Anxiety seminars help parents help children
By Joann Groff joann@theacorn.com

In the fourth seminar in his teen disorder series, Stazan Sina spoke to parents about anxiety disorders in children and adolescents, offering advice on how to react and the steps to take after diagnosis.

Sina focused on depression and anxiety, which are the two most common mental illnesses and often co-occur. According to his statistics, between 8 and 10 percent of teens have an anxiety disorder.

Anxiety, which is defined as distress or uneasiness of mind caused by a fear or danger that could be real or merely perceived, is important to the survival of species but becomes problematic when it's excessive, Sina said.

An anxiety disorder is characterized by misperceiving threat or having a high sensitivity to threat and stress, as well as a tendency to be neurobiologically overreactive to stress, leading to false alarms. In other words, Sina said, the fightorflight mechanism is activated too easily.

Panic attacks, periods of intense fear or discomfort, have many symptoms, including heart palpitations, sweating, trembling, chest pain, nausea, a choking sensation, a fear of dying or going crazy, and numbness or tingling sensations.

Panic disorder is when panic attacks are recurrent and unexpected; attacks can be followed by weeks or months of persistent concern.

"The thought of 'When is this going to happen next?' inhibits you," Sina said. "You are constantly worrying about worry."

Agoraphobia, or anxiety about being in places or situations from which escape may be difficult or embarrassing, can often accompany panic disorder.

Sina also spoke about social phobia, or social anxiety disorder, at the seminar attended by 20 or so parents.

"Social anxiety disorder is a persistent fear of social or performance situations in which the individual is exposed to unfamiliar people or possible scrutiny by others," Sina said. "It is like a fear of public speaking. Adults recognize this fear is excessive, but children may not."

A teen with generalized anxiety disorder has endured excessive anxiety most days for at least six months about any number of potential events or activities.

"It's hard for the individual to control the worry," Sina said.

The anxiety is associated with at least three of the following: restlessness, easy fatigue, difficulty concentrating, irritability, muscle tension and sleep disturbance. However, Sina said, only one of those symptoms is required for a child to be diagnosed with generalized anxiety disorder.

Sina warned parents to watch out for teen-specific symptoms of anxiety disorders.

"They may be likely to report fewer friends and less satisfying peer relationships," he said. "They may also need more time to take tests or complete work or (may) refuse to do schoolwork."

There is also the danger of increasing illegal substance use in an effort to cope or self-soothe. The risk of developing an eating disorder increases as well.

Sina stressed building trust and safety in a therapy environment before expecting many results. A psychologist should work on manageable and gradual exposure to anxiety-producing stimuli and assess the parents' management of their own anxiety, as it is a learned trait. The doctor should also aid the teen in predicting, planning and prepping for events that may cause anxiety and should consider a medication assessment.

A parent in attendance wanted advice on whether she should encourage her child to take small steps toward "conquering" his phobia. Sina agreed, explaining that moving slowly is key.

For example, he said, a child who became anxious around people in large animal costumes doesn't need to confront the school mascot. Perhaps having the child's therapist bring in the costume for the child to look at would be a good first step.

There were also concerns about the addictive nature of medications, but for some children and teens suffering with anxiety, antidepressants or antianxiety medications will be necessary. Close monitoring is important, Sina said.