Transcript A Look At Anxiety and Depression - Inclusive Special Education Wiki

By: Mark Neves
Nicole Elias
Rochelle Reynolds
(#6724026)
(#6504111)
(#6723665)
We are seeing more and more youth that are
being diagnosed with or exhibiting signs of
depression and anxiety. As the youth spend
much of their day in school, it is essential
that teachers and other staff learn to
recognize the characteristics and treatment
options in order to help them.
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Genetics
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Life Events
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Personality (worriers and perfectionists are
especially prone)
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Hormones
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Chemical imbalances
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Depression is a persistent sadness or loss of
interest in activities for more than 2 weeks in
absence of external precipitants. It requires a
distinct change in mood accompanied by
several physiological changes (R.H. Belmaker,
M.D., and Galila Agam, Ph.D-New England
Journal of Medicine)
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is not depression in the
deepest sense of the word. It is
like a sky that is always filled with
gray clouds. The child may not
feel deeply depressed but they
may not feel good either.
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is a reaction as a direct result
to an event that occurs in one's
life. This is often due to a loss of
some kind (like a death). We
commonly know this as grief and
it is a normal form of reactive
depression.
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This occurs when the person enjoys normal
moods some of the time. During times of
depression though, the person may appear
manic. During the manic phase, they typically
will exhibit:
-increased energy
-aggressive responses
-decreased need for sleep
-increased risk-taking
-feelings of mood elevation
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This is the most common form of
depression. This occurs when the
child feels low but has no actual
stressor in his or her environment.
They have normal moods much of the
time but end up having a number of
depressive episodes during their life.
There isn’t necessarily one specific
trigger.
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Seasonal Affective Disorder (SAD)-This
is the scientific term for what is
frequently known as the “winter
blahs.” A despair will set in with the
disappearance of the shortened
daylight hours and will persist as long
as the cold winter and lack of sun
remain present. As spring returns
though, many children will feel their
energy return.
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Stomach or body aches
Tense face
Trembling
Sweating
Nausea
Difficulty sleeping
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Always sees the bad or negative side of
things
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“All or Nothing” type of thinking
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Difficulty concentrating
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May think of hurting themselves
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Sad
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Irritable or grumpy
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Feels hopeless or worthless
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Loss of interest in things they once enjoyed
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Trouble with family and friends
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Drop in grades or work ethic
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Avoid people
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Lack of energy
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Only medical doctors can diagnose
depression.
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The most common resources would be counseling
through school or a health professional (family
doctor, psychiatrist etc) and medication (antidepressants).
For mild depression in adolescents, the answer does
not lie in medication. Research has shown that while
they may be helpful in adults, they are not as
effective with young people. Medications need to be
used with other treatments and strategies.
For those with major depression, cognitive
behavioural therapy (CBT) may be used. CBT is a
talking therapy that teaches new skills for thinking
and acting more effectively.
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Encourage the student to participate in class
activities but understand they have low energy
student should be reassured that the teacher is
there to help when needed
education priorities should ensure the child does
not fall behind in academics to protect self-esteem
avoid punitive approaches
Incorporate exercise into the day
focus on specific strengths (“I like the colors you
have chosen for the flowers.” instead of “You are a
great artist.”)
Refer to student support services
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Have fun with the child!
Encourage exercise and physical activity
Don’t tell the child to “snap out of it”
Be positive and use non-punitive discipline
Don’t compare the child to his or her siblings
Don’t overprotect and overdirect
Learn as much as possible about this
condition
Communicate well with the school
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Watch for signs (crying, negative comments,
loss of interest)
Listen and reassure (do not judge or tell them
they shouldn’t feel that way)
Help them get help (see a counselor)
Common Misconceptions
Regarding Depression
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Myth: Depression is not a real medical illness.
Clinical depression is a serious medical condition that affects not only an
individual’s mood and thoughts, but also the individual’s body. Research has
shown that depression has genetic and biological causes. Individuals coping with
depression have a higher level of stress hormones present in their bodies, and the
brain scans of depression patients show decreased activity in some areas of the
brain.
Myth: Even if depression is a medical illness, there’s nothing that can be done
about it.
Fact: Depression is treatable, and more than 80 percent of individuals with
depressive disorders improve with treatment. As new medications and treatments
are discovered, the number should continue to rise.
The first step to finding effective treatment is to get a physical examination by a
doctor to rule out other causes for your symptoms, such as thyroid problems.
Once you’ve been diagnosed with depression, you and your doctor will decide on
a course of treatment, which will include medication, psychotherapy or a
combination of both.
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Myth: Depression will go away by itself.
Fact: For extremely fortunate individuals, depression may go away by
itself. But for the rest of us, depression can hang on for months, years or
indefinitely. Depression can go away on its own, only to return in the
future; once an individual has one episode of depression, they are
predisposed to have more. Clinical depression is a potentially fatal
disease – and suicide could be the end result of waiting for it to go away
without any help.
Myth: Depression is a normal part of getting older.
Fact: Depression is not a normal part of aging, but seniors do generally
experience more of the events that can trigger depression: loss of family
and friends, ill health, isolation and financial worries. Furthermore,
people over the age of 60 grew up in an era in which mental illness was
not discussed, and they may feel more shame about asking for help than
someone from a subsequent generation.
The highest rate of suicide of any age group occurs in that of people 65
and older, with men being more vulnerable than women. It’s imperative
that seniors with depression seek help.
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Myth: Depression only affects women.
Fact: Although women report being affected by depression twice
as much as men, depression certainly affects men as well. Often,
clinical depression is underreported in men, particularly in
cultures that discourage them from asking for help or showing
any weakness. Furthermore, men have a higher rate of successful
suicide attempts than women, so it is crucial that men seek help
for their symptoms.
Myth: Depression does not affect children or teenagers — their
problems are just a part of growing up.
Fact: We’d like to believe that all children experience a happy,
carefree childhood, but that’s simply not the case. According to
the National Institute of Mental Health, studies show that 1 in 33
children and 1 in 8 adolescents are depressed in any given year.
Children are not as practiced at articulating their feelings as
adults, so adults must take the initiative to look for and notice
symptoms of depression in children.
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http://www.depressioncenter.net/wbdat/defa
ult.aspx
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It is clinically significant distress and impairment
in functionning. It is related to the « fight or
flight » response
Anxiety is a normal emotion and we all have it.
Distress and dysfunction are the two major signs
that indicate a person has cross over from
normal anxiety to clinical anxiety. The third is
inflexibility (that is, reacting in a maladaptive way
to anxiety-provoking situations).
This is excessive anxiety and worry that occurs
more days than not for a period of six months.
The anxiety is focused on a number of different
events or activities. Three of the following
symptoms must occur:
-Restlessness or edginess
-Tiring Easily
-Difficulty Concentrating or the mind going blank
-Irritability
-Muscle Tension
-Insomnia
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A marked fear in social situations. There is
some similarity to shyness but these
symptoms are much more extreme and
disabling
This is a type of anxiety that usually starts in
early adolescense
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This type of anxiety is closely related to social
anxiety. Performance anxiety involves having
to do something. An example would be
having to write an answer on the board.
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Performance
Speaking in front of
the class
Volunteering answers
Getting called upon
Making a mistake
Getting in trouble
Not knowing what to
do
Asking for help
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Social
Fear of humiliation
Fear of separation to
those who are familiar
Picking a partner or
group work
Going out at recess
and lunch
Phys. Ed class
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The presence of uncontrollable obsessions or
compulsions. These are recurrent thoughts
that are intrusive and provoke distress.
Compulsions are repetitive behavioural or
mental acts that a person feels driven to
perform. These compulsions are aimed at
preventing or reducing distress (even though
there may be no actual connection between
the action and the feared situation). *As
many as 1% of youth may have this disorder
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Trichotillomania-Feeling the need to pull out
one’s hair, leading to noticeable hair loss
Body Dysmorphic Disorder-Becoming
consumed by an imaginary defect in one’s
appearance that it causes significant distress
Anorexia Nervosa and Bulimia Nervosa
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This is the only anxiety disorder that requires
an event that precedes it. This is when a
person feels intense feelings of fear,
helplessness or horror (examples: witnessing
a murder, a car accident). It is viewed as a
physical danger to oneself. The person will
relive the trauma over and over through
flashbacks or nightmares.
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This disorder is found primarily in younger
children. It involves excessive anxiety about
being separated from the parent or home. As
many as 4% of children and young
adolescents may suffer from this disorder.
Incessant worry about harm coming to a
parent or about an event that involves
separation (like being kidnapped) occurs. In
extreme forms, these children may be afraid
of going to school.
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This occurs when the person experiences
spontaneous panic attacks. These are
sudden and intense waves of intense fears
and panic. There are physical symptoms
involving shortness of breath, choking
sensations, sweating and rapid heart rate. It
is essentially a fear of being in places or
situations from which escape might be
difficult or impossible. It tends to get worse
with age and develops into a full blown panic
disorder.
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An intense fear that is out of proportion to
any real threat and focused on a specific
object, activity, situation or animal
Panic attacks can occur but they have very
specific triggers
*Most people have one or two irrational fears
(airplanes, heights, dogs are some examples)
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Liebowitz Social Anxiety Scale Test
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Social Phobia Inventory (SPIN)
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Only medical doctors can diagnose anxiety
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Excessive worry
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Perfectionism
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Frequent questioning of situations
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Difficulty concentrating
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Overly sensitive to criticism
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Socially withdrawn
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Easily embarrassed
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Excessive worry about multiple topics
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Easily agitated
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Avoidance of evaluations
Reluctant to answer questions
Reluctance to join social situations (avoidance
and withdrawal)
Difficulty concentrating/remembering
Irritability
Disorganized
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Weight loss
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Change in eating habits
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Difficulty sleeping
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Stomach aches or headaches
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Cries often
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Excessively reassuring the child
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Being too directive
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Permitting or encouraging avoidance
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Becoming impatient with the child
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Prevent avoidance
Communicate your empathy effectively
Prompt the child to cope constructively
Model brave, non-anxious behaviour
Provide consistent discipline
Symbolic play
Teach self-talk
Develop a list of strategies to use when
unpleasant feelings/thoughts arise
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Pay attention to your child’s feelings.
Stay calm when your child becomes anxious about a
situation or event.
Maintain a healthy lifestyle and encourage exercise
Reward brave behaviour
Don’t permit avoidance
Recognize and praise small accomplishments.
Don’t punish mistakes or lack of progress.
Be flexible and try to maintain a normal routine.
Modify expectations during stressful periods.
Plan for transitions
Communicate well with the school
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Keep an anxiety log
Incorporate exercise into the day
Prevent avoidance
Music therapy
Visual imagery
Circle breathing
Allow for open-ended assignments and choices
Chunk work
Have the student set realistic goals
Provide a lot of structure and predictability
Model mistake-making
Plan for Transitions
Be flexible-allow for re-do’s and re-write’s
Provide fidget tools (such as a squeeze ball)
Incorporate self-reflection activities (journaling, poetry, etc)
Try the “5 Point Scale”
Teach the student that drugs/alcohol will not help the problem
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Watch for signs (overly jumpy or worried,
panic attacks, avoids situations)
Listen and reassure (do not judge, tell them
they may have anxiety)
Help them to get help (counseling)
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Myth: Panic Attacks are deadly.
No. It may seem like that for someone having an attack but
it's just the body's natural defensive reaction to (an
exaggerated) perception of threat or danger. Being a natural
body response, these attacks cannot kill.
Myth: A Panic Anxiety Attack can happen to anyone, at
anytime, anywhere.
True. However, those suffering from some other forms of
Anxiety Disorder (e.g. General Anxiety Disorder or GAD) are
at a bigger risk of having one. Cumulative stress, heavy
emotional disturbance, major life changes and negative
thinking can all cause panic attacks.
Myth : A Panic Anxiety Attack is not really an illness"
Fact: The National Institute of Mental Health begs to differ.
Panic disorder is a real and serious illness, afflicting 6.8
million Americans today. If left untreated, this can seriously
debilitate and affect someone's life.
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Myth: If your parents and grandparents had Panic Disorder, you will too.
Fact Genetics has been linked to causing panic disorders that can span
generations. However, this is just one of its many known causes and is not
the sole basis for diagnosing this disorder.
Myth: In real sense, anxiety disorders are not true illnesses or diseases.
Fact: Just like diabetes, anxiety disorders are true, severe medical conditions
that may have emerged from various reasons and factors like your genes,
upsetting events and even ones that makeup your brain.
Myth: Anxiety disorder is only of one type.
Fact: There are indeed many types of anxiety disorders: generalized anxiety
disorder, social anxiety disorder, obsessive-compulsive disorder, and panic
disorder.
Myth: Men and women are affected by all types of anxiety disorders equally.
Fact: Women are normally twice as likely to be affected as men for four out
of the many anxiety disorders: post-traumatic stress disorder generalized
anxiety disorder, obsessive-compulsive disorder, and panic disorder.
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http://cl1.psychtests.com/bin/transfer?req=
NDF8Mjk3OXwxMjE3NzE1fDB8MQ==&refemp
t=
http://www.socialanxietysupport.com/disord
er/liebowitz/
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Depression and anxiety often co-exist together
Anxiety is the most common mental disorder
Up to 5% of children and adolescents have an
anxiety disorder on any given day.
Girls are more likely than boys to have an anxiety
disorder (the hormone Estrogen in females may
play a role in how it interacts with serotonin).
Anxiety can also co-exist Substance Abuse and
Tic Disorders
If anxiety is caught before the age of 12, it
becomes highly treatable!
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There is a high correlation between
aggressive destructive behaviours in
preschool years with anxiety disorders.
(Tyson, 2005).
It was also determined that children with
anxiety issues may have grown up with
chronic stress, disturbed attachment and
maladaptive parent-child interactions in their
environment as young children.
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2% of children experience clinical depression
but 3-5% of adolescents will experience it
Depression is higher in females of all ages
If anxiety is caught before the age of 12, it
becomes highly treatable!
Depression occurs in persons of all genders,
ages, and backgrounds
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Only 25% of children and adolescents have
depression alone. 75% have at least one
other (co-morbid) condition. This could
include:
-ADHD
-Conduct Disorder
-Learning Disabilities
-Delinquincy
-Anxiety Disorders
-Eating Disorders
-Substance Abuse
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School refusal
Social isolation
Depression
Substance abuse
Physical illness (such as irritable bowel
syndrome, pneumonia, thyroid disorders)
Basically, a person who continues to live with
anxiety will have a diminished quality of life.
**Besides not living one’s life to its
fullest potential, the greatest
danger is suicide**
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Paul Foxman is currently one of the leading world
experts on anxiety. Good professional books are
The Worried Child and Dancing with Fear.
Stories for Youth:
David and the Worry Beast: Helping Children Cope
with Anxiety By: Anne Marie Guancy
When My Worries Get Too Big: A Relaxation Book for
Children Who Live with Anxiety By: Kari D. Buron
Anxiety:
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http://www.worrywisekids.org/
http://www.adaa.org
http://www.anxietycanada.ca
http://www.adam.mb.ca/helpful.asp
http://www.socialanxietysupport.com/disord
er/liebowitz/
Depression:
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http://www.depression.mb.ca/
http://www.afm.mb.ca/
http://www.manitoba.cmha.ca/bins/site2.asp
?cid=284-683&lang=1
http://www.cmhawpg.mb.ca/
http://www.mentalhealthworks.ca/
http://www.depressioncentre.net/
Websites:
http://www.anxietybc.com/
http://www.who.int/en/
http://www.worrywisekids.org/
http://www.adaa.org
http://www.anxietycanada.ca
http://www.adam.mb.ca/helpful.asp
http://www.socialanxietysupport.com/disorder/liebowitz/
http://www.depression.mb.ca/
http://www.afm.mb.ca/
http://www.manitoba.cmha.ca/bins/site2.asp?cid=284-683&lang=1
http://www.cmhawpg.mb.ca/
http://www.mentalhealthworks.ca/
http://www.depressioncentre.net/
http://www.healthcentral.com/depression/just-diagnosed-822-143.html
http://www.medicinenet.com/script/main/art.asp?articlekey=22653
http://myanxietyattacks.com/anxiety-disorders/anxiety-disorders-facts-myths
Books:
Carlson, Trudy (1998). Depression in the Young-What We
Can Do To Help Them. Duluth: Benline Press
Foa, Edna B. & Wasmer Andrews, Linda (2006). If Your
Adolescent Has An Anxiety Disorder. New York: Oxford
University Press.
Foxman, Paul (2004). The Worried Child. Almeda: Hunter
House.
Randall, Kaye & Strom, Donna & Bowman, Susan (2007).
102 Creative Strategies for Working With Depressed
Children and Adolescents. Youth Light Inc: Chapin.