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How Can Schools Help Kids With Anxiety?

I met Brianna Sedillo when she pitched my radio station a personal perspective on anxiety, a topic that comes up over and over as teachers and parents try to support young people.

“Everything kind of started with the anxiety and depression after the passing of my grandfather,” Brianna said. “He was kinda my safe space. And losing that was really big.”

Brianna missed her grandfather’s supportive presence acutely during her middle school years, which were difficult. Middle school can be a difficult time for anyone, but for Brianna it was particularly hard socially because her family moved several times. She had trouble making new friends and felt each change of school acutely. Despite all that, she was a good student; she made the honor roll all three years in middle school.

But everything got worse when she started at El Cerrito High School, just outside San Francisco. Brianna’s feelings of isolation intensified, and her depression and anxiety kicked into high gear. She knew that she should be doing her homework, participating in class, and trying to be more social, but she couldn’t bring herself to do any of it. By sophomore year, Brianna was barely passing.

“It was just really rough for me,” Brianna said. She couldn’t stop worrying about what people thought of her, which made her so self-conscious she could barely function. “With my anxiety I tend to overthink everything. And I’m always aware of who’s looking at me and who’s talking about me, who’s judging me.”

Brianna remembers an endless cycle of waking up, going to school, taking work she couldn’t bring herself to do, and coming home to hide in her room and sleep. She lost a lot of weight and didn’t even enjoy playing soccer anymore, her favorite activity. She scrutinized her appearance every few minutes, and became so self-conscious she avoided answering questions she knew in class because she didn’t want people to look at her. When she got home, where she felt safe, all the anxiety she’d been bottling up all day came spilling out.

“It’s like something goes off and the anxiety kind of kicks in,” Brianna said. She would go over every tiny detail of the day. “Everything that I did that day. The way I pronounce something, the way I did something, The way I walked.” Then she would start thinking about her mom and how she should be working harder to make her mom proud, and that only made her feel worse.

“And then I start to panic and then it’s like, what am I going to do? Like, I’m going to disappoint my mom. And then I can’t breathe and then I get shaky, and I end up in a ball on the floor just trying to get my breathing back on track,” she said.

Brianna is just one of many young people around the country experiencing anxiety, and often the depression that comes with it. Teachers and parents all over the country are noticing an increase in mental health issues, including anxiety, among students.

There isn’t much research directly surveying adolescents on their anxiety. In 2004, the National Institute of Mental Health estimated that about a third of adolescents (ages 13-18) have been or will be seriously affected by anxiety in their lifetimes. More recently, a study published in the Journal of Developmental and Behavioral Pediatrics, based on parent surveys for the National Survey of Children’s Health, concluded that more than one in twenty U.S. children (ages 6-17) had anxiety or depression in 2011-2012. And a UCLA survey of college freshman conducted each year, found in 2017 that close to 39 percent frequently felt “overwhelmed by all I had to do.” Parents and educators are scrambling to understand why kids seem to be more anxious and how to help them.

One School’s Attempt to Dispel the Isolation That Accompanies Anxiety

Brianna is far from the only student at El Cerrito High suffering from anxiety. In fact, counselors at the James Morehouse Project, the school’s wellness center, began noticing a few years ago that more and more students named anxiety as a chief concern. Most felt completely alone.

“A lot of students [were] coming in saying, ‘people don’t get this. Other students don’t experience this. People don’t know what it’s like,’” said Rachel Krow-Boniske, a social work intern at the James Morehouse Project. “And seeing that from so many different students made me want to be like, ‘Actually, this is really common! And if you all got to talk with each other and connect with each other over the experience, it might feel less alienating.’”

So Krow-Boniske and another intern, Forest Novak, started an anxiety group in the 2018-19 school year. They recommended some students they were seeing individually, and spread the word among teachers, who also recommended students who might benefit from participating.

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The group includes students from all grades and fluctuates in size from eight to ten. It meets once a week so students can discuss their anxiety, gain confidence that they aren’t the only ones struggling, and learn coping strategies. Krow-Boniske and Novak want students to become more aware of the signs of their anxiety, what triggers it, and how they can tell themselves a different story about what’s happening.

The course is broken down into sections. The first several weeks the two counselors facilitate a process of self-discovery for students. They do writing exercises with students to help them think carefully about how their bodies feel when they’re getting anxious, what’s happening around them, and what messages their anxiety tells them about themselves. After they validate that a lot of people are having similar feelings, the curriculum moves on to dig into seven types of coping strategies: grounding, distraction, emotional release, thought challenging, self-love, and accessing the truest parts of oneself to help hold all the other coping mechanisms.

“I’ve been amazed by how much they know about their own anxiety,” Krow-Boniske said. “They seem so aware of what’s happening for them and just haven’t quite had the words or the space to talk about it.”

Part Of a Broad Strategy to Support Students Where They’re At

The anxiety group is just one of many student wellness services offered at the James Morehouse Project, or the JMP as everyone at El Cerrito High calls it. The center is named for a former staff member who had a gift for connecting with students. Jenn Rader, a former history teacher, started the JMP when she realized that her students were struggling with far more than academics in her classroom.

“Those things were taking up so much space that there was really nothing left over to receive what was being offered in the building,” Rader said.

When it opened more than 20 years ago, the James Morehouse Project focused on providing health services and a little bit of counseling to students. Now, it offers an impressive array of services. It has a free, full-service medical clinic where students can get physical exams and an array of reproductive health services. It also has a dental clinic for students with MediCal, California’s Medicaid program.

It offers a youth development program aimed at cultivating students’ leadership and activism. Its staff provide one-on-one counseling services, as well as groups dedicated to almost everything a struggling student would need: support for queer-identified young people of color, an Arabic-speaking girls group, a support group for Muslim students, another support group for students who’ve suffered a catastrophic loss, and social skills groups for students who have a difficult time connecting with other young people.

“I think there’s been kind of a culture shift, a growing awareness and a growing commitment to ensure that children and young people arrive in a building with what they need in order to enter a classroom ready to learn,” Rader said.

More than 1,500 students attend El Cerrito High. Rader says almost a third of them have a meaningful interaction with the JMP each year either through groups or counseling. That’s only possible because the JMP runs a robust clinical social work internship program.

All those extra adults make a big difference in the lives of kids. When Brianna first came to the JMP, she saw an intern counselor who she says changed her life.

“She didn’t tell me what I was supposed to be, who I was supposed to be,” Brianna said. “She sat there and she listened, and she helped me just discover who I was. She helped me get deeper with myself and realizing things I hadn’t realized before. By the end of that, I was a much happier person. It was like a weight was on my shoulders, and piece by piece, she helped me take it off.”

How Parents Can Help Their Kids With Anxiety

Many students I spoke with for this story feel misunderstood by the adults around them. Their anxiety makes it difficult for them to complete assignments or be proactive, and that can look like procrastination. Brianna, for example, felt she was letting her mother down when she couldn’t bring herself to do her homework. Feeling inadequate made the anxiety and depression worse.

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Nina Kaiser is a child psychologist based in San Francisco who has been working with anxious kids for over 15 years. She says the feelings Brianna describes, as well as the misunderstandings that can arise with parents, are common. If parents want to get to the bottom of the problem, the first step is to understand how anxiety works.

“Your brain is constantly scanning your environment, looking for danger,” Kaiser explained. “It’s true for all of us, every single one of us, but when you are experiencing anxiety, it’s like a smoke detector or alarm that goes off more frequently.”

Kaiser likes working with anxious kids because there are effective treatments. One of the most effective ways to treat anxiety is with cognitive behavioral therapy. She helps her patients address both their physical responses to anxiety, as well as their distorted thoughts or “cognitions.” These thoughts often tend towards catastrophizing or ruminating on something that happened in the past, or could happen in the future.

“You’re teaching kids strategies around noticing those thoughts and being able to push back against them, or to shift gears instead of getting stuck in that pattern,” Kaiser said.

But it takes a lot of practice to step back from the panicked feelings and to look at them with a little more objective distance. She describes anxious thoughts to her clients as junk mail or spam. She directs them to look for evidence that supports the negative thoughts, or disproves them. So, if a student is anxious about failing a test, Kaiser will coach them to think about their past performance on tests, their grades overall, and whether this one test even matters that much.

But, she adds, “Those [anxious] thoughts tend to be really powerful and really automatic. They’re coming into your mind really quickly, really loudly, and it’s challenging to step back and notice that there are other ways to think about the situation.”

Kaiser says anxiety can be tricky for parents to handle because they may see it as laziness on the part of their child. But rather than judging them for not doing their homework or not wanting to go out with friends, she recommends they try to approach the situation with curiosity. When parents don’t assume they know what’s happening with their child, they can open up more space for the child to confide what’s really going on.

Kaiser also says that one of the hardest parts about treating anxiety is confronting the things that make a person anxious. Kids aren’t going to want to do that, and a parent’s first instinct is often to protect their child from things that cause them distress. Kaiser reminds her clients and their parents that anxiety is trying to control them and the best way to get out from under that is to push back.

“So if a kid is really spiraling about something, if parents are overly reassuring, they’re also sending a message that there’s something valid about that anxiety,” Kaiser said.

She recommends parents and their kids read reputable sources about anxiety ahead of time, when tensions aren’t high. Then, when a panic attack hits or a student is particularly anxious, it’s easier for parents to gently push them without making their child feel they aren’t emotionally supported. Kaiser knows this is hard for parents to do, but she says having a collaborative relationship established ahead of time will make it easier.

It’s All About Resilience

After Brianna got help with her depression at the James Morehouse Project, she also developed coping strategies for her anxiety. She still gets panic attacks sometimes, but now she knows how to handle them. And she’s headed to community college in the fall, a new phase of life that excites her.

James Morehouse Project director Jenn Rader says it’s no surprise students are anxious in today’s world. Her students are dealing with a lot of trauma from the world around them. Their families are struggling to make ends meet in an economy that is increasingly unequal. They are worried about their futures in an insecure world. Many feel that if they aren’t perfect, they’ve failed. And they’re constantly comparing themselves to others on social media. They are terrified of school shootings, immigration raids, violence in their neighborhoods, and even not getting into a good college.

Nina Kaiser says she’s seeing patients with serious anxiety at younger and younger ages. She’s even started an anxiety group, called Mighty Minds, with elementary school-aged children to help kids build up the resilience they’ll need to face middle and high school stress before they get there.

“Why are we waiting until kids are already struggling? These are really life skills. The ability to calm yourself down, to notice when you’re feeling stressed. I’m practically 40 years old. These are still skills that I’m practicing day by day.”

She hopes with these tools available to them, kids will have skills to fall back on when they run up against adversity.

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Source: How Can Schools Help Kids With Anxiety?

 

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No, Eating Chocolate Won’t Cure Depression

A recent study published in the journal Depression and Anxiety has attracted widespread media attention. Media reports said eating chocolate, in particular, dark chocolate, was linked to reduced symptoms of depression.

A recent study published in the journal Depression and Anxiety has attracted widespread media attention. Media reports said eating chocolate, in particular, dark chocolate, was linked to reduced symptoms of depression.

Unfortunately, we cannot use this type of evidence to promote eating chocolate as a safeguard against depression, a serious, common and sometimes debilitating mental health condition.

This is because this study looked at an association between diet and depression in the general population. It did not gauge causation. In other words, it was not designed to say whether eating dark chocolate caused a reduction in depressive symptoms.


Read more: What causes depression? What we know, don’t know and suspect


What did the researchers do?

The authors explored data from the United States National Health and Nutrition Examination Survey. This shows how common health, nutrition and other factors are among a representative sample of the population.

People in the study reported what they had eaten in the previous 24 hours in two ways. First, they recalled in person, to a trained dietary interviewer using a standard questionnaire. The second time they recalled what they had eaten over the phone, several days after the first recall.

The researchers then calculated how much chocolate participants had eaten using the average of these two recalls.

Dark chocolate needed to contain at least 45% cocoa solids for it to count as “dark”.


Read more: Explainer: what is memory?


The researchers excluded from their analysis people who ate an implausibly large amount of chocolate, people who were underweight and/or had diabetes.

The remaining data (from 13,626 people) was then divided in two ways. One was by categories of chocolate consumption (no chocolate, chocolate but no dark chocolate, and any dark chocolate). The other way was by the amount of chocolate (no chocolate, and then in groups, from the lowest to highest chocolate consumption).


Read more: Monday’s medical myth: chocolate is an aphrodisiac


The researchers assessed people’s depressive symptoms by having participants complete a short questionnaire asking about the frequency of these symptoms over the past two weeks.

The researchers controlled for other factors that might influence any relationship between chocolate and depression, such as weight, gender, socioeconomic factors, smoking, sugar intake and exercise.

What did the researchers find?

Of the entire sample, 1,332 (11%) of people said they had eaten chocolate in their two 24 hour dietary recalls, with only 148 (1.1%) reporting eating dark chocolate.

A total of 1,009 (7.4%) people reported depressive symptoms. But after adjusting for other factors, the researchers found no association between any chocolate consumption and depressive symptoms.

Few people said they’d eaten any chocolate in the past 24 hours. Were they telling the truth? from www.shutterstock.com

However, people who ate dark chocolate had a 70% lower chance of reporting clinically relevant depressive symptoms than those who did not report eating chocolate.

When investigating the amount of chocolate consumed, people who ate the most chocolate were more likely to have fewer depressive symptoms.

What are the study’s limitations?

While the size of the dataset is impressive, there are major limitations to the investigation and its conclusions.

First, assessing chocolate intake is challenging. People may eat different amounts (and types) depending on the day. And asking what people ate over the past 24 hours (twice) is not the most accurate way of telling what people usually eat.

Then there’s whether people report what they actually eat. For instance, if you ate a whole block of chocolate yesterday, would you tell an interviewer? What about if you were also depressed?

This could be why so few people reported eating chocolate in this study, compared with what retail figures tell us people eat.


Read more: These 5 foods are claimed to improve our health. But the amount we’d need to consume to benefit is… a lot


Finally, the authors’ results are mathematically accurate, but misleading.

Only 1.1% of people in the analysis ate dark chocolate. And when they did, the amount was very small (about 12g a day). And only two people reported clinical symptoms of depression and ate any dark chocolate.

The authors conclude the small numbers and low consumption “attests to the strength of this finding”. I would suggest the opposite.

Finally, people who ate the most chocolate (104-454g a day) had an almost 60% lower chance of having depressive symptoms. But those who ate 100g a day had about a 30% chance. Who’d have thought four or so more grams of chocolate could be so important?

This study and the media coverage that followed are perfect examples of the pitfalls of translating population-based nutrition research to public recommendations for health.

My general advice is, if you enjoy chocolate, go for darker varieties, with fruit or nuts added, and eat it mindfully. — Ben Desbrow


Blind peer review

Chocolate manufacturers have been a good source of funding for much of the research into chocolate products.

While the authors of this new study declare no conflict of interest, any whisper of good news about chocolate attracts publicity. I agree with the author’s scepticism of the study.

Just 1.1% of people in the study ate dark chocolate (at least 45% cocoa solids) at an average 11.7g a day. There was a wide variation in reported clinically relevant depressive symptoms in this group. So, it is not valid to draw any real conclusion from the data collected.

For total chocolate consumption, the authors accurately report no statistically significant association with clinically relevant depressive symptoms.

However, they then claim eating more chocolate is of benefit, based on fewer symptoms among those who ate the most.

In fact, depressive symptoms were most common in the third-highest quartile (who ate 100g chocolate a day), followed by the first (4-35g a day), then the second (37-95g a day) and finally the lowest level (104-454g a day). Risks in sub-sets of data such as quartiles are only valid if they lie on the same slope.

The basic problems come from measurements and the many confounding factors. This study can’t validly be used to justify eating more chocolate of any kind. — Rosemary Stanton


Research Checks interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate.

Associate Professor, Nutrition and Dietetics, Griffith University

Rosemary Stanton is a Friend of The Conversation.

Visiting Fellow, School of Medical Sciences, UNSW

Source: No, eating chocolate won’t cure depression

Anxiety: Why It’s Different From Stress – Peg Rosen

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There’s a math test tomorrow and 14-year-old Katherine should be studying. Instead she’s in bed. “I’m not taking the test! What happens if people see I can’t do it? What if I fail again?” she cries to her mom.

Anxiety is a sense of fear and worry. And it’s easy to understand why Katherine and other children with learning and attention issues are more likely to have anxiety than other children. Many have to work harder to keep up with their classmates. Other kids may bully them. Kids with learning and attention issues may not have the coping skills or maturity to handle these difficulties.

“When anxiety stops your child from functioning or enjoying life, it’s probably time to find help.”

But anxiety can be managed. The key is noticing the signs and providing the tools your child needs to keep worry in check.

Read on to learn how anxiety is different from stress—and what might cause anxiety in kids with learning and attention issues. You’ll also learn when to get help for your child’s anxiety.

Anxiety vs. Stress

Stress and anxiety are closely related but are not the same thing.

  • Stress is a natural and normal response to a challenge. Our heart pumps faster and our palms sweat as we get ready to act.
  • Stress can make us feel nervous, angry, frustrated—even anxious.
  • Stress can have a positive effect. For example it can “pump up” a child to study for a test.
  • Stress can also be overwhelming. Feeling stress every day for a long time can take a toll on your body and mind.
  • Anxiety makes a kid feel worried and afraid. “What if?” is a common phrase for anxious kids.
  • The anxious feeling is often out of proportion to the real or imagined “threat” (for example, a child crying in terror because she’s afraid to enter a birthday party).
  • Anxious children may expect that something bad will happen and not believe they’ll be able to handle it. (That bee’s going to sting me and I’m going to die!)
  • The bad feelings associated with anxiety can come from something specific, like algebra. Or anxiety can be a more general sense of uneasiness that affects much of everyday life.

Common Causes of Anxiety

Just about everyone feels anxiety at some point. But kids with learning and attention issues may have extra reasons for feeling worried and afraid. These include:

  • Anxiety about not being able to keep up: Kindergarten is often when children with learning and attentions issues first show signs of anxiety. They may notice they can’t do what their friends can do. As they go through grade school, their anxiety may get worse if the skill gap widens between them and their classmates. Kids with anxiety issues may just generally be hard on themselves.
  • Anxiety about feeling different: Much of childhood is about fitting in. Children with learning and attention issues may worry that someone will notice if they get extra time on tests. They may fear someone will see them in the resource room. Teenagers may fear the other kids will find out they take medication or see a therapist. Children with social skills issues may want to be part of things but are afraid of being rejected.
  • Anxiety about the future: Teens with learning and attention issues may fear what’s after high school. “If I can’t pass a math test, how will I ever take an SAT?” Or they may worry they won’t be able to live away from home. They may avoid dealing with these issues by not taking tests or refusing to talk about their plans after graduation.

When Anxiety Becomes an Issue

When anxiety stops a child from enjoying life, that child may have an “anxiety disorder.” The most common forms of anxiety disorders include:

  • Generalized anxiety disorder: Your child may seem “anxious by nature.” She’s worried about anything and everything. She fears someone will see her counting on her fingers. She won’t go in the backyard because there’s a beehive next door. She may have nightmares or trouble sleeping.
  • Obsessive-compulsive disorder (OCD): People with OCD often follow unusual routines or rituals. They believe that doing this will stop bad things from happening. For example, your child might wash her hands every time she thinks about something she’s afraid of.
  • Panic disorder: Your child is often terrified when there’s no real danger. At these times, she may find her heart beats fast; she has chest pain and difficulty breathing and may feel nausea or even a fear that she’s dying. Your child worries about having another episode and may even change her behavior because she’s so fearful of having another panic attack.
  • Separation anxiety disorder: Fear of separating from a parent is a natural part of childhood. It is considered a disorder if your child can’t get past this stage, continues to cling, and can’t separate easily from you at school or elsewhere.
  • Social anxiety disorder: Your child may be fearful of social situations. If you force her to go on a playdate or to a party, she may cry or throw a tantrum. She may be very shy around strangers and avoid playing with classmates.
  • Phobias: Your child may be extremely afraid of a particular thing, such as bees, the dark, or doctors. Her phobia may prevent her from getting involved in activities and cause her to scream or act out in other ways.

When to Seek Help

When anxiety stops your child from functioning or enjoying life, it’s probably time to find help. Your school psychologist might suggest someone who specializes in helping children with learning and attention issues. The therapist can work with you and your child to manage the anxiety. He may also refer you to a physician if he thinks medication will help.

Children with learning and attention issues have reasons to feel anxious. That doesn’t mean their anxiety can’t be managed. Learn about signs of anxiety and stress so you can identify these feelings in your child. From there you can work with your child and possibly a therapist to keep her worries in check.

 

Key Takeaways

  • Anxiety is a feeling of worry or fear.
  • Children with learning and attention issues often have anxiety about keeping up and fitting in with their peers.
  • When anxiety stops your child from enjoying life, it may be time to get outside help.

 

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