Anxiety Disorder in Youth

1. Anxiety Disorder in Youth

2. Necessary Competencies • Friendship skills ( higher predictor success in life than poverty ) • Strong interpersonal skills • Adaptive/flexibility problem solving • Need stress management skills

3. Prevalency Rates • 13- 20 % adolescents have mental health issues that are clinically sufficient, but only 1:6 contact mental health professionals Of those seeking help for Mental health : • 13% Anxiety disorder • 10% Disruptive Behaviour disorder • 10% mood disorders ( Depression ) • 2% substance use disorder

4. Some Complications of Untreated Anxiety ( Dodds, et al, 1997) • Diminished academic achievement • Impaired relationships • Subsequent depression, alcohol abuse, • Greatest predictor of suicide

5. Onset • Mean age of onset 10-12 years old • Often elevated IQ, teacher pleasers • Teachers are best referral resource • Families often reluctant to seek mental health support

6. ANXIETY… • Normal human emotion for survival; smart for evolution; helped be alert from predators, prepared ; pay attention to possible dangers • Individual differences continuum ____________________________ low normal excess

7. Causes of Anxiety • Inborn, inherited tendency • Shy or cautious temperament • Unpredictable lifestyle • Stressful experiences • Learning from anxious parents • Habit patterns of avoidance

8. Anxiety is Developmental • Infant/Toddler: separation • Preschool: animals, dark, separation • School age: performance, adaptations, family change • Pre-adolescence: health, performance, social • Adolescence: social, existential, future

9. Anxiety is Physical • Classic “Fight or flight “ response -sweating (slippery to get away) -pupils dilate ( to take in more light and gain more sensory input in order to react quickly to danger) - arousal ( increased heart rate, shallow breathing, shaking, dizzy) -aches (tension, headaches, muscles, fatigue) -sleep (insomnia)

10. - the brain releases stress hormones, like epinephrine, and steroid hormones, like cortisol to give the body its much needed fuel to ward off the threat. -Muscles become tense, heartbeats start accelerating, and blood sugar shoots up. stomach ache, “scared peoples”

11. Common Associated Features • Depressed, irritable moods, cries easily • Fidgety, nervous habits ( nail biting) • Sleep problems ( huge sleep rituals) • Headaches and stomach aches • Difficulty coping, easily overwhelmed • Perserverance- difficulty shifting tasks • Low frustration threshold • Perfectionist don’t want to disappoint

12. Frequently Overlooked Features • Angry outbursts • Oppositional behaviours- refusals, resistance • Temper tantrums • Aggression • Attention seeking behaviours • Hyperactivity, difficulty sitting still • Attention and concentration skills • underachieving

13. 1. Thoughts 4. Behaviour 2. Feelings 3. Physical Symptoms

14. Normal vs. Anxiety Disorder • Anxiety is a problem if it: - occurs too much of the time, or -is interfering with daily life • Remember: Internalized, so often doesn’t draw attention, often physical complaints

15. Common Types of Anxiety Disorders • Separation Anxiety - age 5/6, then at 10, at 13 (usually girls) 2) Obsessive Compulsive Disorder 1- 4 % , age 8-10 onset, engage behaviours to stop negative thought patterns; usually high intelligence (movie: “As Good As It Gets” )

16. 3. Specific Phobias Most people have at least one: -dogs, heights, spiders, public speaking closed spaces, -Most common for kids is: Dogs -Most common for adult women: Spiders -Most common for adult males: Heights

17. 4) Generalized Anxiety Disorder : -amongst most difficult to treat, not one trigger, can have carry over to others 5) Social Anxiety Disorder: -everyone looking at me, judging me -typical adolescence - drop out of social situations 6) Panic disorder: -all at once, out of blue, - simulated heart attack (like over- excercise) -can’t tell difference, end up in ER;

18. 7. Post-Traumatic Stress Disorder violent home, car accident, fire,

19. Other common co-occurring • Depression • More than one anxiety • ADHD • LD • Tourettes/ticks

20. Evidence Based treatments • Medications- anti-depressants (Prozac, Paxil) -benxodiozepines (Valium, Ativan) - Cognitive Behaviour Therapy (CBT)

21. Cognitive Behaviour Therapy • Shift thinking cognition • Calming tools, lower distress • 5 main steps

22. 1. Teach about Anxiety • Teach anxiety is normal, can be helpful, not dangerous • Talk about “talent for worrying”

23. 2. Recognize Anxiety • Teach about worrying thoughts • How affects body- draw • Explain fight or flight ( physical aspects) • “false alarm” set “too sensitive,” like a fire alarm, name it - worry bug”

24. 3. Scale It • 1-5; what number are you feeling ?

25. 4. Relaxing Tools • Calm Breathing ( flower/ candle ) • Progressive Muscle Relaxation • Visual Imagery • Counting • Bubbles

26. 5. Stop Thought pattern • Red light to Catastrophic Thought • Green Light • Come up with helpful brave thoughts, • Write them down, draw them, over and over • One step at a time, worry box, step ladder • “What’s your evidence?” • “What’s the worst that can happen ?”