Transcript St. Vincent`s Anxiety Presentation

Creekside Middle School
Parent Presentation
Presenter: Laura Guzzi, LCSW
St. Vincent Carmel Medical Social Work
What is Anxiety?
 Anxiety is normal. Everyone experiences anxiety at some point in time. For
example, it is normal to feel anxious when on a rollercoaster or before an exam.
Young children can experience stranger anxiety and older children often get
nervous performing in front of their peers.
 Anxiety is not dangerous. Although anxiety feels uncomfortable, it is
temporary, and will eventually decrease.
 Anxiety is adaptive. Anxiety helps us prepare for real danger, such as crossing a
busy street. It can also help us perform at our best, and motivate us to study for
an exam or practice for a big game. When we experience anxiety, it triggers our
"fight-flight-freeze" response, and prepares our body to react. For instance, our
heart beats faster to pump blood to our muscles, so we have the energy to run
away or fight off danger. Without it, we would not survive.
How is anxiety triggered?
 The amygdala is an almond-shaped structure deep in the brain that is believed to be a
communications hub between the parts of the brain that process incoming sensory
signals and the parts that interpret these signals.
 It can alert the rest of the brain that a threat is present and trigger a fear or anxiety
response.
 When the amygdala is stressed, information is not transferred. Information is then
processed directly by the amygdala itself which in turn triggers our fight or flight
response. When information is not transferred to the prefrontal cortex, there is not an
opportunity to make good decisions for ourselves…we just react.
 Research has shown that our flight or fight response is equally triggered by events that
vary greatly in significance. For example, missing a light in traffic and losing your
job both trigger the release of cortisol and other hormones.
Manifestations of Anxiety:
 Physically - Anxiety is felt in the body. Often, when young children feel
anxious, they do not actually recognize or describe it as anxiety or nervousness.
Instead, they may say that they feel sick, or have a stomachache. Teens may also
complain of similar symptoms as well as headaches, insomnia or nightmares.
 Mentally - Anxious children and teens worry! These worries can be about a
past or current situation or about some future event. Young children may not be
able to identify any anxious thoughts even when they are very anxious.
 Behaviorally - Some children become so anxious that they alter their behavior
to protect themselves from experiencing anxiety. For example, some children
have rituals they perform as a means of protecting themselves (hand washing) or
some may refuse to sleep over at another child’s house. Some may act out in
other ways as a means of avoiding an uncomfortable situation.
What Warrants a Closer Look?
Sometimes the behaviors of anxious children and teens can seem unreasonable to others. These
children and teens may be labeled as "difficult", "stubborn" or "too sensitive". Indeed, their
actions can be very frustrating for the entire family!
It is important to remember that an anxious child or teen who lashes out, cries, and avoids
situations is, in fact, responding instinctually to a perceived threat. Like an animal who is
frightened, your child is reacting by either fighting (e.g. yelling, tantrums), fleeing (e.g.
avoiding), and/or freezing (e.g. mind going blank).
Anxiety disorders last at least 6 months and can get worse if they are not treated. Each anxiety
disorder has different symptoms, but all the symptoms cluster around excessive, irrational fear
and dread.
Types of Anxiety Disorders:
Generalized Anxiety Disorder, OCD, Panic Disorder, PTSD, Social phobia or social anxiety
disorder
What do Middle-Schoolers worry about most often?
Several studies indicate that the top five worries for Middle School
Students include:
1. Having friends and being liked by peers
2. Fitting in, both in terms of physical appearance and social acceptance
3. Getting good grades and managing the demands of school
4. Fretting over being “a failure” or disappointing someone
5. Family issues including finances, relationships, etc.
At the Crossroads
Middle School Students are in a unique position:
•
At no other stage of development do students encounter so many
differences in themselves and others. Their physical appearances often
differ greatly in terms of height and weight.
•
Most want to belong to a peer group and at the same time individuate
from their parents.
•
In addition, the Middle School setting encourages students to live within
a more complicated and demanding system (as opposed to Elementary
School).
•
While there can be a heightened sense of anxiety, there are also
wonderful opportunities to experience a sense of mastery.
Talking with Kids about Anxiety:
Use the Smoke Alarm analogy to help kids understand what is going on in their
bodies:
“An alarm can help protect us when there is an actual fire, but sometimes a smoke
alarm is too sensitive and goes off when there isn’t really a fire (e.g. burning toast in
toaster).
Like a smoke alarm, anxiety is helpful when it works to help make us aware of true
dangers. But when it goes off when there is no real danger, then it is worth exploring
so we can fix it.”
What can you do as a parent to help your child
cope with anxiety?
1) Establish routines and structure
As parents, it is helpful to establish consistency in schedules and discipline. Anxious
children cope more effectively if they have an idea of what to expect. It is important for
them to have limits and consequences on behavior.
Be mindful of your children’s basic needs to prevent fatigue and hunger. Twelve step
programs encourage members to be aware of self-care by using the acronym HALT:
 H – hungry
 A – angry
 L – lonely
 T – tired
If your child is hungry, angry, lonely , or tired, he/she is not likely to handle stress well.
This is true for us as parents as well!
2) Help your child(ren) identify
feelings
and provide opportunities for them to
discuss feelings
By talking about their feelings, children are better
able to self-monitor when their anxiety might be
ramping up.
You might also ask, “In what part of your body
do you feel anxiety?” (Examples are: stomach,
chest, head)
One exercise that may help you get started:
High/Low
At the dinner table or in the evening when the
family has time to get together, have each family
member talk about a high point and low point of
his/her day. Other family members can ask
questions about how they felt, handled the
situation, etc.
3) Comfort Your Child:
Often as our children grow, we are often not as quick to cuddle with them as when they were
younger. There is a great deal of research that shows that the more often children are hugged or
touched, the better they manage challenging situations. Having a movie night on the couch
together or offering quick back or foot rub is a great way to help your child relax and may open a
door to communication that otherwise might not have occurred.
4) Model positive coping behaviors:
Children look to their parents for guidance, even when we are not aware they are watching us. It
is important that we take time to engage in relaxation activities ourselves and set a positive
example. Taking a minute to take a walk when feeling stressed and sharing how this has helped
you, helps your child understand how they could use this tool as well.
5) Monitor your child’s social group
Are they supportive of one another? Do they tear each other down? Helping your child
recognize patterns of interaction can be helpful as they continue to develop friendships with new
peers. Also, talking with children about social media and helping them better understand how
they are impacted by posts or tweets as well as how they can impact others can go a long way in
relieving some fears or anxieties.
6) Help your child identify helpful adults and/or friends in their peer group
and have a plan in place
It’s often helpful to let your child’s guidance counselor know that your child is struggling with
anxiety and the guidance counselor can talk to your child and get to know him/her. If your child
has more anxiety in certain social settings, maybe there is another parent or coach they can see if
things get difficult. Some schools utilize a “hot pass” that a child can show to the teacher which
automatically allows him/her to leave the room. This is helpful because it serves as an escape
strategy. Children’s anxiety is often heightened if they do not have a plan or they are fearful of
having a panic attack in front of their peers.
7) Encourage a healthy lifestyle
We know how beneficial it is for us to eat well and to exercise. This is especially
important for children. Too much sugar or caffeine can enhance feelings of anxiety.
Taking a few minutes to exercise everyday helps children better understand how moving
their bodies can help release anxious feelings.
8) Challenge unhelpful thoughts
Anxious children and adults often catastrophize, for example. Your child might think of
all the things that could go poorly during an important event. What if I blank out during
the test?, for example. It is helpful to encourage the child to stay in the present. Unhelpful
thoughts sometimes include absolutes, like always and never. “I always mess things up.”,
Challenge that by reminding your child of a time he or she did well.
Be a detective. Look for patterns. Have your child track when, where, and in what
situations they experience anxiety and what makes them feel good.
Tools for Kids – And Adults!
Relaxation

Deep Breathing (diaphragmatic or deep belly) Learning to become aware of your breath is a
powerful tool that can be used to interrupt negative thoughts. And it’s a tool that they
always have access to. When we are anxious or in pain, we often engage in shallow
breathing without even realizing it. We can use various breathing exercises to help
ourselves calm down more quickly…and we can use them without anyone else being aware
that we are doing so!

4-7-8 Breathing – Breathe in for a count of 4, hold your breath for a count of 7 and slowly
release your breath to a count of 8.

Progressive muscle relaxation

The Naming Game – Naming items you see in the room can often help distract anxious
thoughts.

Meditation – Loving Kindness Meditation

Aromatherapy – Oils like lavender and mandarin are great to help manage anxiety

Apps for teens– Breath2Relax and MindShift
The more often you practice these exercises, the more quickly your body recognizes what you
are doing and you can access a state of relaxation more quickly.
Journal
Journaling about daily events or stressors can help us better recognize patterns of coping that
may or may not be helpful. It can help us devise a plan of how we would like to react to specific
stressors. This is particularly helpful if you can encourage kids to keep a “Gratitude” Journal to
keep record of a few (3-5) things each day that they are grateful for. There are many ways to
journal that include writing, collage or photo journaling. There are many coloring books devoted
to mindfulness that can help too.
Listen to music, play an instrument
Music can be an incredible way to help us relax or re-energize, depending on the music we
choose to listen to. Playing an instrument can help us articulate things in a different way than we
can with words alone. And a kitchen dance party…always a good idea!
Practice positivity
We are wired to focus on the things occurring in our day that don’t go well. Research shows that
we need at least three positive statements to counteract every negative statement. Is there a way
you can model this or help your child to reframe the way he or she looks at things? Is there
something they can identify that went well in a situation? Learning to find the good in situations,
even if they don’t turn out as we anticipated is a great life long skill to learn.
Get some Fresh Air – Go Outside
Writer, Richard Louv, coined the term “nature deficit disorder” to describe the decline in the
amount time children now spend outdoors. He reasons that the increase in many of the
behavioral and mental health issues experienced by children could be attributed to the
diminished amount of time they spend outdoors. “Kids who do play outside are less likely to
get sick, to be stressed or become aggressive, and are more adaptable to life’s unpredictable
turns,” says Louv.
Take an Electronics Break
“The average young American now spends practically every minute — except for the time in school
– using a smartphone, computer, television or electronic device,” reports a 2010 Kaiser Family
Foundation study. Taking a break encourages children to get up and move their bodies, to get more
sleep or to spend time daydreaming.
As mentioned in the beginning, each of us struggles with some anxiety
each day. Teaching our children at a young age how to better manage daily
worries will be a huge benefit to them as they grow to become happy,
successful adults.