Anxiety Depression

According to the American Psychological Association, anxiety is “an emotion characterized by feelings of tension, worried thoughts, and physical changes . . .”

A little anxiety can be helpful… Motivation Protection Improved performance
YET too much can be detrimental… Distress then avoidance Interference with functioning Other difficulties (potential depression)

Physical Changes

• Pounding heart
• Sweating
• Hot and cold flashes
• Trembling voice
• Shaky hands
•  Headache
• Upset stomach/nausea
•  Shortness of breath
• Dizziness
• Tense muscles
• Difficulty with sleep
• Changes in eating habits

• Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities
• The individual finds it difficult to control the worry
• The anxiety and worry are associated with 3 or more of the following:
  • • NOTE: Only one item is required in children
  • Restlessness or feeling keyed up or on edge
  • Being easily fatigued
  • Difficulty concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)
• The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

Some signs include:

Sweating, heart-pounding, trembling, shortness of breath, chest pain, nausea, dizziness

Frequent headaches, upset stomach or somatic complaints

Avoidance of situations where evaluation is possible

Unrealistic worries 

Concerns expressed as “what might happen if…” in many situations

Fear of evaluation is social situations

Concerned with being perfect

Fear they are going crazy or will die

Excessive need for reassurance

• Marked fear of anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others typically lasting 6 months or more
• In children, the anxiety must occur in peer settings and not just during interactions with adults
• The individual fears that he/she will act in a way or show anxiety symptoms that will be negatively evaluated (will be humiliating or embarrassing, will lead to rejection or offend others) 
• The fear or anxiety is out of proportion to the actual threat

DO NOT avoid everything that causes anxiety. The flight-fight-freeze response urges your child to escape the uncomfortable situations. 

Meditation and mindfulness

Daily exercise helps stimulate endorphins and feel-good hormones so try incorporating that into your child’s routine (even before school)

Adequate sleep, healthy meals, plenty of water, downtime to decompress, outdoor play, 

Limit screen time as this can increase anxiety, especially social media

each your child to be a thought detective. Imagine every thought you have floats above your head in a bubble (like what you see in a comic strip). Now catch onto the worry thoughts and collect evidence to support or negate the thought. Teach your child not to make judgments about what to worry about based only on feelings. Feelings are not facts. Teach your child to have a debate in their mind.

Help your child go from “what if” to “what is”

Develop a step by step checklist to calm down - a coping list with concrete strategies to use in the moment of distress (deep breathing, progressive muscle relaxation, stress ball, write it out, talk back to worries) 

Make sure that they practice the strategies when they are not anxious so they gain confidence when needing to use them

Use Calm Classroom

Belly Breathing 

Help your child pretend to blow up a giant balloon. “We’ll take a deep breath and blow it up to a count of 5” - do this together with them

I will say something and I want you to say it exactly as I do: “ I can do this” say it 10 times at variable volumes

“Let’s put your worry on the shelf while we _______ (listen to your favorite song, read a story, walk the dog, bake) Then we’ll pick it back up again. 

 “Let’s count…”- distraction techniques. Count the number of people wearing sneakers, the number of kids in the room.

Grounding exercise – Look around the room and have your child identify and name 5 things they see, 4 things they feel, 3 things they hear, 2 things they smell, 1 think they  taste 

Tell me the worst thing that could possibly happen. This helps to change their thought process. Talk about the likelihood of that situation happening. Ask about the best possible outcome. Then ask them about the most likely outcome. The goal of this is to help your child think more accurately during their anxiety. (similar to thought detective)

“Close your eyes and picture this”- visualization is a powerful technique used to ease anxiety. Guide your child through imaging a safe, warm, happy place where they feel comfortable. (Encourage this skill in the classroom or on the ride to school)

Areas of Self-Care and Examples

MIND:

• Setting boundaries for, or taking breaks from social media
• Journaling
• Setting, and working towards, personal goals
• Engaging in volunteer work that is different from your paid work

Body

• Eating regularly/food that makes you feel good
• Drinking plenty of water
• Getting enough rest
• Physical activity
• Relaxing (taking a bath, getting a massage, drinking a hot cup of tea)

Spirit

• Practicing spirituality/faith
• Making time for self-reflection
• Meditating
• Connecting with nature
• Traditional cultural and spiritual practices

Emotions

• Taking time to process your emotions
• Expressing yourself creatively
• Expressing gratitude (for friends, family, and coworkers, etc.)
• Practicing mindfulness
• Asking for help at work and in your personal life
• RelationshipsConnecting with friends
• Having fun and laughing
• Having hobbies/interests

Work

• Noticing the joys and achievements fo the work
• Having allies at work
• Delegating at work and in your volunteer roles
• Setting, and sticking to, limits when it comes to paid and volunteer work

Your Self-Care Plan

Once you've determined your personal needs and strategy, write it down. Your self-care plan can be as simple or complex as you need it to be. You may choose to keep a detailed plan at home and carry a simplified version in your wallet, in your purse or on your phone. Here is a template you can use.

• Help your child maintain a routine for sleep, mealtimes, and activities
• Anticipate stressful situations
• Family dinners - high point and low point of the day
• Teach relaxation - gentle music, relaxation tapes, dim lights, warm baths, meditation, guided imagery
• Offer emotional support and reassurance, that with time and help, they will feel better
• Focus on your support system
• Listen and tell your child how you plan to help - GOOD COMMUNICATION
• Have your child evaluated by a licensed mental health professional in order to get an appropriate diagnosis
• TAKE CARE OF YOURSELF

Changes in Behavior

Withdrawing Socially

Easily Angered

Increase in Anxiety

Changes in Sleep or Appetite

Expressing Thoughts of Ending Their Life

Mental Health Symptoms are often misinterpreted as:

Normal Adolescent Mood Swings

Laziness

Poor Attitude

Immaturity

Suicide risk factors endure over some period of time, while warning signs signal an imminent suicide risk.

Warning Signs: Talk

If a person talks about:

• Ending their lives
• Feeling hopeless
• Having no reason to live
• Being a burden to others
• Feeling trapped
• Unbearable pain

Warning Signs: Behavior

• Increasing the use of alcohol or drugs
• Looking for  a way to kill themselves, such as searching online for materials or means
• Withdrawing from activities
• Isolating from family and friends
• Sleeping too much or too little
• Visiting or calling people to say goodbye
• Giving away prized possessions
• Aggression
• Fatigue

Warning Signs: Mood

• Depression
• Anxiety
• Loss of interest
• Irritability
• Humilaition
• Agitation
• Rage

Suicide risk in teens is most clearly linked to 7 mental health conditions which often have overlapping symptoms.

• Major Depressive Disorder
• Conduct Disorder
• BiPolar Disorder
• Eating Disorders
• Generalized Anxiety Disorder
• Schizophrenia
• Substance Use Disorders

This presentation was created to help participants be able to:

• Learn about teen depression and suicide risk.
• Identify the warning signs and risk factors for suicide in teens.
• Understand the role of treatment in reducing risk.
• Identify how to approach your child to talk about depression and suicide.

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