Hi there, I’m Dr Golly and today we’re talking about ANXIETY in children and adolescents. This is a difficult topic, one that’s not well understood by many in the community, but one that is being diagnosed more and more – so it’s important we get a better understanding about what it is, how to recognize it and how best to manage and prevent it, in children and adolescents.
The word anxious derives from the Latin ango, meaning choked or strangled, which is a common feeling described by people who suffer from anxiety attacks. Anxiety is a perfectly normal body response to a real or perceived stress, let’s jump to the whiteboard and look at why anxiety occurs, and why it’s a necessary part of our physiology (turns with marker)…
This story begins in the amygdala, a pair of almond-shaped nerve cells near the base of the brain. The amygdala is in charge of memory, decision-making and emotional responses. Once triggered by a real or perceived threat (e.g. lion), the amygdala activates another part of the brain, the medulla oblongata. This prepares your body for fight or flight – running away. It’s a great system if you were to encounter a lion whilst out for your morning coffee, but this doesn’t tend to happen in most cafes. The medulla oblongata activates multiple body systems in readiness to fight, with a flood of cortisol and adrenaline, which is why you commonly (1) breathe rapidly – to get more oxygen, (2) your heart starts to race – to feed your muscles with more blood, and (3) you begin to feel nauseous as the blood rushes away from your stomach – and toward your muscles. This is often referred to as an adrenaline rush.
A little bit of anxiety is helpful – it’s what makes you prepare for tomorrow’s exam or train for this weekend’s soccer game. But it becomes a disorder, when the worry is intense and frequent or when the trigger is mild, or does not yet exist.
People can then develop behaviours that help them to avoid potentially stressful situations. This may include shying away from social interaction, staying home from school or spending excessive amounts of time alone. Anxiety becomes a disorder when it begins to interfere with normal functioning, affects sleep or appetite, is excessive for a child’s age or is associated with these avoidance behaviours.
So how do we treat anxiety? The first step is recognizing that it might be a problem, starting a dialogue about it and seeking professional help. One of the best approaches is to teach (turns to whiteboard)…
…mindfulness and relaxation techniques. This serves to tone down that adrenaline response, calming the breathing and heart rate – to return the body to a comfortable, resting state. Mindfulness is like a muscle – the more you practice, the better and quicker the effect becomes. Guided meditations can be performed multiple times per day, without waiting until a moment of high stress to try and calm down. Primary school children can be taught to write down their worries and put them in a ‘worry box’ where the worries remain. For older children, break down their worry into more manageable, smaller pieces (ie: one step at a time into the pool, not straight into the deep end) and work towards a greater goal. Encourage children to ‘have a go’ and not be fearful of failure and imperfections – and remind them of a prior stressful situation that they overcame, in order to build their confidence.
It’s very important to never dismiss a child’s worry, no matter how absurd it may seem. Show them that you also have worries and model ways of coping well with these. Your GP, psychologist, school counsellor or paediatrician are there to help if things don’t improve.
Remember to be on the look-out for some more subtle signs of anxiety in children and adolescents. These can include excessive worry, difficulty sleeping, new behavioural difficulties, mood-swings or frequent complaints of tummy pain. Talk to your children and speak with your GP about managing your child’s anxiety.
Thanks for watching – I’m Dr Golly, I’ll see you next time.