Anxiety: Types, Differences, and Impacts
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Four Types
Four Types
Four Types
Four Types
Which will you be?
Take a minute to answer this question
What is anxiety? What words do
you use to describe anxiety?
Fear VS Anxiety
Fear –
an unpleasant emotion
caused by the belief that someone or
something is dangerous, likely to cause pain, or a threat.
.
https://www.youtube.com/watch?v=AV6rhYssCQM
Anxiety VS Stress
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https://www.youtube.com/watch?v=S8-zfk9_lhg
Anxiety
Anxiety –
anxius [L, 1500s], a condition of agitation and distress
-- internal focus
-- a response to a vague, distant
or even unrecognized danger
a feeling of worry, nervousness, or unease, typically about an imminent event
or something with an uncertain outcome
Anxiety
Anxiety:
- inevitable
- response to
everyday challenge
- proportioned,
*appropriate,
*reasonable
Anxiety is normal!
Some statistics
At least 20% of children under age 18 have significant mental health problems.
75% of those don’t get help.
Too much anxiety is unhealthy.
Often there is a family (genetic) tendency to anxiety
Stress can be in family, school or neighborhood
Anxious parents can model anxious behavior for children
Children who live with too much stress can develop anxiety disorders
Dimensions of Anxiety: Symptoms in four
arenas
Dimensions of Anxiety: Symptoms in four
arenas
Somatic
- Hyperventilation
- Tachycardia
- trembling
- palpitations
- shakiness
- swallowing
- sweating
- lump in throat
- flushing
- urgency to urinate
-nausea
- hair raising
- dizziness
- tinnitus
- wobbling legs
Dimensions of Anxiety: Symptoms in four
arenas
Cognitive
- Specific fears
- Embarrassment or shame is
intolerable
- Something awful will happen
- I am going crazy
- I will lose control
- I am going to die
Dimensions of Anxiety: Symptoms in four
arenas
Behavioral
Withdrawal
Avoidance
Escape
Clinging
Aggression
Dimensions of Anxiety: Symptoms in four
arenas
Emotional
- Tense
- Nervous
- Worried
- On edge
- Panicky
- Feelings of unreality
- Terrified
- Hypervigilant
- Scared
- Depressed
- Anxious
When to be concerned
Avoidance of school (refuses to go)
Frequent stomachaches or headaches in the morning before school
Avoidance of activities
Easily upset – distress out of proportion
Parent or teacher reports they spent a lot of time comforting the child and/or
urging her/him to participate in regular activities
Parent or teacher reports family/classroom functioning is being disrupted by your
child's fears and worries, or meltdowns.
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When to be concerned
Sudden overwhelming fear
for no reason, often with difficulty breathing and
racing or pounding heart
Decline
in school performance
Wanting to
avoid
school
Anxiety
Anxiety disorders are the most common mental health disorders.
Up to 6% of children and youth have an anxiety disorder severe enough to
need treatment.
Children may have more than one kind of anxiety disorder.
Many anxiety disorders start in childhood and if untreated, they may persist into
adulthood.
Anxiety Disorders
Anxiety Disorders:
- intensity
- duration
- impairment
Types of Anxiety
Separation anxiety
Selective mutism
Specific phobia
Situational Anxiety
Other
Social Anxiety
Panic Disorder
Agoraphobia
Generalized anxiety disorder
Substance Induced Anxiety
Anxiety not due to medical condition
Other specified anxiety disorders
Unspecified anxiety disorder
Separation Anxiety Disorder
Child is afraid of leaving their parent(s)
They may worry that something bad will happen to the parent or to someone they
love or to themselves
May refuse to go to school
May have stomachaches, headaches, or throw up if they fear separation
May refuse to go to playdates at other people’s houses
Diagnosed if it causes problems at school or socially and has been going on at least
4 weeks
https://
www.youtube.com/watch?v=dRFgSpJz-K4
Generalized Anxiety Disorder
Children with this kind of anxiety may:
Have lots of worries and fears
Have problems sleeping because of worries
Have trouble concentrating
Get tired easily or have tension headaches
Be tense or restless
Be perfectionist
Have an anxious desire for approval
https://www.youtube.com/watch?v=SYfvtVooPM8
Panic Disorder
Happens less often with younger children
People with this kind of anxiety have panic attacks
Feel very scared
Heart pounding, hard to breathe
May feel shaky, dizzy, or sick
May feel like they are going crazy or something really awful is going to happen
Sometimes they avoid school or want to stay in the house
Frequent panic attacks = panic disorder
https://www.youtube.com/watch?v=jJH1fSfqBTs
Selective Mutism
Children may not talk to anyone who is not close to them, such as immediate
family
They may look down, withdraw, turn red if required to talk
Often they whisper if they do speak in a situation where they are anxious
Up to 2% of school age children may have these symptoms
Some kids outgrow it; some go on to have social phobia
https://www.youtube.com/watch?v=aIrDeBoUGlE
Social Anxiety/Social Phobia
Happens more in teens than in young children
Fear and worry about social situations
Going to school
Speaking in class
Social events including recess and lunch
Shy, self-conscious
Easily embarrassed
These kids tend to be sensitive to criticism and find it hard to be assertive
https://www.youtube.com/watch?v=ypHzXOcUQwE
Assessment
List and clarify all symptoms
Look at history: family, drug use, mental health,
medical health.
Analysis of current lifestyle status: stress,
nutrition, exercise, sleep, medications. List
problem areas.
Rule out physical and other psychiatric causes,
getting medical results.
Assessment
Medical Rule Outs
Shortness of breath
Heart
Respiration
Dizziness
Anemia, BPV, BP
Numbness
Circulatory
respiratory
Palpitations
Tachycardia
Thyroid
Hypoglycemia
Chest pain
Heart conditions
Autoimmune
CFS
Fibromyalgia
Epstein-Barr
Assessment cont’
– Drug Usage Rule Outs
Alcohol
Kindling
Neural excitement during
withdrawal
Cocaine
Kindling
Drug-induced panic
Other stimulants
OTC drugs
Diet pills
Laxatives
Caffeine
aspartame
Other medications
Disulfiram
Drugs to treat thyroid and
endocrine
Treatment
Anxiety disorders can be treated!
The most common treatment is cognitive behavior therapy (CBT) in groups or
individually
In CBT children learn relaxation and stress management plus
Gradual exposure to things that make them anxious, to decrease the
fear
Coping strategies to reduce anxiety
Treatment
CBT is first choice, but medication may be needed in severe situations
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Cycle of Anxiety
Treatment –
Psychotherapy
Subjective Rating Scales Use
Explain concepts of SUDs
Discuss the meaning of the ratings 0 – 10
No comparison to other people are ever involved, self-assessment tool
No internal competition: observing only
Grounding!
Look around you. Find 5 things you can
see, 4 things you can touch, 2 things you
can smell and 1 thing you can taste. This
is called “grounding” It is helpful to do
when you are anxious
.
Daily Record of Breathing or Relaxation
Treatment –
Medication Consideration
Benzodiazepines:
For panic, acute
anxiety symptoms
To enhance early tx
Short term use e.g. 30
days
Daily, regular use
Rarely used PRN
Antidepressants
Misnamed
Used for chronic
anxiety and depressed
moods
Long term use
Bolster with lifestyle
changes and
psychotherapy
Treatment –
Medication Choices
Whew- Questions?
Anxiety is a common emotional response characterized by feelings of worry, nervousness, and unease. This content delves into the various types of anxiety, compares fear to anxiety, explores the distinctions between anxiety and stress, discusses the inevitability and normalcy of anxiety, and highlights the impact of excessive anxiety on mental health, particularly in children. It emphasizes the importance of recognizing and addressing anxiety, considering factors such as genetic predispositions and environmental influences.
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Presentation Transcript
Take a minute to answer this question What is anxiety? What words do you use to describe anxiety?
Fear VS Anxiety Fear an unpleasant emotion caused by the belief that someone or something is dangerous, likely to cause pain, or a threat. . https://www.youtube.com/watch?v=AV6rhYssCQM
Anxiety VS Stress Stress is your body's way of responding to any kind of demand or threat. When you sense danger whether it's real or imagined the body's defenses kick into high gear in a rapid, automatic process known as the fight-or- flight reaction or the "stress response." https://www.youtube.com/watch?v=S8-zfk9_lhg
Anxiety Anxiety anxius [L, 1500s], a condition of agitation and distress -- internal focus -- a response to a vague, distant or even unrecognized danger a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome
Anxiety Anxiety: - inevitable - response to everyday challenge - proportioned, *appropriate, *reasonable Anxiety is normal!
Some statistics At least 20% of children under age 18 have significant mental health problems. 75% of those don t get help.
Too much anxiety is unhealthy. Often there is a family (genetic) tendency to anxiety Stress can be in family, school or neighborhood Anxious parents can model anxious behavior for children Children who live with too much stress can develop anxiety disorders
Dimensions of Anxiety: Symptoms in four arenas Somatic - Hyperventilation - Tachycardia - trembling - shakiness - sweating - flushing -nausea - dizziness - wobbling legs - palpitations - swallowing - lump in throat - urgency to urinate - hair raising - tinnitus
Dimensions of Anxiety: Symptoms in four arenas Cognitive - Specific fears - Embarrassment or shame is intolerable - Something awful will happen - I am going crazy - I will lose control - I am going to die
Dimensions of Anxiety: Symptoms in four arenas Behavioral Withdrawal Avoidance Escape Clinging Aggression
Dimensions of Anxiety: Symptoms in four arenas Emotional - Tense - Worried - Panicky - Terrified - Scared - Anxious - Nervous - On edge - Feelings of unreality - Hypervigilant - Depressed
When to be concerned Avoidance of school (refuses to go) Frequent stomachaches or headaches in the morning before school Avoidance of activities Easily upset distress out of proportion Parent or teacher reports they spent a lot of time comforting the child and/or urging her/him to participate in regular activities Parent or teacher reports family/classroom functioning is being disrupted by your child's fears and worries, or meltdowns. Intense worries or fears that interfere with daily activities
When to be concerned Sudden overwhelming fear for no reason, often with difficulty breathing and racing or pounding heart Decline in school performance Wanting to avoid school
Anxiety Anxiety disorders are the most common mental health disorders. Up to 6% of children and youth have an anxiety disorder severe enough to need treatment. Children may have more than one kind of anxiety disorder. Many anxiety disorders start in childhood and if untreated, they may persist into adulthood.
Anxiety Disorders Anxiety Disorders: - intensity - duration - impairment
Types of Anxiety Separation anxiety Selective mutism Specific phobia Situational Anxiety Other Social Anxiety Panic Disorder Agoraphobia Generalized anxiety disorder Substance Induced Anxiety Anxiety not due to medical condition Other specified anxiety disorders Unspecified anxiety disorder
Separation Anxiety Disorder Child is afraid of leaving their parent(s) They may worry that something bad will happen to the parent or to someone they love or to themselves May refuse to go to school May have stomachaches, headaches, or throw up if they fear separation May refuse to go to playdates at other people s houses Diagnosed if it causes problems at school or socially and has been going on at least 4 weeks https://www.youtube.com/watch?v=dRFgSpJz-K4
Generalized Anxiety Disorder Children with this kind of anxiety may: Have lots of worries and fears Have problems sleeping because of worries Have trouble concentrating Get tired easily or have tension headaches Be tense or restless Be perfectionist Have an anxious desire for approval https://www.youtube.com/watch?v=SYfvtVooPM8
Panic Disorder Happens less often with younger children People with this kind of anxiety have panic attacks Feel very scared Heart pounding, hard to breathe May feel shaky, dizzy, or sick May feel like they are going crazy or something really awful is going to happen Sometimes they avoid school or want to stay in the house Frequent panic attacks = panic disorder https://www.youtube.com/watch?v=jJH1fSfqBTs
Selective Mutism Children may not talk to anyone who is not close to them, such as immediate family They may look down, withdraw, turn red if required to talk Often they whisper if they do speak in a situation where they are anxious Up to 2% of school age children may have these symptoms Some kids outgrow it; some go on to have social phobia https://www.youtube.com/watch?v=aIrDeBoUGlE
Social Anxiety/Social Phobia Happens more in teens than in young children Fear and worry about social situations Going to school Speaking in class Social events including recess and lunch Shy, self-conscious Easily embarrassed These kids tend to be sensitive to criticism and find it hard to be assertive https://www.youtube.com/watch?v=ypHzXOcUQwE
Assessment List and clarify all symptoms Look at history: family, drug use, mental health, medical health. Analysis of current lifestyle status: stress, nutrition, exercise, sleep, medications. List problem areas. Rule out physical and other psychiatric causes, getting medical results.
Assessment Medical Rule Outs Shortness of breath Heart Respiration Dizziness Anemia, BPV, BP Numbness Circulatory respiratory Palpitations Tachycardia Thyroid Hypoglycemia Chest pain Heart conditions Autoimmune CFS Fibromyalgia Epstein-Barr
Assessment cont Drug Usage Rule Outs Alcohol Kindling Neural excitement during withdrawal Cocaine Kindling Drug-induced panic Other stimulants OTC drugs Diet pills Laxatives Caffeine aspartame Other medications Disulfiram Drugs to treat thyroid and endocrine
Treatment Anxiety disorders can be treated! The most common treatment is cognitive behavior therapy (CBT) in groups or individually In CBT children learn relaxation and stress management plus Gradual exposure to things that make them anxious, to decrease the fear Coping strategies to reduce anxiety
Treatment CBT is first choice, but medication may be needed in severe situations Teach relaxation strategies such as belly breathing and muscle relaxation Teach visualize or imagine a pleasant, relaxing happy place
Treatment Psychotherapy Subjective Rating Scales Use Explain concepts of SUDs Discuss the meaning of the ratings 0 10 No comparison to other people are ever involved, self-assessment tool No internal competition: observing only
Grounding! Look around you. Find 5 things you can see, 4 things you can touch, 2 things you can smell and 1 thing you can taste. This is called grounding It is helpful to do when you are anxious.
Daily Record of Breathing or Relaxation Time Assign- ment SUD Outset Duration SUD completion
Treatment Medication Consideration Benzodiazepines: For panic, acute anxiety symptoms To enhance early tx Short term use e.g. 30 days Daily, regular use Rarely used PRN Antidepressants Misnamed Used for chronic anxiety and depressed moods Long term use Bolster with lifestyle changes and psychotherapy
Treatment Medication Choices Benzodiazepine Sedative/ Hypnotic Antidepressants - Valium - Xanax - Librium - Ativan - Barbiturates - SSRI s - MAOIs - Tri-cyclics Effects: - Mood altering - Reduce anxiety sx - Addictive Effects: - Insomnia relief - Addictive - Lethal OD Effects: - Not mood altering - Not addictive - have side effects
