Anxiety An exploration of the problem, causes, symptoms and some suggestions for the classroom.
Anxiety is a normal reaction to stress. • Anxiety becomes a disorder when it interferes with our daily life.
Anxiety disorders are among the most common mental, emotional, and behavioral problems to occur during childhood and adolescence. Anxiety disorders can be observed in students with other disabilities. • 30% of students with ADHD have an anxiety disorder • 25% of adolescents with reading problems have an anxiety disorder • 50-85% of children with HFA/Asperger’s have an anxiety disorder • 85% of depressed adolescents have a history of childhood anxiety
Types of Anxiety • Separation Anxiety • Social Phobia • Generalised Anxiety • Specific Phobia • Obsessive Compulsive Disorder • Panic Disorder • Post-Traumatic Stress Disorder
Some causes of an anxiety disorder might be: • genetics (a history of anxiety in your family) • disturbance of brain activity • a stressful event like: • a family break-up • abuse • ongoing bullying at school • A death • a relationship break up • family conflict.
Generalised Anxiety Disorder • For SIX MONTHS or more on more days than not, have you: felt very worried found it hard to stop worrying found that your anxiety made it difficult for you to do everyday activities (e.g. work, study, seeing friends and family)? • If you answered 'YES' to ALL of these questions have you also experienced THREE or more of the following: felt restless or on edge felt easily tired had difficulty concentrating felt irritable had muscle pain (e.g. sore jaw or back) had trouble sleeping (e.g. difficulty falling or staying asleep or restless sleep)? If you answered 'YES' it is important to see a doctor
Depression doesn’t just cause sadness or feeling blue, and anxiety doesn’t just make people worry. Young people can express depression and anxiety in many different ways. They might: • have trouble falling or staying asleep, or spend much of the day in bed • be tired, grumpy, irritable, tearful or upset most of the time • feel restless, keyed up or on edge • lose interest in things they used to enjoy, and have trouble starting and completing assignments or work • lose concentration and be forgetful and easily distracted • become withdrawn and lose friends • be worried and panicky about doing anything out of the ordinary • either refuse to eat or eat a lot • complain of feeling physically awful, with unexplained aches and pains, and not want to go to school
A demonstration……. Focus on the cross when it appears…..
Attentional Bias Studies In eye movement studies, anxious children: • Rapidly orientate eyes toward threat (early attention) • Keep their eyes on the threatening stimulus and ignore neutral or positive information (sustained attention).
Generalised Anxiety Disorder “I think I have generalised anxiety disorder. I don’t really know when it started but it seems like for as long as I can remember now, I have felt worried or anxious. I used to go to school with a massive pit in my stomach, I would be so anxious it was actually painful. I’ve learned how to relax myself now so it’s not as bad but I still get very anxious and stressed out. The littlest things stress me out and change my day from great to absolutely terrible. Most days I come home and cry, not even really knowing why. Explaining it is impossible to others; how much I worry, how the littlest things make me panic. My relatonship with my family is suffering as I am always irritable and lashing out at them, unable to help myself. I thought it was just me because I’ve always beeen described as a ‘moody’ person, but it’s not normal to go from happy to sad in the space of an hour. I can’t remember last time I’ve had a good night’s sleep, and I almost always have bad dreams. I did the symptoms checklist for generalised anxiety disorder (something I’ve never heard of bfore now) and I checked every single box without a second thought. I want to go to a doctor, to get help. but I don’t know how to tell my mum. She always just tells me that I need to cntrol my moods or drink more water or that I’m being silly. Even if I do go to the doctor, and they tell me I’ being sily as well, at least that’s better then not knowing. I just wish I knew what to do. Elisha”
Anxiety/avoidance/depression.. my life is falling apart “I’ve got uni work that is over a week due, and more that is 4 days overdue, and I just can’t bring myself to face it. I really don’t want to fail, but I feel hopeless, I feel like a cop out, I feel like I suck at life for not being able to just get on with it and do this work. I’ve stopped enjoying anything, and all I do is worry. My jaw aches from grinding my teeth in my sleep, when I actually get sleep. Most of the time I’m afraid to sleep because it makes me feel guilty that I’m not using the time to get my work done, and because I’m scared I won’t be able to fall asleep quickly, so I will be lying awake hating myself and worrying. I have called in sick to my uni prac work tomorrow, and I will make an appointment with the GP to get a med certificate and hopefully some kind of referral, and maybe some help or guidance. I’ve been awake all night avoiding the work I should have already done. I am scared that people think I’m just lazy or stupid or just don’t want to do it, and mostly I’m scared that that could be true. I hope I made the right decision tonight, and I’m not just avoiding prac tomorrow because I don’t want my uni tutor to turn up and ask me about my overdue work. I don’t know. I just feel crap about all my decisions lately. Elisabeth”
These strategies will help students with anxiety in your class, but most will also benefit the class as a whole. • Talk to the student about what interventions they would find helpful. • Teach them relaxation techniques they can do at school. • Allow a few minutes at the beginning of the day (or class) for the student to transition into the school day. • Use small group activities throughout the day. • Reward effort by a student with anxiety. • Create activities that role-play appropriate behaviours. • Decrease situations that induce stress.
Discuss anxiety symptoms and anxiety attacks privately with the student. • Teach positive self-talk to the entire class. • Post the daily routine in the classroom and let students know in advance any changes in the schedule. • Help students break assignments down into smaller segments. • Play soothing music during down time. • Incorporate exercise into the school day. • Discuss what sections of a book will be read aloud with a student before calling on them to read. • Create a “safe” place for the child to go when anxiety symptoms are high.
Further Reading List • http://www.beyondblue.org.au/index.aspx? • http://www.cheri.com.au/CHERIAnxandEd_final.pdf.pdf • http://www.studentdepression.org/ • http://www.brains.org/depression.htm • http://www.healthyplace.com/depression/children/depression-in-school-a-students-trial/menu-id-68/ • http://www.healthcentral.com/anxiety/school-258065-5.html • http://www.nimh.nih.gov/health/publications/depression-and-high-school-students/depression-and-high-school-students.shtml • http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml • U.S. Department of Health and Human Services. (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services.