Anxiety in Children & Adolescents 4/1/2019. Mental Health America of Eastern Missouri. Addressing Anxiety and Depression In Children.

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1 Addressing Anxiety and Depression In Children 1 Mental Health America of Eastern Missouri Our Mission To promote mental health and to improve the care and treatment of persons with mental illness through advocacy, education and service 2 Anxiety in Children & Adolescents 3 1

2 Fear vs. Anxiety FEAR Directed toward some concrete, external object or situation The event feared is in the range of possibilities (real & imminent) The focus is more external than internal Affects the whole body ANXIETY Can t specify what you are anxious about The focus is more internal than external It is in response to a vague, distant ( in the future), or unrecognized danger Affects the whole body 4 Fear vs. Anxiety: Anxiety Disorders are different from everyday disorders in that they: 1. Are more intense-panic attacks 2. Last longer-may persist for months, not going away when the stressor has passed 3. Lead to phobias that interfere with life functioning 5 Types of Anxiety Disorders Specific Phobia Social Phobia Panic Disorder Generalized Anxiety Disorder Agoraphobia 6 2

3 Fight or Flight Response Increases Blood Pressure Increase Heart Rate Increase Breathing Pupils dilate Cortisol, Norepinephrine, Epinephrine kick in to provide the energy to fight or flee 7 Panic Attack A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms develop abruptly and reach a peak within 10 minutes: Palpitations, pounding of the heart, or accelerated heart rate Sweating Trembling or shaking Sensations of shortness of breath or smothering Feeling of choking Chest pain or discomfort Nausea or abdominal distress Feeling dizzy, unsteady, lightheaded, or faint De-realization (feelings of unreality) or depersonalization (being detached from oneself Fear of losing control or going crazy Fear of dying Parenthesis (numbness or tingling sensations) Chills or hot flashes 8 Causesof Anxiety Disorders Heredity Childhood Circumstances Cumulated Stress Biological Short-term triggers Personal losses Life changes Stimulants/drugs Classical and Operant Conditioning 9 3

4 Heredity 15-25% of children growing up with at least one agoraphobic parent become agoraphobic themselves, while the rate of agoraphobia in the general population is only 5% Identical twins: 31-88% if one has anxiety disorder the other will too You don t inherit a particular anxiety disorder, what you inherit seems to be a general personality type that predisposes you to be overly anxious. Diathesis stress model 10 Childhood Circumstances Edmund Bourne s experience: Parents communicate an overly cautious view of the world (they have phobias themselves or are over- concerned about potential dangers) Parents are overly critical and set excessively high standards(critical perfectionistic parents) Emotional Insecurity & Dependence Parents suppress the expression of feelings and self-assertiveness 11 Causes of Anxiety Fight or Flight Response that is out of control Sympathetic and Parasympathetic Nervous Systems Classical & Operant Conditioning 12 4

5 Learning Theory Classical Conditioninglearning by association Operant Conditioninglearning by reinforcement or punishment 13 Classical Conditioning COPYRIGHT 2012 THE MCGRAW-HILL COMPANIES, INC. 14 Biological Causes Disorders that Mimic Anxiety Disorder Hyperventilation Syndrome Hypoglycemia Hyperthyroidism Mitral Valve Prolapse Premenstrual Syndrome Inner Ear Disturbance 15 5

6 Helping Children Relax Relaxation Techniques: Progressive Relaxation technique Abdominal Breathing Peaceful Scene Meditation Yoga Blowing Bubbles Elmo Belly Breathing 16 Mindfulness Definition: a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique. 17 Any behavior that keeps the person in the present moment will be practicing mindfulness. Paying attention to your surroundings Focusing on your breath Using a mantra Yoga Paying attention to what you are eating and how it tastes Mindfulness 18 6

7 Mindfulness 19 Countering Negative Self Talk Socratic Questions 1. What is the evidence for this? 2. Is this always true? 3. Has this been true in the past? 4. What are the odds of this really happening (or being true)? 5. What is the very worst that could happen? What is so bad about that? What would you do if the worst happened? 6. Are you looking at the whole picture? 7. Are you being fully objective? 20 Depression in Children and Adolescents 21 7

8 Statistics on Depression in Children & Adolescents Occurs in 1-2% of children before puberty Preschoolers can have depression, but that usually occurs when there is a strong family history of depression After puberty the rate increases to 3-8% with a higher rate among girls than boys 1 in 5 teens will experience a depressive disorder by the time they reach adulthood Statistics on Depression in Adolescents 3 million teens ages had a least one major depressive episode in the past year (Dept. of Health and Human Services, 2015) 30% of girls and 20% of boys totaling 6.3 million teens have had an anxiety disorder (National Institute of Mental Health) Only 20% of young people with an anxiety disorder get treatment (Child Mind Institute) Signs and Symptoms of Depression in Children & Adolescents Sad or irritable most of the day, most days in a week for at least 2 consecutive weeks Lost interest in things they used to really enjoy or lack of enjoyment in anything Change in eating or sleeping habits Having no energy or motivation to do anything 24 8

9 Signs and Symptoms of Depression in Children & Adolescents Feelings of worthlessness, hopelessness or guilt about things that are not their fault Dropping grades or difficulty concentrating Thoughts of suicide or dying If so they should be evaluated by a mental health professional immediately or go to the ER if there is imminent threat of suicide 25 Causes of Depression Combination of brain chemistry and life circumstance Diathesis-stress model Serotonin gene Stressful events Abusive environments Adverse childhood experiences (Toxic Stress) 26 Treatments for Depression Antidepressants Psychodynamic Therapy Cognitive Behavioral Therapy Combination of both therapy and medication 27 9

10 What Can Parents Do Get you child professional help as soon as you recognize the symptoms Talk with your child about depression and moods Be supportive, not judgmental listening is one of the most loving things you can do Schedule an appointment with your child s pediatrician Don t expect them to Just get over it Encourage exercise by doing it with them Limit screen time Call MHA for a referral or take our online screenings 28 Resources MHA Help Line Children s Services Fund Family s Insurance carrier Various Sliding Scale agencies

11 THANK YOU FOR MORE INFORMATION: Visit our website! Give us a call! Send us an ! info@mha-em.org TO STAY CONNECTED: Find us on Facebook! Mental Health America of Eastern Missouri Follow us on 31 11