#49: A Story of Two Sisters: The Good Student and the “bad”: Recognizing Anxiety Early

July 29, 2020

In the summer kids usually come in for their check-ups. This is an opportunity for doctors to touch base with families and see how their kids are doing. This day was no different than others, and the next family hurried in. A 14 year old girl, tall and lean, walked in with her little sister. The young girl, turning 12 in a few days, followed closely behind and sat herself on the exam table. The mother followed. 

I love seeing families in the summer. Usually the kids and the parents are more relaxed than during the school year, when they are busy with school, sports and other extracurricular activities. I get to hear about summer vacations and camp. I also get to learn about how things are at school and if there will be any changes in the coming year for the kids. 

The little girl was sitting on the exam table with her head down, fidgeting with her fingers. I smiled at her and asked her about her summer and what she had been doing. She went on to tell me that she had been spending her days cooking and practicing basketball, which she loved. 

I asked her to give me more details about what exactly she was cooking and what kinds of foods she enjoyed the most. Her eyes lit up and she went on and on about how she loved finding new recipes to try on the internet and looked for you-tube videos showing people making different dishes. 

Then I asked her about basketball and she explained how this was her favorite sport. She was enjoying a summer camp that focused on helping kids perfect their skills and she “LOVED IT!”. This year, she was excited because she was trying out for the basketball team at school and she couldn’t wait. 

Finally, I asked her about school. This is when her face quickly changed and her eyes hit the floor. Her mom jumped in. “She isn’t trying very hard in school”, “We know that she can do better, but she doesn’t have any interest in school.” The little girl didn’t say a word. I tried to change her focus and asked her what her favorite subject was. She told me it was Science. 

Ah! A girl after my own heart! She explained to me how she had an amazing Science teacher that loved to teach them about their bodies, nature and the ocean. She told me that this teacher was her absolute favorite teacher ever! 

As we finished her exam and discussed healthy habits, I reminded her to read over the summer and keep her math skill sharp so that when the new school year began, she would be ready. She nodded and jumped off the exam table. 

Her older sister was next and we began her exam in the usual way. Her interests were different and the mom quickly jumped in to tell me how wonderful she was doing in school and how she had achieved the Honor Roll every semester. She smiled and shrugged her shoulders. 

She told me that her passion was History and English and that she was participating in a writing camp over the summer because she loved to write. The mother beamed. She went on to tell me about how proud she was and how she ALWAYS put forth her maximum effort. She then went on to say that she wished that her younger daughter would have at least half the interest in school that her son had. She told me that she knew that she could do better, if she only applied herself. 

The little girl sat next to her mom, staring at her nails. Her nails were chewed and little was left. Her mom then told me about how she wouldn’t stop biting her nails.  That her hands “looked terrible”. 

The visit ended and I spoke to each child and mother alone. I always like to speak to tweens and teens alone to see if they have any concerns or questions about their health. Sometimes they do and sometimes they don’t, but I think they like when a doctor addresses them directly and gives them the opportunity to talk. Sometimes they do reach out, but even when they don’t, they know that they can if they decide to in the future.

I asked the little girl about school and she started crying. She told me that she did try but that school was hard for her. She told me that her older sister was the smart one and that she was just dumb. We talked about how she wasn’t dumb and discussed a little more about what exactly was happening in school. 

I won’t get into the details but I then went to speak to the mother alone, explaining to her that I was worried about how her daughter was feeling. The mom then began to cry. She told me how she had tried everything and that nothing seemed to work. She agreed that she needed help but that she just didn’t know what to do. 

We discussed some options and I encouraged her to have her daughter have a formal evaluation to rule out possible learning challenges. She agreed. At the end of the visit, I explained to the girl how we all learn differently and that she was not dumb. The secret was finding out how SHE learned best so that she too could succeed in school. She wiped away her tears and smiled a tiny smile. 

These visits sometimes feel so rushed, since we only have a few minutes with each patient, but there are so many things that run through my mind when I see a family like this. It’s actually more common than you think and it pains me when I know kids are suffering in silence and well-intentioned parents just don’t know what to do. It’s impossible to fix these issues in a simple well check up and my hope as a pediatrician is to at least begin the process of healing instead of letting these issues spiral out of control. These circumstances can often lead to anxiety and depression later in adolescence and into adulthood.

The take away from this story I’m sharing with you is that we are all unique. We are all born with talents and as we grow, our focus should always be on learning more about ourselves. Finding out what doesn’t work for us is sometimes even more important than figuring out what does. 

The best gift a parent can give a child is to help them figure out what their unique gifts are and resist the use of labels to describe them. We are so much more than those labels, and those labels are sometimes carried for a lifetime. 

Have a wonderful week! 

Elizabeth Vainder, M.D. 


Some Signs of anxiety in children:

  • Difficulty concentrating
  • Difficulty sleeping, or waking in the night with bad dreams.
  • Not eating properly.
  • Often angry or irritable
  • Constantly worrying or having negative thoughts.
  • Feeling tense and/or fidgety
  • Stomach aches/ Headaches

Symptoms of Generalized Anxiety Disorder:

  • Trouble falling asleep.
  • Fear of being alone.
  • Picking at skin.
  • Nail biting.
  • Strong startle response.
  • Being overly self-critical.
  • OCD-like behaviors (e.g. checking and rechecking the door to make sure it is locked, etc. )
  • Refusing to go to school or having a hard time at school drop-offs
  • Difficulty participating in class and interacting with peers
  • Excessive worry about everyday things
  • Trouble answering questions when called on by the teacher
  • Disruptive behavior
  • Squirming
  • Frequent trips to the nurse (with complaints of headaches, nausea, stomachaches, or even vomiting)
  • Avoiding socializing or group work
  • Not turning in homework

Resources: www.childmind.org

Please remember that like everything, if your child has some of these behaviors, they can be normal ways of managing stress. If you are noticing multiple symptoms or all of the behaviors described above, please talk to you pediatrician.

#48: Are you feeling like you don’t even remember who you are? How to keep your sense of self after becoming a parent: YOU MATTER

May 27, 2020

Good Morning! Today I want to talk to you about a topic that is very important. I am a parent, wife, a pediatrician and I am also myself. What I mean by that is that before I was any of those other titles, I was a person with interests, likes and dislikes, dreams and fears.

It seems that more often than not when people become parents many of these things get shoved to the side to make room for this amazing new person that has come into your life…your baby. As a new parent, it is easy to be mesmerized by the soft, perfect features you see in your baby. You spend hours analyzing their face, their hands, their feet, caressing the softest skin you have ever touched. You marvel at the reality that this baby was created by you. It is truly a miracle.

When first time parents come into the office, they are nervous and are almost in a state of bliss; albeit exhausted! They want to do everything right. They come in with lists and ask many questions (the funny thing is that parents all have the same questions regardless of culture or race). They listen intently when I recommend something for the baby and take notes. They carefully take turns holding the baby and feeding him or her. Their entire focus is now on this baby. It has become a 24/7 “job” that we are immediately immersed in. It is the most important job you will ever have….

By the second or third week of parenting, the visits are a little different. Parents come in looking for tips to get their baby to sleep the entire night. They come in with bags under their eyes and forget to bring extra diapers and wipes (and of course the baby decides to poop in the office..). I remember those days of early parenting. They are difficult. You feel exhausted. Crying sometimes just comes naturally as you repeat your day over and over again with feeding schedules and diaper changes. It is over-whelming, but you push through and you keep trying to be the “perfect parent”.

I want you to know that there is no “perfect parent”. Be kind to yourself when you parent. Take care of YOURSELF too. In the beginning the idea of ME time is elusive but it is possible. If you are lucky enough to have someone other than yourself in the home, take 10/15 minutes to take a shower without a worry or simply just go for a walk alone to clear your mind. Don’t spend all day in pajamas day after day.. and don’t feel guilty about wanting time for yourself. Make time to talk to friends and friends even if it’s just a few minutes per day. Write down ideas about things you are interested in or dream about.

Make a promise to yourself that you will not lose yourself in this parenting journey. When you take care of yourself, spend time with those that you love, cultivate your interests and continue to dream, you will be happier. Being a good parent does not mean forgetting about yourself. In fact, the happiest moms that I see in the office are the ones that have their own interests outside of parenting.

I truly believe that one of the primary reasons women are depressed as their children get older is that they have lost themselves in the world of parenting. You don’t know who you are anymore. You sometimes lose your identity all together. Your days, weeks, months and years consist of playdates, school responsibilities and day to day parenting.

Please do not lose yourself to parenting. Make a conscious effort every day to do something that is important to YOU that is independent of your parenting responsibilities. Make it a priority. Schedule it into your calendar. It can be a short walk, meditation, practicing a hobby, reading, exercising…the possibilities are endless. Taking the time to take care of yourself will in turn make you a better parent. You will feel happier.

Parenting should enhance your life not stifle it. Keep dreaming and becoming the best version of yourself. It is truly the best gift you can give your children. It will teach them to keep dreaming, to take care of themselves and to nurture their friendships and relationships. Grow with your children. Life is about  becoming the best version of yourself, and this includes YOU.

Elizabeth Vainder, M.D.

Share with a friend

Tagged : / / /

#44: How to stop worrying and start making decisions

April 29, 2020

I think my tendency to worry grew 100 fold when I became a parent. Deciding on a doctor, how and what to feed the baby, what to buy, understanding what is harmful and what isn’t. There are so many decisions to make as a parent and you want to make sure that your baby not only has the best of everything but that you don’t mess anything up. The internet doesn’t help. It provides an endless display of options from diapers, lotions, soaps, clothes, schools, shoes, etc….It is easy to get lost in the millions of opinions  and options available.

A few years ago, in the middle of parenting my 3 kids, I felt as though all I ever did was worry. I approached each decision with trepidation and fear and worried about making the wrong decisions all of the time. Even after I finally made a decision, the worrying just wouldn’t stop. I was trapped in a sea of thoughts going nowhere. One day I sat down to really thing about what good it did to worry anyway.

The first thing I realized is that worrying is exhausting and time consuming. It literally will eat up hours in your day and keep you up at night.  Some thoughts become repetitive and you can find yourself trying  to analyze the same situation in a million different ways. Sometimes too many options can literally paralyze you. You don’t even know where to start! In the end, I learned several lessons about worrying. 

  1. Worry doesn’t make anything happen. 
  2. Worrying is exhausting.
  3. Worrying disrupts my sleep.
  4. Worrying does not make problems disappear. 
  5. Worry is the synonym of inaction.
  6. Worry doesn’t make anything happen.

It is really only useful if it leads to action. Otherwise it is a waste of time. 

This time in quarantine, is making it even harder to make decisions and move forward. This unfortunately leaves too much room for worry. 

Here are some ways to decrease the amount of time that you spend worrying:

  1. When you are feeling worried, write down your thoughts and try to get to the core of your concerns. Just write everything that’s in your mind on a paper and try not to think too much as you write. Put the paper aside and read it a few minutes later. Seeing your thoughts on paper can sometimes help you to understand why you are actually worried. -What you write may surprise you!
  2. Try to focus on what you want as your end result and write a plan on how to get there.
  3. When a thought enters your mind reminding you to worry, acknowledge it as a thought and move on. Do not dwell on those thoughts/worries.
  4. If you are worried about something specific, try to learn as much as you can about the subject. Understanding something can help you make decisions.
  5. Find friends or people that can help you make objective decisions. Ask questions and listen with an open mind. Sometimes talking about something and listening to others opinions can help you feel that you are not alone.
  6. Limit how much news you listen to or watch. The news has a way of playing on repeat the same extreme circumstances over and over. The truth is that for every bad news broadcast, there is probably 10 times the amount of good news, it’s just rarely shared.
  7. Find the good news and read about it. 
  8. Reach out to a friend, even it is someone you haven’t spoken to in a while. This will not only help you, but it will help them too.

So instead of spending so many hours worrying,  try to focus on the present and make small decisions every day. The truth is that we are no more certain of tomorrow today than we were before this pandemic started. We just felt more confident. So as the next few days unfold, begin making decisions that will move you forward. Don’t let your mind stay stuck just worrying, it’s getting you nowhere.

Share this post with a friend.

Elizabeth Vainder, M.D.

#40: The simple way to find out what your child is worried about

April 1, 2020

“Can you read me one more story?” “I’m thirsty”, “Can I go to the bathroom?”

Parents all around the world have heard these same questions right around the time that their kids should really be going to sleep! It can seem frustrating as you struggle to get your little one down and they get that second wind. 

The idea of having a few minutes to yourself seems so appealing yet your little one keeps on talking and asking for more. 

Tonight I’m encouraging you to stay a little longer and listen. 

There is something magical about that time just before bedtime. Kids will talk about so many things jumping from one topic to another. But – if you really listen closely, you will catch a glimpse into what their little minds are actually thinking about. 

Over the last few weeks, life has changed in ways that many of us could never have imagined. It has changed for our kids too and they feel it. Everything is different. No one is going to school, they can’t see their friends, school is perhaps on a computer now and there are no more playdates or get-togethers with friends. It is hard. Change is hard. 

Kids are not very good at expressing what they are feeling. (some adults aren’t either!)

They will complain of physical symptoms when they feel anxious or afraid. Other times they will misbehave or have tantrums. Pay attention to all of it. 

Kids are very good at eavesdropping on adult conversations and listening to the media. They make their own interpretations of what they hear. This can bring about feelings of worry or overwhelm. Sometimes they create ideas in their head that are not even real. Pay attention to what you say in front of your kids. They are listening. 

So tonight, when it’s time for your little one to go to bed, snuggle with them a little longer and lay down to listen. Listen with an open heart and validate their concerns and feelings. You don’t need to have all of the answers. Help them to understand what they are feeling and what they have seen and heard. You will learn a lot about your child in these few minutes before they fall asleep and they will know that you cared. You cared enough to listen. That is the greatest gift of all.

Share with a friend that can use this!

Have a wonderful Wednesday and stay safe and healthy

Elizabeth Vainder, M.D. 

Tagged : /

#39: The only thing guaranteed is change…

March 27, 2020

“In the light of the moon, a little egg lay on a leaf….” -Eric Carle 

The Little Hungry Caterpillar by Eric Carle is one of the books that I loved reading to my kids when they were little. 

One sunday morning the warm sun came up and -pop! – out of the egg came a tiny and very hungry caterpillar.” 

The caterpillar in the story is so simple and has no idea of what the future will bring. It is born hungry and spends most of its time eating and crawling around. A simple life. One would argue maybe even insignificant. You wonder if it even thinks about the future. It just goes through life until one day….

He built a small house, called a cocoon, around himself. He stayed inside for more than two weeks. “

You wonder what goes on in the mind of a caterpillar in this moment. Is it scared? Does it think that life is over? Does it think that it is dead? I imagine that all of these uncertainties and fears can be extraordinarily frightening for a little caterpillar. Yet, we all know how the story ends, 

Then he nibbled a hole in the cocoon, pushed his way out and… he was a beautiful butterfly!”

The story of the Little Caterpillar is a story of change and of hope. The only thing ever guaranteed in this life is change. Nothing ever stays the same. This is true for all of us. Most of us, like the little caterpillar, go through life hungry for a deeper meaning of why but all the while feeling small or insignificant. A small voice in the howling winds. Perhaps afraid to take chances on becoming who we know in our hearts we want to be. 

So we build walls around us and we stay in there for weeks, months or even years, afraid. Comfortable in our cocoon.  Afraid to evolve, and frightened of the unknown. What a shame to be the caterpillar that stays in the cocoon. It will never know how beautiful it can be. 

So as we face the coming days of uncertainty and fear in our cocoons, I hope that we will use this time like the caterpillar and transform into our best selves with hope for better tomorrows. I hope that we can all become the butterflies we were always meant to be. 

Share with a friend! Together we are stronger!

Elizabeth Vainder, M.D.

Tagged :