by: mark neves(#6724026) nicole elias (#6504111) rochelle reynolds (#6723665)
TRANSCRIPT
Examining Anxiety and Depression
By: Mark Neves (#6724026) Nicole Elias (#6504111) Rochelle Reynolds (#6723665)
We are seeing more and more youth that are being diagnosed with or exhibiting signs of
depression and anxiety. As the youth spend much of their day in school, it is essential
that teachers and other staff learn to recognize the characteristics and treatment
options in order to help them.
Why Are These Conditions Important?
Research has shown that social anxiety and depression regularly co-occur (Ingram et al. 2001). In children, many reviews have found correlations between depression and anxiety.
Genetics
Life Events
Personality (worriers and perfectionists are especially prone)
Hormones
Chemical imbalances
What Causes Anxiety and Depression?
Depression is a persistent sadness or loss of interest in activities for more than 2 weeks in absence of external precipitants. It requires a distinct change in mood accompanied by several physiological changes (R.H. Belmaker, M.D., and Galila Agam, Ph.D-New England Journal of Medicine)
The Clinical Definition of Depression
This is not depression in the deepest sense of the word. It is like a sky that is always filled with gray clouds. The child may not feel deeply depressed but they may not feel good either.
Dysthmia
This is a reaction as a direct result to an event that occurs in one's life. This is often due to a loss of some kind (like a death). We commonly know this as grief and it is a normal form of reactive depression.
Reactive Depression
This occurs when the person enjoys normal
moods some of the time. During times of depression though, the person may appear manic. During the manic phase, they typically will exhibit:
-increased energy -aggressive responses-decreased need for sleep-increased risk-taking -feelings of mood elevation
Bipolar Illnesss
This is the most common form of depression. This occurs when the child feels low but has no actual stressor in his or her environment. They have normal moods much of the time but end up having a number of depressive episodes during their life. There isn’t necessarily one specific trigger.
Recurring Unipolar Depression
Seasonal Affective Disorder (SAD)-This is the scientific term for what is frequently known as the “winter blahs.” A despair will set in with the disappearance of the shortened daylight hours and will persist as long as the cold winter and lack of sun remain present. As spring returns though, many children will feel their energy return.
Seasonal Affective Disorder (SAD)
Always sees the bad or negative side of things
“All or Nothing” type of thinking
Difficulty concentrating
May think of hurting themselves
Mental Symptoms
Sad
Irritable or grumpy
Feels hopeless or worthless
Loss of interest in things they once enjoyed
Feelings
The most common resources would be counseling through school or a health professional (family doctor, psychiatrist etc) and medication (anti-depressants).
For mild depression in adolescents, the answer does not lie in medication. Research has shown that while they may be helpful in adults, they are not as effective with young people. Medications need to be used with other treatments and strategies.
For those with major depression, cognitive behavioural
therapy (CBT) may be used. CBT is a talking therapy that teaches new skills for thinking and acting more effectively.
How Depression is Treated
Encourage the student to participate in class activities but understand they have low energy
student should be reassured that the teacher is there to help when needed
education priorities should ensure the child does not fall behind in academics to protect self-esteem
avoid punitive approaches Incorporate exercise into the day focus on specific strengths (“I like the colors you
have chosen for the flowers.” instead of “You are a great artist.”)
Refer to student support services
How Teachers Can Help
Have fun with the child! Encourage exercise and physical activity Don’t tell the child to “snap out of it” Be positive and use non-punitive discipline Don’t compare the child to his or her
siblings Don’t overprotect and overdirect Learn as much as possible about this
condition Communicate well with the school
How Parents Can Help
Watch for signs (crying, negative comments, loss of interest)
Listen and reassure (do not judge or tell them they shouldn’t feel that way)
Help them get help (see a counselor)
How Peers Can Help
Myth: Depression is not a real medical illness. Clinical depression is a serious medical condition that affects not only an
individual’s mood and thoughts, but also the individual’s body. Research has shown that depression has genetic and biological causes. Individuals coping with depression have a higher level of stress hormones present in their bodies, and the brain scans of depression patients show decreased activity in some areas of the brain.
Myth: Even if depression is a medical illness, there’s nothing that can be done about it.
Fact: Depression is treatable, and more than 80 percent of individuals with depressive disorders improve with treatment. As new medications and treatments are discovered, the number should continue to rise.
The first step to finding effective treatment is to get a physical examination by a doctor to rule out other causes for your symptoms, such as thyroid problems. Once you’ve been diagnosed with depression, you and your doctor will decide on a course of treatment, which will include medication, psychotherapy or a combination of both.
Myth: Depression will go away by itself. Fact: For extremely fortunate individuals, depression may go away by
itself. But for the rest of us, depression can hang on for months, years or indefinitely. Depression can go away on its own, only to return in the future; once an individual has one episode of depression, they are predisposed to have more. Clinical depression is a potentially fatal disease – and suicide could be the end result of waiting for it to go away without any help.
Myth: Depression is a normal part of getting older. Fact: Depression is not a normal part of aging, but seniors do generally
experience more of the events that can trigger depression: loss of family and friends, ill health, isolation and financial worries. Furthermore, people over the age of 60 grew up in an era in which mental illness was not discussed, and they may feel more shame about asking for help than someone from a subsequent generation.
The highest rate of suicide of any age group occurs in that of people 65 and older, with men being more vulnerable than women. It’s imperative that seniors with depression seek help.
Myth: Depression only affects women. Fact: Although women report being affected by depression twice as
much as men, depression certainly affects men as well. Often, clinical depression is underreported in men, particularly in cultures that discourage them from asking for help or showing any weakness. Furthermore, men have a higher rate of successful suicide attempts than women, so it is crucial that men seek help for their symptoms.
Myth: Depression does not affect children or teenagers — their problems are just a part of growing up.
Fact: We’d like to believe that all children experience a happy, carefree childhood, but that’s simply not the case. According to the National Institute of Mental Health, studies show that 1 in 33 children and 1 in 8 adolescents are depressed in any given year. Children are not as practiced at articulating their feelings as adults, so adults must take the initiative to look for and notice symptoms of depression in children.
http://www.depressioncenter.net/wbdat/default.aspx
Online Depression Assessment
It is clinically significant distress and impairment in functionning. It is related to the « fight or flight » response
Anxiety is a normal emotion and we all have it.
Distress and dysfunction are the two major signs that indicate a person has cross over from normal anxiety to clinical anxiety. The third is inflexibility (that is, reacting in a maladaptive way to anxiety-provoking situations).
The Clinical Definition of Anxiety
This is excessive anxiety and worry that occurs more days than not for a period of six months. The anxiety is focused on a number of different events or activities. Three of the following symptoms must occur:
-Restlessness or edginess-Tiring Easily-Difficulty Concentrating or the mind going blank-Irritability-Muscle Tension-Insomnia
Generalized Anxiety Disorder
A marked fear in social situations. There is some similarity to shyness but these symptoms are much more extreme and disabling
This is a type of anxiety that usually starts in early adolescense
Social Anxiety
This type of anxiety is closely related to social anxiety. Performance anxiety involves having to do something. An example would be having to write an answer on the board.
Performance Anxiety
What Do Children Worry About The Most?
Performance Speaking in front of
the class Volunteering answers Getting called upon Making a mistake Getting in trouble Not knowing what to
do Asking for help
Social Fear of humiliation Fear of separation to
those who are familiar Picking a partner or
group work Going out at recess
and lunch Phys. Ed class
The presence of uncontrollable obsessions or compulsions. These are recurrent thoughts that are intrusive and provoke distress. Compulsions are repetitive behavioural or mental acts that a person feels driven to perform. These compulsions are aimed at preventing or reducing distress (even though there may be no actual connection between the action and the feared situation). *As many as 1% of youth may have this disorder
Obsessive-Compulsive Disorder
Trichotillomania-Feeling the need to pull out one’s hair, leading to noticeable hair loss
Body Dysmorphic Disorder-Becoming consumed by an imaginary defect in one’s appearance that it causes significant distress
Anorexia Nervosa and Bulimia Nervosa
Conditions Associated With Obsessive-Compulsive Disorder
This is the only anxiety disorder that requires an event that precedes it. This is when a person feels intense feelings of fear, helplessness or horror (examples: witnessing a murder, a car accident). It is viewed as a physical danger to oneself. The person will relive the trauma over and over through flashbacks or nightmares.
Post-Tramatic Stress Disorder
This disorder is found primarily in younger children. It involves excessive anxiety about being separated from the parent or home. As many as 4% of children and young adolescents may suffer from this disorder.
Incessant worry about harm coming to a parent or about an event that involves separation (like being kidnapped) occurs. In extreme forms, these children may be afraid of going to school.
Separation Anxiety Disorder
This occurs when the person experiences spontaneous panic attacks. These are sudden and intense waves of intense fears and panic. There are physical symptoms involving shortness of breath, choking sensations, sweating and rapid heart rate. It is essentially a fear of being in places or situations from which escape might be difficult or impossible. It tends to get worse with age and develops into a full blown panic disorder.
Panic Disorder
An intense fear that is out of proportion to any real threat and focused on a specific object, activity, situation or animal
Panic attacks can occur but they have very specific triggers
*Most people have one or two irrational fears (airplanes, heights, dogs are some examples)
Specific Phobias
Liebowitz Social Anxiety Scale Test
Social Phobia Inventory (SPIN)
Only medical doctors can diagnose anxiety
Diagnosis Checklists
Excessive worry
Perfectionism
Frequent questioning of situations
Difficulty concentrating
Mental State
Overly sensitive to criticism
Socially withdrawn
Easily embarrassed
Excessive worry about multiple topics
Easily agitated
Feelings and Emotions
Avoidance of evaluations Reluctant to answer questions Reluctance to join social situations
(avoidance and withdrawal) Difficulty concentrating/remembering Irritability Disorganized
Behaviour
Weight loss
Change in eating habits
Difficulty sleeping
Stomach aches or headaches Cries often
Physical Symptoms
Excessively reassuring the child
Being too directive
Permitting or encouraging avoidance
Becoming impatient with the child
Unhelpful Strategies
Prevent avoidance Communicate your empathy effectively Prompt the child to cope constructively Model brave, non-anxious behaviour Provide consistent discipline Symbolic play Teach self-talk Develop a list of strategies to use when
unpleasant feelings/thoughts arise
Helpful Strategies
Pay attention to your child’s feelings. Stay calm when your child becomes anxious about a
situation or event. Maintain a healthy lifestyle and encourage exercise Reward brave behaviour Don’t permit avoidance Recognize and praise small accomplishments. Don’t punish mistakes or lack of progress. Be flexible and try to maintain a normal routine. Modify expectations during stressful periods. Plan for transitions Communicate well with the school
How the Parent Can Help
Keep an anxiety log Incorporate exercise into the day Prevent avoidance Music therapy Visual imagery Circle breathing Allow for open-ended assignments and choices Chunk work Have the student set realistic goals Provide a lot of structure and predictability Model mistake-making Plan for Transitions Be flexible-allow for re-do’s and re-write’s Provide fidget tools (such as a squeeze ball) Incorporate self-reflection activities (journaling, poetry, etc) Try the “5 Point Scale” Teach the student that drugs/alcohol will not help the problem
How the Teacher Can Help
Watch for signs (overly jumpy or worried, panic attacks, avoids situations)
Listen and reassure (do not judge, tell them they may have anxiety)
Help them to get help (counseling)
How Peers Can Help
Myth: Panic Attacks are deadly. No. It may seem like that for someone having an attack but it's
just the body's natural defensive reaction to (an exaggerated) perception of threat or danger. Being a natural body response, these attacks cannot kill.
Myth: A Panic Anxiety Attack can happen to anyone, at anytime, anywhere.
True. However, those suffering from some other forms of Anxiety Disorder (e.g. General Anxiety Disorder or GAD) are at a bigger risk of having one. Cumulative stress, heavy emotional disturbance, major life changes and negative thinking can all cause panic attacks.
Myth : A Panic Anxiety Attack is not really an illness" Fact: The National Institute of Mental Health begs to differ. Panic
disorder is a real and serious illness, afflicting 6.8 million Americans today. If left untreated, this can seriously debilitate and affect someone's life.
Myth: If your parents and grandparents had Panic Disorder, you will too. Fact Genetics has been linked to causing panic disorders that can span generations.
However, this is just one of its many known causes and is not the sole basis for diagnosing this disorder.
Myth: In real sense, anxiety disorders are not true illnesses or diseases. Fact: Just like diabetes, anxiety disorders are true, severe medical conditions that
may have emerged from various reasons and factors like your genes, upsetting events and even ones that makeup your brain.
Myth: Anxiety disorder is only of one type. Fact: There are indeed many types of anxiety disorders: generalized anxiety
disorder, social anxiety disorder, obsessive-compulsive disorder, and panic disorder.
Myth: Men and women are affected by all types of anxiety disorders equally.Fact: Women are normally twice as likely to be affected as men for four out of the many anxiety disorders: post-traumatic stress disorder generalized anxiety disorder, obsessive-compulsive disorder, and panic disorder.
Online Anxiety Assessment http://cl1.psychtests.com/bin/transfer?
req=NDF8Mjk3OXwxMjE3NzE1fDB8MQ==&refempt=
http://www.socialanxietysupport.com/disorder/liebowitz/
Depression and anxiety often co-exist together Anxiety is the most common mental disorder Up to 5% of children and adolescents have an
anxiety disorder on any given day. Girls are more likely than boys to have an anxiety
disorder (the hormone Estrogen in females may play a role in how it interacts with serotonin).
Anxiety can also co-exist Substance Abuse and Tic Disorders
If anxiety is caught before the age of 12, it becomes highly treatable!
There is a high correlation between aggressive destructive behaviours in preschool years with anxiety disorders. (Tyson, 2005).
It was also determined that children with anxiety issues may have grown up with chronic stress, disturbed attachment and maladaptive parent-child interactions in their environment as young children.
2% of children experience clinical depression but 3-5% of adolescents will experience it
Depression is higher in females of all ages If anxiety is caught before the age of 12, it
becomes highly treatable! Depression occurs in persons of all genders,
ages, and backgrounds
Only 25% of children and adolescents have depression alone. 75% have at least one other (co-morbid) condition. This could include:
-ADHD -Conduct Disorder -Learning Disabilities -Delinquincy -Anxiety Disorders -Eating Disorders -Substance Abuse
School refusal Social isolation Depression Substance abuse Physical illness (such as irritable bowel
syndrome, pneumonia, thyroid disorders) Basically, a person who continues to live with
anxiety will have a diminished quality of life.
For Anxiety:
**Besides not living one’s life to its fullest potential, the greatest danger is suicide**
For Depression:
Paul Foxman is currently one of the leading world experts on anxiety. Good professional books are The Worried Child and Dancing with Fear.
Stories for Youth:
David and the Worry Beast: Helping Children Cope with Anxiety By: Anne Marie Guancy
When My Worries Get Too Big: A Relaxation Book for Children Who Live with Anxiety By: Kari D. Buron
Resources For Teachers
Anxiety:
http://www.worrywisekids.org/ http://www.adaa.org http://www.anxietycanada.ca http://www.adam.mb.ca/helpful.asp http://www.socialanxietysupport.com/d
isorder/liebowitz/
Anxiety Websites
Depression:
http://www.depression.mb.ca/ http://www.afm.mb.ca/ http://www.manitoba.cmha.ca/bins/site2.asp
?cid=284-683&lang=1 http://www.cmhawpg.mb.ca/ http://www.mentalhealthworks.ca/ http://www.depressioncentre.net/
Depression Websites
Websites:
http://www.anxietybc.com/
http://www.who.int/en/
http://www.worrywisekids.org/
http://www.adaa.org
http://www.anxietycanada.ca
http://www.adam.mb.ca/helpful.asp
http://www.socialanxietysupport.com/disorder/liebowitz/
http://www.depression.mb.ca/
http://www.afm.mb.ca/
http://www.manitoba.cmha.ca/bins/site2.asp?cid=284-683&lang=1
http://www.cmhawpg.mb.ca/
http://www.mentalhealthworks.ca/
http://www.depressioncentre.net/
http://www.healthcentral.com/depression/just-diagnosed-822-143.html
http://www.medicinenet.com/script/main/art.asp?articlekey=22653
http://myanxietyattacks.com/anxiety-disorders/anxiety-disorders-facts-myths
References
Books:
Carlson, Trudy (1998). Depression in the Young-What We Can Do To Help Them. Duluth: Benline Press
Foa, Edna B. & Wasmer Andrews, Linda (2006). If Your Adolescent Has An Anxiety Disorder. New York: Oxford University Press.
Foxman, Paul (2004). The Worried Child. Almeda: Hunter House.
Randall, Kaye & Strom, Donna & Bowman, Susan (2007). 102 Creative Strategies for Working With Depressed Children and Adolescents. Youth Light Inc: Chapin.
References