpful hints that coachPeter shared.
We're excellent.
Basically he said in a muchnicer way, we should stop trying
to coach our kids as parents andjust let the coaches, coach and
our job as parents is to focuson cheering them on and helping
them know that we love them.
Regardless of their performance,whether they win, they lose,
(10:58):
they go a best time or not.
And Julia, when we went to theTaylor swift concert, you made a
big dazzled silver guitar andwore a costume based on the
album called lover.
What exactly did you wear?
You basically said it with thepotassium silver guitar, but I
wear a blue shirt, like she woreon the album cover.
(11:22):
Also Taylor swift famous quote,my favorite colors glitter.
Oh, that is a good quote.
Next is my second favorite albumfolklore.
What exactly is a folklore ofcrying and waffles from the same
episode of before.
Oh, I loved this story.
Coach Peter really talked aboutthe hardest time for a student
(11:42):
athlete.
And you told this story about akid whose mom called him before
early morning practice sayingthat her son couldn't attend
practice because he was cryingin his waffles.
And he used that story toillustrate that.
That child had just recentlygotten his.
Driver's license and was drivingto practice on his own.
(12:03):
It had been about a month or sothat he had not had his mom pick
him up.
From practices and that, thattime in a teenager's life.
Is usually a time when a lot ofhis student athletes break down
because they no longer have thesupport of their parents driving
them to and from practice orjust that little space and zone
to process how they're feeling.
(12:24):
That was a cool factoid orfolklore OID, if you will.
What do you like so much aboutfolk Lord?
That it makes it your secondfavorite?
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 Idon't know.
It was just like the album thathelped us all get through COVID
(12:45):
if you know what I mean.
But anyways, evermore is nextand evermore is also a COVID
album.
And during COVID.
It was pretty hard to sit stilland look at an iPad all day.
My little brother was in pre-Kfour at the time, and it was
extra hard for him to payattention.
We had to bribe him with Dunkindonuts.
Okay.
So maybe it's not okay to betalking about bribing kids with
(13:07):
doughnuts on a child, mentalhealth podcast..
We all did things that we're notproud of during COVID.
So let's move on.
Anyways in episode 38, you talkabout behavioral problems in
preschoolers.
What is one way to tell if apreschooler may be experiencing
these behavior problems?
One of my favorite screeningtools is the brief ECSA or the
(13:29):
brief early childhood screeningassessment.
It's a 22 item.
Caregiver report that assessesfor symptoms of child emotional
behavioral problems.
And it also looks at caregiverstress and caregiver,
depression.
And the brief ECSA is alsoavailable free for download on
our website.
Psyched for paeds.
So back to a quick trivia time,which song on evermore is about
(13:55):
Taylor's grandmother.
That one would be Marjorie.
It's actually a very sad song.
But we only have two areas togo, which are midnight.
And tortured post department.
So get ready for some unreleasedcontent relating to midnights.
Mom.
I know that you're an early birdand you'd like to wake up early,
but not stay up late.
(14:16):
It is a horrible sign if I'm upat midnight and I can guarantee
that no one will be happy thenext day, if that happens, I
highly value my sleep.
And I think that was part of whyit 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 abouthow sleep deprived parents do
(14:37):
we, young kids are at risk fordepression.
In the first four years of achild's life, one in 10 dads,
experienced depression and onein four moms experience
depression.
And so just for all of you whoare parents out there, and for
all of us who are taking care ofparents out there, this is
something to keep in mind andsomething to remind parents
(14:57):
about that in this time wherewe're all just trying to hold it
together.
We're all at increased risk forpotential depression.
And we also know depression isincredibly treatable.
Please encourage parents to gethelp and seek support.
Because we also know thatdepression in parents can
increase the risk of emotionaland behavioral problems in kids.
(15:18):
One last bonus.
Taylor swift trivia question.
When were all of her songswritten on the album?
Midnight.
They were all about her dreamsand she woke up at midnight.
For our final torture poetsdepartment era, we hope that we
don't torture you with any moremental health trivia.
And I want to give a specialshout out and thanks to Julia
for coming up with the idea ofthis episode and for having an
(15:41):
encyclopedic knowledge of Taylorswift music to make it happen.
And for being a fantasticcohost.
Thank you guys so much forlistening.
We hope that this was a helpfulrecap and also a fun review of
Taylor swift trivia.
Check us out on our websites.
Psyched the number fourpaeds.com.
And please send me a chat or addyour email list to the website
(16:04):
so you can get our weeklynewsletter.
And if you're just like, waitback, girl was just like so much
fun to have on a podcast.
You can make this the mostpopular episode instead of
episode five.
How could they do that?
Julia?
They would listen to it.
Oh, tell your friends, tell yourfamily, tell everybody.
All right, we'll see you nextweek.
Bye.