Doc Smo here, you know Dr. Paul Smolen, your pedcast host. Today we are going to discuss a topic that is most relevant for parents with teens in the house. You folks with younger children, you listen up as well: your time is coming before you know it. We all know that teenagers tend to be moody but what should a parent do when their child has persistent fatigue and changes in mood. Well, that’s the topic we are going to take on today. It’s not too uncommon for parents to bring their teenagers to the pediatrician with physical complaints of fatigue, irritability, dizziness, and sleep problems. More times than not, these physical complaints turn out to due to difficulties with mood, either excessive sadness, worry, or even anger. As a pediatrician, I always have my radar up for physical symptoms that might indicate a serious disease process but most of the time fatigue is an emotional symptom. So once we are sure that our tired teen does not have fatigue from a something like diabetes or thyroid disease, what’s next? How can we help them feel better? I thought it would be useful to take a few moments and share with you my practical suggestions that I have found can be very helpful to children and families in who find themselves in this situation… having physical symptoms from emotional fatigue and stress. I think step one is to visit a pediatrician who has cared for your child and knows them well. I think a large part of the healing process comes from a child feeling that those around them care and take their complaints seriously. Reassuring them that they don’t have some dreaded disease by taking their complaints seriously is also an important aspect of the doctor visit. I feel this is best done by someone who they already know and trust. Don’t underestimate the power of a health professional listening, touching, reassuring, and demonstrating understanding. Next I suggest that all my tired teens work on a few things that have been shown to improve mood in anyone, child or adult: -I make sure that they are getting enough physical exercise. I think they should exercise a minimum of an hour a day. Walking is fine, riding a bike, throwing a Frisby, whatever but they need to get out and do it! Movement and enjoyment is the key! And I mean out, that’s outside where there are green trees and lots of light. Light sets our clocks for sleep and can help your child get enough sleep and the light also improves their mood…for real. Actually researchers have found that physical exercise is as effective at improving mood as most anti-depressants and a whole lot cheaper and safer! -Next, we go over their sleep habits and possibly make improvements there. Experts think that children older than 12 years old need 8-9 hours of sleep nightly. Regular bedtimes, turning off electronics, quieter activities in the evening are an important part of a healthy sleep formula. I encourage the child to establish a regular bedtime ROUTINE. Many parents tell me that evening, near bedtime, is a good time to talk about your child’s feeling. Bedside conversations like these can be very powerful and I think you should try and initiate these talks. Enforce no cell phones or other electronics in your teens room. -Nutrition is also an important aspect of mood and energy. I explain to the tired teen that certain fats found in fish and other foods can really be helpful. Fish consumption or an omega 3 supplement is a must as is vitamin D supplementation in case the child’s level should be low. In this situation, I actually recommend a multivitamin, especially if the teen’s diet is poor. It also goes without saying that reducing soda, caffeine, and processed food will help anyone feel better. -Finally, I think that having friends, helping others, and being praised for even the smallest of achievements can all be very uplifting activities. I encourage families who have a tired teen to try all these things. Parents can facilitate their child’s friendships by making an extra effort to provide transportation and activities their teens might like as well as encourage their teen to help around the house, neighborhood, or community… and of course they can praise and recognize any helpfulness, success, or healthy attitude their teen exhibits. And finally, I think a follow-up visit to assess how your teen is doing is really important at which time we determine if things are getting better or a mental health referral is indicated. Let me reiterate that what we have talked about is for mildly depressed or anxious teens and not for children with severe disturbances in mood or behavior. If these measures doesn’t improve things for your child or you think they may be having serious thoughts of harming themselves or others, please…. get some professional psychological help. You’ll be glad you did. For more portable, practical parenting information, take a few minutes and explore the literally hundreds of pedcasts and articles posted at my blog, www.docsmo.com. Your comments and stories are always welcome and of course we love when you share these posts with friends and family. This is Doc Smo, hoping you can find a simple step to increase your teen’s pep. Until next time.