Anxiety in Young People How it Works, How it Looks, and How to Help Emily introduces self Emily Johnson, M.S.W., LGSW, Youth & Family Therapist Youth Service Bureau

What is the Youth Service Bureau? Youth Service Bureau helps youth and families learn the skills they need to be more successful at home, in school and throughout their community. Services Youth-Focused Family Counseling Diversion Services, including Awareness Classes Parent Education Chemical Health Support Locations Cottage Grove Stillwater Woodbury Contact Us! 651-439-8800 www.ysb.net www.facebook.com/YSBKnowsKids Emily

Objectives Gain an understanding of how anxiety works causes contributing factors Gain an understanding of how anxiety looks signs Symptoms Gain an understanding of how to help supporting kids supporting yourself Emily

Emily Brainstorm pressures on kids

What is stress? Any situation (positive or negative) that requires adjustment or change Comes from pressures we experience in life Adrenal gland releases adrenaline There’s not always an extreme reaction Some appear to thrive under stressful situations Chronic stress can lead to anxiety – too much, for too long, with too little help Emily

Some stress is normal Lots of pressures on kids today The majority of stress stems from external situations Able to be prioritized and handled one at a time Associated with frustration and nervousness What is stressful to one person might not be stressful to another Common fears in children/adolescents handout Emily

Life is stressful! Review handout: Sources of Stress in Children With a partner: Identify and put in order the top 10 stressors for kids Emily Discussion points: -What is stressful to some might be more stressful or less stressful to others -Think of your kids: what is the most stressful for them? Some stressors are more likely to lead to anxiety: Seeing a gun or weapon, Seeing violence on TV or in movies, Divorce of parents, Violence in home (often associated with alcoholism), Theft of personal property, Becoming sick and vomiting, A serious or painful injury, Illness or death of a parent, Sexual, physical, emotional abuse, Being bullied in school, Natural disaster (tornado, flood, fire), Terrorism or war You don’t have to figure it all out alone. What resources are available to kids who might be struggling?

Anxiety and Stress: The Difference “With stress, we know what’s worrying us, but with anxiety you become less aware of what you’re anxious about [in the moment] and the reaction comes the problem. You start to feel anxious about being anxious” Comes from a place of fear, unease, and worry

What is Anxiety? A state of apprehension or worry about a danger or threat that might occur Brain based-fight/flight system is activated Sense of helplessness Many children know they are anxious Most common mental health problem of childhood and adolescence More girls than boys Kay

Why it happens Environmental – witnessing a traumatic event/having a traumatic experience/watching another child be scared During life changes/transitions-death in the family, illness, recent move, new school, birth of sibling, etc. Biological-genetic predisposition- studies have shown children are more likely to develop an anxiety disorder if their parents have anxiety disorders Kay

What anxiety can look like Increase in crying Sleep issues, Increase in fatigue/easily tired Unwillingness to try/do activities, go to school, unwillingness to talk Nervous movements/twitches Increase in frustration Impatience Changes in eating patterns Child becomes clingy, impulsive, or distracted A meltdown! Kay

What anxiety can look like Kay There are also somatic symptoms – ask kids where they feel it in their body

Anxiety can be difficult to detect Anxiety personality style Anxious children in school High developed sense of responsibility Well-behaved Sensitive Perfectionism Perfectionistic High Expectations Motivated Oversensitivity to criticism or rejection High-Achieving Strong control needs Intelligent Difficulty relaxing Self-Conscious Tendency to please “Pleaser” Difficulty with assertiveness Frequent worry May also have (but not always): Many “shoulds” All-or-nothing thinking Somatic complaints Attention problems Social isolation Kay I’m going to challenge you a little – some kids fall under the radar. Behavioral kids – that is, kids that are acting out, are able to tell us that something isn’t right. But with the anxious personality – why do you think these children fall under the radar? -these characteristics are desirable in a classroom -they are compliant -but inside they are “in knots” -people who are anxious can be very successful because of their personal characteristics, but may still be struggling Case: Marina (Emily)

Anxiety Disorders A certain amount of anxiety is normal and is to be expected Anxiety is a problem when it becomes a problem: too often, too strong, out of proportion It consistently interferes with daily life (school, grades, social activities, sleep, eating) Excessive amounts of anxiety, fear, nervousness, worry, dread Most common mental health condition Impacts people of all ages Kay Parents need to pay attention to clues and behavior, often, looking for patterns Many kids don’t want to go to school or ride the bus and it DOES NOT trigger inappropriate behavior

How anxiety feels to a child Preoccupied Distracted Tense Always on alert, on guard Confused Scared, unprotected Overwhelmed – even by little things Lonley Embarrassed, ashamed, misunderstood Kay

A few notes about anxiety in kids Kids may not have the language to talk about their experience Kids and teens may act out emotions because they cannot hold them in Some show aggression/hostility due to agitation Others show depressive symptoms or exhibit attention (connection) seeking behaviors Stress/anxiety are frequently mistaken for defiance Kay

Sources of stress & anxiety related to school Unfamiliar situations Pressure to perform Different learning styles/intelligences Social life Bullying, teasing, violence Busyness Amount of homework The future Test anxiety School avoidance Kay Unfamiliar situations: new school/teachers, elementary to middle school or middle school to high school, difficult transitions Pressure to perform- high expectations from parents, teachers, themselves. Not to mention extra curricular activities Different learning styles – multiple intelligences, may lack social skills. Kids who are very high in their language skills and logical/math skills do very well in school. Are there enough opportunities for kinesthetic learners? Interpersonally strong kids who learn best through relating and cooperating? Social stress: cliques, sexuality, acceptance/rejection, relationships Homework – 3-4 hours of homework is common for high schoolers. Parents also become stressed . Cuts in to time for sleep, rest, quiet time, and family time The future – College stress starts many years before kids actually go. Good grades, ACT/SAT scores, developing a “competitive edge” with extra curricular and special accomplishments Tests School avoidance (Courtney)

How To Talk to Your Children About Anxiety Talk privately and tell them you notice something is bothering him/her Listen attentively/calmly to what is wrong Validate feelings & label them if appropriate Involve the child in the solution – help them brainstorm things that might help Be patient – just being there helps Emily

Strategies to support anxious children Create a safe place to go with calming activities Teach relaxation techniques Have realistic expectations: reward effort, not outcome Consistent, daily routines (post them) Play soothing music during downtime, homework, etc Incorporate exercise, stretching Sleep hygiene and eating habits Encourage connection with others (limits to screen time) Help find a hobby/outlet Challenge kids to think about what they can and cannot control When is therapy helpful? Emily Safe place –Bring examples of calming activities Relaxation techniques – deep breathing, yoga, guided meditations (Kay will do one with us in a little bit) Sleep hygiene – kids should be getting 8-10 hours of sleep per day (even teenagers!) When is therapy helpful? (Mady)

Advocacy Communicate with teachers and counselors Encourage attendance Consider making modifications Schedules Breaks Opportunities for movement Emily Modifications – allowing extra time to do work, reducing workloads, modify assignments (ie: presentation in front of the class) Breaks - in it a nurses’ office? Social workers’ office? How many are allowed? Do they need to inform the teacher? Is there a time limit?

Unhealthy coping strategies Smoking/drinking/drugs Bingeing on junk/comfort food Zoning out through computer, TV Procrastinating Taking it out on others Other avoidant behavior - withdrawing from friends/family, sleeping, skipping school Using caffeine can make anxiety worse Emily

Parent Do’s……. Encourage communication Listen and be available Collaborate together to develop solutions Validate their experience Don’t minimize Make it important Be mindful of actions when dealing with your own stress Emily

Food for thought… Kids & Teens learn to handle stress from parents/adults in their lives. What are we teaching them about healthy and successful ways to handle stress? How do we schedule our lives and take care of ourselves? Emily Activity – turn to your table and each take turns letting each other know one way you handle your stress that you’d like to get away from, one one way you handle stress that you’d like to do more of

Review The difference between anxiety and stress Sources of stress for children Signs and symptoms of anxiety Anxiety disorders School stress Coping strategies Talking with your child Advocacy in the schools When additional support may be needed Emily

Questions? Youth Service Bureau www.ysb.net Explain resources EVALUATIONS