Anxiety, worries, fears and phobias – spotting the signs, symptoms and triggers.

Anxiety can manifest in many ways and we often misread the signs and symptoms. We therefore forget to note what the possible triggers are.

I often like to describe someone as an onion. Initially we are that onion seed. As we grow we build up layers of armour to protect ourselves. Some of these layers are open for all to see as these present our courage and strengths. Then there are other layers which are the barriers we put up and are hidden from others.

In order to understand the anxiety a child or young person is going through we need to peel back those layers and support them in not adding more.

We need to be observant. How observant are you?

What is an anxiety disorder?

  • Anxiety is a natural response, useful in helping us avoid dangerous situations and motivating us to solve everyday problems.
  • Anxiety can vary in severity from mild uneasiness through to a terrifying panic attack.
  • It can vary in how long it lasts, from a few moments to many years.

Possible risks and triggers for anxiety?

  • Medical factors
  • Genetics
  • Brain chemistry
  • Substance abuse
  • Stress
  • Usually a response to outside forces
  • Possible from ‘negative self-talk’
  • Environmental factors

 

What are some environmental factors?

Trauma for events

  • abuse
  • victimisation
  • Death of a loved one

Stress

  • in a personal relations
  • friendship
  • parents’ divorce
  • school and exams
  • finances and money

Normal anxiety is necessary – we need it. If we have a hippopotamus hurtling towards us and we don’t have fear and anxiety kicking in, well, you know what happens next?

There is a significant difference between normal anxiety and an anxiety disorder. It is more severe. It is long-lasting. It interferes with school, work and relationships.

You will have heard of fight, flight and freeze.

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Fight – what might we notice?

  • Crying
  • Hands in fists, desire to punch, rip
  • Flexed/tight jaw, grinding teeth, snarl
  • Fight in eyes, glaring, fight in voice
  • Desire to stomp, kick, smash with legs, feet
  • Feelings of anger/rage
  • Homicidal/suicidal feelings
  • Knotted stomach/nausea, burning stomach
  • Metaphors like bombs, volcanoes erupting

Flight – what might we notice?

  • Restless legs, feet /numbness in legs
  • Anxiety/shallow breathing
  • Big/darting eyes
  • Leg/foot movement
  • Reported or observed fidgety-ness, restlessness, feeling trapped, tense
  • Sense of running in life- one activity-next
  • Excessive exercise

Freeze- what might we notice?

  • Feeling stuck in some part of body
  • Feeling cold/frozen, numb, pale skin
  • Sense of stiffness, heaviness
  • Holding breath/restricted breathing
  • Sense of dread, heart pounding
  • Decreased heart rate (can sometimes increase)
  • Orientation to threat

I experienced this when my personal space was invaded and no matter how many times I said no, no never seemed to mean no and be heard.

I began in the freeze mode. I felt trapped in my own body and couldn’t find my voice. There was a sense of dread. I moved into flight mode where I recognised how tense I felt. When fight mode finally arrived I was incredibly angry and wanted to scream and lash out.

Anxiety affects us differently – cognitively, physically, emotionally and behaviourally.

 

 

 

 

It is important to teach children about anxiety so we can support them better and also so they can learn how their triggers affect them.

  • Teach child the physiology of anxiety
  • Learn about their triggers
  • Involve them in decisions
  • Consistency
  • Routine
  • Aim high

Generalised Anxiety Disorder

Generalised anxiety disorder can make it difficult for people to concentrate at school or work, function at home and generally get on with their lives.

GAD present for a long time you may notice inability to make decisions that would have normally been easy and continually seeking reassurance around every day matters.

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Panic Disorder – signs and symptoms

Increased awareness of heart beat

Sweating

Trembling or shaking

Feeling of choking, shortness of breath or smothering

Chest pain or discomfort nausea

Feeling of unreality, detachment from oneself or one’s surroundings

Fear of losing control or going crazy

Fear of dying

Numbness, tingling, pins and needles

Chills or hot flushes

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Panic Attacks

Sudden and develop rapidly

Physical symptoms – heart attack or asthma attack.

Medical assessment

 

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Phobias

Avoids or restricts activities because they have a specific fear.

This fear appears persistent, excessive and unreasonable.

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PTSD

Fear, helplessness or horror

Flashbacks and intrusive memories

Avoidance behaviour

Emotional numbing

Reduced interest

Arousal

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OCD

Least common form of anxiety

Accompanies the feelings of anxiety

Recurrent thoughts, impulses or images

Repetitive behaviours or mental activity

Usually begins in adolescence

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What to do – listen non-judgementally

Listen without judging

Do not be critical

Do not express frustration

Do not give glib advice – ‘pull yourself together’

Avoid confrontation

Seek to understand

Give undivided attention

Use silence effectively

Accept their worries are real for them

Don’t try to solve their problems

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20 Classroom Interventions for Children with Anxiety Disorders

Although anxiety does not necessarily impact a child’s academic abilities, it can affect their ability to learn. Parents and teachers can work together to help a child succeed in the classroom. There are a number of ways teachers can make the school day easier and less stressful for a child with anxiety:

Create a “safe” place for the child to go when anxiety symptoms are high or during stressful times. This may be the nurse’s office or a staff member’s office. Establish rules for the use of the “safe” place. These rules should include items such as, the student must inform the teacher they need a few minutes to calm down, and a set time limit.

Be aware of physical symptoms of anxiety and provide activities to distract the child. Calming activities, such as, reading or listening to music may help to alleviate some of the physical symptoms and allow a child to return to class work after a period of time.

Allow a few minutes at the beginning of the day for the child to transition into the school day. Additional transitional periods might be necessary for other times when routine is disrupted. This can be providing five to ten minutes for the child to prepare their papers and school supplies or simply a few minutes for the child to sit quietly before the school day begins. If the time before school is difficult for the child, it may be beneficial for them to either enter the classroom a few minutes before or a few minutes after the rest of the class arrives.

Talk to the student about what interventions they would find helpful. Having the student discuss strategies may help them to be involved in reducing their anxiety symptoms. This also provides the child an opportunity to talk about situations that cause anxiety symptoms as well as for them to be more aware of their symptoms.

Teach the child relaxation techniques they can do at school, such as deep breathing exercises. Talk with parents about the techniques used at home and try to incorporate them into the classroom.

For children avoiding school because of anxiety, offer suggestions such as coming to school for a shorter day. The longer the child avoids going to school, the more difficult it is for them to return. Allowing them to come to school for shorter periods will give them a chance to face their fears but may make it easier if they know they will be able to return home at lunchtime.

Use small group activities throughout the day. Children with anxiety may be better able to cope with small groups of a few students rather than large classroom study. Have the class break into small groups to complete class work to encourage participation.

Reward effort by a student with anxiety. When a child shows effort or is able to control their anxiety symptoms through interventions, let them know you have noticed and are proud of their efforts.

Create group activities that role-play appropriate behaviors. Teach young children what to do in specific situations. This can help all students learn how to handle situations such as anger management, stress reduction, test anxiety. Providing instruction to the entire class will decrease the focus on the child with anxiety.

Decrease situations that induce stress. Teachers can restructure assignments to decrease the amount of stress for a student. For example, instead of having a child stand in front of the class to read a report, find creative ways to complete reports. Allow students to make posters or record presentations at home on a tape recorder.

Discuss anxiety symptoms privately with the student. Never single out a child or call attention to their anxiety in front of the class. This can cause humiliation or embarrassment and increase anxiety symptoms.

Discuss alternative ways of handling situations. Talk to the student after an anxiety attack about how the situation could have been different or what strategies could have been used (by both the student and the teacher) to make the situation better.

Find books that address children with anxiety. Incorporate these books into reading curriculum. This not only helps the child with anxiety to feel better about their anxiety but also can help the other students in the class be more understanding of the condition.

Teach positive self-talk to the entire class. Helping children to be aware of the negative way they talk to themselves, such as the use of “I can’t” and help them to develop a more positive way of talking to themselves.

Post the daily routine in the classroom and let students know in advance any changes in the schedule. Letting students know exactly what is expected will help lessen anxiety. For a student with anxiety, a sudden change can cause a panic attack. Knowing in advance what the day will be like will help in transitions.

Help students break assignments down into smaller segments. This can help to decrease feeling overwhelmed by large assignments and help a student work on each section.

Play soothing music during down time. Many times playing soft music can help children to calm down and can relieve stress. During quiet activities or seatwork, use soothing music.

Incorporate exercise into the school day. Stop lessons for a few minutes or do stretching exercises in between lessons. This can help reduce stress.

Use computerised reading programs. Allowing children time to work on their own rather than in a large group can reduce stress and anxiety.

Discuss what sections of a book will be read aloud with a student before calling on them to read. If reading aloud in the class causes stress and anxiety, plan ahead of time and let a student practice a small selection the night before.

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Never ask what’s wrong or what’s the matter as this can lead to an anxious person believing they are a fault or becoming very defensive.

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