Categories
Anxiety Mental Health Recovery

Does Your Teen Suffer From Anxiety?

Anxiety is a normal function of stress. It is the nervous system’s way of telling you it’s on overload and needs a break.  Scientists have discovered that the amygdala and hippocampus play a significant part in most anxiety disorders. The amydgala is the part of the brain that alerts the rest of the brain and lets it know a threat is present; this will trigger a fear or anxiety response. The job of the hippocampus is to convert threatening events into memories. Interestingly, research is showing that the hippocampus appears to be smaller in people who have suffered from child abuse or served in the military.

 

Further research will begin to provide clarifying information regarding not only the size of the hippocampus in PTSD sufferers, but also the cause of fragmented memories, deficits in explicit memories, and flashbacks.  Understanding the functionality of the brain will help scientists form more salient ways in which to provide medical relief for anxiety sufferers.

 

Fact: 8 percent of teens ages 13–18 have an anxiety disorder, with symptoms commonly emerging around age 6. However, of these teens, only 18 percent received mental health care.

 

How is anxiety usually treated?

Medication is one option typically given to anxiety sufferers. It is a cure, but rather a means of managing the symptoms.  Often patients are given:

  • >Antidepressants
    • SSRIs, Tricyclics, MAOIs, anti-anxiety medications
  • Anti-anxiety drugs:
    • Benzodiazepines
  • Beta-blockers – which treat the physical symptoms of anxiety

In addition to medication or sometimes in lieu of, therapists may use modalities like:

You can also try one or all of these 8 tools for managing anxiety:

1. Deep breathing exercises: Deep diaphragmic breath helps activate the body’s relaxation response.  Practice exhaling on a longer count than your inhale. This is a wonderful tool to use to bring the heart rate down, provide oxygen to the blood and to the lungs.

 

2. Use calming visualization: Close your eyes and visualize a place that elicits a state of calm. It could be the beach, the mountains, a forest, being in the ocean, or doing something else that you love. This is a way of accessing one of your resources—something that calms you and engages your body’s nervous system.

3. Do something physical: go to the gym, go for a run, do a strong yoga class, do some jumping jacks, skateboard, or roller skate. In other words, get your endorphins going.

4. Play a musical instrument. For example, one of our teens plays the bass when he’s anxious.  Perhaps you play the guitar, or the accordion. Get down and make some music!

5. Connect with a friend so you are not alone. Maybe watch a funny movie together or blast some music and have a silly dance party.

6. Create a gratitude journal.  Write down 5 things you are grateful for and challenge yourself to write this list every day .

7. Focus on a meaningful, goal orienting activity: playing a game with a friend, building something, creating art, or singing.

8. Accept that you are anxious – it is a feeling. It doesn’t mean you like it or want it to be there, it means you are accepting where you are in that moment. The more you talk about how anxious you are, the more anxious you will feel. Accepting where you are allows you to stay in the present–when we are anxious, we are stuck in the future.

 

Anxiety can be accepted and worked with or it can be ignored. Ignoring it leaves you vulnerable to persistent dysregulation and misery. Addressing anxiety and facing it head on allows you to develop self-regulatory techniques. The latter will facilitate emotional regulation and the ability to approach triggers and difficulties more skillfully.

Categories
Dialectical Behavioral Therapy (DBT) Mental Health Mood Disorders Recovery Therapy Treatment

DBT With Dr. Georgina Smith, Ph.D

We are pleased to welcome Dr. Georgina Smith, Ph.D to the Visions clinical team. She has been working with adults, families, and children since 2001, making her vast knowledge of neurofeedback and Dialectical Behavorial Therapy (DBT) accessible to a wide range of clientele. Dr. Smith specializes in treating survivors of trauma, abuse, and those suffering from eating disorders, and addiction. She also treats individuals suffering from chronic depression, self-injury, mood, personality, and anxiety disorders. Her knowledge and use of neurofeedback and DBT allows her to help her clients in a way that empowers them be engaged in their own recovery. Dr. Smith’s approach is holistic, and caring, and she ardently believes in ensuring that her clients feel seen. Her work with adolescents has built an authentic treatment style where she is able to form a genuine connection with her clients, so they feel seen, heard, validated and challenged. Dr. Smith encourages them to be ok in the skin they’re in. That particular tenant of treatment spreads healing throughout one’s mind, body, and spirit.

With the addition of Dr. Georgina Smith, clients have access to DBT in all phases of their treatment. DBT, in particular, is one of the most efficacious treatments for mood disorders, namely Borderline Personality Disorder. DBT uses mindfulness, self-awareness, and skill building in the areas of trauma, emotional regulation, interpersonal effectiveness and crisis management.  One of the most remarkable pieces of DBT is its effectiveness in teaching clients to regulate their emotions and recognize when they are becoming deregulated. Self-awareness in someone trying to manage extreme emotions is undeniably helpful.

Currently, Dr. Smith is seeing Visions’ clients for DBT as well as running a DBT group on a weekly basis. We are looking forward to working with Dr. Smith and are excited to have her as part of our clinical staff.  She is down to earth, and brings a sense of realness to her groups and throughout her clinical practice. She says it best, “So many of the kids I’ve worked with are struggling to make sense of things they’ve been through, struggling with their sense of self and others, and a confusing, chaotic world. The space I create with them is about being ok wherever they are, whoever they are, so we can open the doors to choice and change. It is about ownership, realness & empowerment.” Welcome to the VTeam, Georgina!

Categories
Anxiety Mental Health Social Anxiety

Social Anxiety: It’s Not Just Shyness

Social anxiety/social phobia is an anxiety disorder characterized by a significant fear

of social interactions and interactions with other people which bring about feelings of “self-consciousness, judgment, evaluation, and criticism”1 by those they interact with. In other words, “the extreme fear of being scrutinized and judged by others in social or performance situations.”2  What social anxiety is NOT is simple shyness, but rather a more deeply internalized anxiety disorder. Recently, the National Institute of Health analyzed data gleaned from a study done by the National Comorbidity Survey Replication Adolescent Supplement (NCS-A S), which surveyed more than 10,000 adolescents (ages 13-18). The survey involved a structured, diagnostic interview, assessing a “broad range of mental health disorders.” Those who met all eight “lifetime DSM-IV criteria for social phobia, including one or more social fears, were classified as having social phobia, regardless of shyness.”3

Results of this survey are interesting:

  • Overall, 43% of males and 51% of females rated themselves as shy, but only 12% of these youth met criteria for social phobia.
  • 5% of  youth who did not rate themselves as shy met social phobia criteria.
  • Prevalence of social phobia increased with age:
    • 6.3% of 13- 14-year-olds
    • 9.6% of 15- 16-year-olds
    • 10.4% of 17- 18-year-olds

Compared to shy adolescents, those with social phobia/social anxiety were more likely to suffer from some form of an anxiety disorder, major depressive disorder, oppositional defiant disorder, or addiction. Also notable were definitive issues with school, work, family relationships, and social interactions. Additionally, the statistics show “only 23% of adolescents with social phobia sought professional treatment for anxiety, and just 12% received psychiatric medication.” More than anything, what these results challenge is the perceived perception that social anxiety/social phobia is the “‘medicalization’ of a normal human emotion.”

To outsiders, someone stricken with social anxiety may seem particularly shy, quiet, or reserved, but to the individual suffering, the internal pull of panic-ridden thoughts is often unbearable. What’s interesting, however, is that when alone, one suffering from social anxiety is usually okay. A key factor in the behavior being more than “just shyness” is when the mere thought or suggestion of any social interaction coming into play brings about the emergence of internal panic. Those that suffer may experience “significant emotional distress”4 in these types of situations:

  • Being introduced to other people
  • Being teased or criticized
  • Being the center of attention
  • Being watched while doing something
  • Meeting people in authority (“important people”)
  • Most social encounters, particularly with strangers
  • Making “small talk” at parties
  • Going around the room in a circle and having to say something

Our friends and family members suffering silently need our support. It’s time we gave this disorder the attention it deserves so those suffering can find some solace and relief. It’s one more thing that requires us to remove the stigma so healing can begin.

1, 3: National Survey Dispels Notion That Social Anxiety is the Same as Shyness

2: Social Anxiety Disorder – ADAA

4: Social Anxiety Fact Sheet

Categories
Bipolar Disorder

Bipolar Children and Teens

Bipolar disorder isn’t soley an issue for the adult population—it affects children and teens as well.
Bipolar disorder is a mental illness categorized by its behavioral and mental extremes. Often called “manic depression,” this illness is clearly defined by its moods. Typically recognized as the manic stage, the sufferer may be elated or intensely “up,” even hyper. The flip side of this is the depressive stage, identified by its extreme lows, deep sadness, physical ailments, and for some, suicidal ideation.
According to NIMH, several factors may contribute to this mental illness:
  • Genes, because the illness runs in families. Children with a parent or sibling with bipolar disorder are more likely to get the illness than other children.
  • Abnormal brain structure and brain function.
  • Anxiety disorders. Children with anxiety disorders are more likely to develop bipolar disorder.
Since the causes aren’t concretely defined, scientists continue to do research, seeking more definitive answers in hopes of finding viable solutions, including a possible means of prevention.

These mood episodes can last a week or even two and are heavy in their intensity.  NIMHhas provided a listof symptoms from the two phases of bipolar disorder. Keep in mind, these symptoms are determined by their intensity and are not to be confused with the natural ups and downs of childhood emotional development.

Children and teens having a manic episode may:
  • Feel very happy or act silly in a way that’s unusual
  • Have a very short temper
  • Talk really fast about a lot of different things
  • Have trouble sleeping but not feel tired
  • Have trouble staying focused
  • Talk and think about sex more often
  • Do risky things.
Children and teens having a depressive episode may:
  • Feel very sad
  • Complain about pain a lot, like stomachaches and headaches
  • Sleep too little or too much
  • Feel guilty and worthless
  • Eat too little or too much
  • Have little energy and no interest in fun activities
  • Think about death or suicide.
Bipolar disorder is difficult to diagnose in children because symptoms often mirror other issues, for example: ADHD, conduct disorder, or alcohol and drug abuse issues. Bipolar disorder can, however, occur alongside these other issues, so it’s important to see a professional skilled in recognizing the affectations of various mental health disorders. Treatment for bipolar disorder requires the use of medication, but because the effectiveness in children isn’t as well researched, it’s wise to take note that children may respond differently to medications than adults. NIMH recommends children and adolescents take the “fewest number and smallest amounts of medication possible to help their symptoms,” additionally noting the danger in stopping any medication without the advice of a physician.
Pay attention to any side effects, and immediately tell the treating physician if you recognize new behaviors. Remember: the treatment for bipolar disorder is based upon the effective treatment of adults, which typically applies the use of mood stabilizers like lithium and/or valproate to control symptoms of mania and act as a preventative to the recurrence of depressive episodes.  Still, treatment of children and adults is still being researched. At this time, “NIMH is attempting to fill the current gaps intreatment knowledge with carefully designed studies involving children andadolescents with bipolar disorder.”  Further, scientists continue to perform studies looking at different types of psychotherapy, which would support the pharmaceutical treatment used in children and teens.  
Please see below for links to additional information (note, I also used some of these as reference for this article.)
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