Key Takeaways – June 22, 2020 | 2 p.m.
Nancy Dauphinais, Chief Operating Officer at David Lawrence Centers
“Managing Anxiety in Kids”
- About Anxiety. Anxiety is a natural reaction we all have. When we are faced with a real or imagined threat, our hard-wired “fight, flight, or freeze” response is triggered. These reactions can help to motivate us or help avoid danger. However, when our responses to anxiety get out of hand, anxiety can make decisions for us that are no longer helpful. It’s important to learn to manage anxiety and keep it in check. Ages and Stages: Babies and toddlers might fear loud noises, heights, strangers and separation. Preschoolers might start to show fears of being on their own and of the dark. School-age children might be afraid of supernatural things like ghosts, social situations, failure, criticism or tests, and physical harm or threat. These are normal sources of fears. Anxiety is the most common type of mental health disorder in childhood, affecting approximately 8%-20% of all children and adolescents. It is twice (or even 3 times) as common in females than males.
- Common Types of Childhood Anxiety Disorders. Separation Anxiety – Constant thoughts and intense fears about the safety of parents and caretakers. Symptoms include refusing to go to school, frequent stomachaches and other physical complaints, extreme worries about sleeping away from home, being overly clingy, panic or tantrums at times of separation from parents, trouble sleeping or nightmares. Social Anxiety – Fears of meeting or talking to people. Symptoms include avoidance of social situations and few friends outside the family. Generalized Anxiety Disorder – Particularly common now during the pandemic. Children have many worries about things before they happen, constant worries or concerns about family, school friends, or activities. Panic Disorder – Panic attacks and symptoms that are more acute and include racing heart or heart palpitations, difficulty breathing, sweating/hot or cold flashes, trembling or shaking, dizziness, fear of dying or losing control. Specific Phobias – Particularly intense fear that may result in panic attacks, other avoidance behavior or extreme distress around a specific object or situations, such as fear of clowns, dogs. It is more pronounced than specific wariness of something new. Obsessive-Compulsive Disorder –repetitive unwanted thoughts (obsessions) or actions (compulsions). Post-Traumatic Stress Disorder – Stress reactions related to a particular trauma.
- Symptoms of Anxiety. Symptoms of particular disorder as described earlier. Other systems include irritability and anger, especially with boys, trouble sleeping or eating, fatigue, headaches, and stomachaches.
- Risk factors/vulnerabilities to anxiety. It’s “Nature” AND “Nurture” including biological factors such as genes and brain wiring, psychological factors such as temperament and coping strategies and environmental factors (parenting, early childhood experiences and/or environment).
- Tips for Parents. Goal: To “respect feelings without empowering their fears.” When kids are anxious, they are in destress. Acknowledge the distress and be careful not to dismiss the emotion or label it as wrong. Avoid asking leading questions (which would assume you know what they are afraid of); instead, use open-ended questions to encourage them to describe what they are thinking and feeling. The goal is not to eliminate anxiety altogether, but rather to develop healthy strategies to manage it. Provide support for healthy coping strategies. What has the child tried before that has helped them feel better? Offer non-dismissive confidence in their ability to manage. Beware of overly accommodating a child by assisting them to avoid the situations that may provoke anxiety. This won’t help them learn the coping skills necessary to navigate the world. Help them learn healthy coping skills when they are not in the middle of a stressful situation. Coping with Coronavirus – Be sure to understand your own fears. Kids will pick up on how we manage anxiety. Normalize (don’t minimize) anxiety. Everyone is feeling anxious, and it does seem scary. Shift perspective (e.g., how can we help others, what can we control vs what we can’t control). When you help others, it takes the focus off your own distress. Utilize healthy distractions.
- When and How to Seek Help. Watch for some of these symptoms: Children are avoiding activities they usually enjoyed, showing extreme distress, or creating significant interference and avoidance in daily life. Talk to your child’s pediatrician or a professional at school. Seek routine anxiety or depression screening at check-ups. Treatment doesn’t necessarily mean medication or intensive therapy, but can mean some support, coaching, training in techniques and strategies to manage and navigate anxiety.
- Interventions. Cognitive Behavioral Therapy (CBT) is a highly effective treatment that addresses anxious thoughts and behaviors. It teaches children to be detectives of their own thoughts: catch the anxious thoughts, check the facts of those thoughts and change them. Strategies can be taught to label and distance anxiety can help child learn to “be the boss” of it. Strategies including learning to “cope ahead” by learning to preview anxiety-provoking situations and practice what it would look like to successfully face a fear. Professionals can also help give parents the tools to help support the management of their child’s anxiety. Severe anxiety can become a serious condition and can damage development, disrupt family life and can sometimes be so stressful it can lead to harmful and maladaptive behaviors. Mindfulness techniques are a wide variety of techniques that include diaphragmatic or belly breathing or “flow low” breathing. Headspace for Kids on the Headspace app has guided breathing techniques that help develop calm and slow down the body processes. Physical fitness helps too. In some cases, medications such as antidepressants can help. Many treatments will involve more than one method.
- Additional Resources & References: Mightier program uses game play to help teach children emotion calming skills like deep breathing. Harvard Health Blog: https://www.health.harvard.edu/blog/anxiety-in-children-2018081414532. ChildMind.org: https://childmind.org/article/what-to-do-and-not-do-when-children-are-anxious/. Also, yoga and music. Music can help cue a relaxation scenario. Aroma therapy can also be effective. We need to be able to tolerate and cope with distress because we’ll never be able to eliminate it. Be confident in asking for help. Virtual access center at David Lawrence Center is open: https://davidlawrencecenter.org/get-help-now/access-center/
Questions from viewers:
Q: Do you take insurance at the David Lawrence Center?
A: We take a wide variety of insurances. If you don’t have insurance, we can help you as well with a sliding scale.
Q: My child has destructive tantrums and is throwing things. What do I do?
A: I would definitely seek support from a professional to develop a treatment plan to help with that and to look at what might be contributing to those symptoms. It’s also important to get a thorough examination by a pediatrician, because there are some physical reasons that can cause a child to act out. If it’s not a physical reason, behavioral strategies, as well as strategies for the parents and the whole family, will help decrease the behaviors, as well as develop new behaviors to deal with the anxiety. There is help out there and treatment works!
About Kids’ Minds Matter
The goal of Kids’ Minds Matter is to raise awareness about the need for pediatric mental and behavioral health care services and to raise the funds required to make these services available in the region through Golisano Children’s Hospital of Southwest Florida and Lee Health. An estimated 46,000 Southwest Florida children are impacted by mental and behavioral health disorders like anxiety, depression, eating disorders, psychosis, substance abuse, autism and attention deficit hyperactivity disorder. As part of the region’s strategic solution to the children’s mental and behavioral health epidemic in Southwest Florida, Kids’ Minds Matter is dedicated to fostering partnerships that support existing services, identifying and filling gaps in the continuum of care, and innovating new treatments.
Philanthropic support for Kids’ Minds Matter has allowed Lee Health and Golisano Children’s Hospital of Southwest Florida to: implement a tiered model of care that clinically aligns community, inpatient and outpatient care; hire additional psychiatrists, child advocates and other mental health professionals; offer Mental Health First Aid training to local pediatricians, emergency service providers and others who work directly with children; renovate an outpatient center in Fort Myers where a child’s needs can be addressed in a therapeutic setting; and launch a first-of-its-kind Pediatric Digital Cognitive Behavioral Health diagnostic and treatment protocols interlaced with Tele-Psychology support to treat anxiety, depression and trauma. Most recently, Kids’ Minds Matter introduced mental health care navigators into Lee and Collier County schools who will help families find resources and care to address their child’s mental healthcare needs.
The “Mental Health Mondays” segments are a public forum, designed for open discussions that benefit a large audience, and to provide real-time resources and advice from pediatric mental health professionals and advocates. The information shared on this platform is intended for general public consumption and not intended for individual treatment. The views, advice, and resources shared by each guest speaker are solely their own and are not endorsed by Lee Health, Golisano Children’s Hospital of Southwest Florida and Kids’ Minds Matter. Kids’ Minds Matter is dedicated to raising awareness and essential funding to enhance pediatric mental & behavioral health programs, services and access to care in Southwest Florida. To learn more about Kids’ Minds Matter, visit KidsMindsMatter.com.