Mar 2, 2016

Coping with Worry


Let’s be honest: all of us, at one point or another, have had to deal with some form of worry.  Name it what you will (anxiety, stress, etc.), it happens to everyone.  Anxiety is actually a normal response to stress, and can be beneficial to us in some situations.  Unfortunately, for some, anxiety can become overwhelming and excessive and can negatively impact day-to-day living.  When you couple the difficulties that anxiety creates with also being a young child, the issues can begin to pile up into a seemingly endless mountain to climb.  Understanding the impact of anxiety on our children, as well as how to combat it, goes a long way in helping our children to develop coping skills that they can use on their own when faced with stressful situations.

Just a Little Info


If you have a child coping with anxiety, you are not alone.  Anxiety is actually one of the most common mental health disorders in the United States.  It is responsible for the highest occurrence of doctor visits and psychiatric hospitalization and it costs the United States approximately $42 billion every year (Anxiety and Depression Association of America).  One in eight children cope with some form of anxiety, and 5% of all children miss school due to an anxiety-related disorder every day in the United States.

There are several symptoms to be on the lookout for with anxiety in children.  The most common complaints include: headaches, stomach aches, acid reflux, frequent “accidents”, diarrhea, weight loss, poor hygiene, and poor sleep.  Something that is very important to remember is that anxious children often want to leave the situation that they find themselves in.  When they are experiencing anxiety, they often complain about these symptoms in order to escape the stressor.  They may go to the restroom often or ask to go to the nurse because they do not feel well, when in reality they might simply need a break from the situation.  Many of these children also exhibit catastrophized thinking, leading to comments along the lines of “I’m never going to pass this test!” or “Everyone hates me.” 

 The Anxiety Response


So how does anxiety work?  To take a quote from Shakespeare's Hamlet: “There is nothing either good or bad, but thinking makes it so.”  This is very important to remember, especially when working with children.  Anxiety is all about what the person is thinking, not necessarily about what is actually occurring.  In this case, perception seems like reality.  It is important to be ready to meet the child where they are.

Most children do not automatically understand what is happening to their bodies during an anxiety response.  Being able to recognize the signs and symptoms of anxiety is very important and empowering to the child, and helps them to regain a sense of control over what is happening.  Children already have very little control over what happens in their day-to-day life.  They are told what to do and when for a majority of their day.  When a child also has to cope with the uncontrollable feelings of anxiety, symptoms can often escalate.  Giving them knowledge and understanding of the process can help them retain or regain the illusion of control that so many of them crave.

One easy way to explain the anxiety response to young children is by using the analogy of a bunny rabbit.  You’re a cute little bunny.  The world is very big, and you have no defenses.  All of a sudden, you hear a very loud noise from off in the distance.  What are you going to do?  Your body has to make a decision, and fast, about how to protect itself.  You are either going to fight, run, or freeze in place (fight, flight, freeze).  This is the body’s anxiety or stress response. 

When the anxiety response kicks into full gear, how does your body respond?  These bodily responses are important to note, as they are often the cause of many symptoms described by children.  Furthermore, helping children to recognize what their body does when they feel anxious can help them to identify these reactions before they become out of control and be more proactive in regulating their emotional response. 

·         Heart and Lungs: First and foremost, your heart and lungs act off of each other.  If you think of them as a car, your heart acts as the engine while your lungs act as the battery.  As your heart rate increases, so does your breathing.  If you slow down your breathing, then your heart cannot beat as fast – the engine cannot run without power in the battery. 
·         Eyesight: Additionally, your vision becomes much sharper when you are anxious.  Some children will describe darkness or fog on their periphery because they are only able to focus on what is right in front of them. 
·         Your tongue might swell.  In this case, children might complain of a sore throat or clear their throat.  They might also describe something sitting on their chest making it hard to breathe.
·         Hearing: The tissue around the inner ear swells and becomes engorged.  This makes it very hard to hear directions or what is going on around them.
·         Stomach: Last but not least, the stomach.  Your body flushes acid into the stomach when you are anxious (Gotta run real fast little bunny?! Better poop!).  If your stress response is triggered enough, the stomach stays in this state.

Everyone has this reaction to stress or danger, but when you are struggling with anxiety, this is the way that your body is all the time.  You are constantly in a state of alarm, and have difficulty getting your body to recognize that you’re not in danger – even when you are in the safest place possible.  Anxiety tells you that you are not in control.  As stated previously, there are healthy levels of anxiety, but they vary based on the individual.  For most, the feeling that happens in the pit of your stomach when this response happens normally subsides after a while, but this is not always the case for children.  Imagine living with that feeling on a regular basis, or being a child who does not have the appropriate coping skills needed to manage this feeling.  Our goal then becomes to turn down the volume on the anxiety (fight, flight, freeze) response.

Things that can be Upsetting


So, the body reacts to perceived threat in a number of different ways, but what are the common triggers that might set children into the anxiety response? 
·         Family: Oftentimes, when families are fighting (and I’m not talking about your day-to-day conflicts), children internalize the argument as their fault.  When parents fight each other, they are really fighting their child.
·         Weather: Can you think of anything that impacts more people on a daily basis than the weather?  I can’t.  Is there a snow storm coming?  Yes?  Then we must close school!  Do we have a severe storm or tornado on the way?  Yes?  Then we must drill or hide!  For some reason, our culture really likes to share weather stories too (Blizzard of ’78 anyone?). 
·         Friends: Peer relationships play a vital role in a child’s development.  Interactions with peers provide children with the groundwork they need to learn how to socialize and understand their world.  When these relationships are not going the way that a child plans, or are confusing/hurtful, they can become a source of anxiety.
·         Homework: This one is pretty self-explanatory, and likely one of the most common culprits.  Having a lot of homework can be a major trigger for many children.  Even if it really isn't much, the child feeling like it is can be enough to set off the anxiety response.
·         Media: There is an abundance of information available to children due to technology.  Many times, this leaves children exposed to information that they may not be able to put into perspective or understand. 

Children have the uncanny ability to ruminate like nobody’s business.  They have an enormous amount of time to simply sit and think, so you taking the time to think about these possible triggers is important too!

What you can do as a Parent


When we think about helping our children calm down, we really need to focus on tools that will be immediately available to them regardless of where they might find themselves (classroom, dance class, restaurant, etc.).  Luckily, we can use our five senses to help us out in this area.  Using the five senses (hearing, sight, smell, touch, taste) can help children immediately access tools to help them calm down and breathe.  These tips and tools not only help a child that is overcome with worry, but can also be put into place as a preventative measure to ensure that your child is developing healthy coping strategies in the face of stress!

·         Auditory: What sounds does your child like to hear?  Can you put some of them on a iPad so they can listen to them when they need to relax?  These don’t have to be songs – they can simply be sounds that the child likes (the beach, purring cat, etc.). 
·         Visual: Many children that struggle with anxiety often have a “messy somebody” around.  Take the time to look at your/their personal space and see if there is any clutter you can clear.  Also, consider what the child likes to see, draw, color, and so on.  You can have a visual of this in their bag/pocket for them to look at when they are feeling anxious.
·         Smell: Your sense of smell is amazing, and is one of the best senses of memory that we have! Just think about it – what do you remember about your grandparents?  Any smells?  If we can create a new memory through smell it becomes a great tool for relaxation.  Try and pair a smell like lavender or cookies with a relaxing time for the child.  Make sure that it is a smell that is meaningful to them.
·         Touch: Try and give your child a tool that isn’t too obvious – especially if you are going to send them to school!  Porcupine balls are great for this, so is Velcro, Play-Doh, a small amount of soft fabric, and so on. 
·         Taste: Build your child an anti-anxiety meal for lunch.  Include not only foods that they enjoy, but ones that will provide good tactile and sensory input for them.  If your child often complains of an upset stomach, consider packing them peppermint or ginger, as these are natural stomach soothers.

Do not discount the importance of sleep!  Not getting enough REM sleep every night can increase anxiety in some children.  If you feel like this might be an issue for your child, you may want to consider sleep training (it can be a tedious process, so don’t take it lightly).  Monitor your child’s sleep patterns and note when they are completely asleep and not just lying in bed.  If they are not getting enough sleep based on when they are completely asleep (elementary students need ~10-11 hours a night), then work back in 30 minute increments until they have hit that mark.  Make sure that you stick to the same routine every day (even on the weekends) with when they go to bed and when they wake up.  Create a sleep routine (bath/shower, story, bed) that they follow every night, and absolutely NO television or technology at least 30 minutes before bed.

Remember that a very important aspect of helping a child cope with worry is giving them the illusion of control.  Many of the acting out behaviors that are seen in schools by students having difficulty in this area (pushing, hitting, kicking, etc.) are often a result of their lack of control.  Exacting force on an object is their way of seeing that they can exert force in their world and show control.  If you can build in large movement to their day, you may find that these behaviors decrease.  Running/walking is a great way to relieve anxiety symptoms.  However, it is important to remember that running can cause a panic attack in some children because it mimics a stress response (rapid breathing, etc.).  Make sure your child is aware of this and knows how to respond appropriately!  Yoga can also be very helpful, especially inverted poses as they require you to shift your visual focus.

Finally, one of the most important things you can do for your child is to validate the way that they are feeling.  Validating their feelings does not mean that you agree with their behavior.  In other words, validation and agreement are not synonymous terms!  I’m sure we have all experienced a child screaming over something silly at one point or another (dropping food, not getting their way, etc.).  The thing we need to remember is that the feelings of disappointment, frustration and anger that might arise at the time these things are happening are completely new feelings for our children.  If they’re not new feelings, children are still in the process of learning coping skills to manage them.  These moments can seem like the end of the world to many children, so telling them that it isn’t a big deal and just expecting them to move on and “behave” isn’t realistic.  Instead of just telling the child to stop/get over it, try to help them learn to cope instead!  Validate the way they are feeling, and help them use their coping strategies through modeling and coaching.  Do you agree with their response to the problem?  No, but you can teach them how to cope with it!

Have any tips or tricks that have worked for you to help your child cope with anxiety?  Feel free to comment below! J
Anxiety and Depression Association of America (2015).  Retrieved from: http://www.adaa.org/about-adaa/press-room/facts-statistics
DePasquale, D. (2015).  Anxiety disorders in children and adolescents: Recognizing and treating the emerging epidemic [PowerPoint Slides retrieved from presentation, Winter 2015].
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National Institute of Mental Health (2015).  Retrieved From: http://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-children.shtml
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