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Four Types
Four Types
Four Types
Four Types
Which will you be?
Take a minute to answer this question
What is anxiety? What words do
you use to describe anxiety?
Fear VS Anxiety
 Fear – an unpleasant emotion caused by the belief that someone or
something is dangerous, likely to cause pain, or a threat.
.
 https://www.youtube.com/watch?v=AV6rhYssCQM
Anxiety VS Stress
 Stress is your body's way of responding to any kind of demand or threat.
When you sense danger—whether it's real or imagined—the body's defenses
kick into high gear in a rapid, automatic process known as the “fight-or-
flight” reaction or the "stress response."
 https://www.youtube.com/watch?v=S8-zfk9_lhg
Anxiety
 Anxiety – anxius [L, 1500s], a condition of agitation and distress
-- internal focus
-- a response to a vague, distant
or even unrecognized danger
 a feeling of worry, nervousness, or unease, typically about an imminent event
or something with an uncertain outcome
Anxiety
 Anxiety:
- inevitable
- response to
everyday challenge
- proportioned,
*appropriate,
*reasonable
Anxiety is normal!
Some statistics
 At least 20% of children under age 18 have significant mental health problems.
 75% of those don’t get help.
Too much anxiety is unhealthy.
 Often there is a family (genetic) tendency to anxiety
 Stress can be in family, school or neighborhood
 Anxious parents can model anxious behavior for children
 Children who live with too much stress can develop anxiety disorders
Dimensions of Anxiety: Symptoms in four
arenas
Dimensions of Anxiety: Symptoms in four
arenas
 Somatic
- Hyperventilation - Tachycardia
- trembling - palpitations
- shakiness - swallowing
- sweating - lump in throat
- flushing - urgency to urinate
-nausea - hair raising
- dizziness - tinnitus
- wobbling legs
Dimensions of Anxiety: Symptoms in four
arenas
 Cognitive
- Specific fears
- Embarrassment or shame is
intolerable
- Something awful will happen
- I am going crazy
- I will lose control
- I am going to die
Dimensions of Anxiety: Symptoms in four
arenas
 Behavioral
 Withdrawal
 Avoidance
 Escape
 Clinging
 Aggression
Dimensions of Anxiety: Symptoms in four
arenas
 Emotional
- Tense - Nervous
- Worried - On edge
- Panicky - Feelings of unreality
- Terrified - Hypervigilant
- Scared - Depressed
- Anxious
When to be concerned
 Avoidance of school (refuses to go)
 Frequent stomachaches or headaches in the morning before school
 Avoidance of activities
 Easily upset – distress out of proportion
 Parent or teacher reports they spent a lot of time comforting the child and/or
urging her/him to participate in regular activities
 Parent or teacher reports family/classroom functioning is being disrupted by your
child's fears and worries, or meltdowns.
 Intense worries or fears that interfere with daily activities
When to be concerned
 Sudden overwhelming fear for no reason, often with difficulty breathing and
racing or pounding heart
 Decline in school performance
 Wanting to avoid school
Anxiety
 Anxiety disorders are the most common mental health disorders.
 Up to 6% of children and youth have an anxiety disorder severe enough to
need treatment.
 Children may have more than one kind of anxiety disorder.
 Many anxiety disorders start in childhood and if untreated, they may persist into
adulthood.
Anxiety Disorders
 Anxiety Disorders:
- intensity
- duration
- impairment
Types of Anxiety
 Separation anxiety
 Selective mutism
 Specific phobia
 Situational Anxiety
 Other
 Social Anxiety
 Panic Disorder
 Agoraphobia
 Generalized anxiety disorder
 Substance Induced Anxiety
 Anxiety not due to medical condition
 Other specified anxiety disorders
 Unspecified anxiety disorder
Separation Anxiety Disorder
 Child is afraid of leaving their parent(s)
 They may worry that something bad will happen to the parent or to someone they
love or to themselves
 May refuse to go to school
 May have stomachaches, headaches, or throw up if they fear separation
 May refuse to go to playdates at other people’s houses
 Diagnosed if it causes problems at school or socially and has been going on at least
4 weeks
 https://www.youtube.com/watch?v=dRFgSpJz-K4
Generalized Anxiety Disorder
 Children with this kind of anxiety may:
 Have lots of worries and fears
 Have problems sleeping because of worries
 Have trouble concentrating
 Get tired easily or have tension headaches
 Be tense or restless
 Be perfectionist
 Have an anxious desire for approval
 https://www.youtube.com/watch?v=SYfvtVooPM8
Panic Disorder
 Happens less often with younger children
 People with this kind of anxiety have panic attacks
 Feel very scared
 Heart pounding, hard to breathe
 May feel shaky, dizzy, or sick
 May feel like they are going crazy or something really awful is going to happen
 Sometimes they avoid school or want to stay in the house
 Frequent panic attacks = panic disorder
 https://www.youtube.com/watch?v=jJH1fSfqBTs
Selective Mutism
 Children may not talk to anyone who is not close to them, such as immediate
family
 They may look down, withdraw, turn red if required to talk
 Often they whisper if they do speak in a situation where they are anxious
 Up to 2% of school age children may have these symptoms
 Some kids outgrow it; some go on to have social phobia
 https://www.youtube.com/watch?v=aIrDeBoUGlE
Social Anxiety/Social Phobia
 Happens more in teens than in young children
 Fear and worry about social situations
 Going to school
 Speaking in class
 Social events including recess and lunch
 Shy, self-conscious
 Easily embarrassed
 These kids tend to be sensitive to criticism and find it hard to be assertive
 https://www.youtube.com/watch?v=ypHzXOcUQwE
Assessment
 List and clarify all symptoms
 Look at history: family, drug use, mental health,
medical health.
 Analysis of current lifestyle status: stress,
nutrition, exercise, sleep, medications. List
problem areas.
 Rule out physical and other psychiatric causes,
getting medical results.
Assessment
Medical Rule Outs
 Shortness of breath
 Heart
 Respiration
 Dizziness
 Anemia, BPV, BP
 Numbness
 Circulatory
 respiratory
 Palpitations
 Tachycardia
 Thyroid
 Hypoglycemia
 Chest pain
 Heart conditions
 Autoimmune
 CFS
 Fibromyalgia
 Epstein-Barr
Assessment cont’
– Drug Usage Rule Outs
 Alcohol
 Kindling
 Neural excitement during
withdrawal
 Cocaine
 Kindling
 Drug-induced panic
 Other stimulants
 OTC drugs
 Diet pills
 Laxatives
 Caffeine
 aspartame
 Other medications
 Disulfiram
 Drugs to treat thyroid and
endocrine
Treatment
Anxiety disorders can be treated!
The most common treatment is cognitive behavior therapy (CBT) in groups or
individually
In CBT children learn relaxation and stress management plus
Gradual exposure to things that make them anxious, to decrease the
fear
Coping strategies to reduce anxiety
Treatment
CBT is first choice, but medication may be needed in severe situations
 Teach relaxation strategies such as belly breathing and muscle relaxation
 Teach visualize or imagine a pleasant, relaxing “happy place”
Cycle of Anxiety
Treatment –
Psychotherapy
 Subjective Rating Scales Use
 Explain concepts of SUDs
 Discuss the meaning of the ratings 0 – 10
 No comparison to other people are ever involved, self-assessment tool
 No internal competition: observing only
Grounding!
Look around you. Find 5 things you can
see, 4 things you can touch, 2 things you
can smell and 1 thing you can taste. This
is called “grounding” It is helpful to do
when you are anxious.
Daily Record of Breathing or Relaxation
Time Assign-
ment
SUD –
Outset
Duration SUD –
completion
Treatment –
Medication Consideration
 Benzodiazepines:
 For panic, acute
anxiety symptoms
 To enhance early tx
 Short term use e.g. 30
days
 Daily, regular use
 Rarely used PRN
 Antidepressants
 Misnamed
 Used for chronic
anxiety and depressed
moods
 Long term use
 Bolster with lifestyle
changes and
psychotherapy
Treatment –
Medication Choices
Benzodiazepine Sedative/
Hypnotic
Antidepressants
- Valium
- Xanax
- Librium
- Ativan
- Barbiturates - SSRI’s
- MAOIs
- Tri-cyclics
Effects:
- Mood altering
- Reduce anxiety sx
- Addictive
Effects:
- Insomnia relief
- Addictive
- Lethal OD
Effects:
- Not mood altering
- Not addictive
- have side effects
Whew- Questions?

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best project on anxity

  • 1.
  • 7. Take a minute to answer this question What is anxiety? What words do you use to describe anxiety?
  • 8. Fear VS Anxiety  Fear – an unpleasant emotion caused by the belief that someone or something is dangerous, likely to cause pain, or a threat. .  https://www.youtube.com/watch?v=AV6rhYssCQM
  • 9. Anxiety VS Stress  Stress is your body's way of responding to any kind of demand or threat. When you sense danger—whether it's real or imagined—the body's defenses kick into high gear in a rapid, automatic process known as the “fight-or- flight” reaction or the "stress response."  https://www.youtube.com/watch?v=S8-zfk9_lhg
  • 10. Anxiety  Anxiety – anxius [L, 1500s], a condition of agitation and distress -- internal focus -- a response to a vague, distant or even unrecognized danger  a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome
  • 11. Anxiety  Anxiety: - inevitable - response to everyday challenge - proportioned, *appropriate, *reasonable Anxiety is normal!
  • 12. Some statistics  At least 20% of children under age 18 have significant mental health problems.  75% of those don’t get help.
  • 13. Too much anxiety is unhealthy.  Often there is a family (genetic) tendency to anxiety  Stress can be in family, school or neighborhood  Anxious parents can model anxious behavior for children  Children who live with too much stress can develop anxiety disorders
  • 14. Dimensions of Anxiety: Symptoms in four arenas
  • 15. Dimensions of Anxiety: Symptoms in four arenas  Somatic - Hyperventilation - Tachycardia - trembling - palpitations - shakiness - swallowing - sweating - lump in throat - flushing - urgency to urinate -nausea - hair raising - dizziness - tinnitus - wobbling legs
  • 16. Dimensions of Anxiety: Symptoms in four arenas  Cognitive - Specific fears - Embarrassment or shame is intolerable - Something awful will happen - I am going crazy - I will lose control - I am going to die
  • 17. Dimensions of Anxiety: Symptoms in four arenas  Behavioral  Withdrawal  Avoidance  Escape  Clinging  Aggression
  • 18. Dimensions of Anxiety: Symptoms in four arenas  Emotional - Tense - Nervous - Worried - On edge - Panicky - Feelings of unreality - Terrified - Hypervigilant - Scared - Depressed - Anxious
  • 19. When to be concerned  Avoidance of school (refuses to go)  Frequent stomachaches or headaches in the morning before school  Avoidance of activities  Easily upset – distress out of proportion  Parent or teacher reports they spent a lot of time comforting the child and/or urging her/him to participate in regular activities  Parent or teacher reports family/classroom functioning is being disrupted by your child's fears and worries, or meltdowns.  Intense worries or fears that interfere with daily activities
  • 20. When to be concerned  Sudden overwhelming fear for no reason, often with difficulty breathing and racing or pounding heart  Decline in school performance  Wanting to avoid school
  • 21. Anxiety  Anxiety disorders are the most common mental health disorders.  Up to 6% of children and youth have an anxiety disorder severe enough to need treatment.  Children may have more than one kind of anxiety disorder.  Many anxiety disorders start in childhood and if untreated, they may persist into adulthood.
  • 22. Anxiety Disorders  Anxiety Disorders: - intensity - duration - impairment
  • 23.
  • 24. Types of Anxiety  Separation anxiety  Selective mutism  Specific phobia  Situational Anxiety  Other  Social Anxiety  Panic Disorder  Agoraphobia  Generalized anxiety disorder  Substance Induced Anxiety  Anxiety not due to medical condition  Other specified anxiety disorders  Unspecified anxiety disorder
  • 25. Separation Anxiety Disorder  Child is afraid of leaving their parent(s)  They may worry that something bad will happen to the parent or to someone they love or to themselves  May refuse to go to school  May have stomachaches, headaches, or throw up if they fear separation  May refuse to go to playdates at other people’s houses  Diagnosed if it causes problems at school or socially and has been going on at least 4 weeks  https://www.youtube.com/watch?v=dRFgSpJz-K4
  • 26. Generalized Anxiety Disorder  Children with this kind of anxiety may:  Have lots of worries and fears  Have problems sleeping because of worries  Have trouble concentrating  Get tired easily or have tension headaches  Be tense or restless  Be perfectionist  Have an anxious desire for approval  https://www.youtube.com/watch?v=SYfvtVooPM8
  • 27. Panic Disorder  Happens less often with younger children  People with this kind of anxiety have panic attacks  Feel very scared  Heart pounding, hard to breathe  May feel shaky, dizzy, or sick  May feel like they are going crazy or something really awful is going to happen  Sometimes they avoid school or want to stay in the house  Frequent panic attacks = panic disorder  https://www.youtube.com/watch?v=jJH1fSfqBTs
  • 28. Selective Mutism  Children may not talk to anyone who is not close to them, such as immediate family  They may look down, withdraw, turn red if required to talk  Often they whisper if they do speak in a situation where they are anxious  Up to 2% of school age children may have these symptoms  Some kids outgrow it; some go on to have social phobia  https://www.youtube.com/watch?v=aIrDeBoUGlE
  • 29. Social Anxiety/Social Phobia  Happens more in teens than in young children  Fear and worry about social situations  Going to school  Speaking in class  Social events including recess and lunch  Shy, self-conscious  Easily embarrassed  These kids tend to be sensitive to criticism and find it hard to be assertive  https://www.youtube.com/watch?v=ypHzXOcUQwE
  • 30. Assessment  List and clarify all symptoms  Look at history: family, drug use, mental health, medical health.  Analysis of current lifestyle status: stress, nutrition, exercise, sleep, medications. List problem areas.  Rule out physical and other psychiatric causes, getting medical results.
  • 31. Assessment Medical Rule Outs  Shortness of breath  Heart  Respiration  Dizziness  Anemia, BPV, BP  Numbness  Circulatory  respiratory  Palpitations  Tachycardia  Thyroid  Hypoglycemia  Chest pain  Heart conditions  Autoimmune  CFS  Fibromyalgia  Epstein-Barr
  • 32. Assessment cont’ – Drug Usage Rule Outs  Alcohol  Kindling  Neural excitement during withdrawal  Cocaine  Kindling  Drug-induced panic  Other stimulants  OTC drugs  Diet pills  Laxatives  Caffeine  aspartame  Other medications  Disulfiram  Drugs to treat thyroid and endocrine
  • 33. Treatment Anxiety disorders can be treated! The most common treatment is cognitive behavior therapy (CBT) in groups or individually In CBT children learn relaxation and stress management plus Gradual exposure to things that make them anxious, to decrease the fear Coping strategies to reduce anxiety
  • 34. Treatment CBT is first choice, but medication may be needed in severe situations  Teach relaxation strategies such as belly breathing and muscle relaxation  Teach visualize or imagine a pleasant, relaxing “happy place”
  • 36. Treatment – Psychotherapy  Subjective Rating Scales Use  Explain concepts of SUDs  Discuss the meaning of the ratings 0 – 10  No comparison to other people are ever involved, self-assessment tool  No internal competition: observing only
  • 37. Grounding! Look around you. Find 5 things you can see, 4 things you can touch, 2 things you can smell and 1 thing you can taste. This is called “grounding” It is helpful to do when you are anxious.
  • 38. Daily Record of Breathing or Relaxation Time Assign- ment SUD – Outset Duration SUD – completion
  • 39. Treatment – Medication Consideration  Benzodiazepines:  For panic, acute anxiety symptoms  To enhance early tx  Short term use e.g. 30 days  Daily, regular use  Rarely used PRN  Antidepressants  Misnamed  Used for chronic anxiety and depressed moods  Long term use  Bolster with lifestyle changes and psychotherapy
  • 40. Treatment – Medication Choices Benzodiazepine Sedative/ Hypnotic Antidepressants - Valium - Xanax - Librium - Ativan - Barbiturates - SSRI’s - MAOIs - Tri-cyclics Effects: - Mood altering - Reduce anxiety sx - Addictive Effects: - Insomnia relief - Addictive - Lethal OD Effects: - Not mood altering - Not addictive - have side effects