Anxiety in children

1. Anxiety in children Kolleen L. Simons, MSW, LCSW The Right Solution

2. Kolleen L. Simons • Owner, The Right Solution Counseling Service • 15+ years of experience • Experience working with children and adults • Specializing in depression and anxiety

3. About us… • The Right Solution Counseling • Located in Eureka • Work with children and adults • Tutoring services – ACT test prep • Teen group for High school Girls

4. What is Anxiety? • Some anxiety and worry is normal. • These normal amounts of anxiety can actually help you respond to threats and feel motivated to get things done. • An anxiety disorder can prevent your child from making friends, raising a hand in class, or participating in school or social activities. Feelings of being ashamed, afraid, and alone are not uncommon.

5. Anxiety in children • Anxiety is the most common type of childhood disorder with a prevalence rates ranging from 6%-20%. • Childhood anxiety: What is normal and what is not. Anxiety becomes a clinical disorder when: • 1) the child avoids age-appropriate activities, • 2) it interferes with developmentally appropriate functioning or challenges (playing with others or academic performance), • 3) it causes the child and/or family a considerable amount of distress, and/or • 4) when the child experiences impairing anxiety over a long period of time. Vidair & Rynn. (2010). Anxiety Disorders: Theory, research and clinical perspectives. New York: Cambridge University Press. Chapter 27: Childhood anxiety disorders: Best treatment options and practice.

6. Anxiety in Children • Research suggest approximately 5% to 18% of children suffer from an anxiety disorder. • In general, anxiety disorders can begin at any age. • Children will demonstrate their anxiety in a number of ways. • The younger a child, the less their ability to identify anxiety or fear. Behavioral expression is usually seen when a child feels fear and anxiety and cannot find relief. Saint Louis Behavioral Medicine Institute. (2012). Anxiety disorders in children and adolescents. Retrieved April 20, 2012 from, http://www.slbmi.com/anxiety_center/childhood_ anxiety_disorders.htm

7. Anxiety in Children • Generalized Anxiety Disorder (GAD) is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months. • If your child has generalized anxiety disorder, or GAD, he or she will worry excessively about a variety of things, which may include but are not limited to these issues: • Family problems • Relationships with peers • Natural disasters • Health • Grades • Performance in sports • Punctuality

8. Anxiety in Children • Children with GAD tend to be very hard on themselves and they strive for perfection. • These children may also seek constant approval or reassurance from others, even when they appear not to have any worries.

9. Anxiety • GAD affects about 6.8 million American adults,including twice as many women as men. The disorder develops gradually and can begin at any point in the life cycle, although the years of highest risk are between childhood and middle age.

10. Signs and Symptoms of Anxiety Emotional symptoms of anxiety • Feelings of apprehension or dread • Trouble concentrating • Feeling tense and jumpy • Anticipating the worst • Irritability • Restlessness • Watching for signs of danger • Feeling like your mind’s gone blank

11. Physical symptoms of Anxiety • Pounding heart • Sweating • Stomach upset or dizziness • Frequent urination or diarrhea • Shortness of breath • Tremors and twitches • Muscle tension • Headaches • Fatigue • Insomnia

12. Anxiety in School • An anxiety disorder can prevent your child from making friends, raising a hand in class, or participating in school or social activities. • Feelingsof being ashamed, afraid, and alone are not uncommon.

13. What is an Anxiety attack? • Surge of overwhelming panic • Feeling of losing control or going crazy • Heart palpitations or chest pain • Feeling like you’re going to pass out • Trouble breathing or choking sensation • Hyperventilation • Hot flashes or chills • Trembling or shaking • Nausea or stomach cramps • Feeling detached or unreal

14. What causes an anxiety attack? • Playing the ‘what if’ game – negative self talk which sets us up for failure • Poor self esteem – thinking not worthy • Too much pressure to be perfect • Focusing too much on self vs. others • Eating poorly – too much caffeine • Not exercising • Full exposure to phobias • Holding in feelings

15. Link between Anxiety and Depression • Anxiety and depression are believed to stem from the same biological vulnerability • Often go hand in hand • Depression can make anxiety worse (and vice/versa) • Important to recognize both conditions • When symptoms last for a short period of time, it may be a passing case of “the blues.” But if they last for more than two weeks and interfere with regular daily activities and family and school life, your child may have a depressive disorder. • Depression and anxiety disorders can often be treated the same way and at the same time.

16. Link between Anxiety and Depression Children with depression may display these symptoms: • Depressed or irritable mood • Difficulty sleeping or concentrating • Change in grades, getting into trouble at school, or refusing to go to school • Change in eating habits • Feeling angry or irritable • Mood swings • Feeling worthless or restless • Frequent sadness or crying • Withdrawing from friends and activities • Loss of energy • Low self-esteem • Thoughts of death or suicide Anxiety and Depression Association of America

17. What can you do to help your child Show your child how to be successful • Show your child how to successfully approach and cope with anxious situations. Model success. Understand that your child has a problem • Remember that your child is not being willfully naughty or difficult. They have a problem and need your help. Materials and Worksheets from Anxiety by Paul Stallard published by Routledge

18. Strategies - SUPPORT your child Patient approach • Don’t expect things to change quickly. Be patient and encourage your child to keep trying. Prompt new skills • Encourage and remind your child to practice and use their new skills.

19. Observe your child • Watch your child and highlight the positive or successful things they do. Reward and praise their efforts • Remember to praise and reward your child for using their new skills and for trying to face and overcome their problems.

20. Keep talking… Talk about it • Talking with your child shows them that you care and will help them feel supported • SUPPORT your child and help them to overcome their problems.

21. Cognitive Behavioral Therapy. • Cognitive Behavior Therapy (CBT) is based on the idea that how we feel and what we do are due to the way we think. • CBT is one of the most effective ways of helping children with anxiety problems, and looks at the link between the way we THINK, what we DO and how we FEEL. • CBT assumes that a lot of anxiety problems are related to the way we think. Because we can change the way we think, we can learn to control our anxious feelings. • Thinking in more positive ways can help us feel good. • Thinking in more negative ways may make us feel fearful, tense, sad, angry or uncomfortable.

22. Example about how to talk to your child… • What are thoughts? Thoughts are the ideas we have in our heads (what our brains tell us). Sometimes we say things to ourselves in our heads (not out loud), and these are also thoughts. For example, you might think, “I did a great job on my homework.” Can you think of some other thoughts?

23. Action • What are actions? Actions are the things we do with our bodies! • For example, we walk, dance, talk, draw, laugh, cry, etc. Can you name some other actions?

24. Feelings… • What are feelings? Feelings are the emotions and sensations we have in our bodies and hearts (you already know a lot about feelings!). • Feelings/matching game • How do you stop a bad thought? • See handout about stopping a bad song in your head

25. Writing down the thoughts/fears Imagine Your Negative Thoughts Are in a Cage In the space below, write your worst negative thought. Now draw a cage around this thought, and keep adding bars until you can’t read it anymore.

26. Therapy…. • Teaching practical techniques to reframe negative thinking • Work through the root of the mood disorder • Help understand the reasons that you feel a certain way, what are YOUR triggers

27. What about you? • Be a good healthy, role model for your child • What messages are you sending to your child • What if YOU have anxiety • Do you tell your child • Do you tell them about your treatment

28. The Right Solution Counseling Service • Accept all ages • Will accept insurance – offer sliding scale for those without For more information: RightSolutionCounseling.com 314-374-1620