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
% 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 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 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 ?”