HellerAACTTPHD03042022 Thumb

Treating Children with Anxiety – Moshe Heller


We’re going to talk in the next 30 minutes about treating children with anxiety and it’s definitely a growing issue that I see more and more in my office especially lately and since the pandemic.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hello, my name is Moshe Heller and I’ve been practicing and teaching Chinese medicine for the past. 28 years. And I wanted to first think the American Acupuncture Council for organizing the show and giving me an opportunity to speak about this really important subject matter treating children with anxiety.

If you can start the slide. We’re going to talk in the next 30 minutes about treating children with anxiety and it’s definitely a growing issue that I see more and more in my office especially lately and since the pandemic. And I think the pandemic definitely has a strong influence on children’s.

Tendency to be anxious. And and we can see this very clearly in even in the CDC report from March through October, the PR the proportion of mental health related emergency department visits increased 24% in children aged five to 11, and 31% among teenagers age 12 to 17 compared to 2019.

So there’s a huge increase. And but I wanted to present how we can really help with with Chinese medicine, with our medicine. Very Much. So I wanted to I’m going to start by just going over a case study that will present some of the common issues that I see in my office. So I want to talk about Sally, which is not a, it’s a not her real name is a 17 year old female that.

Came to see me in the office. And she was brought in by her. She gave me with her mother. And then as you walked in the room, I noticed that her, she had a really pale complexion and. With that her eyes were very bright. Although she didn’t, we didn’t, she didn’t have a direct gaze.

At the beginning there was a lot of shyness. Her body was very thin, but looked very tense and her main complaints were having anxiety. Digestive disorders like indigestion. She felt a lot of gas and bloating and very uncomfortable with her in her digestive system. As he said, she came with her mother and she was at first very shy.

And her mother would actually answer her questions, but after a while she opened up and we even I asked the mother to wait outside. So we had some time together to talk about her issues. So she reported that the anxiety really started a little over a year ago and that was about a year into the pandemic and she thought it was related to the changes due to the pandemic.

The pandemic created a lot of change in children’s lifestyle. The way that they had to learn and that caused of course, a lot of stress and therefore anxiety. In the past three months though, her symptoms became much more severe. And they included things like. Difficulty falling asleep, palpitations nightmares difficulty focusing on schoolwork and being easily distracted racing thoughts and then loss of appetite.

And then also a tingling and loss of sensation in the fingers, fingertips and toes which is a very typical of some of the panic disorder. And and also had some diarrhea like on and off diarrhea and a pasty feeling in their mouth and nausea, frequent nausea. So that’s, these are all the symptoms.

She reported. So she also experienced on the background, some seasonal allergies. So she had that tendency to have some damn port phlegm frequent headaches. Mostly occipital and frontal and tension in the neck and shoulders was very, as a co, she experienced that frequently. She also complained of having a weak digestive system even before meaning.

She would be very gassy and experiencing soft stools and diarrhea frequently. She craved sugar and was taking an iron supplement because of low iron count in. Her misses were regular. They came every 28 to 30 days. But there was a lot of heavy bleeding and it lasted four to five days and had some low back pain prior to the arrival of the bleeding and her pulse was really thin and tight.

And the tongue very swollen and puffy, and there were teeth marks and a thick white coat on the all over the tongue. But the tip was a very rare. So I diagnosed her with having a spleen and heart by acuity which is a common pattern that I see in in, in adolescents. And the blood acuity and liver G w also having some blood vacuity and liver cheek constraint with a slight damp accumulation or pretend to have some Dem.

So I chose to include points like heart seven rent, 17 rent, 12 rent, six stomach, 25, stomach 36 and spleen six. So I would choose anywhere between four, four to six points. And you do that by laterally and would see her once a week. So we talked about changing her diet, eliminating Dan producing foods, meaning that reducing her dairy cheese intake and simple carbs white flour products and and.

And adding, eating more foods that strengthened spleen, QI and blood things like beets and yams and butternut squash to include it in her guide. So that there’ll be some nourishment as well as maintaining a warm dive, meeting, eating more soups and And cooked foods rather than raw food.

So we could see here that there’s a, that I arranged all the symptomology and how each with each of the which each of the patterns the loss of appetite and the gas Ines and the sugar cravings and weak digestion and tendency for soft stools, all indicated a spleen. Vacuity the.

Back by acuity was manifested with the palpitations, the nightmares, the difficulty focusing on schoolwork and being easily distracted. And the blood vacuity with difficulty falling asleep which is something I differentiate, Difficulty falling asleep as more of a blood vacuity, as opposed to falling asleep easily and waking up at in the middle of the night, which is a more of a yin vacuity.

Then the heavy menses may also contribute to the blood vacuity. So we are seeing these heavy menses. It may also indicate. The Liberty constraint and we see with the the frequent headaches she will also the tense look, the tense neck and shoulder, and this kind of tendency to be easily stressed.

And this combination of having Liberty stagnation with blood vacuity which points towards the liver blood vacuity would explain this kind of tendency to have loss and tingling sensation in the toes. And. And the seasonal allergies, of course may lead may point to a bit of a lung deficiency, as well as maybe some tendency to have dampness, as we say.

And also the tendency to have nausea and this kind of pasty feeling in the mouth all point towards dampness. I think I skipped the. Okay. So I actually prescribed a F herbal formula and I prescribed a formula called calm plus, this is a formula that I’ve I created in my herbal company called motion herbs.

And then I have a link down at the end of the slideshow to our website motion or. Dot com. And this complex is a combination of herbs that move liver cheese com the heart and and strengthen the blood and yen and therefore, I used that I like to use this formula for anxiety and it’s really fit very well into this picture.

And after 10 days of this formula she reported feeling much calmer. She did not have any anxiety episodes in the last few days and she felt much better and sleep pattern was also. Much better. And she was able to do schoolwork with less effort. So she showed marked in poor improvement with taking this formula.

After three months of this formula, most of her symptoms were resolved and including her digestive issues, and we decided to stop taking the formula. So after three months of this formula, she reported that the. Our symptoms has, we’re almost, we’re completely resolved. So I wanted to to go over I’m actually just going to skim quickly about the definition of anxiety in biomedicine, in the sense that we want.

Understand how, when people say that they ha they’re anxious, what does that mean? Usually anxiety falls under what we call generalized anxiety disorder. And we can you can read this hopefully this th. PowerPoint would be available for you to go back. And there are under this the anxiety section, we also see panic disorders as part of that, as well as things that are associated with D with with anxiety is phobias and specific D different specific phobias included in.

And also social anxiety disorders and separation anxiety disorders, and post-traumatic stress disorder is a very common diagnosis nowadays. And very important that we understand that when somebody complains of having anxiety, it could be related to post-traumatic PTA.

In terms of Chinese medicine. On the other hand, it’s interesting that anxiety is not really a classical category that is used in classical Chinese medicine, but it’s more modern term. And since we see palpitations. As being one of the very common symptoms with anxiety, it is a lot of times included in it.

So fear and palpitation Gingy or panics robbing that’s Chang Chong or junk chow, which is agitation. It’s this kind of feeling of being overwhelmed.

I’m sorry. I think. Okay. But in children, that is really a we have to remember a few things that are very important. I think when we’re treating children with anxiety, because children have unique characteristics that make them more prone to having anxiety. First of all there’s this famous saying that says that all children disease are caused by fear, fright and indigestion, and that starts from an early age.

Most of the pathologies that we see in children stem from having some kind of a fright or fear or being anxious, and then also in combination with

These are the two important aspects. So we also have to remember that it is the characteristics of children to be excess in wood and fire and deficient in earth, metal, and water. So that means that this kind of excess in wood and fire will create a higher. Tendency to be very anxious and very stressed or they would pick up stress more easily.

Whereas the metal where’s the earth being deficient is causing a spleen vacuity which was. Although we think a lot of times as as a spleen vacuum being not necessarily associating with anxiety in reality, I see that a lot of times this kind of earth vacuity is the cause for anxiety because of its relationship with the heart in particular.

It also is important to see that in each developmental stage is each age. We see different pathologies common pathologies. And I wanted to put point out that this. From seven to puberty is the age where we are becoming more aware of our emotions and being challenged, especially by society too.

Control those emotions and in that period of time that is very very time where we need to pay attention because children can easily develop anxiousness around different issues. Because of that. Necessity to be in, in control or have this transformation where suddenly they have to be in control of their emotions.

So a very, as we say, a very livery time, and that is it at that period of time. So we have to remember the children are susceptible to emotional stress, and I’m talking about little kids two years old, a year old, a few months old, four or less, or even later, even the stress doesn’t necessarily need to come from.

Themselves, but rather from the environments of the pickup stress and what’s happening from their mother or from their caregiver or from their family or their surrounding. And I always believe that children are this, like this emotional antenna. So they pick up whatever is in the environment and it affects their their own.

So in that case I always remember that when children come in with anxiety, I always check in with the caregiver in, from this idea of treating the child, treating the mother to treat the child. So especially with anxiety, that is very important to, to consider.

I in the R coursing gene chin pediatrics we tend to we also teach this whole idea that there is this kind of spiral of development, and we revisit different issues at each period of time. And I, we really believe that this developmental Mandela will tell you how to approach children at different ages, according to where they are in this cycle of growth.

And so we see here that each cycle of growth is related to to an element and that and since it is controlled by a certain element, it has the same kind of nature that we would expect from that element in in, in, in that period of time. So attention. Alienation and anxiety are a modern pandemic.

We see that very quick, very commonly. And we see that because I think we are giving children too little, too late of these things and things like too little connection, too little exercise, too little darkness, too little quiet. To the BOR being bored. So children don’t know or don’t want to be bored.

And I think that’s actually an important aspect of growth growing up, but we also give them too much, too fast too much food additives and an energy rich, nutrient poor diet too much pollution too much artificial light and screen time. All these things create an excess of young, whereas not enough of a balance.

And so it and so the so that it creates this kind of. Imbalance of having too much of the fire and the T then scatters and therefore eventually will cause or is it gives a tendency to form a anxious. So there are, I wanted to also point out that there are two there are a few common patterns of illness that I see very frequently that you can pick it, pick up and they, a lot of times.

We’ll be we’ll cause development in, or be part of it. It will be that the child will be anxious. So the first one has to do with it, what we call an accumulation disorder and we see that frequently in younger children. Although, I think we can see a lot of times the remanence of that later on in age, but it’s one of the advantages of treating children, treating pediatrics is that you can catch these things very early on and really prevent.

Years of suffering later on emotional suffering or physical suffering. If you catch that on, when a child is young and that they have a lot of red cheek and a lot of irritability and insomnia, but also have this kind of indigestion or difficulty digesting foods and you might suspect an accumulation disorder in, and by the way, accumulation disorder is something, a term that was coined by Julian, Scott which he has great ideas and I found it to be very true ineffective, but we go very deeply into assessing and diagnosing accumulation disorders in children.

In our course at pediatrics. And that this accumulation disorder also points to this kind of very important triangle or three aspects that we that are connected and interrelated. And that is the new Europe, neuro gastro immune triad. Or a trial. So there’s a relationship between our nervous system through the Vegas nerve that affects our gastrointestinal.

Function. And that affects our immune function. And there is feedback in both directions that that we need to understand that it’s all connected. So when we have an issue with our nervous system, like having anxiety, we definitely need to be in tune with what’s going with the gastro immune function.

Accumulation disorder disorders are a gastric dis disturbance that we need to look at. And we’ll talk about the immune aspect in a second. So I just put in some main points that we use for treatment seafaring is the main points when the child is young up to probably two years of age later on, we might use more body.

For a treating that, that accumulation. Hyperactive spleen sheet deficiency is another diagnosis that we commonly see. This is a child that has all the signs of spleen vacuity, but behaviorly is really having a lot intends to be very anxious, has a lot of sleep disturbances little. Asleep difficulty falling asleep enjoying being the center of attention and w and wants to be very manipulative all these symptoms and usually the child looks very thin and and weak, but the energy is bursting.

So hyperactive splintery deficiency. Another pattern that we commonly diagnosed. And or see frequently especially associated with anxiety later on in life. The interesting thing is that when we have when we have hyperactive spleen Xi deficiency, our treatment is based on strengthening the spleen and not necessarily calming all that excess.

It will come from this. The seemingly a false excess comes from a deficiency and we need to strengthen rather than disperse. There’s another pattern that we usually see, which is called hyperactive kidney cheat deficiency. This this also will have a lot of spleen Xi deficiency, signs and symptoms, but they’ll have very specific other symptoms like dark pools around the eyes.

The page would be a very thin but long a face would be really pale, bright. Wow. And be very fearful and anxious in this case, the fear is very strong and having a lot of anxiety about different things. Being very hypersensitive and also has a lot of issues around sleep and takes very long to go get into bed.

These are very difficult children to treat because they are so afraid from any thing that is done to them, that they can become very hysterical. In any case? The important thing is that the treatment is again mostly use points that strengthen both kidney and spleen and not necessarily any dispersing treatment.

And the last one, which is the other arm of the tr triple the triangle which is the immune part is the lingering pathogenic factor. And I think this is a very important thing to remember because when we look at pathogenic factors that enter into the body, Child as young as they become, they can become lingering.

And there’s a lot of signs and symptoms that will, you will help you diagnose them. And once they are lingering, they can affect our emotional gr the level of the, our nervous system. And therefore, Can cause anxiety later on or tendency to be very anxious. We’re running out of time.

So I’m going to run through the rest of the slides the treatment for the lingering pathogenic factor as we have this really. Amazing. Treatment protocol, which is bylaw. You be 13, 18 and 20. And I use a combination of shout child tongue or some kind of variation of shout child, your tongue to treat that lingering pathogenic factor aspect of the patient.

So in pediatrics I just wanted to point out we have different treatment modalities. We’ll out, tend to use a lot of TuiNa shown Ishan technique is an amazing technique, which we teach again at the Jim Shang pediatrics course. I think that it’s an amazing technique that we can apply to children and get very good results without inserting needles.

And that the gates, the fear factor, especially for anxious kids. And I also use another. Technique, which is cutaneous electricity stimulation, meaning using electrical stimulation to stimulate certain points as opposed to using needles, all that is taught in our course. We also connect we use magnets and we use, we teach how to use them for Paid for pediatric patients.

And they’re an amazing tool that you can actually send patients with it and shows the show them how to massage it and and participate in the treatment. And it creates great results. So I’ve concluded some of the points that I use for anxiety, as well as common patterns in terms of using both both points and herbs.

And I’m actually running out of time. So I will end with this With thank you for being here and listening. And if you want to hear more, there’s many avenues to to hear more and learn more about treating children and and with anxiety or treating children in general through either My herbal company, which is called motion herbs which I have sometimes free webinars on, on, through that venue, I’m going to be treating teaching a course through global branches, which is called the first cycle of life and focusing on the first years, 7, 7, 8 years of children.

So you can Look at the global branches, look it up online and you can register on that their page. And through our Jing Shen pediatrics sent course, which will be distributed through net of knowledge and loss, OMS which, and you can pick it up. So I want to thank the ACA again for this wonderful opportunity to speak.

It’s been a pleasure and I want to remind you that next Wednesday log on here, Sam Collins. Thank you very much.