One of psychologist Lisa Sanchez’s clients, a high school student, recently told her that she wasn’t happy with how she looks. They talked about the amount of time the teen spends looking at herself, trying to take a cute selfie that will get lots of “likes” on Instagram, and how social media makes her feel bad. “There actually is research that shows that the more that you’re on social media sites, the worse you feel, because people put their best foot forward and you get these unrealistic expectations, and you see what you’re missing out on,” Sanchez says. When she said to the teen, “It sounds like you’re thinking of maybe cutting back,” the girl responded, “Oh, no. I can’t do that.”
The impact of social media and technology is contributing to a rise in anxiety among young children and teens, says Sanchez, 43, whose office is in Chevy Chase. Overscheduling and a focus on grades and competition play a part, too. While she sees adults and kids with a range of concerns, including ADHD and depression, Sanchez has the most experience and interest in anxiety-based conditions such as OCD, selective mutism, phobias and social anxiety.
Sanchez says there are several signs of anxiety in kids and teens, things like trouble sleeping, headaches and avoiding activities. “Your easygoing kid might turn into a more moody and irritable kid. They might start complaining about not wanting to go to school. They might be complaining of stomachaches,” she says. Some children have tantrums or behavior problems; some seek reassurance by asking questions. “I call it the ‘what-if train,’ like, ‘Mommy, what if you go out and then you don’t come home?’ The other day a kid asked, ‘What’s cancer?’ ”
Growing up in New Jersey, Sanchez was “more of an introverted child, so I did a lot of watching and observing rather than a lot of talking.” Her parents were social workers. “They’re first-generation immigrants and they really wanted to divert me towards…being a ‘real’ doctor, a lawyer, that sort of thing,” she says. At Tufts University, she was most interested in psychology, so she majored in that and Spanish. She attended the University of Maryland for a Ph.D. in clinical psychology, which included training at Children’s National hospital in D.C. She spent almost nine years at Alvord, Baker & Associates, a psychotherapy practice in Rockville, before starting her own practice in 2017.
Sanchez, who lives in Silver Spring with her husband and 4-year-old son, manages her own stress by prioritizing sleep, exercising twice a week and practicing mindfulness meditation through apps on her phone. One thing she recommends for all of her clients? Find time in the day to do nothing. “We’re in a world full of distractions,” she says. “When’s the last time you’ve waited for an elevator, or you’ve waited on line at Starbucks, and just not done anything and just been aware of your surroundings and just lived in the moment?”
In Her Own Words…
“We should have anxiety. Our brain is wired for that for a reason. It has a protective function. When does it become a problem? When your alarm bells are going off and there’s no good reason for it, when it gets in the way of daily functioning, when it gets in the way of sleep, mood, if you’re avoiding things. It’s OK if you avoid bungee jumping—no one’s saying you need to go bungee jumping. But if you’re avoiding trying a new activity, like, I think doing ice hockey would be fun, but I’m too scared—I don’t think the other kids are going to like me. Or you’re avoiding taking on a new position at work or taking on a new challenge—that’s a problem.”
“One of the biggest red flags is when a parent calls and they’re like, ‘Oh my gosh, Dr. Sanchez, we really need to see you—our son or daughter is having all these problems.’ I’ll say, ‘Great, you know what? I just had an opening at 4:30 on Wednesdays.’ ‘Oh, but the only time we can do it is gonna be Mondays at 6 p.m.’ That happens all the time. What does that tell us? You can’t find the time to schedule therapy for your kid about how to help them relax? OK, big picture, what’s that all about?”
“One of the biggest tools that you have is to reflect on your own behavior. If you have a kid who has very poor frustration tolerance, the first thing that you might think about doing is to reflect on your reactions when you have obstacles. I had a parent who told me that they were in the car using Waze. They missed a turn or something. They started kind of yelling, and then the kid started getting panicked. It’s like, well, let’s think about that, what message does that send?”
“With my 4-year-old, I have a book about feelings. It’s a picture book, and it literally just has one word per page: ‘frustrated’ or ‘proud.’ We talk about, ‘What does that person look like? Oh, he looks mad. Look at that big frown on his face. I think he’s mad because…’ He can tell me, ‘I’m mad because you’re being mean.’ I think kids need to learn to identify that, and to be able to share that. We talk about how to deal with [the emotion] when it happens. If you’re mad, it’s still not OK to hit or have tantrums, but it is OK to stomp your feet or ask for help.”
“It’s really hard to sell the idea that you don’t need to get straight A’s. One of the things that I do is: ‘We’re going to practice doing things where you look a little foolish, where you’re going to make mistakes. You’re going to turn in a homework assignment a day late.’ Or, ‘You’re going to set a timer for the realistic time frame to study for a test, and we’re just going to go with that.’ They’ll say, ‘I can’t do that. That’s my AP physics class.’ My rule is, then you’ve got to give me something you could say yes to. If you want things to change, then something has to change, right? You have to take this risk.”