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Which will you be?
Take a minute to answer this question What is anxiety? What words do you use to describe anxiety?
Fear VS Anxiety Fear – an unpleasant emotion caused by the belief that someone or something is dangerous, likely to cause pain, or a threat. . https: //www. youtube. com/watch? v=AV 6 rh. Yss. CQM
Anxiety VS Stress is your body's way of responding to any kind of demand or threat. When you sense danger—whether it's real or imagined—the body's defenses kick into high gear in a rapid, automatic process known as the “fight-orflight” reaction or the "stress response. " https: //www. youtube. com/watch? v=S 8 -zfk 9_lhg
Anxiety – anxius [L, 1500 s], a condition of agitation and distress -- internal focus -- a response to a vague, distant or even unrecognized danger a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome
Anxiety Anxiety: - inevitable - response to everyday challenge - proportioned, *appropriate, *reasonable Anxiety is normal!
Some statistics At least 20% of children under age 18 have significant mental health problems. 75% of those don’t get help.
Too much anxiety is unhealthy. Often there is a family (genetic) tendency to anxiety Stress can be in family, school or neighborhood Anxious parents can model anxious behavior for children Children who live with too much stress can develop anxiety disorders
Dimensions of Anxiety: Symptoms in four arenas
Dimensions of Anxiety: Symptoms in four arenas Somatic - Hyperventilation - Tachycardia - trembling - palpitations - shakiness - swallowing - sweating - lump in throat - flushing - urgency to urinate -nausea - hair raising - dizziness - tinnitus - wobbling legs
Dimensions of Anxiety: Symptoms in four arenas Cognitive - Specific fears - Embarrassment or shame is intolerable - Something awful will happen - I am going crazy - I will lose control - I am going to die
Dimensions of Anxiety: Symptoms in four arenas Behavioral Withdrawal Avoidance Escape Clinging Aggression
Dimensions of Anxiety: Symptoms in four arenas Emotional - Tense - Nervous - Worried - On edge - Panicky - Feelings of unreality - Terrified - Hypervigilant - Scared - Depressed - Anxious
When to be concerned Avoidance of school (refuses to go) Frequent stomachaches or headaches in the morning before school Avoidance of activities Easily upset – distress out of proportion Parent or teacher reports they spent a lot of time comforting the child and/or urging her/him to participate in regular activities Parent or teacher reports family/classroom functioning is being disrupted by your child's fears and worries, or meltdowns. Intense worries or fears that interfere with daily activities
When to be concerned Sudden overwhelming fear for no reason, often with difficulty breathing and racing or pounding heart Decline in school performance Wanting to avoid school
Anxiety disorders are the most common mental health disorders. Up to 6% of children and youth have an anxiety disorder severe enough to need treatment. Children may have more than one kind of anxiety disorder. Many anxiety disorders start in childhood and if untreated, they may persist into adulthood.
Anxiety Disorders Anxiety Disorders: - intensity - duration - impairment
Types of Anxiety Separation anxiety Selective mutism Specific phobia Situational Anxiety Other Social Anxiety Panic Disorder Agoraphobia Generalized anxiety disorder Substance Induced Anxiety not due to medical condition Other specified anxiety disorders Unspecified anxiety disorder
Separation Anxiety Disorder Child is afraid of leaving their parent(s) They may worry that something bad will happen to the parent or to someone they love or to themselves May refuse to go to school May have stomachaches, headaches, or throw up if they fear separation May refuse to go to playdates at other people’s houses Diagnosed if it causes problems at school or socially and has been going on at least 4 weeks https: //www. youtube. com/watch? v=d. RFg. Sp. Jz-K 4
Generalized Anxiety Disorder Children with this kind of anxiety may: Have lots of worries and fears Have problems sleeping because of worries Have trouble concentrating Get tired easily or have tension headaches Be tense or restless Be perfectionist Have an anxious desire for approval https: //www. youtube. com/watch? v=SYfvt. Voo. PM 8
Panic Disorder Happens less often with younger children People with this kind of anxiety have panic attacks Feel very scared Heart pounding, hard to breathe May feel shaky, dizzy, or sick May feel like they are going crazy or something really awful is going to happen Sometimes they avoid school or want to stay in the house Frequent panic attacks = panic disorder https: //www. youtube. com/watch? v=j. JH 1 f. Sfq. BTs
Selective Mutism Children may not talk to anyone who is not close to them, such as immediate family They may look down, withdraw, turn red if required to talk Often they whisper if they do speak in a situation where they are anxious Up to 2% of school age children may have these symptoms Some kids outgrow it; some go on to have social phobia https: //www. youtube. com/watch? v=a. Ir. De. Bo. UGl. E
Social Anxiety/Social Phobia Happens more in teens than in young children Fear and worry about social situations Going to school Speaking in class Social events including recess and lunch Shy, self-conscious Easily embarrassed These kids tend to be sensitive to criticism and find it hard to be assertive https: //www. youtube. com/watch? v=yp. Hz. XOc. UQw. E
Assessment List and clarify all symptoms Look at history: family, drug use, mental health, medical health. Analysis of current lifestyle status: stress, nutrition, exercise, sleep, medications. List problem areas. Rule out physical and other psychiatric causes, getting medical results.
Assessment Medical Rule Outs Shortness of breath Heart Respiration Tachycardia Thyroid Hypoglycemia Dizziness Anemia, BPV, BP Numbness Circulatory respiratory Palpitations Chest pain Heart conditions Autoimmune CFS Fibromyalgia Epstein-Barr
Assessment cont’ – Drug Usage Rule Outs OTC Alcohol drugs Kindling Diet Neural Laxatives excitement during withdrawal Cocaine Other Caffeine aspartame Kindling Drug-induced pills panic stimulants Other medications Disulfiram Drugs to treat thyroid and endocrine
Treatment Anxiety disorders can be treated! The most common treatment is cognitive behavior therapy (CBT) in groups or individually In CBT children learn relaxation and stress management plus Gradual exposure to things that make them anxious, to decrease the fear Coping strategies to reduce anxiety
Treatment CBT is first choice, but medication may be needed in severe situations Teach relaxation strategies such as belly breathing and muscle relaxation Teach visualize or imagine a pleasant, relaxing “happy place”
Cycle of Anxiety
Treatment – Psychotherapy Subjective Rating Scales Use Explain concepts of SUDs Discuss the meaning of the ratings 0 – 10 No comparison to other people are ever involved, self-assessment tool No internal competition: observing only
Grounding! Look around you. Find 5 things you can see, 4 things you can touch, 2 things you can smell and 1 thing you can taste. This is called “grounding” It is helpful to do when you are anxious.
Daily Record of Breathing or Relaxation Time Assign- SUD – Duration ment Outset SUD – completion
Treatment – Medication Consideration Benzodiazepines: For panic, acute anxiety symptoms To enhance early tx Short term use e. g. 30 days Daily, regular use Rarely used PRN Antidepressants Misnamed Used for chronic anxiety and depressed moods Long term use Bolster with lifestyle changes and psychotherapy
Treatment – Medication Choices Benzodiazepine - Valium - Xanax - Librium - Ativan Effects: - Mood altering - Reduce anxiety sx - Addictive Sedative/ Hypnotic - Barbiturates Effects: - Insomnia relief - Addictive - Lethal OD Antidepressants - SSRI’s - MAOIs - Tri-cyclics Effects: - Not mood altering - Not addictive - have side effects