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 Neela Sakaria: Please tell us a little bit about your professional background. Tell us about your previous experience writing as well.
David Marks: My professional background is varied, and fairly unique, for a physician. I graduated from the Yale University School of Medicine and am board certified in internal medicine. After my residency, I did a fellowship in allergy and clinical immunology at Massachusetts General Hospital/Harvard medical school. However, I have always been interested in studying and treating people with headaches and other stress-related illnesses. So when an opportunity arose for me to become medical director of the New England Center for Headache in Stamford, CT, I jumped at it. While at the Headache Center, I received a graduate degree in public administration (MPA), with an emphasis on health services management, from New York University. I assumed that taking care of headache patients and helping to run a headache center would be my permanent career. Boy was I wrong.
Five years ago, I was approached by a television agent who asked me if I was interested in becoming a television medical reporter. The idea of reaching thousands, indeed millions, of patients at a time intrigued me. One thing led to another and eventually I landed a job with NBC news as a medical reporter. However, I have found that what I love most about journalism is writing stories. That eventually led me to another career as a writer. My first book, "The Headache Prevention Cookbook: Eating Right to Prevent Migraines and Other Headaches (Houghton Mifflin), was published in 2000. My new book, "Raising Stable Kids in an Unstable World: A Physician's Guide to Dealing with Childhood Stress (HCI)" has just been released.
So basically, my professional life is never boring. I enjoy the mix of patient care, television journalism, writing, and other media endeavors. I didn't go to medical school planning this career path, but I love what I do!
Neela: Why do you feel that your book RAISING STABLE KIDS IN AN UNSTABLE WORLD is important for today's parents and children? What inspired you to write this book?
DM: It's estimated that one-third of American children suffer from a stress-related illness. One-third! That's a startling statistic and one I first became familiar with at the Headache Center. I saw many children come in with headaches and other ailments that had no apparent physical cause. When I investigated these cases further, I found that these children were under tremendous amounts of stress. Some of the stress was caused by the pressures of growing up in a violent, competitive, materialistic society. However, some of the stress was caused, inadvertently, by parental pressure and unrealistic expectations.
I began to look at my own family - I have three young children - and my friends' families, and realized that most of us are caught up in life's rat race - and our kids often pay the price, in both physical and psychological
illness.
I think this book is important for parents because we often don't recognize when our kids are under stress. If chronic stress goes undetected, it has long term consequences on our kids' health.
Neela: What are some of the common causes of stress in children today?
DM: One day, a couple years back, my then three-year-old daughter, Rebecca, started singing, "Oops, I did it again. I played with your heart..." She didn't know the rest of the lyrics to the song, but images of her wearing a belly shirt and dancing seductively, like Britney Spears, immediately ran through my mind. I was horrified. Spears sings, "I'm not that innocent," but I'd like Rebecca (and my other children) to be innocent for as long as possible.
I break the common causes of stress into two categories. I call them "The World Around Us," and "The World Within."
Rebecca was influenced by "The World Around Us." The pressure on children to grow up too soon is incredibly dangerous. There are so many sources of stress in a modern society. They include the threat of violence (especially important since 9/11); violence in the media; sex, drugs and rock&roll; pressure to be thin and beautiful; school pressure; raging hormones; social pressure, etc.
Home should be a place where children can find safety and insulation from the stress that surrounds them. Unfortunately, we parents often unwittingly create stress in "The World Within." We do it with the best of intentions. Most of us merely want the best for our children; we want them to have all the opportunities that we never had when we were growing up. To that end, we pack their schedules with play dates, after-school activities, athletic practices, academic lessons, classes, and any other activity we think might help them to stand out among their peers. We start angling for them to be admitted to the best colleges before they are even in high school; we treat their athletic activities as if they are win-at-all-costs death matches instead of childhood games.
We have stopped letting kids be kids. When we try to create mini-adults, however, we create adult-sized problems. Developing minds and bodies break down. And all of this occurs despite our best intentions.
Neela: You talk about SOS's -- can you explain what they are for our readers?
DM: My mother once told me that my younger brother would always be her "baby." He's thirty-seven years old. Although he probably wouldn't appreciate it, I understand where she's coming from. Still, if my brother suddenly forgot his toilet training, even Mom would agree that her "baby" has a problem.
That example may be an exaggeration, but it demonstrates an important point. You have to consider your childıs age when you try to decide if he or she is stressed out. It's normal for a three-year-old to throw a crying, foot-stomping tantrum (as long as they don't do it regularly). However, they don't usually malinger, that is, they don't usually make up physical symptoms like headaches or stomachaches. On the other hand, if your ten-year-old is still throwing tantrums, it may be a sign of stress. (And of course, if your thirty-seven-year-old needs diapers, get him to the doctor right away!)
You can usually tell if your child is under chronic stress by looking for what I call "S-O-S's" - or signs of stress. Children of different ages have different S-O-S's. The book goes into detail about what to look for, but here are some examples of common S-O-S's: headaches, belly pain, frequent colds or other illnesses, clinginess, social withdrawal, aggressive behavior, nervous habits, insomnia, lack of emotions, and nightmares.
Neela: What are a few key things that parents can do to help their children deal with stress?
DM: You can write an entire book about what parents can do to help their children deal with stress. Oh, yeah, I did!
Kidding aside, the proper treatment of stress can turn a physically or psychologically debilitated child into a normal, happy, well-adjusted kid. I have seen it happen with my own eyes. No single technique is right for every child. That is a decision that must be made by both doctors and parents. Fortunately, there are a lot of options available: better communication, art therapy, exercise, a healthy diet, deep breathing techniques, visualization, meditation and relaxation techniques, biofeedback, improved sleeping habits, role-playing, and psychological counseling.
We also have to remember that children emulate us. They watch the way we live our own lives and they try to do the same. If we want our kids to de-stress, we should do it, too. It's not enough to "talk the talk." You have to "walk the walk." That's why I also suggest doing things like setting aside one day on the weekend that the family spends together, and eating dinner together as often as possible. It's a way for everyone in the family to take a break from their hectic lives, talk to each other, and create a safe haven in the middle of the chaotic world that surrounds us.
Neela: It could be considered surprising that you as a physician, rather than as a psychologist, wrote a book on stress. Can you tell us about the mind/body connection and why dealing with stress is important for one's physical health?
DM: The more we know about medicine, the more we realize that we can't separate that mind from the body. The two are connected; they affect each other. So it's not surprising that a physician would write a book about the ravages of stress.
Research has shown that our body responds to stress in the same manner as an allergy. The more we're exposed to stress, the more sensitized, or sensitive, to stress we become. After a while, even small amounts of stress can result in large physical changes. Other research has shown a link between stress and diabetes, memory, immune function, cancer, heart disease, high blood pressure, asthma, stomach ulcers, etc. One report even says that stress can lead to anatomical changes in the brain that may affect a person's mental health.
Not all stress is bad. Our bodies are designed to deal with short term stress. In fact, it may be beneficial. I remember having butterflies in my stomach before most of my high school basketball games. As soon as the game started, the butterflies would go away and I was prepared to play. When I wasn't nervous before a game, I usually didn't perform as well. I needed the adrenaline boost to be at my best.
We - and our kids - run into problems when stress is chronic. Our bodies aren't equipped to handle the constant release of stress chemicals into the brain and bloodstream. We eventually break down, physically and/or mentally.
Neela: Do you think that physicians often overlook stress as a cause for many chidren's mysterious aches and pains? What can be done about that?
DM: Many of the kids I saw at the Headache Center had seen 2, 3, 4, even 10 other doctors before they got to my office. They had been poked, prodded, bled, scanned, and medicated for their headaches - all to no avail. The kids continued to suffer because their doctors overlooked the true cause of the symptoms - stress.
More and more doctors are recognizing the impact of stress on their patients' physical health. However, dealing with a person's stress takes time. That's a commodity physician's usually don't have thanks to the pressures of practicing in an age of managed care and HMOs. So it's important that parents take control of their child's health care. We have to do our best to determine if our children are stressed, why they're stressed, and what we can do about it. Once we recognize the problem, it will be much easier for the doctor to help with advice, support, and treatment.
Neela: What kind of a response have you gotten from readers/critics?
DM: Thankfully, I have had a fantastic response to the book. A number of psychologists and teachers have told me they wish all their parents would read it. And many parents have told me that the book helped them recognize that their own children were showing signs of stress. These parents said the book made them think twice before scheduling their kids for yet another activity, and helped them understand that each kid develops according to his or her own timetable. No amount of parental pressure can force a child to grow up before he's ready. Nor should it. These parents also say the tips I give in the book have helped them to help their kids -- without medications.
Interestingly enough, almost everyone I have spoken to loved my chapter about the mind-body connection, understood that there was a connection, and saw it in their own lives. Yet a lot of them didn't realize that kids were affected in the same way. Some said my book was a wake-up call about the importance of the mind-body connection.
Finally, I have had countless parents tell me stories of children who have been traumatized by the events of September 11th. These people have responded enthusiastically to the portion of the book in which I give advice on how to recognize post traumatic stress, how to deal with it, how much to tell their kids, etc.
Neela: Are you working on any future projects?
DM: My motto is, "Writers write." Thus, I am always working on one project or another. Right now, I am just beginning 2 books. For the first book, I am collecting uplifting, inspirational, humorous, or heart-warming stories by or about people dealing with illness. Everyone has an interesting or offbeat story about being a patient, caring for a patient, having a special doctor, etc. I hope these stories will help other sick people, whether they make them smile or cry. If anyone has a story that might be appropriate, they can contact me through my website: www.drdavidmarks.com.
I can't talk much about the other book I'm working on except that it's an investigational story about a healthcare company gone bad.
Lastly, like any writer, I have a big, fat, unfinished novel in my desk drawer. I hope that one day I will find the time to actually complete it.
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