Anxiety and Depression January 13, 2020 Randolph Township Schools By: Christina Jelly, Director of Community Outreach cjelly@sagethrivetoday.com
Outline 1 Anxiety Overview 2 Depression Overview 3 Case studies and student scenarios 4 What can we do? Questions? 2
About us Partners in School-Based Mental Wellness Est. 2008 Sage Thrive Est. 1997 Early intervention to provide preventative & restorative care ❖ at the first sign of difficulty Sage clinicians can respond to a crisis more immediately, ❖ allowing for quicker recovery time and return to learning Identify students who can remain in-district with the right ❖ therapeutic support Providing a smooth transition for students who are prepared ❖ to come back to district 3
Read the following: 1. Pneumonoultramicroscopicsilicovolcanoconiosis 2. Floccinaucinihilipilification 3. Hippopotomonstrosesquippedaliophobia 4. Subdermatoglyphic 5. Triskaidekaphobia 6. Sesquipedalian 4
Understanding the Anxious Student 5
Anxiety is the most common mental health disorder in the United States for both adults and children Approximately 1 in 8 children ages 9-17 suffer from an anxiety disorder 6
When Anxiety Becomes a Disorder... ✓ Disproportion ✓ Disruption ✓ Distress ✓ Duration 7
DSM-V Anxiety Disorders •Specific Phobia •Panic Disorder with or without Agoraphobia •Separation Anxiety Disorder •Generalized Anxiety Disorder For Further •Obsessive-Compulsive Disorder Discussion •Social Anxiety Disorder 8
Generalized Anxiety Disorder (GAD) Uncontrollable worry and rumination over day to day situations both trivial and major Symptoms: Nervousness ● Poor concentration ● Motor restlessness ● Need for reassurance ● Somatic complaints ● Perfectionism ● Sleep disturbance ● 9
Obsessive-Compulsive Disorder (OCD) Teens with OCD develop concerns or persistent thoughts which are disturbing and carry out repetitive behaviors or mental routines in order to reduce their anxiety and distress. Symptoms: Intrusive thoughts ● Compulsive behaviors, rituals and mental routines ● Excessive focus on neatness ● Need for routine & organization ● Perfectionism ● High self-imposed standards ● Slow deliberate work habits ● Tardiness or school refusal ● Fatigue ● 10
Social Anxiety Disorder (SAD) A significant and persistent fear of social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others. Symptoms: Fear of doing something humiliating embarrassing ● Avoidance of situations involving potential evaluation ● Excessive worry about what others will think ● Self-consciousness ● Common fears: meeting new people, ● speaking in front of others, speaking to authority figures, standing out 11
The “other” anxious child T y p i c a l l y w h e n w e t h i n k o f a n a n x i o u s c h i l d , w e t h i n k o f t h e q u i e t s t u d e n t i n t h e c o r n e r w h o i s a v o i d i n g e v e r y t h i n g t h a t c a u s e s a n x i e t y I t i s i m p o r t a n t t o c o n s i d e r t h e o t h e r a n x i o u s c h i l d : T h e i n a t t e n t i v e c h i l d ● T h e d i s r u p t i v e c h i l d ● T h e n e v e r p r e s e n t c h i l d ● 12
Anxiety Manifestations in our Students Behavioral Outbursts: Tantruming, disrespectful, argumentative, apathetic School Avoidance/Refusal: Absences from school or classes, seeking out counselors/nurse frequently Somatic Complaints: Physical symptoms Difficulties with Concentration/Organization: Feeling overwhelmed, test anxiety, difficulty completing assignments and long-term projects Substance Use 13
Understanding the Depressed Child 14
Globally, depression is one of the leading causes of illness and disability among adolescents 3.2% of children aged 3-17 years (approximately 2 million) have diagnosed ● depression (CDC, 2019) 1 in 6 people (16.6%) will experience depression at some time in their life ● On average, first appears during the late teens to mid-20s (APA,2019) ○ The prevalence of major depressive episode was higher among adolescent females ● (20.0%) compared to males (6.8%) (NIMH, 2019) American College Health Association survey of college students 62% of ● undergraduates reporting “overwhelming anxiety” (2016) from 50% percent in 2011 15
When Depression becomes a Disorder... ✓ Symptoms must be present for at least two weeks ✓ Emotional and physical problems ✓ Decrease ability to function at work and home ✓ Different from sadness/grief/bereavement (APA,2019) 16
My Student’s Diagnostic Profile School related manifestation of anxiety: Perfectionism ● Procrastination as a result of feeling overwhelmed ● Social anxiety ● Panic attacks in class, or social situations with lots of noise ● Fear of adulthood ● 17
Treatment Process Techniques/interventions used to treat anxiety: Weekly individual therapy to address and explore possible origins of S’s anxieties ● Normalize and reframe anxiety as functional: ● Identification of triggers ○ Increase awareness of physiological response to anxiety ○ Develop coping skills to manage anxiety as it occurs ○ Gradual exposure to feared situations with support ○ Boundary setting in relationships ○ Family therapy to address family dynamics that contribute to student’s anxiety ● Communication with school personnel (teachers, guidance counselor, CST) to increase support in the ● classroom 18
Jake Junior in high school (17) ● Three Advanced Placement classes ○ Cross-country team ○ Model United Nations conferences ○ Hard-working, likeable ● Oldest sibling (2 younger siblings) ● Failure was his biggest fear ● Symptoms: Stomach aches, migraines ● Treatment: Prozac; 1st of many medications, almost manic ● NYTimes, 2017 19
Maddy Began when Senior in High School ● Played varsity soccer and cross country track ● The second of three children in an intact family ● Dean's list, AP classes, offered to run track for UPenn ● and play soccer for Lehigh UPenn Varsity Distance Athlete ○ Has a few close friends, but enjoys being on her phone ● and getting her work done Perfectionist ● Uses instagram continuously ● Very conscientious of her diet ● 20
Common Sources of Worry Social media ❖ Anxious teenagers from all backgrounds are relentlessly comparing ○ themselves with their peers, she said, and the results are almost uniformly distressing Digital habits ❖ Round-the-clock responding to texts, posting to social media, obsessively ○ following the filtered exploits of peers “I don’t think we realize how much it’s affecting our moods and personalities,” ❖ he said. “Social media is a tool, but it’s become this thing that we can’t live without but that’s making us crazy.” -College student NYTimes, 2017 21
What the research says... Suniya Luthar, professor of psychology, ASU ● Studied distress and resilience in both well-off and disadvantaged teenagers ○ Conclusion: Privileged youths are among the most emotionally distressed ○ young people in America. Incredibly anxious and perfectionistic ■ “Never get to the point where they can say, ‘I’ve done enough, and now ■ I can stop....” “There’s always one more activity, one more A.P. class, one more thing ■ to do in order to get into a top college. Kids have a sense that they’re not measuring up. The pressure is relentless and getting worse.” NYTimes, 2017 22
Research continued... Internalized the anxiety; the kids at this point are driving themselves crazy ● Stephanie Eken, a psychiatrist and the regional medical director for Rogers ● Behavioral Health More kids than ever worry about terrorism ○ “They wonder about whether it’s safe to go to a movie theater,” she said. ○ Smartphones ○ Provoke anxiety ■ Avoidance Strategy ■ NYTimes, 2017 23
What caused the spike in anxiety and depression in our teenagers? According to Jean Twenge, a professor of psychology at San Diego State ● University Researches adolescent mental health and psychological differences among ○ generations The spike happened in 2011 ■ Number of studies linking social media and unhappiness ■ “The use of social media and smartphones look culpable for the ■ increase in teen mental-health issues” Anxiety is all about avoidance of uncertainty and discomfort ○ NYTimes, 2017 24
iGen Why Today's Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy--and Completely Unprepared for Adulthood--and What That Means for the Rest of Us by Jean Twenge 25
iGen by Jean Twenge 26
iGen by Jean Twenge 27
What can we do? ● Be mindful of smartphone usage ○ Offer illusion of control and certainty ○ “But life doesn’t always come with that kind of certainty, and they’re never practicing the skill of rolling with the punches, of walking into an unknown or awkward social situation and learning that they can survive it.” 28 NYTimes, 2017
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