Wednesday, October 25, 2023

James Donaldson on Mental Health - How to Avoid Passing Anxiety on to Your Kids

James Donaldson on Mental Health - How to Avoid Passing Anxiety on to Your Kids

Help yourself, and them, by learning techniques to manage stress in a healthy way



Writer: Brigit Katz



Clinical Experts: Jamie Howard, PhD , Amanda Greenspan, LCSW



https://www.youtube.com/watch?v=FA-tE7A1OeE&t=6s

What You'll Learn



- How can parents learn to manage stress?

- How do I keep my child from feeling my anxiety?

- What are some good ways to talk to kids about anxiety?

- Quick Read

- Full Article

- Manage stress with mindfulness

- Learn your triggers

- Model stress tolerance

- Explain your anxiety

- Make a plan

- Know when to disengage

- Find a support system

Managing your own stress is the best way to keep your child from picking up your anxiety. You can try mindfulness techniques like deep breathing. Practicing mindfulness every day can help you feel calmer in general and make the techniques more effective when you are feeling anxious. You can also try to identify the things that make you anxious and set boundaries or come up with a plan for how to respond to them. Working with a therapist can help. 



Once you know how to manage your own stress, you can help kids learn those same skills. You don’t need to hide your anxiety. Instead, talk to kids about what you feel and how you cope with it. You might say: “I’m feeling scared right now, but I know it’s not that likely that the thing I’m scared of will actually happen.”  



If you do something you regret later, talk about that too: “I yelled at you this morning because I was anxious we would be late. But I know there are better ways to react when I feel that way.” Talking about anxiety sends kids the message that stress is normal and they can manage it. It can also help to plan for dealing with anxiety before it happens. Talk to kids about how you can work together to make life less stressful. For example, maybe they get points toward a little reward every time they get ready for school on time. But try to avoid putting kids in charge of managing your anxiety. If a certain thing causes you a lot of stress, find other adults to take over or give you support. Parenting while taking care of your own mental health is hard, but you don’t have to do it alone. 



Witnessing a parent in a state of anxiety can be more than just momentarily unsettling for children. Kids look to their parents for information about how to interpret ambiguous situations; if a parent seems consistently anxious and fearful, the child will determine that a variety of scenarios are unsafe. And there is evidence that children of anxious parents are more likely to exhibit anxiety themselves, a probable combination of genetic risk factors and learned behaviors.



It can be painful to think that, despite your best intentions, you may find yourself transmitting your own stress to your child. But if you are dealing with anxiety and start to notice your child exhibiting anxious behaviors, the first important thing is not to get bogged down by guilt. “There’s no need to punish yourself,” says Jamie Howard, PhD, director of the Stress and Resilience Program at the Child Mind Institute. “It feels really bad to have anxiety, and it’s not easy to turn off.”



But the transmission of anxiety from parent to child is not inevitable. The second important thing to do is implement strategies to help ensure that you do not pass your anxiety on to your kids. That means managing your own stress as effectively as possible, and helping your kids manage theirs. “If a child is prone to anxiety,” Dr. Howard adds, “it’s helpful to know it sooner and to learn the strategies to manage sooner.”



Manage stress with mindfulness



It can be very difficult to communicate a sense of calm to your child when you are struggling to cope with your own anxiety.



When we are feeling anxious, we start worrying about what might happen in the future — all those “what ifs.” To avoid getting caught up in worries about the future, try practicing mindfulness, which is a technique for focusing on the present. Here are two common mindfulness techniques to try:



- Squeeze Muscles: Starting at your toes, pick one muscle and squeeze it tight. Count to five. Release, and notice how your body changes. Repeat exercise moving up your body.

- Belly Breathing: Put one hand on your stomach and one hand on your chest. Slowly breathe in from your stomach (expand like a balloon) and slowly breathe out (deflate).

You can try to practice mindfulness in the moment when you’re feeling anxious, but it is also a good idea to set aside time to be mindful every day. Regular practice will help you use the techniques more effectively when you really need them, and it can also make you feel calmer in general.



Learn your triggers



Pay attention to what triggers your anxiety. While feeling anxiety is unavoidable sometimes, we can also make it worse by dwelling on it. If you are someone who jumps to the worst-case scenario when you have a tickle in your throat, using WebMD might make you even more alarmed. Likewise, if you are stressed out by what’s happening in the news, spending time reading it — or even using social media — might make you feel worse. Setting boundaries about when and how you will engage with things that could trigger your anxiety is a good idea.



If your anxiety is severe and practicing mindfulness and setting boundaries on your own isn’t helping, consulting a mental health professional makes sense. A clinician can help you work through methods of stress management that will suit your specific needs. As you learn to tolerate stress, you will in turn be teaching your child — who takes cues from your behavior — how to cope with situations of uncertainty or doubt.



“A big part of treatment for children with anxiety,” explains Laura Kirmayer, PhD, a clinical psychologist, “is actually teaching parents stress tolerance. It’s a simultaneous process — it’s both directing the parent’s anxiety, and then how they also support and scaffold the child’s development of stress tolerance.”



Model stress tolerance



When you learn some strategies for managing stress that work for you, you can then impart them to your child when she is feeling anxious. If, for example, you are working on thinking rationally during times of stress, you can practice those same skills with your child. Say to her: “I understand that you are scared, but what are the chances something scary is actually going to happen?”



Try to maintain a calm, neutral demeanor in front of your child, even as you are working on managing your anxiety. Dr. Howard says, “Be aware of your facial expressions, the words you choose, and the intensity of the emotion you express, because kids are reading you. They’re little sponges and they pick up on everything.”



#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.
  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy



Link for 40 Habits Signup
bit.ly/40HabitsofMentalHealth



Book

www.celebratingyourgiftoflife.com

Explain your anxiety



While you don’t want your child to witness every anxious moment you experience, you do not have to constantly suppress your emotions. It’s okay — and even healthy — for children to see their parents cope with stress every now and then, but you want to explain why you reacted in the way that you did.



Let’s say, for example, you lost your temper because you were worried about getting your child to school on time. Later, when things are calm, say to her: “Do you remember when I got really frustrated in the morning? I was feeling anxious because you were late for school, and the way I managed my anxiety was by yelling. But there are other ways you can manage it too. Maybe we can come up with a better way of leaving the house each morning.”



Talking about anxiety in this way gives children permission to feel stress, explains Dr. Kirmayer, and sends the message that stress is manageable. “If we feel like we have to constantly protect our children from seeing us sad, or angry, or anxious, we’re subtly giving our children the message that they don’t have permission to feel those feelings, or express them, or manage them,” she adds. “Then we’re also, in a way, giving them an indication that there isn’t a way to manage them when they happen.”



Make a plan



Come up with strategies in advance for managing specific situations that trigger your stress. You may even involve your child in the plan. If, for example, you find yourself feeling anxious about getting your son ready for bed by a reasonable hour, talk to him about how you can work together to better handle this stressful transition in the future. Maybe you can come up with a plan wherein he earns points toward a privilege whenever he goes through his evening routine without protesting his bedtime.



These strategies should be used sparingly: You don’t want to put the responsibility on your child to manage your anxiety if it permeates many aspects of your life. But seeing you implement a plan to curb specific anxious moments lets him know that stress can be tolerated and managed.



Know when to disengage



If you know that a situation causes you undue stress, you might want to plan ahead to absent yourself from that situation so your children will not interpret it as unsafe. Let’s say, for example, that school drop-offs fill you with anxiety. Eventually you want to be able to take your child to school, but if you are still in treatment, you can ask a co-parent or another trusted adult to handle the drop off. “You don’t want to model this very worried, concerned expression upon separating from your children,” says Dr. Howard. “You don’t want them to think that there’s anything dangerous about dropping them off at school.”



In general, if you feel yourself becoming overwhelmed with anxiety in the presence of your child, try to take a break. Danielle Veith, a stay-at-home mom who blogs about her struggles with anxiety, will take some time to herself and engage in stress-relieving activities when she starts to feel acutely anxious. “I have a list of to-do-right-this-second tips for dealing with a panic, which I carry with me: take a walk, drink tea, take a bath, or just get out the door into the air,” she says. “For me, it’s about trusting in the fact that the anxiety will pass and just getting through until it passes.”



Find a support system



Trying to parent while struggling with your own mental health can be a challenge, but you don’t have to do it alone. There is a lot of support online, on blogs, forums and social media. Getting support from the people in your life is important, too. Those people can be therapists, co-parents, or friends — anyone who will step in when you feel overwhelmed, or even just offer words of support. “I am a part of an actual support group, but I also have a network of friends,” says Veith. “I am open with friends about who I am, because I need to be able to call on them and ask for help. ”




https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-to-avoid-passing-anxiety-on-to-your-kids/

Tuesday, October 24, 2023

James Donaldson on Mental Health - The Silent Struggle: Understanding Loneliness

James Donaldson on Mental Health - The Silent Struggle: Understanding Loneliness


Loneliness is an emotion that can affect anyone, regardless of age, gender, or social status. It is an overwhelming feeling of isolation and emptiness that can have a profound impact on a person's mental and physical well-being. This silent struggle often goes unnoticed, but its consequences are far-reaching.



In today's hyperconnected world, it may seem paradoxical to talk about loneliness. We are constantly surrounded by people, be it physically or virtually. We have social media platforms that allow us to connect with friends and family at the touch of a button. However, despite this apparent connectivity, studies show that feelings of loneliness are on the rise.



Loneliness can arise from various factors, including social isolation, a lack of meaningful relationships, or even an inability to connect with others on a deep level. It can occur in individuals who live alone, but it can also affect those in crowded environments, such as students in a bustling university or employees in a busy workplace. It is not the quantity of relationships that determines loneliness, but rather the quality and depth of connection.



The impact of loneliness is not limited to an individual's mental well-being. It can also have significant physical consequences. Numerous studies have linked chronic loneliness to an increased risk of developing health issues such as heart disease, obesity, and weakened immune systems. Loneliness can even shorten an individual's lifespan, increasing the risk of premature death.



Understanding and addressing loneliness requires a multifaceted approach. First and foremost, it is essential to recognize that loneliness is a legitimate and widespread issue. Many individuals suffer silently, fearing judgment or shame. Normalizing conversations around loneliness can help break down barriers and encourage people to reach out for support.



Building and maintaining strong social connections is crucial in overcoming loneliness. Creating meaningful relationships takes time and effort, but the rewards are immeasurable. Engaging in activities that align with personal interests and passions can help individuals connect with like-minded individuals and foster a sense of belonging.



#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.
  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy



Link for 40 Habits Signup
bit.ly/40HabitsofMentalHealth



Book

www.celebratingyourgiftoflife.com

Seeking professional help should not be stigmatized when loneliness becomes overwhelming. Mental health professionals can provide support, guidance, and tools for managing loneliness. Therapies such as cognitive-behavioral therapy (CBT) or support groups can offer individuals the opportunity to share their experiences and learn coping strategies.



To tackle the rising loneliness epidemic, societal changes are necessary. Communities must prioritize fostering social connections, both online and offline. Schools, workplaces, and public spaces should create environments that foster inclusivity, empathy, and a sense of belonging.



In conclusion, loneliness is a pervasive issue that has far-reaching consequences. It is not simply a fleeting emotion but a silent struggle that affects individuals on a deep level. Understanding loneliness, normalizing conversations around it, and taking proactive steps to combat it are essential for the well-being of individuals and society as a whole.



Image prompt: Image: A person sitting alone on a park bench, surrounded by a crowd of people. The person's face appears somber, reflecting the emotion of loneliness.



Tags: loneliness, mental health, social connections, isolation, well-being




https://standingabovethecrowd.com/james-donaldson-on-mental-health-the-silent-struggle-understanding-loneliness/
James Donaldson on Mental Health - Mood Disorders and Teenage Girls
Why they are more vulnerable than boys, and what signs and symptoms you should look for

Writer: Ron J. Steingard, MD

Clinical Expert: Ron J. Steingard, MD

What You'll Learn

- What does depression look like in teenage girls?

- What does anxiety look like in teenage girls?

- What treatments are available for teenage girls with mood disorders?

- Quick Read

- Full Article

- Symptoms of depression in teenagers

- Symptoms of anxiety

- Why early intervention is critical

- Other disorders

- Treatments for anxiety and depression

Kids of any gender can experience depression and anxiety. But by the teenage years, girls are much more likely to be diagnosed with those mood disorders. Experts don’t know for sure why this is, but it could be because girls sometimes gain emotional maturity more quickly and may be more emotionally sensitive.

An early sign of both depression and anxiety is withdrawing from things they usually enjoy. You might notice other changes in your daughter’s mood, like sadness or irritability. Girls dealing with depression may start eating or sleeping much more or much less. They may start doing worse in school. Girls with anxiety often structure their lives around avoiding things that they’re afraid of, like new activities or social situations. If you notice any of these signs getting in the way of your daughter’s daily life and not going away over time, she may have a mood disorder.

If you think your daughter may have depression or anxiety, it’s important to get her help early. Over time, mood disorders can have negative impacts on friendships and academic success. Sometimes the same symptoms can also be signs of a different mental health challenge, like an eating disorder, self-harm or drug use.

A mental health professional can help you figure out what is going on. For depression and anxiety, the most common treatment is a therapy called cognitive behavioral therapy (CBT). CBT can help teenagers recognize and change negative thought patterns. It is often very effective for both depression and anxiety. Sometimes antidepressant medication is also prescribed alongside therapy.

Anxiety and depression occur in both genders, but by the teenage years, girls are much more at risk than boys. Before puberty, the prevalence of mood disorders is about the same in boys and girls—3 to 5 percent. But by mid-adolescence girls are more than twice as likely to be diagnosed with a mood disorder as boys, with the prevalence at adult levels, 14 to 20 percent.

Why such a big disparity in mood disorders? We know from looking at brain scans that there are differences in the way girls and boys process emotional stimuli. Girls mature, in terms of their emotional recognition, faster than boys—and that sensitivity could make them more vulnerable to depression and anxiety.

It’s plausible that that these gender differences around the time of puberty can be traced to evolutionary advantages: Girls may be wired to tune in earlier to emotional stimuli because it was advantageous for nurturing babies; for young men, given their roles as hunters and tribe protectors, emotional responsiveness might have been an important attribute not to have.

The argument that the differences in emotional sensitivity are hard-wired is underscored by the fact that even as women’s lives have clearly changed—with many more women living professional, competitive, Type-A lives—the rate of depression hasn’t dropped. Even the participation of far more girls in sports and other intense physical activities hasn’t reduced the rate of depression, though physical activity is important to emotional wellbeing, and one effective way to help jumpstart recovery in someone who’s depressed.

Symptoms of depression in teenagers

In adolescent depression, the thing people tend to notice first is withdrawal, or when the teenager stops doing things she usually likes to do. There might be other changes in her mood, including sadness or irritability. Or in her behavior, including, appetite, energy level, sleep patterns and academic performance. If several of these symptoms are present, be vigilant about the possibility of depression.

This is especially important because by the time family members and other people around a teenager note her lack of interest in most things, or what we call anhedonia, she’s usually been depressed for some time. Depression is an internalizing disorder, i.e. one that disturbs a patient’s emotional life, rather than an externalizing one, which manifests in the form of disruptive or problematic behavior. As such, it takes a while not only for others to recognize it, but often for the patient herself to realize that her thinking, and emotional responses, are disturbed.

Note that there are actually two kinds of depression. In major depressive disorder—the most familiar form of depression—the cluster of symptoms that define depression occur in what may be severe episodes that tend to last from seven to nine months. But there is also another form of depression called dysthymic disorder, in which the symptoms are milder, but they last longer, measured in years. So while the experience of dysthymia may be less debilitating for the child at any given moment, the risk is that there is more accrued damage, more time in which the child is kept out of the healthy development process.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth

www.celebratingyourgiftoflife.com

Symptoms of anxiety

Anxiety is a normal adaptive system that lets the body know when it’s in danger. But anxiety becomes a problem when it’s out of proportion to the situation, and interferes with a person’s ability to function. An overly anxious teen might withdraw from activities because she’s too scared or anxious, and her anxiety doesn’t go away with reassurance.

A teenager who has been anxious since childhood may have a lifestyle built around her anxieties: the activities and environments she chooses and those she rules out, the friends she is comfortable with, the expectations and limitations she has trained her family, friends, and teachers to accept. That’s why it’s more challenging to treat anxiety the longer a child has lived with it, and developed unhealthy coping mechanisms to manage it.

Why early intervention is critical

When a child is depressed or anxious, her suffering isn’t the only reason it’s important to get help.

In addition to the disorders themselves, there are add-on effects that may cause lifelong issues. With depression comes low energy and poor concentration, two factors that are likely to have a significant impact on social and academic functioning. Anxiety, and the withdrawal that may accompany it, is likewise a detriment to social and academic progress.

It’s easy to see the effects of poor academic functioning: falling behind in school undermines a child’s confidence and self-image, and can impact her future if it’s prolonged. But social learning is just as critical as academic learning in childhood and adolescence. This is a time when a girl would normally be learning such things as how to be a daughter, a sister, a friend; with either depression or anxiety, she may miss or fall behind on these critical kinds of learning. These deficits not only put her behind her peers, but in themselves they can compound her depression or anxiety.

Other disorders

It’s important to understand that anxiety and depression often occur in the same teenager, and may need to be treated as two separate disorders. Anxiety is more likely to occur without depression than depression without anxiety. It may be that depression leads to anxiety—the negative state of mind of a depressed teenager lends itself to uncertainty. If you’re not feeling good about yourself, or confident, or secure, or safe, anxiety may find fertile ground. It may also be because the regions of the brain affected by anxiety and depression are close together, and mutually affected.

Two serious problems that are directly associated with teenage depression and anxiety are suicidal thinking (or behavior), and substance abuse. Suicide is the third leading cause of death among adolescents and young adults aged 15 to 24, and we know that most kids who commit suicide have been suffering from a psychiatric illness. Especially at risk are teenagers who hide their depression and anxiety from parents and friends. That’s why it’s important to be alert to signs of these disorders—withdrawal, changes in school performance, eating habits, sleeping patterns, things she enjoys doing—even when teenagers aren’t forthcoming about how they feel. Similarly, the majority of teenagers who develop substance abuse problems also have a psychiatric disorder, including, most commonly, anxiety or depression, which is another important reason to get treatment in a timely way.

Two other problems associated with teenage girls—that is, occurring with greater frequency in girls than boys—are eating disorders and self injury, or cutting. While both of these can overlap with depression, the common assumption that they’re caused by depression is not borne out by research. Girls who have eating disorders often show no signs of depression; indeed, they are often very high-functioning, competitive girls who have a distorted body image, but not the symptoms of depression. Similarly, self-injurious behavior is a kind of dysfunctional coping mechanism kids get into to alleviate emotional pain, or numbness they’ve developed as a result of that pain. It can occur with, and be complicated by, a mood disorder, but isn’t thought to be a result of the latter. Antidepressants, the medication of choice for mood disorders, don’t usually alleviate eating disorders or cutting, which receive different kinds of treatment.

Treatments for anxiety and depression

Fortunately, early involvement of health care professionals can shorten the period of illness and increase the likelihood of her not missing important life lessons.

The most common treatment a mental health professional is apt to use is some form of cognitive behavioral therapy, and depending on how young the child is, it may involve teaching the parents as well. Cognitive behavioral therapy is based on the idea that a person suffering from a mood disorder is trapped in a negative pattern of thought. Depressed kids tend to evaluate themselves negatively, interpret the actions of others in a negative way, and assume the darkest possible outcome of events. Similarly, a child suffering from anxiety is overwhelmed by fears of negative outcomes long before events occur. In CBT, we teach sufferers to challenge those negative thoughts, to recognize the pattern and train themselves to think outside it. And in many cases we see real improvement in teenagers with depression and anxiety.

If the anxiety or depression is moderate to severe, treatment may involve medications such as antidepressants. For both anxiety and depression, a combination of psychotherapy and medication usually works better than either alone.
https://standingabovethecrowd.com/james-donaldson-on-mental-health-mood-disorders-and-teenage-girls/

Monday, October 23, 2023

James Donaldson on Mental Health - Mood Disorders and Teenage Girls

James Donaldson on Mental Health - Mood Disorders and Teenage Girls

Why they are more vulnerable than boys, and what signs and symptoms you should look for





Writer: Ron J. Steingard, MD



Clinical Expert: Ron J. Steingard, MD



What You'll Learn



- What does depression look like in teenage girls?

- What does anxiety look like in teenage girls?

- What treatments are available for teenage girls with mood disorders?

- Quick Read

- Full Article

- Symptoms of depression in teenagers

- Symptoms of anxiety

- Why early intervention is critical

- Other disorders

- Treatments for anxiety and depression



Kids of any gender can experience depression and anxiety. But by the teenage years, girls are much more likely to be diagnosed with those mood disorders. Experts don’t know for sure why this is, but it could be because girls sometimes gain emotional maturity more quickly and may be more emotionally sensitive.



An early sign of both depression and anxiety is withdrawing from things they usually enjoy. You might notice other changes in your daughter’s mood, like sadness or irritability. Girls dealing with depression may start eating or sleeping much more or much less. They may start doing worse in school. Girls with anxiety often structure their lives around avoiding things that they’re afraid of, like new activities or social situations. If you notice any of these signs getting in the way of your daughter’s daily life and not going away over time, she may have a mood disorder.



If you think your daughter may have depression or anxiety, it’s important to get her help early. Over time, mood disorders can have negative impacts on friendships and academic success. Sometimes the same symptoms can also be signs of a different mental health challenge, like an eating disorder, self-harm or drug use.



A mental health professional can help you figure out what is going on. For depression and anxiety, the most common treatment is a therapy called cognitive behavioral therapy (CBT). CBT can help teenagers recognize and change negative thought patterns. It is often very effective for both depression and anxiety. Sometimes antidepressant medication is also prescribed alongside therapy.



Anxiety and depression occur in both genders, but by the teenage years, girls are much more at risk than boys. Before puberty, the prevalence of mood disorders is about the same in boys and girls—3 to 5 percent. But by mid-adolescence girls are more than twice as likely to be diagnosed with a mood disorder as boys, with the prevalence at adult levels, 14 to 20 percent.



Why such a big disparity in mood disorders? We know from looking at brain scans that there are differences in the way girls and boys process emotional stimuli. Girls mature, in terms of their emotional recognition, faster than boys—and that sensitivity could make them more vulnerable to depression and anxiety.



It’s plausible that that these gender differences around the time of puberty can be traced to evolutionary advantages: Girls may be wired to tune in earlier to emotional stimuli because it was advantageous for nurturing babies; for young men, given their roles as hunters and tribe protectors, emotional responsiveness might have been an important attribute not to have.



The argument that the differences in emotional sensitivity are hard-wired is underscored by the fact that even as women’s lives have clearly changed—with many more women living professional, competitive, Type-A lives—the rate of depression hasn’t dropped. Even the participation of far more girls in sports and other intense physical activities hasn’t reduced the rate of depression, though physical activity is important to emotional wellbeing, and one effective way to help jumpstart recovery in someone who’s depressed.



Symptoms of depression in teenagers



In adolescent depression, the thing people tend to notice first is withdrawal, or when the teenager stops doing things she usually likes to do. There might be other changes in her mood, including sadness or irritability. Or in her behavior, including, appetite, energy level, sleep patterns and academic performance. If several of these symptoms are present, be vigilant about the possibility of depression.



This is especially important because by the time family members and other people around a teenager note her lack of interest in most things, or what we call anhedonia, she’s usually been depressed for some time. Depression is an internalizing disorder, i.e. one that disturbs a patient’s emotional life, rather than an externalizing one, which manifests in the form of disruptive or problematic behavior. As such, it takes a while not only for others to recognize it, but often for the patient herself to realize that her thinking, and emotional responses, are disturbed.



Note that there are actually two kinds of depression. In major depressive disorder—the most familiar form of depression—the cluster of symptoms that define depression occur in what may be severe episodes that tend to last from seven to nine months. But there is also another form of depression called dysthymic disorder, in which the symptoms are milder, but they last longer, measured in years. So while the experience of dysthymia may be less debilitating for the child at any given moment, the risk is that there is more accrued damage, more time in which the child is kept out of the healthy development process.



#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.
  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy



Link for 40 Habits Signup
bit.ly/40HabitsofMentalHealth



Book

www.celebratingyourgiftoflife.com

Symptoms of anxiety



Anxiety is a normal adaptive system that lets the body know when it’s in danger. But anxiety becomes a problem when it’s out of proportion to the situation, and interferes with a person’s ability to function. An overly anxious teen might withdraw from activities because she’s too scared or anxious, and her anxiety doesn’t go away with reassurance.



A teenager who has been anxious since childhood may have a lifestyle built around her anxieties: the activities and environments she chooses and those she rules out, the friends she is comfortable with, the expectations and limitations she has trained her family, friends, and teachers to accept. That’s why it’s more challenging to treat anxiety the longer a child has lived with it, and developed unhealthy coping mechanisms to manage it.



Why early intervention is critical



When a child is depressed or anxious, her suffering isn’t the only reason it’s important to get help.



In addition to the disorders themselves, there are add-on effects that may cause lifelong issues. With depression comes low energy and poor concentration, two factors that are likely to have a significant impact on social and academic functioning. Anxiety, and the withdrawal that may accompany it, is likewise a detriment to social and academic progress.



It’s easy to see the effects of poor academic functioning: falling behind in school undermines a child’s confidence and self-image, and can impact her future if it’s prolonged. But social learning is just as critical as academic learning in childhood and adolescence. This is a time when a girl would normally be learning such things as how to be a daughter, a sister, a friend; with either depression or anxiety, she may miss or fall behind on these critical kinds of learning. These deficits not only put her behind her peers, but in themselves they can compound her depression or anxiety.



Other disorders



It’s important to understand that anxiety and depression often occur in the same teenager, and may need to be treated as two separate disorders. Anxiety is more likely to occur without depression than depression without anxiety. It may be that depression leads to anxiety—the negative state of mind of a depressed teenager lends itself to uncertainty. If you’re not feeling good about yourself, or confident, or secure, or safe, anxiety may find fertile ground. It may also be because the regions of the brain affected by anxiety and depression are close together, and mutually affected.



Two serious problems that are directly associated with teenage depression and anxiety are suicidal thinking (or behavior), and substance abuse. Suicide is the third leading cause of death among adolescents and young adults aged 15 to 24, and we know that most kids who commit suicide have been suffering from a psychiatric illness. Especially at risk are teenagers who hide their depression and anxiety from parents and friends. That’s why it’s important to be alert to signs of these disorders—withdrawal, changes in school performance, eating habits, sleeping patterns, things she enjoys doing—even when teenagers aren’t forthcoming about how they feel. Similarly, the majority of teenagers who develop substance abuse problems also have a psychiatric disorder, including, most commonly, anxiety or depression, which is another important reason to get treatment in a timely way.



Two other problems associated with teenage girls—that is, occurring with greater frequency in girls than boys—are eating disorders and self injury, or cutting. While both of these can overlap with depression, the common assumption that they’re caused by depression is not borne out by research. Girls who have eating disorders often show no signs of depression; indeed, they are often very high-functioning, competitive girls who have a distorted body image, but not the symptoms of depression. Similarly, self-injurious behavior is a kind of dysfunctional coping mechanism kids get into to alleviate emotional pain, or numbness they’ve developed as a result of that pain. It can occur with, and be complicated by, a mood disorder, but isn’t thought to be a result of the latter. Antidepressants, the medication of choice for mood disorders, don’t usually alleviate eating disorders or cutting, which receive different kinds of treatment.



Treatments for anxiety and depression



Fortunately, early involvement of health care professionals can shorten the period of illness and increase the likelihood of her not missing important life lessons.



The most common treatment a mental health professional is apt to use is some form of cognitive behavioral therapy, and depending on how young the child is, it may involve teaching the parents as well. Cognitive behavioral therapy is based on the idea that a person suffering from a mood disorder is trapped in a negative pattern of thought. Depressed kids tend to evaluate themselves negatively, interpret the actions of others in a negative way, and assume the darkest possible outcome of events. Similarly, a child suffering from anxiety is overwhelmed by fears of negative outcomes long before events occur. In CBT, we teach sufferers to challenge those negative thoughts, to recognize the pattern and train themselves to think outside it. And in many cases we see real improvement in teenagers with depression and anxiety.



If the anxiety or depression is moderate to severe, treatment may involve medications such as antidepressants. For both anxiety and depression, a combination of psychotherapy and medication usually works better than either alone.






https://standingabovethecrowd.com/james-donaldson-on-mental-health-mood-disorders-and-teenage-girls/
James Donaldson on Mental Health - How Anxiety Affects Teenagers
Signs of anxiety in adolescents, and how they're different from anxious children

Writer: Caroline Miller

Clinical Experts: Jerry Bubrick, PhD , Dave Anderson, PhD

What You'll Learn

- How is anxiety different in teenagers than younger children?

- What are signs of anxiety in teens?

- Why is substance use a problem for anxious teens?

- Quick Read

- Full Article

- How is anxiety different in teenagers?

- What are teenagers anxious about?

- Symptoms of anxiety in teenagers

- Anxiety and school refusal

- Anxiety and substance use

- Anxiety and depression

- Treatment for anxiety

Anxious teens are different from anxious children. When they’re younger, kids worry more about things like the dark, monsters, or something bad happening to their parents. But teenagers are more likely to be worried about themselves.

Often this looks like perfectionism. Teens might fear not doing well in school or sports. Or they may be very worried about what other people think about them. It’s also common for kids to be worried about their bodies. Going through puberty before or after their friends is a big trigger.

Some anxious teens have been struggling for a long time, but it’s gotten worse. Other times, kids who weren’t anxious before will suddenly start being anxious as teens. Social anxiety and panic attacks are two kinds of anxiety that often start in the teenage years.

It can be hard to notice anxiety because teens are good at hiding their feelings. Symptoms also vary from kid to kid. Some teens tend to avoid things. Others are more irritable or lash out at people around them. They might start refusing to go to school or complain a lot about stomachaches and headaches.

Anxious teens may get into the habit of using marijuana or alcohol to feel less anxious. It works in the short term. But their anxiety doesn’t actually go away, and eventually kids can become dependent on the substance.

Anxiety often leads to depression, too. A life full of avoidance or worry undermines wellbeing. As anxious kids start doing less and less, their depression grows.

The best treatment for teens with anxiety is cognitive behavioral therapy (CBT). CBT teaches kids how to face their anxiety instead of avoiding it. Then they learn that their anxiety actually gets smaller over time. Sometimes CBT is also combined with an antidepressant medication for kids who are too anxious to do CBT alone.

There is substantial evidence that the pandemic has increased the number of adolescents (and even some pre-adolescents) who are anxious. It’s no wonder, given that Covid lockdowns and distancing robbed teenagers of many of the activities they care about most, disrupted their education, and isolated them from their friends.

We’re all hoping that as life returns to something like normal, adolescents will rebound. But anxiety in adolescents was already on the rise before the pandemic. Why? Experts cite increased pressure to succeed in school, a world that feels scarier and the toll social media can take on self-esteem. But nobody really understands it. It’s important to recognize the signs of anxiety, and get kids who are struggling help.

How is anxiety different in teenagers?

Anxious teenagers are different from anxious children. At each stage of development, kids have different worries and vulnerabilities.

Younger children are prone to be anxious about external things — like animals or insects, the dark, monsters under the bed, or something bad happening to mom and dad. But teenagers are more likely to be worried about themselves — their performance in school or sports, how they are perceived by others, the changes in their bodies.

Some anxious teenagers have been anxious for many years by the time they reach adolescence. Maybe parents have been aware of it, but the child functioned well despite their distress, so nothing was done about it. Or the child was treated, and things got better. But as more is expected of them, in middle and high school, and as they develop more focus on their peers, the anxiety can resurface and become more severe. And some teens who weren’t anxious children develop adolescent-onset kinds of anxiety, including social anxiety and panic attacks.

What are teenagers anxious about?

Their performance. “We see a lot of fear of not doing well,” explains Jerry Bubrick, PhD, a clinical psychologist at the Child Mind Institute who specializes in anxiety and OCD. “A lot of anxiety is geared towards perfectionism, or needing to do their absolute best in school, beyond an intense work ethic.” Even when parents report that they urge kids not to stress over college admissions, teenagers say they feel intense pressure to get those straight A’s.

How they’re perceived.  “Every teenager is going to have an awareness of and a certain vigilance about how they’re being perceived,” Dr. Bubrick notes. “That’s just part of the adolescent process, but some kids have that on steroids.” The result can be debilitating social anxiety. “They’re going to be really excessively worrying about whether they might be seen as incompetent or stupid, or they’re really worried about doing something embarrassing.”

Their bodies. Physical changes of adolescence are a cause of discomfort for many teenagers. Developing either before most of your peers, or after them, can make kids feel different and out of step.  “For girls if you’re on the early side in development, it’s going to affect you more negatively than if you were on time with development or even late,” notes Dr. Bubrick. Boys, he adds, are especially sensitive to height. “So if a 15-year-old hasn’t gone through puberty yet, and they’re looking like they’re 12 and their peers are looking like they’re 19, that can have a pretty profound impact on self-esteem and confidence.” Some kids develop a form of extreme anxiety called body dysmorphic disorder, becoming so obsessed with a perceived physical flaw (real or imagined) that it causes great distress and interferes with their functioning.

Symptoms of anxiety in teenagers

Symptoms of anxiety vary widely, from withdrawal and avoidance to irritability and lashing out. Anxiety is often overlooked because teenagers are good at hiding their thoughts and feelings. But these are some of the behaviors that might be a sign that a teenager is anxious.

- Recurring fears and worries about routine parts of everyday life

- Irritability

- Trouble concentrating

- Extreme self-consciousness or sensitivity to criticism

- Withdrawal from social activity

- Avoidance of difficult or new situations

- Chronic complaints about stomachaches or headaches

- Drop in grades or school refusal

- Repeated reassurance-seeking

- Sleep problems

- Substance use

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth

www.celebratingyourgiftoflife.com

Anxiety and school refusal

Since so much of what adolescents are focused on is connected with school — think academics, sports, other activities and social life — school can be the setting of a lot of things a teenager might be anxious about. Hence when kids resist going to school, it’s not necessarily about school itself.

Dr. Bubrick notes that what we call school refusal used to be called school phobia, but that implied that school is the source of their anxiety. Instead, in dealing with kids who find frequent excuses to stay home, or flat-out refuse to go, the focus isn’t on that decision to not go to school. “We’re more focused on why they’re making that decision to not go to school.”

The problem could be worry about being called on randomly by a teacher and making a mistake. Or having apanic attack in class. Or worry that they look wrong, and people will make fun of them. “You could interview a hundred kids refusing to go to school,” adds Dr. Bubrick, “and get a hundred different reasons why.”

Anxiety and substance use

Teenagers who are anxious (not unlike adults who are anxious) may use recreational drugs, especially marijuana, as a way of coping with their discomfort. It’s self-medication, notes Dr. Bubrick, and the reality is, in the short term, it works. “It does alleviate anxiety and stress. It numbs it. It does shut off the worry part of your brain.” But it’s a poor coping mechanism in the longer term, because the anxiety persists and the teenager becomes dependent on the substance.

Dr. Bubrick says what he hears about most from teenagers is that marijuana is healthier than alcohol. And now that marijuana is legal in many places (for those over 21) and vaping is an option, it’s easier than ever to smoke — on the street, at home or at school — without adults being aware of it.

But he notes that neither is a healthy way to manage anxiety, and he urges kids not to use recreational drugs as medicine. “If you have a joint in your pocket all the time and you’re smoking during the day, to get through your day at school, that’s no different from having a bottle of vodka in your desk drawer at work.” You’re still relying on a substance to get through the day — and the more you use it, the more dependent on it you’ll be.

Anxiety and depression

It’s common in teenagers to find that they are depressed as well as anxious. That is in part because an anxious lifestyle can be so distressing, or so limiting, that it leads to depression.

Dr. Bubrick recalls treating a young woman whose move to a new high school triggered intense social anxiety. She was so worried about failing in a more competitive atmosphere that she began to withdraw from activities. Then she had a panic attack, and began to withdraw from friends because she was afraid of having another panic attack in front of them. Eventually she was so isolated she became severely depressed.

This kind of layering of anxiety and depression is both common and commonly missed, Dr. Bubrick notes. If a clinician just treats the presenting symptoms of depression, and misses the anxiety, the result won’t be effective.

But it’s also possible that anxiety and depression are two separate co-occurring disorders.

Dr. Bubrick explains: “The question I ask kids is ‘If I was able to go into your brain and just remove your anxiety, would you still be depressed?’ If they say ‘Yes, I would still be depressed,’ that would suggest it might be a co-occurring depression. If the answer is, ‘No, I would feel amazing if you took the anxiety away,’ then I would think the anxiety is causing the depression.”

Dr. Bubrick notes that among the various kinds of anxiety, generalized anxiety disorder, commonly calledGAD, is particularly linked to depression later in life — so much so that it’s also thought of as a precursor for depression. GAD is anxiety that’s not triggered by a particular thing (that’s called specific phobia) but by persistent and excessive worry about a variety of everyday things.

What’s the link between anxiety and depression? Dr. Bubrick thinks anxiety undermines well-being. If you can’t trust yourself and you can’t trust that you’re going to make good decisions and you live defensively, then you’re especially at risk for depression.

“If you’re walking around always worrying and always doubting, and everything in life is ‘what if?’ that’s going to start to have a pretty profound effect on how you see yourself and your confidence and your self-esteem,” he explains. It’s not surprising, he adds, that if you’ve been living defensively, with a steady diet of fear, it could lead to depression.

Treatment for anxiety

The most effective treatment for anxiety in teenagers is cognitive behavioral therapy (CBT), combined, if needed, with antidepressant medication. And the good news is that it’s very effective.

CBT teaches anxious kids strategies for thinking differently about anxiety and responding to it differently when it occurs. By tolerating anxiety rather than avoiding things that trigger it, they learn that it diminishes over time. And by gradually increasing exposure to feared objects or activities (a type of CBT called exposure therapy), the anxious response itself is reduced or eliminated.

Antidepressants called SSRIs (selective serotonin reuptake inhibitors) ? are the medications recommended for treating anxiety disorders in children. They are combined with CBT in kids whose anxiety is too great to enable them to participate in CBT alone.
https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-anxiety-affects-teenagers/

Sunday, October 22, 2023

James Donaldson on Mental Health - How Anxiety Affects Teenagers

James Donaldson on Mental Health - How Anxiety Affects Teenagers

Signs of anxiety in adolescents, and how they're different from anxious children





Writer: Caroline Miller



Clinical Experts: Jerry Bubrick, PhD , Dave Anderson, PhD



What You'll Learn



- How is anxiety different in teenagers than younger children?

- What are signs of anxiety in teens?

- Why is substance use a problem for anxious teens?

- Quick Read

- Full Article

- How is anxiety different in teenagers?

- What are teenagers anxious about?

- Symptoms of anxiety in teenagers

- Anxiety and school refusal

- Anxiety and substance use

- Anxiety and depression

- Treatment for anxiety

Anxious teens are different from anxious children. When they’re younger, kids worry more about things like the dark, monsters, or something bad happening to their parents. But teenagers are more likely to be worried about themselves.



Often this looks like perfectionism. Teens might fear not doing well in school or sports. Or they may be very worried about what other people think about them. It’s also common for kids to be worried about their bodies. Going through puberty before or after their friends is a big trigger.



Some anxious teens have been struggling for a long time, but it’s gotten worse. Other times, kids who weren’t anxious before will suddenly start being anxious as teens. Social anxiety and panic attacks are two kinds of anxiety that often start in the teenage years.



It can be hard to notice anxiety because teens are good at hiding their feelings. Symptoms also vary from kid to kid. Some teens tend to avoid things. Others are more irritable or lash out at people around them. They might start refusing to go to school or complain a lot about stomachaches and headaches.



Anxious teens may get into the habit of using marijuana or alcohol to feel less anxious. It works in the short term. But their anxiety doesn’t actually go away, and eventually kids can become dependent on the substance.



Anxiety often leads to depression, too. A life full of avoidance or worry undermines wellbeing. As anxious kids start doing less and less, their depression grows.



The best treatment for teens with anxiety is cognitive behavioral therapy (CBT). CBT teaches kids how to face their anxiety instead of avoiding it. Then they learn that their anxiety actually gets smaller over time. Sometimes CBT is also combined with an antidepressant medication for kids who are too anxious to do CBT alone.



There is substantial evidence that the pandemic has increased the number of adolescents (and even some pre-adolescents) who are anxious. It’s no wonder, given that Covid lockdowns and distancing robbed teenagers of many of the activities they care about most, disrupted their education, and isolated them from their friends.



We’re all hoping that as life returns to something like normal, adolescents will rebound. But anxiety in adolescents was already on the rise before the pandemic. Why? Experts cite increased pressure to succeed in school, a world that feels scarier and the toll social media can take on self-esteem. But nobody really understands it. It’s important to recognize the signs of anxiety, and get kids who are struggling help.



How is anxiety different in teenagers?



Anxious teenagers are different from anxious children. At each stage of development, kids have different worries and vulnerabilities.



Younger children are prone to be anxious about external things — like animals or insects, the dark, monsters under the bed, or something bad happening to mom and dad. But teenagers are more likely to be worried about themselves — their performance in school or sports, how they are perceived by others, the changes in their bodies.



Some anxious teenagers have been anxious for many years by the time they reach adolescence. Maybe parents have been aware of it, but the child functioned well despite their distress, so nothing was done about it. Or the child was treated, and things got better. But as more is expected of them, in middle and high school, and as they develop more focus on their peers, the anxiety can resurface and become more severe. And some teens who weren’t anxious children develop adolescent-onset kinds of anxiety, including social anxiety and panic attacks.



What are teenagers anxious about?



Their performance. “We see a lot of fear of not doing well,” explains Jerry Bubrick, PhD, a clinical psychologist at the Child Mind Institute who specializes in anxiety and OCD. “A lot of anxiety is geared towards perfectionism, or needing to do their absolute best in school, beyond an intense work ethic.” Even when parents report that they urge kids not to stress over college admissions, teenagers say they feel intense pressure to get those straight A’s.



How they’re perceived.  “Every teenager is going to have an awareness of and a certain vigilance about how they’re being perceived,” Dr. Bubrick notes. “That’s just part of the adolescent process, but some kids have that on steroids.” The result can be debilitating social anxiety. “They’re going to be really excessively worrying about whether they might be seen as incompetent or stupid, or they’re really worried about doing something embarrassing.”



Their bodies. Physical changes of adolescence are a cause of discomfort for many teenagers. Developing either before most of your peers, or after them, can make kids feel different and out of step.  “For girls if you’re on the early side in development, it’s going to affect you more negatively than if you were on time with development or even late,” notes Dr. Bubrick. Boys, he adds, are especially sensitive to height. “So if a 15-year-old hasn’t gone through puberty yet, and they’re looking like they’re 12 and their peers are looking like they’re 19, that can have a pretty profound impact on self-esteem and confidence.” Some kids develop a form of extreme anxiety called body dysmorphic disorder, becoming so obsessed with a perceived physical flaw (real or imagined) that it causes great distress and interferes with their functioning.



Symptoms of anxiety in teenagers



Symptoms of anxiety vary widely, from withdrawal and avoidance to irritability and lashing out. Anxiety is often overlooked because teenagers are good at hiding their thoughts and feelings. But these are some of the behaviors that might be a sign that a teenager is anxious.



- Recurring fears and worries about routine parts of everyday life

- Irritability

- Trouble concentrating

- Extreme self-consciousness or sensitivity to criticism

- Withdrawal from social activity

- Avoidance of difficult or new situations

- Chronic complaints about stomachaches or headaches

- Drop in grades or school refusal

- Repeated reassurance-seeking

- Sleep problems

- Substance use

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.
  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy



Link for 40 Habits Signup
bit.ly/40HabitsofMentalHealth



Book

www.celebratingyourgiftoflife.com

Anxiety and school refusal



Since so much of what adolescents are focused on is connected with school — think academics, sports, other activities and social life — school can be the setting of a lot of things a teenager might be anxious about. Hence when kids resist going to school, it’s not necessarily about school itself.



Dr. Bubrick notes that what we call school refusal used to be called school phobia, but that implied that school is the source of their anxiety. Instead, in dealing with kids who find frequent excuses to stay home, or flat-out refuse to go, the focus isn’t on that decision to not go to school. “We’re more focused on why they’re making that decision to not go to school.”



The problem could be worry about being called on randomly by a teacher and making a mistake. Or having apanic attack in class. Or worry that they look wrong, and people will make fun of them. “You could interview a hundred kids refusing to go to school,” adds Dr. Bubrick, “and get a hundred different reasons why.”



Anxiety and substance use



Teenagers who are anxious (not unlike adults who are anxious) may use recreational drugs, especially marijuana, as a way of coping with their discomfort. It’s self-medication, notes Dr. Bubrick, and the reality is, in the short term, it works. “It does alleviate anxiety and stress. It numbs it. It does shut off the worry part of your brain.” But it’s a poor coping mechanism in the longer term, because the anxiety persists and the teenager becomes dependent on the substance.



Dr. Bubrick says what he hears about most from teenagers is that marijuana is healthier than alcohol. And now that marijuana is legal in many places (for those over 21) and vaping is an option, it’s easier than ever to smoke — on the street, at home or at school — without adults being aware of it.



But he notes that neither is a healthy way to manage anxiety, and he urges kids not to use recreational drugs as medicine. “If you have a joint in your pocket all the time and you’re smoking during the day, to get through your day at school, that’s no different from having a bottle of vodka in your desk drawer at work.” You’re still relying on a substance to get through the day — and the more you use it, the more dependent on it you’ll be.



Anxiety and depression



It’s common in teenagers to find that they are depressed as well as anxious. That is in part because an anxious lifestyle can be so distressing, or so limiting, that it leads to depression.



Dr. Bubrick recalls treating a young woman whose move to a new high school triggered intense social anxiety. She was so worried about failing in a more competitive atmosphere that she began to withdraw from activities. Then she had a panic attack, and began to withdraw from friends because she was afraid of having another panic attack in front of them. Eventually she was so isolated she became severely depressed.



This kind of layering of anxiety and depression is both common and commonly missed, Dr. Bubrick notes. If a clinician just treats the presenting symptoms of depression, and misses the anxiety, the result won’t be effective.



But it’s also possible that anxiety and depression are two separate co-occurring disorders.



Dr. Bubrick explains: “The question I ask kids is ‘If I was able to go into your brain and just remove your anxiety, would you still be depressed?’ If they say ‘Yes, I would still be depressed,’ that would suggest it might be a co-occurring depression. If the answer is, ‘No, I would feel amazing if you took the anxiety away,’ then I would think the anxiety is causing the depression.”



Dr. Bubrick notes that among the various kinds of anxiety, generalized anxiety disorder, commonly calledGAD, is particularly linked to depression later in life — so much so that it’s also thought of as a precursor for depression. GAD is anxiety that’s not triggered by a particular thing (that’s called specific phobia) but by persistent and excessive worry about a variety of everyday things.



What’s the link between anxiety and depression? Dr. Bubrick thinks anxiety undermines well-being. If you can’t trust yourself and you can’t trust that you’re going to make good decisions and you live defensively, then you’re especially at risk for depression.



“If you’re walking around always worrying and always doubting, and everything in life is ‘what if?’ that’s going to start to have a pretty profound effect on how you see yourself and your confidence and your self-esteem,” he explains. It’s not surprising, he adds, that if you’ve been living defensively, with a steady diet of fear, it could lead to depression.



Treatment for anxiety



The most effective treatment for anxiety in teenagers is cognitive behavioral therapy (CBT), combined, if needed, with antidepressant medication. And the good news is that it’s very effective.



CBT teaches anxious kids strategies for thinking differently about anxiety and responding to it differently when it occurs. By tolerating anxiety rather than avoiding things that trigger it, they learn that it diminishes over time. And by gradually increasing exposure to feared objects or activities (a type of CBT called exposure therapy), the anxious response itself is reduced or eliminated.



Antidepressants called SSRIs (selective serotonin reuptake inhibitors) ? are the medications recommended for treating anxiety disorders in children. They are combined with CBT in kids whose anxiety is too great to enable them to participate in CBT alone.




https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-anxiety-affects-teenagers/
James Donaldson on Mental Health - Depression and Anger
How irritability and anger can be signs of depression in children and teenagers

Writer: Caroline Miller

Clinical Expert: Lauren Allerhand, PsyD

What You'll Learn

- When are irritability and anger signs of depression in children and teenagers?

- How is this different from typical teenage irritability?

- What should you do if your child seems unusually irritable and angry?

- Full Article

- What does irritability look like when it’s part of depression?

- What to do if you’re concerned

- Talk to a mental health professional 

We usually think of someone who’s depressed as being sad or “down” for a very long time. But children and teenagers who are depressed can also be irritable or angry a lot of the time. They may seem on edge. Some depressed kids are irritable instead of sad. Others are both: they alternate between sad and irritable.

Since teenagers are often irritable, how can you tell if your child’s irritability might be associated with depression? Normal irritability is intermittent, a reaction to something specific. In depression, it’s their mood most of the time. It’s also normal for kids to be cranky at home, but not at school or when they’re with friends. Or cranky in the morning, and then in a better mood later. But if they’re irritable all the time, and not just at home, but in all settings, it could be depression.

To be diagnosed with depression a child would need to meet other criteria for depression, too. Those include losing interest in things they used to enjoy, lacking energy, changes in eating and sleep habits, among other things. If they are irritable but high in energy, it’s more likely to be connected to anxiety.

If you’ve noticed that your child has been unusually irritable and angry, the first step is to talk to them. Ask them if there’s something bothering them. If they’re upset about something specific, listen to their concerns without being judgmental. If not, and it seems to be a generally irritable mood, it’s a good idea to get care from a mental health professional.

Especially when it’s caught early, depression is very treatable. Treatment for depression includes both medication and specialized forms of cognitive behavioral therapy that focus on helping kids learn to cope with difficult emotions.

We usually think of depression as a form of prolonged sadness, being “down” for a disturbingly long time. But depression can also take the form of irritability in children and teenagers. And irritability — a tendency to react angrily to slight annoyances or provocations — can result in everything from angry outbursts in younger children to cutting or snide remarks in teenagers.

“What we see with younger kids and teenagers is they’re always feeling annoyed or feeling on edge,” explains Lauren Allerhand, PsyD, a clinical psychologist at the Child Mind Institute. “They always appear to be a little bit frustrated, like they’re simmering under the surface.”

In some kids, irritability replaces the depressed mood that we think of as the defining symptom of depression. In others it appears along with feeling down. “What I see most often is kids who experience both,” adds Dr. Allerhand. “It’s like an inability to experience positive emotions. They’re waffling between this irritability and low mood.”

Dr. Allerhand notes that it can be helpful for parents to know that anger can be what is called a “secondary emotion.” That means that for some people – kids or adults — it’s easier to experience anger than sadness or loss or grief. “The locus of anger is usually external,” she notes, so it can be easier to be angry with those around you than to acknowledge some very painful negative feelings. It makes sense, then, that kids who are feeling deep sadness might express anger instead.

What does irritability look like when it’s part of depression?

There are many things that can prompt irritability and anger in young people. What are the signs that these negative moods might be associated with depression?

If the irritability is constant rather than conditional. We expect some level of irritability from teenagers in general, especially when they’re being asked to do something they don’t want to do, like put down their phones and join the family for dinner. But that typical kind of irritation or anger is intermittent, and it’s provoked by something specific.

“However, if irritation is the main way that a teenager is throughout the day,” says Dr. Allerhand, “and not only at home but also at school or in other environments, it may be related to a mood disorder rather than an environmental circumstance.”

If the irritability is accompanied by other symptoms of depression. In addition to depressed mood or irritability, to be diagnosed with depression a child would have to have at least four of these symptoms:

- Losing interest in things they once enjoyed

- Feeling worthless, saying negative things about themselves

- Lacking energy, feeling tired or seeming lazy

- Trouble concentrating or making decisions

- Gaining or losing weight, changes in appetite

- Trouble sleeping or sleeping too much

- Thinking about or attempting suicide

Irritability with high energy could be caused by anxiety. Depression generally comes with low energy levels. So when irritability appears with high energy, or it is accompanied by a lot of worried behavior, Dr. Allerhand says it’s more likely to be associated with anxiety. Or, in some cases, it can be a sign of bipolar disorder. “I would look at anxiety first,” she said, “unless there was a very strong family history of bipolar or some very strong indicators, because that’s much less common.”

If the irritability is explosive, it could beDMDD. When a child regularly has explosive outbursts of anger with seemingly little provocation, they may have the relatively new disorder calleddisruptive mood dysregulation disorder, or DMDD. “Those are the kids who go from zero to 100, throwing stuff, hitting — those really big tantrums, big displays,” notes Dr. Allerhand. The kind of irritability associated with depression is more of a steady state of being on edge, and prone to snap at someone or lash out verbally. DMDD usually shows up before age ten, but it isn’t diagnosed in kids younger than six, since temper tantrums are common in very young children.

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What to do if you’re concerned

If you’re wondering if the irritability or anger you’re seeing from a child or teenager could be a sign of depression, Dr. Allerhand has these recommendations:

Talk to them about how they’re feeling. If your child seems unusually irritable, something may be going on that’s driving the behavior. A good place to start is having a conversation with them to see if there’s something at school or at home that’s causing them stress.

“Start with something open-ended like, ‘How have you been feeling lately? I know things have been tough,’ ” she suggests. “See what the child says. If they are open to talking about how they feel, great! Parents should listen and validate without jumping immediately to problem solving — unless the child is specifically asking for problem solving.”

If the child is unresponsive to first attempts, Dr. Allerhand encourages parents to let it go and let the child know they are always available to chat. “I’d recommend doing this often — even daily — so they will come to you when they’re ready,” she says. “This shouldn’t be a power struggle, or kids will never want to share.”

If it’s less than constant, try to ignore it. If your child’s irritability seems to be triggered by things they don’t want to do, or they’re irritable in the morning but pleasant in the afternoon, it’s less likely to be a sign of a mood disorder. “If it’s more conditional and not happening all the time, I would ignore it as much as you possibly can,” advises Dr. Allerhand. “It’s best to avoid saying things like, ‘That’s disrespectful,’ or, ‘You don’t talk to me like that.’ Any of that kind of attention is going to increase the likelihood that you see more of it.”

On the other hand, do praise behavior you do want to see: “So anytime they come down to the dinner table and sit down and grunt one word at you, you say, ‘Thank you so much. I love when you have dinner with us.’ No sarcasm either.”

If it’s only happening at home, you probably don’t need to worry. Even if a teenager is irritable most of the time at home, if they’re happy at school or in other environments, then it’s more likely to be typical edginess than a mood disorder, Dr. Allerhand advises.

Teenagers tend to direct anger and irritability towards parents, since venting is less risky where you are most secure. “Forming strong peer relationships is a high priority for teenagers. And if you’re irritable and blow up at people, they don’t generally want to be your friend. So oftentimes kids save it for the people who they have the most secure relationships with,” adds Dr. Allerhand.

And since parents have control over so much of a child’s – and even a teenager’s — life, they’re very easy targets for irritation and anger.

Talk to a mental health professional 

If your child’s irritability and anger are a pattern that’s going on every day, for more than a couple of weeks, and outside the home as well as with the family, it’s a good idea to consult a mental health professional. Especially when it’s caught early, depression is very treatable. Treatment for depression includes both medication and specialized forms of cognitive behavioral therapy that focus on helping kids learn to cope with difficult emotions.
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