Episode 76: What Kids Need From Parents to Support Their Mental Health with Dr. Jeri Fitzpatrick

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This week on the podcast, we’ve got one of our favorite and one of Nashville’s most respected psychiatrists, Dr. Jeri Fitzpatrick. We can’t wait for you to listen in on this conversation around what she’s seeing in her offices these days, what she believes kids need from their parents to support their mental health and why and when medication might be important.

A special thank you to our partners of this week's episode:

Automated Transcript

Sissy Goff

00;00;03;15

Welcome to the Raising Boys and Girls podcast. I'm Sissy Goff.

David Thomas

00;00;06;25

I'm David Thomas.

Melissa Trevathan

00;00;08;00

And I'm Melissa Trevathan.

Sissy Goff

00;00;09;24

And we are so glad you've set aside a few minutes to spend with us today. In each episode of this podcast, we'll share some of what we're learning in the work we do with kids and families on a daily basis at Bazaar Counseling in Nashville, Tennessee. Our goal is to help you care for the kids in your life with a little more understanding, a little more practical help, and a whole lot of hope. So pull up a chair and join us on this journey from our little yellow house to yours.

Sissy Goff

00;00;39;28

We talk a lot about anxiety and worry and kids on this podcast. Actually, this whole season of the podcast is about tools that can help you raise emotionally strong and worry free kids. But what about you?

David Thomas

00;00;52;05

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Sissy Goff

00;01;13;19

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David Thomas

00;01;17;26

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Sissy Goff

00;01;51;18

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David Thomas

00;02;05;07

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Sissy Goff

00;02;17;16

So when we think about our years, David, in my years practicing with kids and families, this is my 30th. This is your 25th, there is a name that we have talked about in our offices all of these years that is one of like the highest, most respected psychiatrists in town that we have referred. I mean, we were laughing. I really bet we referred thousands of kids to you or tried to you're so great that so often we can't get them in.

Sissy Goff

00;02;47;06

But Dr. Jerry Fitzpatrick, I mean, you have made such a mark on and I can't even imagine the lives you've saved, the hope that you've brought in, the kids and families lives and the kids I've worked with in common with you. I just am so grateful. And so when we start talking about experts, you were one of the first people we wanted to ask come on this season.

Dr. Jeri Fitzpatrick

00;03;07;11

You are kind.

Sissy Goff

00;03;08;17

Well, I am truthful. Honest. We would say this under percent.

David Thomas

00;03;11;29

Truthful. Yeah, we just talked about how many families have sat in one of the offices of this house we're in right now and wept at times talking about the gift you've been to their family. So to get to reflect that back to you today is a real gift to us.

Dr. Jeri Fitzpatrick

00;03;27;16

Is really touching me. It's to hear that.

Sissy Goff

00;03;30;07

Thank you. Very true. And will you tell a little bit about I mean, I'd be curious even how you became a psychiatrist.

Dr. Jeri Fitzpatrick

00;03;36;06

So really, technically, I guess this is 31 years that I've been after finishing residency, I.

Sissy Goff

00;03;42;03

Was about to say took a fellowship to get trained. Then it did me I.

Dr. Jeri Fitzpatrick

00;03;46;02

Guess it was.

Sissy Goff

00;03;47;03

A multi-year prolonged. Yes.

Dr. Jeri Fitzpatrick

00;03;48;27

So well, I initially planned to be a child neurologist because in my past life I had been an EEG tech, did brainwave tests and actually worked at the old Vanderbilt Hospital. Many years ago. But I had had several experiences in my pediatric residency that had had a pretty profound impact on me in pediatric oncology, where that was so difficult and felt very attached to the patients and the parents and what a journey they were on.

Dr. Jeri Fitzpatrick

00;04;24;03

And then in the emergency room with trauma kids that would come in with a lot of abuse and inner city, it was tough and all of those things I think went together that when push came to shove, I thought, I'm going to do child psychiatry. So I accepted a position for training here at Vanderbilt and came and did adult psychiatry, then child psychiatry fellowship and then stayed at Vanderbilt for a couple of years on faculty, went into private practice along the way, went back to Vanderbilt briefly for just part time.

Sissy Goff

00;05;01;12

I remember because we couldn't get anybody. That's right.

Dr. Jeri Fitzpatrick

00;05;04;08

And then that was your chronicle. I did that for about five years and then came back into full time private practice. So I think it honestly fit me better to be a child psychiatrist. To tell you the truth, I think we're all geared in a certain direction, and that was where I was scared we were cured.

Sissy Goff

00;05;24;02

So all these years of working with kids, what would you say are some of the primary struggles you're seeing with kids today?

Dr. Jeri Fitzpatrick

00;05;31;06

You know, it's so funny. In some ways, kids present with the same things in many ways that they presented with 30 years ago. Meaning I see a lot of anxiety. I see depression sometimes with suicidal ideation, trauma, attentional difficulties, school struggles, social problems, the interactions with peers, family conflicts. I also see kids who are on the spectrum, various developmental disabilities.

Dr. Jeri Fitzpatrick

00;06;01;12

I saw kids like this 30 years ago too, but I think it is fair to say that over time, maybe kids haven't changed that much and parents haven't changed that much. It's our environment has changed and our culture has changed. And so I think the new things have come up because of that, which number one I would say is media.

Dr. Jeri Fitzpatrick

00;06;27;29

It's become such a phenomenal part of our lives and it has changed the flavor of the presentations.

Sissy Goff

00;06;35;22

I think that's a great description.

Dr. Jeri Fitzpatrick

00;06;38;16

So some things are the same and I think all of us would say in the field the intensity is greater. Many years ago, actually, psychiatric hospitalization. And when I first went in to practice, kids did go into the hospital, only go in for a month or two months or three months, and we would see them. And when we were in training for an hour of therapy a day, it was a very different treatment program.

Dr. Jeri Fitzpatrick

00;07;07;28

What we did, there was a lot more psychotherapy during hospitalization. So everything has changed in that regard. And so the acuity of what we see on an outpatient basis now is different than what we saw years ago.

David Thomas

00;07;24;27

It makes sense.

Sissy Goff

00;07;25;24

Yes, it does make sense.

Dr. Jeri Fitzpatrick

00;07;27;07

And yet some things stay the same. I just took a trip with my kids to France and Italy and visiting Rome. And you look at the history and you say to yourself, history does repeat itself, doesn't it? I suspect similar problems were there back then to very true.

David Thomas

00;07;47;28

Great observation.

Dr. Jeri Fitzpatrick

00;07;49;11

Right. But how you deal with them is very different.

David Thomas

00;07;54;14

I love the way you talked about that of as the environment has changed and having all the wisdom and perspective that you do for practicing all these years as the environment has changed, how have you seen kids and parents change over the years?

Dr. Jeri Fitzpatrick

00;08;09;23

I think what's been really interesting, certainly when I was growing up and obviously I'm older than you guys, but I wonder if there were some similarities, meaning there were sort of different expectations if you were involved in sports. It was unusual if they came to your practice or game, right? Because everybody was busy doing what they did. There was a lot more.

Dr. Jeri Fitzpatrick

00;08;34;17

I guess independence is the best way to put it. Parents were less involved in some respects less involved in school. I think what has changed over time is parents are much more involved in everything really. And so the good news of that is, is that they're more involved and seem to express more interest in what's going on in their job.

Dr. Jeri Fitzpatrick

00;08;58;02

And they want to go to their games and they want to participate. But what's also maybe on the downside is sometimes it's hard for kids to learn certain things without some just independence with safety. So all of that has gotten complicated in many respects. So we've seen positives with all of the involvement and some negatives. So there's a bit more.

Dr. Jeri Fitzpatrick

00;09;23;28

Sometimes I think kids haven't learned how to problem solve in the same way that maybe you did years ago because you were thrown into it. And now sometimes as parents and I've been guilty too, by the way, so please, I don't want anybody to take this as a criticism. We try to fix everything for our kids. And in doing that, I feel like they've missed out on some steps.

Dr. Jeri Fitzpatrick

00;09;49;00

We all fail, we all have difficulties, and we have to learn to tolerate failure. Move through it, learn from it. Picasso. Alsop Which is obviously what kind of defines resiliency and so on. And I think it's a little harder to come by than it used to be, because more recent generations of parents have tried to do more to step in and protect their kids.

Dr. Jeri Fitzpatrick

00;10;17;22

Maybe they didn't have a lot of encouragement. Right? Right. So now they want to encourage their kids to use that pendulum swing. So it's the balance. How do you balance things?

Sissy Goff

00;10;28;23

Maybe you will get to a balanced place. Maybe we swung one way and now the other. And now we're going to come back, I hope.

Dr. Jeri Fitzpatrick

00;10;34;11

Yeah, I do, too.

Sissy Goff

00;10;35;29

So if you had to say big picture, two or three top things you feel like kids really need from parents today, what would you say?

Dr. Jeri Fitzpatrick

00;10;43;08

Well, I'm going to say something that'll sound probably a little bit, I don't know, a little mushy or hokey whatever. But I'm going to say this. I think first and foremost, kids need to be secure in their parents love meaning that it's not going anywhere. Yes, they want to teach you to make good moral judgments. And there are certain things we should do and not do and kind of give you these limits and boundaries and so on.

Dr. Jeri Fitzpatrick

00;11;12;23

But the thing is, they need to know first and foremost that you love them and that they are secure in your love. And if they mess up or disagree with you on something, that you're still going to be there. So that's number one. I would say that to me is huge. But then you move to also parents have got to give kids bumper guards and boundaries and limits.

Dr. Jeri Fitzpatrick

00;11;38;14

That's part of our job, is trying to let our kids kind of explore and have some independence. But with the safety of us backing them up, teaching them about boundaries, I think I didn't understand when I was a child. Now I think I was taught some of these things. I just didn't have terms for them. I didn't quite understand boundaries.

Dr. Jeri Fitzpatrick

00;12;00;16

As I got older and began to learn things, I discovered, you know, setting boundaries is tough.

Sissy Goff

00;12;07;15

It is tough.

Dr. Jeri Fitzpatrick

00;12;08;11

It really is tough. And yet our kids, they almost begged for it, even though they wouldn't necessarily admit that. But they need that structure. There's limits, those boundaries, and parents have to figure out which ones they're going to set. And then our next big goal is consistency. Right. But that's also our hardest thing to achieve and care who we are.

Dr. Jeri Fitzpatrick

00;12;30;12

But more kids know what to expect from their parents. You know, if one day you let them do whatever and they have complete freedom and then the next day you're in a bad mood and you tell them they can't do anything. It's such a mixed message. And so how can we strive to be more consistent and give them reasonable boundaries and limits, and then stick to it?

Dr. Jeri Fitzpatrick

00;12;57;09

Be consistent, but keep loving them even when they mess up. And we mess up, by the way.

Sissy Goff

00;13;03;14

Right. You know.

Dr. Jeri Fitzpatrick

00;13;04;06

As parents, we mess up.

Sissy Goff

00;13;05;13

Yes. Security, boundaries, inconsistency. Yeah.

Dr. Jeri Fitzpatrick

00;13;09;17

Those are probably be. Yes. The ones I think about a lot. I mean, there are obviously other things, but I think those are important if kids have those green.

Sissy Goff

00;13;19;21

Yes. Thank you for those reminders.

David Thomas

00;13;22;04

This season of our podcast is focusing on raising emotionally strong and worry free kids. And would love to just ask you, what do you think an emotionally strong child looks like?

Dr. Jeri Fitzpatrick

00;13;34;28

Well, I mentioned resiliency. Okay. Really, again, I want to just define we're going to have difficult times all through life and as children and we're going to have failures. One of the worst things you see is a child who somehow has sort of missed that along the way. And every now and again, like I saw it occasionally in medical school where somebody had excelled and everything and they were not overly familiar with failure, and all of a sudden they had one because it usually happens to all of us at some point.

Dr. Jeri Fitzpatrick

00;14;10;28

You just may not happen as early as others, and they didn't know what to do, didn't know how to handle it. So I feel like that is huge. And so how do we teach kids that? And I think we teach it by, first of all, allow it to happen, you know, instead of trying to protect and hover and legislate what happens.

Dr. Jeri Fitzpatrick

00;14;31;20

You know, it's like really painful when your child doesn't make a team that they've worked so hard to be on. And I know this, it's and it is very painful, but the answer is not to go and yell at the coach or, you know, everybody's bad. And that's just not the best way to deal with it. And what we need to do with that is just talk about a lot of times we have disappointments.

Dr. Jeri Fitzpatrick

00;14;56;12

Maybe we had a bad day and we didn't play our best or any number of things can go into that. But we have to learn to accept that and we have to grieve it. We have to grieve when we fail. That's hard, it's painful. And we've got to let our kids grieve. And then we've got to talk about what you learned from it.

Dr. Jeri Fitzpatrick

00;15;17;23

What did you learn? How are you going to do things differently moving forward? And does this really have to define also who you are? So I think teaching kids that over and over and allowing that to happen and secure in the love supporting them through it. I think sometimes as parents we need to share things sometimes, but there are limits also to what we need to share.

Dr. Jeri Fitzpatrick

00;15;44;25

I don't need to get into the nitty gritty sometimes of choices we made or, you know, you have to use your judgment, is this a good time to share a little more or not? Because you don't want to overwhelm your child. But I think kids need to know that as parents, we have failures, too. And this is what we've done to try to cope with that and come back from it and learn from it.

Dr. Jeri Fitzpatrick

00;16;09;16

So I think if we talk about that, we model that for our kids. I think that's huge. Yeah. So resiliency to me is huge. Yeah. I think if we teach our kids to be as much as we can, self-aware, you know, to try to examine, okay, I just had a conflict. Who owns the problem here too, that 50% of that belong to me?

Dr. Jeri Fitzpatrick

00;16;32;23

That 100% belong to me? Could I have, you know, 20%? What part did I play in that? And again, to try to sort of learn from that, I think a huge goal to me for children is to have empathy, too, and to be concerned about others and to show compassion and understanding and and love and really learn how to be empathetic and express that comes easier to some than others, there's no question.

Dr. Jeri Fitzpatrick

00;17;05;16

For some people, it's really hard. But I think, again, these are sort of ideal sort of goals that to me, these are the things that go in to making you emotionally stronger and to get through a number of things, you know, another thing I think we have to let kids explore a lot to like explore their creativity and support them in stepping outside the box, trying on something new and learning from that.

Dr. Jeri Fitzpatrick

00;17;40;18

Those are all the things that come to my mind quickly anyway.

Sissy Goff

00;17;44;05

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Sissy Goff

00;17;49;09

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David Thomas

00;17;54;13

Because they make me look younger and I can't seem to take them off.

Sissy Goff

00;17;58;02

I get it. I have my Pair glasses on as well and I clip on my sunglasses, but only when I go outside.

David Thomas

00;18;05;05

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Sissy Goff

00;18;06;29

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David Thomas

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I know.

David Thomas

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00;18;54;29

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00;19;03;17

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David Thomas

00;19;33;26

We're talking about anxiety a lot this season also because we're all sitting with it in our offices a lot.

Dr. Jeri Fitzpatrick

00;19;39;24

A lot.

Sissy Goff

00;19;40;14

So what would you say to parents whose kids are struggling with worry and anxiety?

Dr. Jeri Fitzpatrick

00;19;44;25

One of the biggest things is communication. If we just act like it's not there or weren't denial ourselves, that's not good. So we need to be talking with our kids. And then what's the most important piece of that is we need to be listening right? And sometimes we forget to do that. We're pretty busy giving them advice and out of a good place because we are trying to protect them and keep them safe and teach them things.

Dr. Jeri Fitzpatrick

00;20;11;26

But sometimes if we just listen more and really hear what they're going to say, validate for them. This is scary. This is frightening. I understand why that felt so bad to you. So sort of give that back and validate what their feelings are. I think that's really huge. So the communication piece and I'm going to say this as a parent, especially when you have teenagers, sometimes they don't respond well when we're trying to help them and they're really put off by it.

Dr. Jeri Fitzpatrick

00;20;46;24

And they'll be, oh, I don't know, a little bit offensive or rejecting here. You're trying to help them and they're rejecting you. And so our tendency is to want to withdraw and back up and say, fine, you work it out yourself. I've tried to help you. I can say as a parent, I regret every time that I've withdrawn because I felt a little bit hurt.

Dr. Jeri Fitzpatrick

00;21;09;18

And so I think we have to try not to personalize things so much. And I tell parents this over and over, that's hard. You're tired, you're working and you're trying to help your child and maybe they're disrespectful to you or they reject you. I just want to say, let them know you're there and hang in. You may need to give them some space, but these are all goals, I guess is what I'm trying to say.

Dr. Jeri Fitzpatrick

00;21;32;18

Their goals, ideally, yes.

Sissy Goff

00;21;35;00

One of the things that we see so often with anxious kids is kids who we give them all the tools in the world and it does not matter. And the parents will come back in either. Their parents who say it's not working because they're believing their child, that maybe they're kind of trying them or the parent will say the child's not trying.

Sissy Goff

00;21;55;07

What do you do in those scenarios.

Dr. Jeri Fitzpatrick

00;21;57;20

You.

Sissy Goff

00;21;57;28

Perspective ourselves?

Dr. Jeri Fitzpatrick

00;21;58;27

Well, I find that pretty hard to, actually, but I have to remind myself, too, some of us are a little more psychologically minded than others. Right. And so some people are more some kids are incredibly insightful and observant and they want a process and they do want to work on something. But other kids, their nature is just to avoid escape, make it go away.

Dr. Jeri Fitzpatrick

00;22;28;20

Want a quick fix? As a psychiatrist, I want to say sometimes people come in looking for that magic pill. Yeah. To fix everything. And obviously I prescribe medicine. I believe in it. There are times it's absolutely a helpful adjunct, but it is an adjunct meaning that we need to develop skills and work through things. What I have found when I was a child fellow, I remember one of our older attendings who had been around for a long time who was teaching us child faculty.

Dr. Jeri Fitzpatrick

00;23;01;28

He would say to us over and over when we would be so frustrated and we didn't feel like we were doing anything to help anybody because people weren't utilizing these skills and they were still complaining of the same things. And we would think, what's the point of continuing the treatment really? Because nothing's happening. And he would just say to us, smile and say, It's all about the relationship.

Dr. Jeri Fitzpatrick

00;23;26;12

It's all about the relationship. And I remember at first when he would say this thinking it's surely about more than that. Come on, there's something you're not sharing with us that we could use to get the point of cross that you need to do this, this and this to feel better and to get better. But I learned through the years so much is about the relationship, meaning even when kids aren't doing the things we're suggesting and parents are frustrated, the kids are frustrated.

Dr. Jeri Fitzpatrick

00;23;56;13

I'm one of those people that sort of willing to hang in. Some people are. Some people aren't. And I have found that the longer you hang and at some point they're more likely to do it, you know what I mean? And I do think it's about the relationship, people not giving up on them, continuing to brainstorm. Okay, you can't do this, but could you do this?

Dr. Jeri Fitzpatrick

00;24;18;03

Could you try this? And over the course of time, I do think often things get better. And sometimes because of the relationship, meaning because you didn't give up, because you kept on and you explored this and you explored that and you tried this. I think kids appreciate that at the end of the day. So I really do think ideally we hang in with it.

Dr. Jeri Fitzpatrick

00;24;44;03

That's sort of my biggest recommendation, but we encountered a lot and it's just going to come easier for some than others.

Sissy Goff

00;24;50;14

Yes. So true.

David Thomas

00;24;51;28

Yes. What about when a parent finds that they're the one who is worrying? What would you say in that situation?

Dr. Jeri Fitzpatrick

00;25;01;01

So what's been so fascinating to me through the years is sometimes a parent will bring in a child and they are very concerned about the child's anxiety. Before I even meet the child adolescence, I tend to meet with them first and then meet with parents, sometimes with children. They're apprehensive. They want their parents to come in and then maybe they want to step out.

Dr. Jeri Fitzpatrick

00;25;24;27

Let the parent give me the history, and then they've settled enough to come back in. And so I'm flexible and do it in different ways. But what I'm really going to say about that is sometimes I feel anxiety just emanating from this. Yeah, just. Just coming from there cause like, you can just feel they are about to, you know, jump off the sofa.

Dr. Jeri Fitzpatrick

00;25;49;25

And I think, again, the best thing we can do in situations like that is, you know, when we have the opportunity to take a little history there and say it kind of give back to them, I can see that you're really worried. You're really frightened about what's going on. And I'm wondering how you're taking care of yourself. You know, sometimes parents are very open if you suggest, and sometimes they'll say, yes, I feel like I need to see somebody.

Dr. Jeri Fitzpatrick

00;26;18;15

And, you know, a lot of times you do and having your own treatment because anxiety today I think we all know this is very contagious. When you're in a family where there's a lot of anxiety, chances are you're going to have more. Sometimes if a parent is so anxious, they themselves sort of collapse and then they don't model what they want to model for their child who's anxious.

Dr. Jeri Fitzpatrick

00;26;44;19

Right. And so I think they really either need to have a few visits with us alone to kind of talk about this and maybe talk about, you know, should you talk to your doctor or could we refer you to a therapist for your treatment? And sometimes when parents actually do that, they actually find it even easier to support their child's treatment because they see how helpful treatment has been for them.

Dr. Jeri Fitzpatrick

00;27;11;27

And then they're less frightened to let their child see a therapist because sometimes parents are frightened of that. Or in my case, sometimes the medication piece too comes up and they're so frightened about that. And so I do a lot of referring for families, and sometimes it takes a family session or two to be able to recognize those things.

Dr. Jeri Fitzpatrick

00;27;35;12

But parents, if they're really anxious, they themselves really need to get that help because until they do and your child can't be your therapist, by the way, and sometimes that happens. You have such a close relationship, you start saying more things maybe than you should, and then kids already blame themselves. Like when parents have problems, like there's a divorce, their financial struggles, any number of things, substance abuse.

Dr. Jeri Fitzpatrick

00;28;03;11

Kids blame themselves frequently. So I think if they even sense their parent is so anxious, I think sometimes they think it's their fault. And we have to remember that, too. And that's another motivator for us to get our own treatment as parents.

Sissy Goff

00;28;21;16

What do you wish every parent raising a child today knew?

Dr. Jeri Fitzpatrick

00;28;25;25

I actually have several thoughts about that. Good. One thing. It's okay to apologize. Let's say you're having a really rough day at work. You come home, your child hasn't jumped into their homework or whatever. You know, you're frustrated by it. And the point is, is sometimes we all say things that we shouldn't say. We raise our voices when we shouldn't.

Dr. Jeri Fitzpatrick

00;28;51;16

And I think as parents, it's really good when appropriate to apologize and say, you know what, I'm sorry, I really am in a bad mood and I shouldn't have snapped at you like that or something bigger. I look back on how I handled this and I wish I had handled it in a different way. I think that models for kids that something really good to be able to learn how to apologize themselves.

Dr. Jeri Fitzpatrick

00;29;19;06

I also think they need to learn how to forgive. Sometimes you hold a lot inside about what a parent's done. One of the greatest things in life. Later, down the road is if you can forgive your parents for some of the things they messed up with. I think if we model that and we teach parents, it's okay to apologize.

Dr. Jeri Fitzpatrick

00;29;40;12

So that's a big one in my mind. Another one I want to say parenting and we say this all the time. It's probably the hardest job you'll ever have, harder than anything you do at work. It's just incredibly hard. And you are going to mess up and you are going to wish you had handled things in different ways.

Dr. Jeri Fitzpatrick

00;29;57;23

And sometimes kids will like to let you know that over and over and over. And so I also want to say about that as a parent, most of the time, I think parents try to do the best they can with what is going on, and maybe what they did wasn't the best thing. And sometimes they really beat themselves up tremendously and then it's almost like they give up.

Dr. Jeri Fitzpatrick

00;30;22;19

You know, I'm just not a good parent. I can't do it. Don't respond like that. You need to cut yourself a little slack and say, I messed up. If you need to apologize for something, fine, I think you should do that. But you've got to learn how to forgive yourself as a parent too, and recognize my heart was in the right place.

Dr. Jeri Fitzpatrick

00;30;42;03

I was wanting to help and love and protect my child and I messed up. So forgive yourself and then again pick yourself up. What did you learn from it? Work really hard not to repeat those same things over and over. So to me that went huge about that sort of blame. And then I think the other thing I want to say really to parents is the more rigid we are, it causes us problems.

Dr. Jeri Fitzpatrick

00;31;11;24

And that doesn't mean we don't have to have limits and boundaries, because I've already said that. But life sometimes you begin to see it's a little more gray than you might have thought it was when you started out. With parenting, you'll always hear parents say, I'm so much harder on my firstborn, right? Because there was that rigidity and you had in your head what was right and wrong.

Dr. Jeri Fitzpatrick

00;31;33;21

And now really, sometimes with age, we begin to appreciate that every kid doesn't fit a box. The methods don't have to be the same for every child and have some grace with your child too, because there are a lot more grays. It's not quite so black and white. And then the last thing I try to tell parents over and over, because I am reminded of this over and over and I've had this privilege since I've been in practice for 31 years.

Dr. Jeri Fitzpatrick

00;32;04;22

I've had some patients who I start seeing as little kids and I still see them, you know, they have more chronic things like chronic anxiety, OCD, some form of and I continue to see them. I always tell parents this don't ever underestimate growth and development because so often that child that was really difficult, difficult temperament, oppositional, defiant and sometimes, by the way, that's out of an anxious place or out of a depressed place.

Dr. Jeri Fitzpatrick

00;32;36;10

I rarely, maybe twice in my career, if I given a diagnosis of oppositional defiant disorder, and somebody may say to me, well, you've misdiagnosed, you haven't given that diagnosis more, but I find that most of that comes out of an anxious place, a depressed place. Something else is driving that oppositional defiant behavior. And so hold on with emotional maturity.

Dr. Jeri Fitzpatrick

00;33;02;08

And a lot of times I start seeing it around 11th, 12th graders, right? That's when it really starts to kick in. So I look forward to that. That's coming. And most of the time we see that happen, it's in varying degrees, but we see it.

Sissy Goff

00;33;17;25

Those are wonderful things for insights.

David Thomas

00;33;24;08

Sissy, tell folks who didn't grow up in Arkansas what a bunkin’ party is.

Sissy Goff

00;33;30;01

Well I'm not sure why everyone doesn't know what a bunkin’ party is because they should. In Arkansas, for whatever reason, we didn't call them sleepovers. We called them bunkin’ parties, which sounds way more fun to me.

David Thomas

00;33;41;08

It does.

Sissy Goff

00;33;41;26

If we're not traveling on Friday nights, I try to have a bunkin’ party every week with Henry or Whit or both. Even to the degree that our friends who've been on the podcast Pace and Brandon Verner last year for Christmas, she gave me the cutest blanket. That said bunkin’ party on it.

David Thomas

00;33;55;21

I love that! And I understand you've added a new reed to your bunkin’ parties with the boys.

Sissy Goff

00;34;01;14

I sure have. It's the Explorer Bible for Kids. I got an early copy. It's coming out officially on October 15th. It helps place God's word in middle of God's world for your kiddos with the clear language of the Christian standard Bible translation and engaging full color designs.

David Thomas

00;34;18;16

The designs are amazing. Kids of all ages can explore and understand the Bible for themselves, including fun, facts, timelines, photography and more. Your kids will see the Bible as real, exciting and life changing truth.

Sissy Goff

00;34;33;18

To learn more, go to ExplorerBibleforKids.com.

David Thomas

00;34;37;07

Buy your copy today from Lifeway.com and get 50% off using code RBG.

Sissy Goff

00;34;47;05

We have so many parents that we feel like they've been in therapy, which we always recommend. First, let's get them in counseling. Let's do some cognitive behavioral therapy. If they're anxious, let's do some therapy. If they're depressed, let's talk about some things if they have attention, hurdles that we can do to support them in different ways. You know, we talk about these different ideas and then if after a couple of months it doesn't feel like the needle's moving, we will often say it's time to call Jerry Fitzpatrick or, you know, see a psychiatrist.

Sissy Goff

00;35;16;04

And we have a lot of parents really fearful of medicine, and you can speak to that differently than we can. I would love to hear you talk about maybe when it's time to see a psychiatrist and why why medicine for kids. Is that what you were thinking, the exact same thing? Sure.

Dr. Jeri Fitzpatrick

00;35;33;09

I think this does come up a lot. And I'll even say sometimes you guys have referred people or other people have you almost think, well, by the time they've decided to break down and make the appointment, they're probably ready to consider possibly a recommendation for medicine. It may have come to that. What I find is some people, it's so intense, their fear about this and their discomfort that sometimes they'll come in and they'll start at the very beginning and they'll say, Just want you to know that I will never agree to any medication.

Dr. Jeri Fitzpatrick

00;36;08;25

And if you see I mean, it definitely happens. So interesting. And I do think sometimes I think to myself it's interesting that you followed through, though, to come and do the appointment. But what I've learned through the years with this, when there are people that are that anxious about it, they need time and sometimes they need more information.

Dr. Jeri Fitzpatrick

00;36;31;01

In other words, if I do an evaluation and I think, yes, you know, you've been doing therapy, the therapies been helpful, or maybe you feel like it hasn't been helpful. Usually it's been more helpful than people realize, and it takes a little bit to really come to that realization. But I love it when kids come to me that have already been in therapy because I think therapy is a great place to start for a lot of people and in some place, a great place to keep going.

Dr. Jeri Fitzpatrick

00;37;01;06

By the way, sometimes when people come to see us, they think, Oh, all right, I'm ready for medicine. I'm going to stop therapy now. And we're constantly saying, Wait, no, no, please don't do that, because sometimes if kids are so depressed, I'm just going to give a few examples. They don't have the energy to do therapy. There's a lack of motivation.

Dr. Jeri Fitzpatrick

00;37;21;12

They're tired, they're apathetic, they don't care. What's the point? You guys have been working with them, trying to do therapy and you just can't engage them in the process. And sometimes they're just too depressed to do it when in fact we see them. And if they meet criteria for a major depressive episode or more persistent depressive disorder, we'll say, we actually think you're going to get better a lot quicker if we get you on some medicine and we can target what we call these neuro vegetative symptoms, which are low energy, loss of enjoyment, change in appetite, change in sleep, irritability, feeling, guilt all the time, ruminate ing concentrations down, though all those symptoms go with

Dr. Jeri Fitzpatrick

00;38;07;05

depression and we see that every child has every single symptom, but they have a lot of them. Sometimes. And sometimes when you're like that and you're in that state, you don't make the kind of progress in therapy until we can treat some of those neuro vegetative symptoms. If we can get your sleep better, get you eating better sometimes when you're so depressed, you don't want to eat.

Dr. Jeri Fitzpatrick

00;38;30;07

If we can help that, help the energy. Sometimes they come back in for therapy and boy, they're ready to roll. Yeah, because they start to feel better. So you tell parents, us and some people that's still not enough for them. My sort of view is I never want a pressure. Probably the only time I really think I pressure a little bit about medicine is if there's significant suicidal thinking.

Dr. Jeri Fitzpatrick

00;38;55;01

So I'm so worried about safety, then I'm going to be a little bit more, I don't know, pushes the right word. But I'm going to emphasize that your child's really in a fragile, delicate state right now. And if we don't try on some new things, I'm worried about what I'm hearing from your child. I also would say with anxiety and a great example we've all seen, this is like obsessive compulsive disorder, which is so exhausting.

Dr. Jeri Fitzpatrick

00;39;23;23

I mean, kids come in in an exhausted state from constant obsessing. They usually don't sleep well. They can hardly deal with anything else. And they feel like that sometimes they miss their childhood. They're missing adolescence because all they can do is obsess and sometimes engage in these compulsions. I'm amazed how many parents refuse medication in that situation, but if we can reduce those symptoms 20, 30, 40, 50%, and then kids do engage in the therapy process to really work on how to pick up these skills, to push away these obsessive thoughts, to watch the face of a child that begins to get better from that.

Dr. Jeri Fitzpatrick

00;40;10;08

It's amazing because all of this is quite exhausting. But we have some people that no matter what you do, sometimes I'll see people and they decide and I'll say, I really do think medicine could help your child, but I hear you're not comfortable. Let me give you some literature, give you some resources, give it some thought. I'm here, call me back.

Dr. Jeri Fitzpatrick

00;40;29;21

And sometimes they do call back. Sometimes they call back six months later. But you can only present the information and kind of hope for the best. And occasionally I'll see somebody and I'll say, I'm not there with you yet either. I think you ought to try maybe this type of therapy. And what is true is all medicine's I don't care what it is.

Dr. Jeri Fitzpatrick

00;40;50;14

Tylenol, ibuprofen, antibiotics, everything we put in our body has potential side effects and potential benefits and constantly we've got to be weighing that. And sometimes we initiate treatment and the side effects outweigh the benefits. And we have to go back to the drawing board and those things happen. We wish it didn't. You know, we have this genetic sort of testing you can do now where you swab a cheek and in theory, that's supposed to help us pick medicines that might be more appropriate for this individual based on genetic basis.

Dr. Jeri Fitzpatrick

00;41;23;22

And sometimes it really does help, but sometimes it doesn't because we're not quite, totally there. This is new. This is new medicines, a new frontier, and they're identifying new genetic markers all the time. I think this will get better and better, better, and maybe there will be a little less trial and error. But sometimes we just have to pick something based on symptom picture.

Dr. Jeri Fitzpatrick

00;41;48;10

If they agree to it started go over risk and benefits monitor closely. That's the other thing. Kids need to be seen an appropriate interval if you're taking medicine. We usually want to see kids back pretty soon and sometimes parents are frustrated by that because they feel like I'm doing these therapy appointments and but safety first and then we can spread out a bit.

Dr. Jeri Fitzpatrick

00;42;12;14

But these are hard and I have some parents that never will agree. It does happen sometimes if I'm really worried about safety, I just try to tell them that because that can happen. Kids can get that depressed. Yes.

Sissy Goff

00;42;24;29

Yes. And as impulsive as they can be.

Dr. Jeri Fitzpatrick

00;42;27;01

Yes.

Sissy Goff

00;42;27;19

This is a.

Dr. Jeri Fitzpatrick

00;42;28;02

Life or self-medication. Another topic. Yes. With substances or other things.

David Thomas

00;42;35;08

So we like to end with something fun. Okay. Talk a little about food. Okay. And we want to ask you a two part question. First part being kaso or guacamole and the second part being, what's your favorite taco?

Dr. Jeri Fitzpatrick

00;42;50;13

I definitely will have to go with the guacamole. I love guacamole. So would be my favorite tacos, man. I like a lot of different. And you know what? Nashville now has a lot of different places that have different tacos. I grew up for most of my life in so I love seafood and grew up near the bay. So I love crabs and fish of all sorts and shrimp.

Dr. Jeri Fitzpatrick

00;43;18;01

So I have to say I love seafood tacos, love I tuna tacos, just a variety of fish tacos. That would be my favorite of all.

Sissy Goff

00;43;26;23

So fine.

David Thomas

00;43;27;25

Join you in that.

Sissy Goff

00;43;29;06

Thank you. I feel like you have shared such truth as we know that you would, knowing who you are, but with such graciousness and kindness.

Dr. Jeri Fitzpatrick

00;43;37;21

So thank thank you for asking. Oh, I'm honored to be here. And again, what you've provided in this community is just incredible in many different ways, including your camp. Oh, my goodness. It's been tremendously helpful to so many people. And I, I have appreciated the partnership and the communication when.

Sissy Goff

00;43;57;04

Things is like a teamwork.

Dr. Jeri Fitzpatrick

00;43;58;20

Yeah, well, it's good to be able to talk and brainstorm together, and that's another way I think sometimes parents are apprehensive. It does help when we all talk together. MM.

Sissy Goff

00;44;11;29

Okay. This conversation makes me so excited about how we're formatting the season, which I don't know if we've even officially said we tell what we're doing.

David Thomas

00;44;18;27

We are focusing in on your amazing book, Raising Worry Free.

Sissy Goff

00;44;23;00

Girls and your amazing book. But even each episode we're going to do speaking. Then we're going to have Melissa come in and do a timeless truth, and then the next episode will always be.

David Thomas

00;44;34;07

An expert who's going to talk about that topic.

Sissy Goff

00;44;36;16

And then a parent in the trenches.

David Thomas

00;44;38;23

We can't wait to bring you all those important voices.

Sissy Goff

00;44;42;04

I think I want Jerry Fitzpatrick to be my psychiatrist just based off her voice. She's so kind and gentle and affirming and says hard things wrapped up in a lot of kindness.

David Thomas

00;44;51;24

And the wisdom of having practiced for over three decades. We're just so excited to bring you that kind of wisdom to this season and our conversations around really important things related to the kids we love.

Sissy Goff

00;45;03;03

And we're hearing a lot of kids struggle and let kids fail and they'll develop resilience and it's going to be okay. I feel like that's a message over and over that we're here in which we sure believe in wholeheartedly.

David Thomas

00;45;14;27

Yes, we do.

Jess Wolstenholm

00;45;18;15

Hi. I'm Jess Wolstenholm, mom of two and director of education and faith formation for Minno, a streaming service for Christian families. Wow, what an episode. This was definitely a heavy topic. But as Sissy just said, Jeri Fitzpatrick speaks a lot of hard truths wrapped up in so much kindness. And I think hope.

Jess Wolstenholm

00;45;40;14

As hard as the topic of mental health in children can be, I was left with a feeling of hope that as we lean into resources like this amazing podcast, and the voices it brings us, and we look to God in his word, we'll know how to guide our kids. You know, I'd love to have a sissy Goff or David Thomas or Jerry Fitzpatrick that fits right into my pocket that I could carry around with me every single day to help me parent my kids. Wouldn't that be amazing? But the reality is, Sissy and David are way too busy to follow us around and co-parent, but that doesn't mean we're left to do it alone.

Jess Wolstenholm

00;46;15;03

Psalm 46:1 is one of my favorite verses to remember. As a parent, God is our refuge and strength a very present help in trouble. This is true for our children and it's true for us. He is very present. That means every single minute of every single day on the good days, and especially the bad ones. When we feel like we're doing things right, and when we feel like we've failed, or we have no idea what to do next. He is your very present help. He is your child's very present help.

Jess Wolstenholm

00;46;47;18

Try saying the verse like this any time you need God's help: “God, you are my refuge. You are my strength. Would you be a very present help to me right now? Please help me...” and fill in the blank. I promise you he'll run to your need. Actually, he's already there.

Sissy Goff

00;47;09;10

It's our joy to bring the experience and insight we gain through our work beyond the walls of the Daystar House.

David Thomas

00;47;15;26

If you enjoyed this conversation, please share it with your friends and don't forget to click the follow button in your favorite podcast app so you never miss an episode. To learn more about our parenting resources or to see if we're coming to a city near you, visit our website at RaisingBoysandGirls.com.

Sissy Goff

00;47;36;11

Join us next time for more help and hope as you continue your journey of raising boys and girls.

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