At the recent MHA-FC (Mental Health America-Franklin County) conference, speakers Amy Przeworski, PhD of Case Western Reserve University –Department of Psychology, and Rebecca Hazen, PhD Case Western Reserve University Department of Pediatrics and Rainbow Babies and Children’s Hospitals University Hospitals presented ‘evidence-based interventions for anxiety spectrum disorders in children and adolescents’. Simply put, ‘Dr. Amy’ explained the difference between anxiety disorders versus typical anxiety and gave some definitions. ‘Anxiety disorders are irrational fears or worries that cause significant distress and/or avoidance and interfere in the person’s life. For instance 10-20% of school age children have anxiety disorder symptoms which can be associated with school difficulties, low self-esteem, social isolation, peer problems and family difficulties.’
Dr. Przeworski identified the types of anxiety disorders: obsessive compulsive disorder (OCD), social anxiety disorder, selective mutism (not talking though one can), separation anxiety disorder, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), panic disorder, and specific phobia. Symptoms might include refusing to go to school, avoidance of specific situations, physical complaints like stomach aches, and shyness with friends- any fears which might interfere with normal functioning and/or at a point of growth which isn’t typical. Social anxiety might include fear of taking tests, performing in front of others etc. PTSD might involve ‘recurrent or intrusive recollections’ of a distressing event which provoke ‘intense fear, helplessness or horror’. About 25% of kids have experienced a trauma by age 16 according to one study, and the type of trauma affects not only likelihood but severity of response.
In last night’s news there was an example of a pro golfer who experienced a serious panic attack, even though he was making winning shots. His response mimicked that of a heart attack- sweating, short of breath, tightness in his chest, racing pulse. It is estimated that 40-60% of adolescents have had at least 1 panic attack. Roughly ¾ of kids with a specific phobia also have another anxiety disorder-such as separation anxiety and just under 1/3, a depressive disorder. Dr. Przeworski also reported that anxiety disorders run in families. She outlined risk factors, genetics, conditioning, and temperament. One little boy didn’t talk though he could; his parents thought it was cute, as his grandfather paraded him around the office in a suit. Later, he admitted he was just afraid to say something wrong and screw up. He also suffered claustrophobia and a panic disorder in certain situations which began to manifest as a teen.
Cognitive behavioral therapy CBT (one of the tools Pomegranate Health Systems uses), and specific techniques like exposure therapy are effective in treating anxiety disorders. Modeling and relaxation techniques are helpful. There are common cognitive distortions which can be corrected with cognitive restructuring. (A few examples are: all or nothing thinking, jumping to conclusions, labeling, or personalization). It is not ‘all about me’; ‘always about me’.
In the afternoon, Dr. Hazen discussed the impact of anxiety on daily activities such as sleep problems (‘Eighty eight percent of children with anxiety disorder experience one or more sleep problems like insomnia, nightmares, anxiety about sleeping alone.’) Physiological problems associated with anxiety disorders can extend to eating disorders-avoidance of foods, fear of the dark, bed-wetting or other toileting issues. Parents and school personnel should ‘openly communicate their observations’ and ‘consider an anxiety assessment’. Healing is possible and one can live a healthy, production life with the tools in place to control debilitating anxiety.
[Photo credit: seriously thinking by Nikhil Gangavane/Dreamstime.com 2838166]