Friday gratitude here in relation to POPSUGAR who allowed me to speak on my passion related to children. It's a wonderful article so please click on it. Here's the behind the scenes extended interview you didn't get to see....
What are some common signs and symptoms of anxiety in children, and how can parents recognize these signs? What are some steps parents should take if they recognize anxiety in their kids? Would the kid's age change any of the signs/symptoms/steps to take? How might anxiety show beyond typical kid worries?
The most important thing when talking about mental health in children is to notice changes - whether it's anxiety, depression, or other issues there will be changes in how they interact. This could be physical changes like not sleeping well, changes in appetite, and not wanting to socialize in the same ways they would before. With children especially, we can see a shift in their independence - they may show a sudden separation anxiety and fear of doing things on their own they once did. Those are important changes to notice. School-age children might experience anxiety in terms of working about grades and tests in a manner that is excessive. Typical "kid worries" might be getting some butterflies in the tummy on the day of a standardized test and that resolves when the test is over, however the child with high anxiety might worry about that days or weeks in advance and not be able to let it go after the test ends. They might perseverate on what they got wrong and beat themselves up over a lack of perfection. Instead of some simple butterflies, highly anxious children might experience physical symptoms of headaches, knots in their stomach, tears and at times school refusal may be present. Because children are still developing emotionally and cognitively, they often are not fully aware or able to place in words what they are thinking or feeling. They might need help in being able to connect their worries about grades with the fact that they get a headache every morning as they are getting ready for school.
How can parents create an environment for their kid to feel open to discussing their anxiety? Are there any strategies you can offer for how to help a parent navigate that conversation? Especially if the parent initiates the conversation about anxiety or their concerns. Any specific dos and don'ts for either?
First, I would encourage parents to be kind to themselves too - just because your child is anxious does not mean you are a bad parent or that you did something wrong. The best of parents can have anxious children. It is far more important that you simply open a safe space for your child to express themselves. When talking to children, get on their level - sit down with them and maybe go into their space where they feel safe. Maybe have a talk in their room or sit outside in a place with little stimulation and few distractions- this ensures that the environment itself is set up for open discussion and safety. Using open-ended questions that encourage your child to open up can be very helpful. Often anxious children might be afraid to upset others, including their parents. So, we could say something like, "It seems like you're feeling a lot of things right now and I want you to know I am here. It's okay to 'feel all the feels.'" It can also be helpful to empathize with your child and let them know you are not perfect either. For example, "I might be a grown up, but I get scared sometimes too," by doing that you are modeling for them that feeling feelings is normal and healthy. Our feelings are not the problem but rather what we do with our feelings can lead to a problem if it's not healthy. When you are first starting to have conversations about these things, start slow and allow your child to slowly open up. Shift the goal from "fixing your child or their problem," to "listening to your child and creating an open space." That makes a world of difference in the reaction over time. One very important thing to certainly always do is to rule out if your child is developing anxiety or if they are experiencing a trauma reaction. Most often, it will be uncomplicated anxiety, but we want to rule those things out. So we can always ask a child directly in a gentle and caring tone, "has anything happened to you directly that is making your feel scared or unsafe right now?" If there is an unsafe situation happening than of course we manage those situations swiftly and with immediate professional guidance. Anxiety is also something that can gain power over time, so we want to help the child feel small wins "wow - you made it to school today without any headaches this morning - that's amazing!" Or "wow, I am so proud of how you used your deep breathing and positive self-talk to pull yourself out of the worry spiral!" Praise the wins so they begin to see how they are improving in time. In terms of "don'ts" - here we just want to stay away from trying to "fix" the child or make something go away overnight. Patience is key with shifting anxiety. I would also recommend never using a forceful or judgmental tone, or closed ended questions. That can increase the intensity of the anxious feelings. And, if you make a mistake in parenting and you could have handled something better, just own that. That can make a world of difference to your child.
If a parent is worried about their child's anxiety, who should they contact? Their family doctor? What about any school resources? Would this be different for older kids or pre-teens?
There are many options these days and often the parent can decide what they feel is best in alignment with their family values. Schools have many options - sometimes kids and teens have anxiety that is so extreme that it can impact their schooling process. Schools are aware of this and there are methods of managing this that can vary from school accommodations, to placement in exceptional student education programs to ensure that the child is helped to make school the safest place possible for them. Some schools also have counseling available and/or group therapy. In addition, therapists can help greatly! Anxiety is very responsive to treatment and the earlier it's caught the better the outcome! Therapy can focus on shifting unhelpful thinking styles, developing coping techniques to regulate one's nervous system (eg., deep breathing, grounding exercises, positive self-talk, etc), and lots of other things. In addition, your family doctor or psychiatrist can assist to discuss potential medication options that can also help to regulate the brain so that the person less likely to be in 'fight or flight' and more capable of using the coping techniques they have learned. The major point is that options exist and anxiety can be helped! With regards to older children and teens, the process is really the same. The differences are mostly going to be in adapting the language we might use to help the child open up about their worries. Older children and teens might also be more aware of what the thoughts are that are fueling their anxiety which can sometimes make it easier to reframe.
What are common assumptions people have about panic attacks?
People feel like they are causing this and they can "will" themselves out of it too. They often think that they are being weak and they should be able to "get over it". This type of self-talk actually perpetuates the panic and anxiety and does not help the individual who is suffering. You are not to blame for having panic attacks and you deserve help!
What does a panic attack feel like?
Have you ever been stuck in an elevator and felt suddenly the world was closing in on you and you couldn't breathe? That might have been a panic attack. They are often sudden and unexpected - that means you could be doing fine in your day and out of nowhere you have overwhelming physical sensations of being out of control. Your heart is pumping fast, you can't breathe, your head might feel full, you might feel dizzy or like you are going to pass out. That's panic. It is a truly helpless and painful state for people to experience. Once they've had it happen, they fear it happening again which can create a vicious cycle leading to avoidance of things they think will bring on the panic.
What causes a person to have a panic attack? Is it something that can be controlled with practice? Why or why not?
There's no known scientific reason why. What I have seen in my practice is often people who are prone to panic attacks are those people that are actually very strong. They are independent, they take care of all their responsibilities and they value being driven. They often do not share their feelings a lot, which lets them build up in the system. I see a panic attack almost as an explosion of the built up feelings over time. They often happen in down time of being in the car or getting ready to rest for the evening.
At what point should someone seek medical attention for a panic attack?
Something becomes a problem when it is impacting the quality of your life in some way -- either taking away from your social life, work-life, etc. If you have had more than one attack and you see them increasing in intensity and frequency then being seen is a good idea. First, panic is very treatable, and second it responds best to immediate treatment. The longer we let it go, the more the mind wraps up other conclusions that make the anxiety worse (e.g., I am weak, what's wrong with me, I'm defective, etc). It is a good idea to see a panic therapist specialist and a psychiatrist/primary care so that medications and therapy can be used as needed. There is help out there and you don't have to live like this!
How can you tell if something is a panic attack or something physically more dangerous?
Sometimes you cannot and if you are not sure, don't chance it! If it is your first panic attack and you cannot breathe, or you become weak and are sweating profusely, you should go to the doctor to ensure everything is okay. People who have had panic attacks before get to know them better and do not need to seek medical help in the midst of the attack when they learn to manage it themselves. Sometimes panic disorder occurs alongside of a medical disorder, so any strong therapist is going to want you to have a medical work up to rule out anything that could be impacting or underlying your panic.
What practices do you personally recommend when someone experiences a panic attack?
Grounding and deep breathing are key! This gets us in the present and out of the future/past of the panic (I should be able to or I wish I did something....etc). In 5-4-3-2-1 we list five things we see, four things we hear, three things we can touch, two things we can smell and one thing we can taste. This quick trick paired with square breathing can help us cool down our nervous system a bit. Your physician may also prescribe a medication(s) for short-term and long-term control of you panic. And, of course therapy like EMDR and CBT can help you get ot the underlying root and reframe your thinking. I have personally used these techniques, as I am a psychologist who has had panic attacks most of my life and I use these daily practices to keep my nervous system in check! :)
What should you NOT do when having a panic attack?
Do not use escape behaviors like avoiding or leaving somewhere as that reinforces the anxiety. Do not surround yourself with high stimulation - remove stimulation when in panic because your system is already overwhelmed. Stay away from energy drinks and other stimulants that can increase your anxiety.
How long do panic attacks typically last?
Usually about 20-30 minutes. They can last longer (usually the mind will create more thoughts in response to the body reaction and this will speed up the reaction!) and less if the person knows how to manage them.
How can people prevent panic attacks in the future?
Get help! Learn about your anxiety and becomes friends with your anxiety. That goes a long way. Be compassionate and kind to yourself - you didn't ask for hits but you do have to manage it. Treatment is available - KML has expertise in anxiety and panic so don't hesitate to reach out!!!
OPEN DISCUSSION REGARDING TODAY'S HOT TOPICS!
Dr. Kelsey explores the actual science behind today's "hot topics". She also explores deep dive behind some of her featured media topics. Come aboard to see the simple solutions to complex problems!