In our last columns, I discussed the various types of anxiety disorders
and the signs and symptoms to look for. As an essential reminder, anxiety
is the most common form of mental health issue and also the most treatable.
Since we all experience anxiety of some sort, at some times in our lives,
we tend to dismiss it as a problem. As I have pointed out, when our children
suffer from significant anxiety disorders, it becomes quite disabling
and problematic. Following are some ways to understand and cope with anxiety.
First and foremost—accept the anxiety as real, accept the concerns
your child feels as real and don’t judge or minimize his/her feelings. Communicating to your child that “it is no big deal” will
not make him/her feel better, but will make your child less likely to
talk to you about it. At the same time, encouragement and support is essential.
If you have had personal experience with anxiety, you can tell your child
about it so that he/she doesn’t feel abnormal. Whether learned or
genetic, anxiety disorders of childhood usually have roots to an adult
with a history of anxiety.
If your child’s anxiety is leading to major life changes (e.g., not
going to school, not socializing, not partaking in events, lack of sleep),
then consider getting professional help for them. As stated, anxiety is
disabling, but also quite treatable.
Understand the connection between stressors, perceptions/thoughts, feelings
and physical sensations. Anxiety is a combination of environmental stressors, perceived stressors,
unrealistic and exaggerated thoughts, and physical reactions. The cycle
of anxiety can be broken at any of those points. We can change our environmental
stressors. We can learn to breathe deeply, learn relaxation training and
learn mindfulness exercises to calm our physical reactions. Finally, we
can adjust and change our cognitions and thinking patterns to “dilute”
anxiety producing thoughts. An easily learned clinical tool is called
“thought stopping,” where one learns to recognize feelings
of anxiety, identify unrealistic thoughts, attain a state of physical
relaxation, and change the thinking pattern. The ultimate result is lowering
Practice mindfulness, relaxation and guided imagery. Learning how to bring the body and mind into a state of calm is an essential
tool for dealing with anxiety. It allows one to have a sense of control
of the problem, and provides a tool that is accessible at any time. Guided
tapes and training are readily available on the internet. With practice,
one can calm the body and mind down in only seconds. In guided imagery,
we can imagine ourselves in a safe and special place.
Learn how to change the negative self talk. Anxiety is a result of a cascade of unrealistic negative thinking, which
often feeds on itself and turns into catastrophic thinking. It generally
relies on what we call all-or-none thinking, usually involving self-judgmental
words including “should," “always," “never,"
and “have to.”
Learning how to identify these negative thinking patterns and changing
them is the core of Cognitive Behavior Therapy (CBT). Success can often
be achieved in six to 10 sessions with a professional skilled in CBT.
Distract yourself. When experiencing anxiety, one cannot get away from the thoughts or feelings.
Relief can sometimes be found in distractions like music, writing activities,
physical activity (running, pushups, jumping jacks, etc.) and deep breathing.
The producers of the movie Angst suggest putting ice cubes in your hand.
This focuses your attention away from the fear and onto the freezing sensation.
Try to confront the fear. This is very tricky. When one experiences anxiety over a particular situation,
and then avoids or flees from the situation, the feelings of anxiety will
most likely reduce temporarily. However, the anxiety disorder will actually
strengthen, as the reduction reinforces the avoidance. The difficult part
is that being pushed into the fearful situation will also increase the
anxiety. Learning how to face your fears with tools of controlling your
body and your thinking will eventually lead to a more realistic understanding
of the situation and reduction in anxiety. When the anxiety is severe,
it may require some professional help. Gradually exposing oneself to the
fearful situation is known as Exposure Therapy.
Praise and reward all attempts at confronting fears. If your child makes an attempt to deal with his/her perceived fears and
threats, provide encouragement and care for such courage and for the process.
Dealing with anxiety is often a series of small incremental victories.
See a professional. If anxiety persists, see a physician to rule out any physical or medical
problems which may be causing the anxiety. When anxiety is severe and
disabling, medication is sometimes indicated to break the cycle, and can
be best determined by a child psychiatrist. As stated, Cognitive Behavior
Therapy is evidence based treatment for anxiety disorders.
I have mentioned the movie Angst. If you have a chance to see it, you will
gain a great deal. The website angstmovie.com is filled with great information,
videos, and resource materials. Remember, anxiety is very common, can
be disabling and is very treatable.
Remember, if you have issues you would like to see addressed, please email me at
Moe Gelbart, Ph.D.
Executive Director, Thelma McMillen Center