Matthew Biel, MD, MSc Georgetown Day School May 7, 2012

1. When To Worry About Your Child’s Worries Matthew Biel, MD, MSc Georgetown Day School May 7, 2012

2. Anxiety can be a good thing • Anxiety is a normal and adaptive system in the body that tells us when we are in danger. • Sometimes our bodies warn us about danger that isn’t real.

3. Anxiety is a partof childhood • Stranger anxiety • Separation anxiety • Fears • Worries • Stress

4. When To Worry About Anxiety? • Anxiety becomes a problem when it interferes with functioning: • Intensity • What is the degree of the stress present? • Impairment • Does the stress interfere with daily life? • Flexibility • Can your child recover when the stressor is not present?

5. When To Worry About Anxiety Severe anxiety is: • unrealistic • out of proportion • unwanted and uncontrollable • doesn’t go away • leads to avoidance

6. Facts About Anxiety Disorders • Anxiety disorders affect approximately 13% of American children and adolescents. • Anxiety disorders are the greatest predictors of mood disorders and alcohol abuse in adulthood. • More than 40 million adults in the US (18%) have reported disabling anxiety that negatively impacts their lives.

7. Generalized Anxiety Disorder • Characterized by pervasive, unwarranted worry about a variety of everyday things • Often focused on performance in school or sports • Can lead to physical symptoms like stomachaches and headaches

8. Separation Anxiety Disorder • Characterized by inappropriate and excessive anxiety about separating from parents or caregivers • Difficulty separating is normal in early childhood development; it becomes a disorder if the fear and anxiety interfere with age-appropriate behavior. • Usually occurs before age 10

9. Social Anxiety Disorder • Characterized by excessive self-consciousness that goes beyond common shyness or nerves • Performance anxiety • Anxiety about interactions • Mostly affects adolescents • Can lead to isolation and depression

10. Selective Mutism (SM) • Children with SM are unable to speak outside the home • Should not be confused with reluctance to speak • Can cause severe distress

11. Specific Phobias • Characterized by an excessive and irrational fear of an object or situation not normally considered dangerous • Common childhood phobias • Natural environment • Animals • Blood

12. Obsessive-Compulsive Disorder (OCD) • Characterized by unwanted thoughts, images or impulses (called obsessions) that a child attempts to fend off or neutralize by performing compulsions (ritualized or repeated behaviors). • OCD can manifest as early as 5 years old.

13. What to Do When Kids Are Anxious • Try to manage anxiety, not eliminate it • Model healthy ways of handling anxiety • Don’t reinforce fear • Stop avoiding • Talk things through • Find help

14. Where to find help • Georgetown University Hospital www.georgetownpsychiatry.org • Children’s National Medical Center • www.cnmc.org • Great resources right here at GDS • Amy Killy • Adrienne BIel Learn more about anxiety on childmind.org

15. Thank you for joining us to Speak Up for Kids!