Talking To Teens: Expert Tips for Parenting Teenagers

Andy Earle: You're listening to Talking to Teens, where we speak with leading experts from a variety of disciplines about the art and science of parenting teenagers. I'm your host, Andy Earle.

We're talking today about a new way to think about anxiety and panic attacks.

Often, when our teenagers are feeling anxious, we just get focused on what can we do to make it stop and make them feel better.

But actually, anxiety can be a helpful messenger that is telling us something about what's going on in our body.

If we learn to interpret and listen to what it's saying, then we can address the root cause rather than just trying to alleviate the symptoms.

Our guest today is Nicole Cain, who is a pioneer in integrative approaches for mental and emotional wellness. She's the founder of the Holistic Wellness Collective. And she's the author of the new book, Panic Proof.

Dr. Cain, welcome to the Talking to Teens podcast and thank you so much for coming on the show today.

Nicole Cain: I'm happy to be here. Thanks for having me.

Andy Earle: Yes. I'm super excited. I think we have a great topic today. You've got this book Panic Proof and It is a really groundbreaking, way of thinking about anxiety and panic, different types of anxiety, how it works in your body.

I'm interested to talk about it and hear about where it came from. What inspired you to write this book?

Nicole Cain: I wanted to prove myself and what I've been told growing up wrong, that was Can anxiety actually be healed? I'd been told it couldn't. And so I was setting out to prove that wrong.

Going through anxiety myself, seeing my loved ones dealing with really terrible anxiety and anger and depression, going through a lot of this just from a personal basis, and then going through my master's degree in clinical psychology training, my medical degree training, working with patients, my whole goal was is this a life sentence?

Am I going to have to be anxious forever? A lot of the dominant medical messaging is yes, and so we have all these young people being prescribed medications to try to help them get through their day to day life. That was my story by the time I started college, going through adolescence, I was on six different prescriptions.

Just imagine what that does to the brain, the body, the nervous system, the gut, your hormones. It wasn't making me healthier. Arguably I was farther from health than I had been at the beginning. That's been my mission. That's been the creation of this entire book. It was a project of necessity, but it was also a project of triumph.

As I looked into the research, the neuroscience, the studies, I worked with my patients. Over a decade of clients, all ages that I've worked with, but I'm really passionate about making a change for our kids because our kids deserve an option that doesn't just end with a period at the end of the sentence of therapy and medications.

I think our kids are worthy of a semicolon that allows us to look just a little bit further as to the why of anxiety and therefore the what we can do about it.

Andy Earle: It's reframing for me so much of how we think about not just anxiety, but a lot of aspects of our health and medicine and how we are supposed to address different things that feel like, as you put it in the book, like it's us against our body. There's these things that are going wrong that are bad that I don't like and I need to stop them or get rid of them or subdue them.

And anxiety definitely it's like that. It's bad. It doesn't feel good. I want my body to stop it. How do I just get it to not do that anymore? And it's I think not a really helpful way to think about it.

Nicole Cain: And that feeling of being out of control is fundamentally one of the main parts of anxiety.

When we're going through life and you're raising your kids and when you were raised, when your parents are raised and when their parents were raised, we come into a world where we're virtually helpless. People have to tell us what to eat when to eat and what to do when we got sick. It creates this idea of I don't have agency, autonomy and authority over my body or my mind.

I need to turn to those who know more than me. And so we have this foundation for a lack of empowerment. And then when things happen that are confusing or scary, they're pathologized as problems or symptoms. Suddenly we have this vicious circle of for whatever reason I'm experiencing fear or autonomic arousal.

Now I'm afraid of that happening. And we try to make it stop.

And then as a parent your loved one, your child, you have this programming. You're looking at your child and you're passing that programming on, even though you have great intentions.

But then we see generations and generations of people growing from children into adults that have anxiety. And that's why our medication prescriptions are skyrocketing. During the pandemic, I don't know if you saw, there's this New York Times article that was published, it was like, we have a benzodiazepine shortage here going on, and that's one of the main prescriptions for acute anxiety, and so many people were being directed towards these medications, which then we had a shortage of, just perpetuates, and so I'm really passionate, I'm grateful to be here talking with you today, because we can do so much better, and the science proves it.

Andy Earle: But when you see your child just feeling so bad you want to do something, you want to help, you want to make it stop. Interestingly, you talk in the book about reframing the way we think about anxiety to where it actually can be helping us in certain ways, or maybe it's telling us something about ourselves that we need to instead of trying to make it go away, almost open it up or look a little deeper into it.

Nicole Cain: Our symptoms are indicators about what's going on. And thank goodness for that. Our symptoms help direct us to treatments. This is something that is really well established in conventional medicine. If somebody goes to the doctor and they have constipation dry skin and weight gain.

The doctor may think, it could be a thyroid imbalance. Maybe they have hypothyroidism. They can confirm that with a test, and then they, there's established treatments for that. But we don't have that same easy diagnosis, with anxiety. So I think we have a lot more opportunities for research and development with that.

And we have a lot of opportunities to educate our kids and teenagers about how to understand what is my body saying so that I can understand. My nephew, he's 16 years old. He's been sensitive to dairy from the beginning. He used to get terrible eczema. And he learned over the years that when I eat pizza with cheese, I'm going to have a stomach ache, and I'm probably not going to sleep well.

And so now, from a place of personal power, he's able to make the choice. If he wants to eat pizza with cheese on it, and let's be real, he often does make that choice, but he's doing it from a place of empowerment. So then when he gets these yucky, awful symptoms, he's I know why, and I know how to fix it if I want to.

And that's a big difference. Between I have these whole compositive symptoms. Nobody really knows why because there isn't one blood test to confirm it. And we're all afraid of what's going on and we don't know how to make it stop.

Andy Earle: Or almost you take it on as an aspect of your personality or something, or this is just who I am.

Rather than looking a little deeper and seeing what might be really triggering it or what the core cause might be behind it.

Nicole Cain: I really validate that. And I have heard so many stories over the years that speak on that, where we identify, as opposed to anxiety is a signal from my mind to my body that something is out of balance. And I am being blessed with the indicators so that I know how to get back into balance. We say I am anxious, or I have ADHD, I have bipolar, I have Crohn's, whatever it is, we start to, as you're saying, identify with that.

And then that can present an obstacle to cure because who am I, if I'm not anxious, I don't know what that looks like. The devil we know feels a whole lot safer than the devil we don't. I really appreciate what you're saying in terms of just that identity, that label can be validating. Oh my gosh, this is what this is.

This is why I feel this way. But then that label can also be a deterrent from actual healing.

Andy Earle: This is who I am. This is a part of who I am then. Almost it's impossible to change it. Or even if you would never start to notice some of those things like you're talking about with your nephew or how different foods affect you or different situations affect you.

I feel more anxious when I do this and less anxious when I do this and start to look for those things because you've already taken on. No, this is who I am. And it puts you in the gut, not empowered. It puts you in a place of feeling helpless or just this is the way it is.

Nicole Cain: I teach a lot of teenagers I feel like concrete examples work really well for teens.

I talk about the Barracuda story. There's this experiment that was done and they had this big aquarium and there's a Barracuda inside of the aquarium and he was happy.

He's happy as a clam, but a Barracuda. He's swimming around and eating little fish. Just living his best life. The experimenters put a piece of glass down the center of the aquarium and they put the food on the opposite side. He's running into the glass and trying to get to the food and he can't.

And so now his sense of personal agency, as much as a barracuda can possess, He starts to feel like he can't do it and he becomes really despondent. He goes down into the corner of the aquarium and just gives up. In the next phase of the experiment they take the glass out and then all the little food sources are all swimming around.

But he does not believe that he is free, that he can go and get that. And so that's an image that I use with teenagers to talk about if you identify as that glass being there, that glass wall between where you are and where you want to be. If you believe that's there and that's who you are, and that's just reality.

That belief can hold you back from accessing what is actually there and accessible to you.

Andy Earle: I love that. That's so powerful and makes me wonder how we can start to reframe that and break out of that kind of limiting belief system we have built around mental health in general.

Nicole Cain: Yeah, I have it broken down into four steps. Cause otherwise it's all these ideas and information and it can be incredibly overwhelming for people. I would love to go through those four steps in hopes that could give your audience something really tangible that they could start using today.

Andy Earle: That sounds awesome.

Nicole Cain: So this is in the book. The first step is. We think about what is anxiety like in your child and your teenager, and maybe even in yourself, this is relevant for all of us. The first step is to just simply notice and acknowledge it. I think it's really important to take a sidebar here because the way that anxiety presents can vary from person to person.

One of the biggest myths about anxiety is that I don't have anxiety. I'm just nervous or worried or overwhelmed or angry or I have a stomach ache every time I have to go to school. We redefine anxiety as autonomic arousal. Autonomic arousal is when the nervous system starts to prepare you for fight flight freeze and that recruits participation from your whole body head to toe.

So this is your gut, your muscles, skin, heart, respiration, enzyme production, immune system cells, your whole body plays a role in it. When the autonomic arousal begins, we're in the green light.

And we're feeling good, we're creative, we're motivated, we're chill, we're just flowing. This is when you're teen, it's just, they may be doing something they really like. They may be in flow, they may be reading a book, hanging out with their friends, you're having dinner, everyone's getting along, we feel great.

But then, for whatever reason, like my nephew could be the cheese pizza, it could be something at school, it could be bullying, it could be the absence of something, it could be an unmet need. It could be lots of things, but for whatever unique reason for that individual, as we start to become more aroused, as we become activated, we start to shift along the continuum out of the green into the yellow light zone.

And so now we're starting to see, okay, I'm getting a little activated here. Some people use the word triggered. I like the word activated a little better. It feels a little bit less violent. And so I'm noticing my heart is beating a little faster or it's hard to catch a breath. I see this a lot in teens where they have a natural inclination to sigh, they'll be like, and then his parents were like, What are you doing?

Why are you sighing? They're in a yellow zone or maybe a red zone and they're trying to calm their body, whether or not they're aware of it mentally. When we sigh like that, it's one of our mechanisms our body uses to try to shift down into a more calm state through activation of the vagus nerve.

So now we're in the yellow zone, we're becoming more activated, more aroused, and then if that continues, we'll shift up into the red light zone. That's rage attacks and anger. I had a teen once who would have a panic rage attack.

He would break the television. Slam doors. Punch holes in the wall. He had all of this adrenaline, all of the stress hormone, but he didn't have access to the brakes of his brain to stop it. He had this impulsive behavior to try to release all of this autonomic energy. So that's crisis.

It could be panic. It could be anger. Some of my kids, when they become really activated, they're not in touch with the feelings, but they just get sick, like vomiting. So they get physical symptoms, whatever the crisis is for that person shows up in the red light zone. When we look at that continuum, the first step is to understand what it's like for you in each of the zones.

Because then when we go through this four part process that I'm going to teach you you'll be able to match the right treatments. People will come to me and they'll say, my teenager gets really anxious before going into school in the morning. And the doctor's like, well, you can give them a beta blocker like propranolol, or an emergency benzodiazepine like Xanax. But it's really not appropriate for teens and it's habit forming and will make them into a zombie.

Or we could give him an antidepressant, but then that might cause other side effects, gut symptoms, brain fog. I had a girl, she was 13, and oftentimes people will find me after they've tried all of the conventional approaches. When she was 12 she went to school, and the little boy next to her got sick and vomited all over his desk.

From that moment onward, she was terrified to go to school. She got so much anxiety. They tried counseling. Logically, she knew she shouldn't be anxious. It was fine. There's nothing wrong. But her body didn't know. And so she's getting all these stomach upset issues. She was feeling really nauseated.

She would get bowel urgency before school. So they tried her on an antidepressant. Her test scores went down, she became less social, she stopped gaining weight, she was smaller in the growth curve and her parents are like, there's got to be something else that we can do for her. They came in, we worked with her, and she got better really quickly. It was amazing.

And so what we do is we map out where are you on that green light, yellow light, red light. When you stop listening to this episode, sit down with your teenager and have them map that out. It's a really nice visual because they're learning to drive, right?

So they know what a stoplight looks like and you can map that out. And then the first phase is if we start with a panic attack. So let's say that your loved one, your kiddo, your team, you are in the red light zone. And you're looking at them, and they're crying, or they're screaming, or they're maybe frozen, or perhaps they're in a flop.

I can't go to school. I can't finish this assignment, and you're, like, this isn't an option. You have to do X, Y, and Z. And so then you're trying to reason with them, right? But what we want to know is what's happening in the body, the mind and the nervous system in the red light zone and what's occurring is that the logical part of the brain becomes less active and the emotional part of the brain becomes more active.

When you're trying to reason with your loved one, and say, it's okay, I'll help you, don't worry, all of these wonderful true things that you as their parent knows, they're not going to compute. It's not going to resonate. They're not going to have access, especially teenagers.

They're not going to have access to those resources. And we also know that logical prefrontal cortex part of their brain isn't even fully developed yet. They don't even have full access to those resources anyway. Let alone when they're in a red light zone panic, right? So when you're in that very first state, we have to calm the body before we do anything else.

I have a strategy for that. May I share it?

Andy Earle: Oh, I'd love that. What do we got?

Nicole Cain: We build a panic pack and it's so fun. Honestly, teens love this. I love it. Who doesn't love a panic pack? It can be customized to anybody's personality type.

You get a bag. It could be a pencil case. Fanny packs are back in style. I would do a sparkly fanny pack. It could be. anything. It's just like small bag. And then inside of it, you're going to select things that are going to activate the body and the brainstem to shift you out of that autonomic fight flight freeze mode.

That's just looping you in that red zone. And so we're thinking fidgets. There's actually a lot of clinical research talking about how fidgets are effective at calming the nervous system and kids love fidgets. Kids know stuff, right? Our teens know stuff. So different kinds of fidgets, like spinny fidgets, you can get a ring that you can wear and you can fiddle with the ring.

Play doh, different textures. I really like the ones they look like a hair tie, but it's metal and it's spiky and you can roll it up and down the finger. Because the more activated we get, the stronger the stimulus needs to be to get us out. Temperature is really good. In dialectical behavioral therapy the founders talked about we want to just stop panic in the moment, stick your face in a bucket of ice water, but that's not very practical.

I don't carry around a bucket of ice water and your teenager probably isn't going to be down with that as well. And so we have another solution. You can go online and you can look in the first aid supplies and they have these little chemical freezer pack things. And so they're like the size of a deck of cards and you can put it in your pocket.

You can put it in your panic pack. And when you shake it up, it gets really cold. Place it on your face around your eyes on your chest or on the back of your neck for 30 seconds at a time. And that can work really fast. So those are a couple of the things that we've put in the panic pack.

Things are going to stimulate sound, touch, taste. Kids love this. Like sour candy, ginger, lemon. Maybe even something spicy. I've seen some people talk about putting a salt packet on their tongue because this can activate the vagus nerve. Some kids are into that.

But taste can be another thing that you can put in your panic pack. So the number one step is, oh my goodness. We're in red light zone. Calm the body. So have you tried any of these strategies? I'm wondering as I'm sharing this, has this ever come up for you?

Have you tried it?

Andy Earle: I read about that mammalian dive reflex that you talk about in the book and the cooling of the face in cold water. And I have found that's very effective. But I hadn't thought about creating this pack and bringing a cold pack with you wherever you go.

It is smart. I like that.

Nicole Cain: Yeah, it was out of necessity. I used to have terrible panic attacks on airplanes. I need something other than a drug, because when I get to the other side, if I'm zonked out on an out of van, I can't drive or do the thing that I need to do. I need another option.

The best bet is to stimulate your vagus nerve to stimulate the brainstem to get back in the body. So maybe sour works great for me, but somebody else feel sick and they're like, ah. It doesn't work.

Andy Earle: And I love what you're talking about with the traffic light, because it's really developing a sense of awareness of getting a little more in touch with your body and starting to notice when you're moving up from the green to the yellow, when you're moving up from the yellow to the red. The more you can start to recognize those things or think about the last time you were in the red zone and what led up to that and start to get a little more in touch with those things so that next time you feel yourself starting to escalate like that, then you can catch it or you can understand what's going on.

Wow we are getting to the end of our time here. There is so much to unpack. You mentioned histamines. That was a whole fascinating thing for me in your book, understanding how that works and what foods how histamines and why you talk about so many different things too, Ayurvedic, body types and how that plays into your symptoms and.

Different ways of approaching anxiety based on that, how to create tinctures. It goes on and on. There's so much packed into this book. I highly encourage people to check out a copy. It's called Panic Proof, the new holistic solution to end your anxiety. Nicole, thank you so much for coming on the show today and sharing your wisdom and stories with us.

It's been enlightening and fascinating.

Nicole Cain: It's been such an honor. Thank you for having me.

Andy Earle: Can you talk a little bit about where people can go to find out more about you, about what you're doing? Maybe get more resources or learn more about all this.

Nicole Cain: Everything we talked about today.

It was probably a fire hose to the face of stimulated information, but it's all in the book. And then you can connect with me on Instagram. I'm really active on there and I love connecting with people answering questions. My Instagram is at drnicolecain, which is C A I N.

Andy Earle: Lovely. And you mentioned also quiz people can take to find out their anxiety type and all kinds of resources on your website that I would also encourage people to check out.

Nicole Cain: Yes. The nine types of anxiety quiz is totally free.

Andy Earle: Lovely. Awesome.

We're here with Dr. Nicole Cain talking about a new way to think of anxiety. And we're not done yet. Here's a look at what's coming up in the second half of the show.

Nicole Cain: When you understand what the symptoms are trying to tell you, you can leverage that data to put your body and your mind and your nervous system back in balance. Study after study shows this form of therapy is the most effective for anxiety, stress, all the way up into that red light zone of extreme combat trauma, you can't get over what you don't go through. We don't want to suppress it or avoid it or ignore it.

We're going to go through it. We have to train the nervous system, arousal. And come back out of arousal in a way that is in our control and safe and empowering. You're actually expanding your world as opposed to anxiety, making our world smaller and smaller. All of these offer really valuable data into what might be a message from my body is going on and what can I do to figure out how to heal.

Andy Earle: Want to hear the full interview? Sign up for a subscription today. It's completely affordable and your membership supports the work we do here at Talking to Teens. You can now sign up directly through Apple Podcasts. Thanks for listening and we'll see you next time.