What Parents Need To Know About Anxiety Medication For Children

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Show Notes

The decision to medicate an anxious child is a big one for parents, as it should be. In this episode, we address the most important considerations. And Lynn gets real about the changes she’s seen over her thirty years of clinical practice.

NEW Course for Parents!

Managing Anxiety in Children: A Guide for Parents

This self-paced course covers the core tools a family needs to manage their anxiety, the same principles Lynn teaches to families in her private practice.

This course includes 6 video modules from Lynn Lyons, LICSW, and 9 additional Q&A videos from Lynn and Robin of Flusterclux.

What you’ll get:

  • Understand how anxiety works so that you can help manage your kids and your own.
  • Learn what to say when anxiety shows up for you or your kids.
  • For Kids: A special video that explains how anxiety works suitable for those ages 6 and up.

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Episode Transcript

What You Need to Know About Anxiety Meds for Kids

There is not a pill that can take away all of the things that we need as human beings. And I think this idea that it’s all about brain chemistry, misses that. And when we’re dealing with our children, when we’re dealing with our families, we just need to keep that in mind.

Welcome to Flusterclux with Lynn Lyons, where we talk about worry and other big feelings in parenting. I’m your co-host, Robin, I’m Lynn’s sister-in-law, and I’m here to ask your questions.

And I’m Lynn Lyons. I’m an anxiety expert, speaker, mom, and author. And I’ve been a therapist for over 30 years. Parenting can be a Flusterclux, and I’m here to help you find your way.

So, Lynn, I want to talk about something today that I don’t feel we’ve talked enough about on the podcast about anxiety medication.

Mm hmm.

I know how you feel, but I also want to understand how you came to the conclusions that you did after years of practice and seeing what really works, because I was talking to a friend recently and I really understand that when parents feel at their wit’s end, when their children are not managing their anxiety and it’s starting to really affect the family, it is exhausting for the parent.

Mm hmm.

And the parent then tries to figure out what to do. They might involve a pediatrician. They might talk to somebody at school and medication is suggested.

Mm hmm.

And then they’re like, okay, we’re going to try this, but it doesn’t really work in many cases.

It’s true. You are correct. I have lots of feelings about this and I will be very honest about this. This is something that I dance around a lot. This is a topic that I am very careful with. It’s interesting you should say you were just talking to a friend. I just got an email yesterday from somebody who, I don’t know, somebody who contacted me through my website and the gist of the email was basically that their child who, I don’t know how old the child is, their child is really struggling. 

The family is really struggling and they have tried many, many medications he said, and nothing is working. And this is not an unusual email for me to get. This is not an unusual story for me to hear. I do want to talk about this. I’ve got a lot of information about this and I’ve got a lot of feelings about it. So, I guess I should share them.

Well, as I’ve learned from you, of course you have feelings about them.

Yes, of course I have feelings and I try to have informed feelings about it. I’ve been doing this a long time, and I think that my goal is always to give people the most accurate and the most updated and the most helpful information possible. If I just may be so bold as to say, this is something that drives me up a wall, because I feel like parents are missing out on some really valuable stuff. I feel like oftentimes, parents are going down a path based on the desire to help, based on their exhaustion, based on the desperation like you said, that we feel when our kids are suffering. But I feel like we’ve got to talk about it and I’ve got to just take this opportunity to lay it out there.

Okay. Let’s do it.

Alright. So, here are the facts. 

There are times if you are dealing with anxiety with a child, when medication can be a really helpful adjunct, and I’ll tell you when those times are: if you’ve got a child who’s really crippled, really crippled by obsessive compulsive disorder.

And define what that, what does that mean? Coz that sounds subjective as well.

You mean what crippled means?

Right. Like to you, what are you calling crippled?

They are not able to function. The family is absolutely held hostage by the OCD. The child is in great distress all the time, because one of the things about obsessive compulsive disorder is that it feels really awful to be experiencing it. Your brain is really hijacked by the need to do these compulsion. So there are kids that, that have to compulse continually, there are kids that are having really scary, intrusive, obsessive thoughts that are really, really awful. They’re not able to sleep at night. They’re not able to go to school or if they go to school, they’re not able to function. They’re not able to, as we always talk about, they’re not able to connect outside of themselves, it impacts their relationships. So, when OCD shows up at an early age like that one, we know that it’s probably in the family, there’s a genetic push to it.

And so oftentimes an SSRI, oftentimes it’s Zoloft or sertraline, sometimes Prozac can be really helpful to bring the symptoms down. That said, even with something that we know like OCD, where the medication can be really helpful, the key to helping move in a really more positive direction with this thing, one, is that the family is involved in the treatment because it runs in the family, everybody, the families involved in the treatment. And also, that they’re learning the skills to manage this, so that the medication isn’t just the only thing holding your kid together, because what we know about OCD and medication is that if a child learns the skills, if they get good treatment OCD, we know how to treat it. You’ve got to go to somebody who knows how to treat OCD. Then even if we decrease the medication and for some kids come down off the medication, those skills hold, but if just do the medication and then we take the medication away, it’s very likely that the symptoms will just come back oftentimes within two to three months.

So, it’s very important for parents to hear that what you just said is that there’s no psychiatric intervention that is the comprehensive solution.

Yes. I should put that on a poster and laminate it in my office.

I know what to get you for Christmas now.

Okay. Oh, alright. So say that again. I’m going to say, I’m going to repeat it. That was just so perfectly stated. There is no psychiatric intervention that is a comprehensive solution. That’s exactly true. And when we say psychiatric, unfortunately, what psychiatric means in 2021 in the United States of America, for the most part, means medication. And I know that there are some psychiatrists that are still doing therapy, that are still really working on trying to address this from a non-purely biological or medical standpoint. But to truly be honest with you, that is a rarity these days. So, when we’re talking about psychiatric intervention, unfortunately in my opinion, it’s going to mean medication and it’s going to be inadequate to just do that as an intervention for anxiety and for depression in kids and teenagers and adults, to be honest.

So, you were explaining that when there are scenarios that you have found medication to be effective, you described a scenario where a family is trying to help manage a child with OCD whose symptoms are absolutely controlling their lives and what you described, it does sound like a psychiatric drug that also facilitates the ability to learn the treatments. That’s a great combination.


What’s another example of a situation where a psychiatric support helps treatment?

So, another example of that would be, if I’ve got a teenager who’s really struggling with social anxiety, which means that again, the disorder itself is getting in the way of their ability to connect. And so one of the things I talk about a lot is that when kids are little and they have a lot of social anxiety or what we call that behaviorally inhibited temperament, which is a risk factor for developing social anxiety, the adults are able to manage the social life and make sure that connections are made. But once you hit adolescence, if you have a lot of social anxiety and it’s really hard for you to step into the world and you’re not making connections and having that sense of belonging, depression is soon to follow. So, if that social anxiety thing is so profound, again, a little bit of sertraline also known as Zoloft, sometimes a little bit of Prozac, I say a little bit, coz we start low and then we work our way up if necessary, that can help to just give them a little bit of a hardwood floor underneath so that they can do the things that I need them to do in treatment.

So, again, I think some parents will listen to this. They need to hear what you describe a profound situation that requires the medication. You need to unpack that, because so many teens have social anxiety. So, like define that scale where it gets into that region you describe.

Not able to go to school.

So, at school refusers.

School refusers. Yup. Not able to participate in what we would call normal developmental events. So, even if you’re going to school, feeling absolutely overwhelmed with the idea of communicating with people. Oftentimes, this becomes an issue because somebody’s so socially anxious that they can’t even ask for help in situations. So, being able to advocate for yourself. I’ll give you an example. You send your daughter or your son off to college, and they’re not able to leave their dorm room, or even if they are able to go to class, maybe they’re falling behind or they have some questions about something and they cannot go and talk to a professor. They can’t initiate a conversation. Even if they’re feeling physically ill, they have difficulty maybe going to the health center, so they’re really incapable of getting their needs met, of asking for help. That would be a situation in which it would be really, really appropriate to think about how can we use some medication here in order to allow them to get a little unstuck so they can do the things that we need them to do.

It’s still important that the foundation that the small dosage is giving them is enabling them to participate in the cognitive behavioral therapy that is the treatment.


Again, and it’s not just that the drug itself will fix anything.

Correct. And so one of the things too, I want you to hear as I’m talking about, this is when I’m talking about treatment, I’m not just talking about going and see a therapist and sitting in their office for 50 minutes or an hour once a week or twice a month. Treatment is really much more comprehensive than that. Treatment involves the family and involves changing patterns. It involves everybody working together. The time you spend in a therapist’s office, and the guidance you get from a good therapist is really helpful, but that’s not all that I’m talking about.

Right. It’s a lot of family conversations.

It’s a lot of family conversations. It’s working on it all the time. And one of the things I’ve been talking about a lot with the schools that I’ve been in, and the parents that I’ve been talking about is the importance of small adjustments that we’re consistently making small adjustments. We’re consistently working on increasing our communication, paying attention to connection. We don’t have to treat this as if it’s this, you know, I’m in treatment and it really is much more comprehensive than that. It’s a part of your daily life. It’s a part of your family life. 

So, when we look at treatments that are really effective for depression and anxiety, a huge part of it is behavioral activation. So, that means that we’ve got to get that person out into the world so that they can start doing things because our brain learns experientially. And if you’ve got a child or a teenager that is so stuck or so locked down so unreachable because they are trapped inside of this thinking and inside of these, these very strong feelings, they’re really real strong feelings, then we can’t get them to do the things we need them to do. And that’s when sometimes unsticking them helps. So, the reality is, is that we don’t really know exactly how these drugs work. 

We know what they do, but the question of, of how they work and what they do, that’s still up for a lot of debate. And so when people talk about depression as being based on a lack of serotonin, or when people talk about OCD as being based on a serotonin deficiency, we just don’t know that, what we do know, and the research is pretty clear about this is that a drug like Zoloft, which has been researched a lot can help in those extreme cases. But the important caveat is this: medication alone is the least effective treatment when we’re talking about anxiety and depression. It’s better than doing nothing sometimes, but I would even make the arguments that it’s sort of worse than doing nothing because you’re missing out on what is so, so important, which is how does the family change their patterns? How do you increase communication? And really what we’re talking about is relapse prevention. So, if you’ve got a kid that’s really struggling, even if you give them a medication, oh my gosh, this has changed their mood. They’re so much better. Oh my gosh, this is so great. What we know is medication alone does not prevent relapse. We’ve got to think long-term with this.

So, I’m thinking of the parents who are listening and I’m thinking of the body of listener comments that we’ve gotten over, now over the years. So many people are listening who have their children on anxiety medication, and might even have them in therapy, but it’s still not effective. There are reasons why people come to you and they say nothing has worked. So you think about the child who was prescribed an anxiety medication at seven or eight by the pediatrician.

Which makes me crazy by the way.

Because it’s not really their training.

Well, I’m not blaming the pediatrician for prescribing the medication. I just think that as a forced course of treatment, you’ve got a seven or eight year old who’s anxious. Guess what, everybody? This is a family problem. It doesn’t just show up. So to say, oh, I’ve got this seven or eight year old who is anxious, so the first thing I’m going to do is prescribe them a psychiatric medication. That makes me crazy. I’m just going to say it. It just makes me crazy.

Well, that’s actually what we talked about in last week’s episode, anxiety is a family problem and it is an essential family solution.


The family gets you in it and the family has to get you out of it.

And again, as I’ve said it before, but I really want people to hear this because I don’t want anybody to feel shamed or blamed. If you’re listening to this and you’re like, oh my gosh, I put my kid on an anxiety medication when they were 8 or 10, that’s what you’re told to do. That’s the course of action. The most frequent treatment of depression in this country for adults is medication alone. That’s the most common treatment. That’s the most common course of action. So, it’s not like if you did this, you are bucking the trends that you are going rogue. This is what we’re telling people to do with themselves and with their families. If you’re listening to this, having an anxious child is not an unusual thing. Having a depressed kid is not an unusual thing. You going through an episode of depression or you’re struggling with anxiety or grief or all of the things that we struggle with as human beings, OCD, men, these things are common. These things are absolutely common. It’s just that the treatment of medication alone, this idea that these pills are the solution it’s just falling flat. It’s just not working.

And this is because of the years in practice that you see. 

I mean, tell me what, the common patterns and the common trends in your practice over the last 30 years. Lay that out so that people understand why you’re coming from where you’re coming from.

So, I’ve been in this field for a long time. This is my 31st year. And what everybody should know is that it’s a very trendy field. Things come and go, solutions come and go, medications come and go, treatment models come and go, diagnoses come and go. Anxiety does the same thing over and over and over again. And so when my field, both the mental health field and general psychiatry and therapy and psychotherapy, we keep trying to come up with these solutions to these problems that oftentimes exist outside of the family unit. We try and make it more complicated. We try and figure it out. I can’t tell you how many things that I’ve heard over the years that are going to be the next amazing, great thing. After 30 years, I’ve become a little skeptical because they don’t really pan out. And so what I’ve been seeing in the last probably five or 10 years that I haven’t heard before very often, but it’s becoming more frequent is somebody comes to see me and they’ve already gone to see somebody who is able to prescribe medication.

They have talked to the child for a short period of time, a short period of time, and they have recommended sometimes one or two very powerful psychiatric medications. They have interviewed the family. Oftentimes, there hasn’t been a conversation with the parents, an open conversation about the struggles that the family is having, but immediately and quickly and without a lot of time spent figuring out what’s going on, that child is prescribed medications quickly. This can happen in a single visit to the pediatrician. It can happen in a single visit to a nurse practitioner or to a psychiatrist. So, that’s very disturbing to me. Here’s the other thing that is starting to happen much more frequently. I will be working with a family for six months and we’re trying to figure things out and maybe there’s a lot that we’re working on and we’re seeing some progress, but, you know, understandably, the family is sort of wanting to move things along and maybe the child is bumped up.

They had a particularly bad week or a particularly bad day. So, they go to see somebody who can prescribe medication and that person writes a prescription for a psychiatric medication and has no contact with me, not a phone call, not an email. Sometimes these are families that I’ve known off and on for years, and there’s a lot of crap going on that this family is trying to deal with, and the person prescribing the medication after a short conversation, never says, gosh, you’ve been seeing Lynn and I don’t care if it’s me or anybody else, you’ve been seeing this person for a long time, is there something that I should know or would it be helpful for me to have a conversation? The lack of communication between the people that are actually treating the mental health issue and the people that are prescribing, that has gotten really, really problematic in the last five years.

So, this is going to be pretty unpopular, but I’m going to say this.

Okay. Well, I thought you were gonna say what I just said was pretty unpopular.

When I, when I have talked to friends of mine about medication too, they’re just at their wit’s end. So, it’s like as a parent, how do you stay away from that place? How do you stay strong, especially when you feel like you have got nothing left to give for the kind of conversations you need to have?

And I think sometimes they’ll avoid a conversation with me about it because probably they don’t want to hear what I have to say about it, which I totally get. So, they, they want to sort of sidestep me and they know that they, they can get the medication.

The equivalent of this is someone who’s trying to lose weight without the trainer and the dietician goes to get liposuction.

Yeah. Although liposuction is probably more effective. Well, so, um, so what, what, what I think the issue that you’re talking about, which I think is a really important thing for us to talk about is when parents feel desperate, when they feel like they’re not getting the help they need, when they feel like they’re not being heard, when they feel like perhaps they’re not doing all that they can. So, I hear that a lot from parents, like, “Well, what if this really would help and somehow I’m not doing it? So, I missing out or I’m, I’m depriving my child of something that would help them.” I think that’s when they tend to perhaps, and I’m making air quotes, “go behind my back.” 

And I think also there’s a lot of pressure from other parents like parents talk and they hear about, well, this kid is on this and, and kids talk about what medications they’re on. There’s a feeling of like, am I depriving my child of something that would really help the situation? And there certainly have been cases where parents have been very reluctant to go on medication for a child. This happens sometimes with kids with OCD, or it happens sometimes with kids that are really struggling and the parent has really been reluctant and then I will say like, “Let’s give it a try. It’s less restrictive than signing a cell phone contract. You can try the medication. We’ll just take it a step at a time. Let’s just see what happens.” And then good things happen and the parents is like, oh my gosh, I can’t believe I waited so long. Or maybe I should’ve started this earlier. Like maybe I was too scared to try this, and I deprived my child of the opportunity to feel better. So, I get both sides of the issue.

All I’m saying in terms of this, going to the medical provider and getting the medication is that if there is somebody working with a family that this is their area of expertise, it just seems to me that it would behoove you to speak to the person who’s treating this issue rather than you sort it. I know that in talking to pediatricians and talking to family physicians, they are really overwhelmed by the amount of mental health stuff that they are dealing with.

Of course.

And that’s what’s in their toolbox. So, a parent comes in and you know, I bet you, I bet you, this is how the conversation goes sometimes. The parent comes in, takes their child to see the pediatrician or to the family physician or to the nurse practitioner, and they say, “My child’s really struggling. I’m really concerned. Here are the symptoms.” Oftentimes, they have them fill out something at the appointment. There are these screening tools that they use.

So, if a kid comes into an office and is really struggling with some mood issues, this happened during the pandemic a lot, by the way, and the first thing that you do is write them a prescription for a psychiatric medication, if that’s the first line of treatment, I, I don’t agree with that. And let me just say, I also know and recognize that it can be really hard to get good treatment for your kid. That’s an issue. There’s an accessibility issue that’s going on in this country that also plays into this whole thing. So it’s easier to get a medication than it is to get therapy. It is much, much easier to get a medication than it is to get therapy. And that’s what also is driving this. If you’ve got a kid in crisis and you take them to your pediatrician or to your family physician, it is going to be easier for you to get a prescription than it is for you to get an appointment with someone like me. That’s just a fact.

Well, I was happy to see someone who reached out to us for the podcast actually heard about Flusterclux from their pediatrician’s office. So I think it’s great to know that some pediatricians are not just grabbing a pen. But say you’re a parent and you think your child would benefit from talking to someone and they know that there’s nobody around that they could use, but there are other resources.

There are other resources. Yeah. So one of the things that parents can do, one of the, one of the things they can think about is how can they learn as parents. And I know that, that having somebody coach you through this, having somebody walk you through this is really, really helpful. I get that. But parents can learn a lot from getting information, from reading, from listening to podcasts, from looking at articles, there’s online courses, there is a lot of information out there that can really give parents a super head start in being able to recognize the patterns of this thing and do what they need to do in their family. And one of the things that, that I think is probably the sort of, one of the most important things to me is to keep saying to parents that once you learn about this, and once you learn about what makes it better and what you learn about what makes it worse, you are going to have to change those patterns.

My husband always tells this story about how somebody came up to him at one of our talks. He was doing a parent talk and a mom came up to him coz he was there and she said, “I just want you to tell this to Lynn. I want you to tell Lynn that I came and listened to her when she was here a few years ago, I bought her books and we are doing the book, we are learning about it, we are walking through the process and I took this on as my job to learn what I could and to implement what I could.” Now, not everybody can do that on their own, I get it. But it’s really, really possible. It really, really is. And I’m not saying this, oh, buy my book. There’s all sorts of great resources out there. I like my book. 

I like what my book says, because I, you know, we wrote the book, but, but we have so many resources available that parents can really learn about this and learn about their patterns. It’s hard work, but it’s not that complicated, truly. 

So, Robin, you mentioned that pediatricians, that people find out about me, they hear about Flusterclux or, or they give, you know, resources, they find out about me through their pediatrician. I am not throwing pediatricians under the bus. I have, I have talked to pediatricians, I have talked to family physicians, and as I said before, they are totally overwhelmed.

Yeah. They’re doing the best they can.

They’re doing the best they can. And I think that one of the things that’s hard for them is that they’ve got 15 minutes to talk to a family. Oftentimes, the family is in crisis and they’re trying to do the things that they know how to do. They’re trying to guide the family to the best resources possible, the resources oftentimes aren’t available. So, so I just want to say, and I think when I talked to pediatricians in a way, and I talked to family physicians, they totally agree with me. They’re like, yeah, we don’t know what to do with all these kids coming in. And they’re really just trying to get through all of the patients that they have to see.

I’m not a provider. I’ve just listened to you talk about your work over the years as your sister-in-law. But the thing that I, I have so much compassion for, and of course, I know you do too, that I just want to repeat is that I feel so badly for the parents who have a child in crisis. They don’t know what to do. They want to do everything they can on a really empty tank because the crisis that their kid is in, has completely depleted them. 

And then they finally try and do something and it doesn’t work.


I just feel really bad for them for that. And I think that that’s, that’s actually why I wanted to talk about this today and sort of get you to, to just say it like it is, because if you’re a parent right now, who’s trying to figure out what direction to go. What would you tell them?

So, a few things. One is that when you talk about this crisis and when you talk about a family in crisis and that the parents are feeling completely and totally depleted, one of the things that’s important to know is that parents often wait between two and eight years after they start seeing symptoms before they get treatment or go for help for their child. So, don’t wait. If you start noticing these things, don’t deny it. Don’t say it’ll go away. Don’t hope that they grow out of it. Start paying attention to it as early as possible, rather than waiting for such a long time. Because when a parent gets to the point where they’re absolutely depleted and worn out, it’s not because this has been going on for a week or a month, it’s often because it’s been going on for several years. So, with anxiety, when you start seeing it, jump on it quickly, and you don’t have to jump on it quickly by saying, oh, we’re going to immediately get therapy, or we’re going to immediately go talk to the pediatrician, but start investigating it and learning about it.

Particularly, if you have anxiety in your family, particularly if you know that this is something, this is something that hangs around in your family, get on it earlier, because that’s going to help you feel better about it. The other thing I just want to say to parents, I have a lot of empathy for this. This is what I do for a living. I’m a mom. I get it. Don’t give up. There are really helpful things that you can do as a parent that you can look at, that you can learn about, that you can talk to people, find out what, what works, find out what doesn’t work, educate yourself about this. Don’t act as if or don’t believe that you can’t help this because you don’t know anything about it. Learn about it, because I’ll tell you anxiety is not mysterious. We know how it operates. We know what it does. Learn about it. 

Become your own source of information about this and start talking about it with your family and your kids. There’s no shame involved in this, right? I, I make a big distinction between blame and responsibility. I am not blaming any parent for finding themselves in this situation, but you can take action. You can ask, you can look, you can read, you can learn. And then you’ve got to put these things into practice. You can do it. You can do it. I know it takes energy. Don’t wait until you’re depleted. That would be my advice. Don’t wait until you’re depleted. I want you to know something. Robin really pushed me to have this conversation. 

She really wanted us to address this issue because it’s an anniversary for her of losing one of her friends during her teenage years to suicide. And one of the things that Robin has talked to me about and chime in when you want to, Robin, because I know this is emotional for you, is that just thinking or just believing that medication alone is all we need to do to help our kids and our teenagers when they’re struggling, I think that’s why Robin really wanted to have this conversation and why she really, really advocated for me to talk about this thing as openly as I possibly can, because quite honestly, it’s often a conversation I steer away from, which I shouldn’t. If you have a child that’s struggling, if you have a child that’s depressed, if you have a child that has OCD, if you have a child that has social anxiety, medication alone is just not enough. It can be a very helpful adjunct sometimes. But the research is very, very clear that we need to do more for our kids. It’s about connection. It’s about emotional management. It’s about feeling supported, all of the things. If you’re listening to this episode now, and you didn’t listen to the episode we did last week, I strongly recommend that you go back and listen to that one now. This is about connection. It’s about humanity. It’s about love and caring. And there is no pill that alone is going to make up for the things that our kids need right now. And I think that’s the message that I want to convey.

Yeah, I’ll say it through tears, but there’s no psychiatric intervention that is a comprehensive solution.

That’s right. For some people, it’s really helpful. But look, even when we look at people who have severe mental illness, people who are struggling with schizophrenia, for example, which is just one of the most heartbreaking mental illnesses that we see, there is so much good research and so many incredibly wonderful programs for people with severe mental illness that revolve around a sense of community and a sense of belonging and a sense of connection. That’s what it comes down to over and over and over again. If we can look at the mental health issues in our kids right now, not as these diagnostic categories, but as something that we as families and we as communities need to address all the time, every day with all sorts of skills and all sorts of connections and taking every opportunity we have to teach our kids how to manage their emotions and understand what’s going on inside of them, that’s treatment. Treatment doesn’t just happen sitting in my office. Treatment happens every minute of every day as we’re working to give our kids the skills that they need. And I talk about those skills all the time. It’s just not a pill and it’s even just not a therapy session. It’s much more comprehensive.

So, join the Facebook Group so that you can ask Lynn your question on an upcoming episode.

Thanks for joining us on another episode of Flusterclux. Bye, Robin.

Bye, Lynn.

1 Response
  • Gisella
    September 13, 2021

    A very interesting and informative podcast. Thank you for clarified some of my doubts about anxiety and medications.

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