Anxiety and Anxiety Based Disorders guidance11-16 year olds

Anxiety is a word we use to describe feelings of worry, fear and panic. As well as these emotional feelings, people with anxiety might also experience physical (body) sensations such as a racing heart, breathing fast, sweaty hands, dry mouth and feeling shaky. Many people also have “what if” or negative thoughts when they are anxious.

Anxiety is a normal human response to feeling threatened or in danger, even if that threat or danger is a thought, image or memory. Anxiety can become a real problem if the thoughts, emotions (feelings) and physical sensations are very strong, happen even when there is no real danger or if it lasts for a long time.

Lots of people experience worry and anxiety although for some people it can impact on everyday life and get in the way of school/college, socialising and even home life.

All young people will worry and feel anxious from time to time.

In some cases children may develop an irrational fear of something specific. These are often referred to as phobias. Whilst we all experience irrational fears, with a phobia the sufferer feels extreme anxiety, even terror, at the thought of coming in contact with their feared thing or situation. The stronger the feeling of anxiety, the more likely we are to avoid the thing or situation.

Some children experience obsessive thoughts and compulsive rituals which can be distressing if they start to take over their normal lives. They tend to be more common in children when another family member has a similar problem, and they are more likely to experience these difficulties when they are under stress or during significant life changes.

This is a general guide to help you know how best to support your young person if they are experiencing anxiety. This is not an exhaustive list; young people may experience symptoms which may not be included in this guide. If in doubt advice and guidance is available from the services listed below.

Top tips

Talk to your child about their anxiety or worries. Label the emotion that the child may be feeling to show them you are taking their concerns seriously. E.g. ‘ I can see that you are feeling worried about going to school’

If your child is seeking frequent reassurance, it could be helpful to manage this by using distraction or relaxation or mindfulness.

Worries and anxiety are common; everyone worries so it’s important the young person knows they are not alone. Some worries may seem very real and very scary. Remind them to tell someone how they are feeling no matter what their worries are, even if they are worried about doing so.

Although anxiety feels horrible, the feelings will pass and the […]

How to tell if your child is being bullied online and what to do

How to tell if your child is being bullied online and what to do

In addition to possible bullying at school, there is now the added concern for parents of cyberbullying online, which can be difficult to monitor and detect.

Anti-bullying charity Ditch the Label found nearly one in five (19%) children aged 10-15 in the UK experience cyberbullying, equating to approximately 764,000 children. That’s a huge and worrying number.

To help parents navigate online bullying, Envirofone has collaborated with Dr Kalanit Ben-Ari, a child development expert and founder of online parenting community, The Village, to share tips on how to spot if your child is being bullied online and how to approach the situation.

How online trolling can affect a child

Short term effects

“Online trolling can harm a child’s sense of safety, joy, and trust in others. It can cause them to withdraw from social interactions, anxiety and be closed off in their bedroom, affecting their self-esteem, mental health, and in some cases their body confidence. If the child has a strong connection with their family, they can reach out to an adult for appropriate support and guidance. Sleeplessness is also a common short-term effect of online bullying.”

Long term effects

“Unfortunately, the effect can even be more devastating when children don’t have a strong connection with their family, and the child or teenager has no educational or emotional support systems to enable them to cope with the situation. This can worsen the long-term consequences of being bullied. Such as chronic depression, substance abuse, self-half, and suicidal thoughts/attempts.”

How to spot the signs your child is being bullied online

Changes in your child’s behaviour

“Changes could include, but are not limited to, anxiety, withdrawal from friends and family, closing themselves off in their bedroom, feeling upset and expressing sadness without a clear reason as to why.”

They stop taking part in activities

“Many victims of online and offline bullying experience that they no longer participate in activities they used to enjoy. This usually ties in with victims of bullying no longer seeing people that they used to.

“Look out for an obsession with being online, checking messages all the time, feeling stressed and anxious if they are not able to do so constantly.”

They are isolating themselves

“Your child may appear to be isolating themselves within the home, expressing anger, or showing an unexpected decline in their schoolwork. The signs can vary in intensity and quantity from one child to the next, but if there is very little joy in their life, or they are trying to avoid school or their usual social life this can be a clear indicator of an issue such as online trolling.”

How to help if you think your child is a victim of online trolling

Initiate a safe conversation

“Initiate a conversation while you are busy doing another activity, such as walking or driving, so the child or teenager doesn’t need to maintain eye contact. Safe conversations mean speaking without any judgment or strong emotions as this can lead them to close up even more.

“The message that you want to portray is that your child will not regret sharing their struggle with you. Parents should avoid blaming or shaming, allowing space for the teen or child to talk about what is going on for them and explore together what can be done to resolve the situation.”

Get the school involved

“Reporting bullying incidents to the child’s school is essential for the bullying to be taken seriously. There is also a need, between parents and schools, to educate children about online safety.”

Show them privacy settings

“It is important to educate them about privacy settings on social media, and about not engaging with people they do not know directly and in person.”

Monitor your children online

“From restricting screen time, blocking apps at certain areas and filtering what content kids can see, security apps permit parents to customize the apps to their family. There are many apps you can choose from, some free and some at a subscription cost.”

Comorbid ADHD Complicates Most Diagnoses and Treatment Plans

Comorbid ADHD Complicates Most Diagnoses and Treatment Plans

An accurate ADHD evaluation must screen for far more than ADHD. Though 60 percent of people with ADHD have some co-existing psychiatric condition1, comorbidities rarely factor into the evaluation — leading to an incomplete diagnosis. You have ADHD, but what else might you have? Or, no, you do not have ADHD but rather some other condition that explains the symptoms that led you to seek help.

This is why checklist evaluations, while helpful screening tools, are inadequate by themselves. You need to sit down and talk to a human being and tell your story. In medical parlance, this is called sharing your history, and your history is the most revealing and useful test in all of medicine. While most mental health professionals do not perform a physical exam, the “history and physical” remains the cornerstone of a medical evaluation.

Whether you’ve yet to undergo an ADHD evaluation, or you’ve already been diagnosed with ADHD, be sure to ask your doctor if you might have any of the following comorbid conditions often seen with ADHD:

ADHD and Common Coexisting Disorders

1. Learning differences

About 30 to 50 percent of people with ADHD have a learning disorder (LD) 2 3. These include most of the “dys-eases”.

  • Dyslexia. The most common learning disability, dyslexia makes you slow to learn to read and spell your native language. I have both ADHD and dyslexia, which can manifest quite differently and change over time. For example, I majored in English in college and now make my living with words, even though to this day I am a painfully slow reader.
  • Dyscalculia is sometimes called “math dyslexia.” A person with dyscalculia has trouble with math facts, with counting, with computation, and with word problems. But, just as the dyslexic individual may turn out to be gifted with words, the child with dyscalculia may mature into a gifted mathematician.
  • Dysgraphia includes trouble with handwriting, an awkward way of gripping a pen or pencil, trouble spacing written words or letters, frequent need to erase, and an awkward body position while writing.
  • Dyspraxia, or Developmental Coordination Disorder (DCD), denotes clumsiness, lack of coordination, a tendency to drop or spill things, awkwardness in movement. DCD often leads to tremendous problems with confidence and self-esteem in childhood and adolescence, when athletic prowess and physical fluidity are so highly valued among peers.
  • Dyslexia. The most common learning disability, dyslexia makes you slow to learn to read and spell your native language. I have both ADHD and dyslexia, which can manifest quite differently and change over time. For example, I majored in English in college and now make my living with words, even though to this day I am a painfully slow reader.
  • Dyscalculia is sometimes called “math dyslexia.” A person with dyscalculia has trouble with math facts, with counting, with computation, and with word problems. But, just as the dyslexic individual may turn out to be gifted with words, the child with dyscalculia may mature into a gifted mathematician.
  • Dysgraphia includes trouble with handwriting, an awkward way of gripping a pen or pencil, trouble spacing written words or letters, frequent need to erase, and an awkward body position while writing.
  • Dyspraxia, or Developmental Coordination Disorder (DCD), denotes clumsiness, lack of coordination, a tendency to drop or spill things, awkwardness in movement. DCD often leads to tremendous problems with confidence and self-esteem in childhood and adolescence, when athletic prowess and physical fluidity are so highly valued among peers.

Treatment for all of these LDs includes specialized tutoring (like Orton-Gillingham, Wilson, or Lindamood-Bell for dyslexia) or coaching; occupational therapy; and counseling to help with the attendant emotional problems.

2. Behavioral or conduct problems

The diagnostic terms for these include oppositional defiant disorder (ODD); conduct disorder (CD); and anti-social personality disorder (ASPD). Without intervention, a child may move from ODD to CD to ASPD as they age (though these conditions are more common in males). It’s critical to get help early on, and treatment is best undertaken by a team of providers.

3. Anxiety disorders

Sometimes anxiety occurs in the wake of untreated ADHD. Once an individual takes stimulant medication and gains focus and control, the anxiety wanes.

However, sometimes an individual has a freestanding anxiety disorder, which needs to be treated with a combination of education, counseling, cognitive behavioral therapy (CBT), physical exercise, positive human connection, and, perhaps, medication, such as an SSRI or an anxiolytic.

4. Mood problems

  • Depression. Once again, what looks like depression may occur in the wake of untreated ADHD. If the person responds well to ADHD medication, performance improves and the “depression” disappears. However, sometimes an individual has primary (not secondary) depression as well, which requires its own treatment.
  • Dysthymia. The sadness and low mood of dysthymia is less severe than with depression, but it lasts longer.
  • Lifelong low mood. Historically, there have been many terms for this, but a common clinical observation is that some people who have ADHD struggle with low mood and emotional dysregulation.
  • Bipolar disorder (BD). Up to 1 in 13 patients with ADHD has comorbid BD, and up to 1 in 6 patients with BD has comorbid ADHD4 .

5. Substance use disorder

SUD is common with ADHD, as are behavioral addictions or compulsions. Do not let shame hold you back from talking with your doctor about them. There are treatments other than willpower and white knuckling.

Internet vigilance can protect children, teens from online predators

Internet vigilance can protect children, teens from online predators

Devin Vargas didn’t think there was anything to worry about when interacting with people online.

Vargas, like many teenagers, had heard it all before in school assemblies, from parents, or in lectures from people older than them. For many children growing up in a digital age, online safety is something hammered into them from a young age.

However, when Vargas was old enough to be in online spaces, things were different than expected.

“You’re told in school that predators are going to look a very specific kind of way. They’re going to come and ask for your personal information, but you don’t really expect they’re going to come to you under the guise of friendship,” Vargas said.

On social media accounts, Vargas could find people to connect with in ways that felt more authentic than most real-life friendships. Vargas had friends at school, but online friends were different. These friends shared interests and wanted to talk all the time. It didn’t hurt that interacting online helped Vargas feel more confident and free to be themselves.

Before long, Vargas had a large circle of online friends who shared interests in music, movies and television. Those friends varied in gender, location and sometimes age.

One of the people Vargas interacted with online was an older user who occupied the same internet spaces. This person was in their twenties, but still consumed almost the same content as Vargas.

Online, Vargas was used to getting messages often with compliments or conversations. When Vargas messaged this person, he would reply with obscene images. At only sixteen, Vargas was confused why this had happened. The man messaging Vargas said it had been his roommate playing a joke.

So, naively, Vargas believed the person. Until it happened again. And another time after that.

At that point, Vargas realized it was time to block this individual, but even after doing so, the damage was done.

In online spaces, people like the person Vargas interacted with are often hiding online.In a digital age, many children and teenagers have constant internet access. Being online may make them vulnerable to predators, and parents can learn how to stop it.

The numbers

According to a Rape, Abuse & Incest National Network study conducted on child sexual abuse, one in nine girls and one in 53 boys under the age of 18 have experienced sexual abuse or assault at the hands of an adult. These statistics indicate thousands of children are entering adulthood with sexual abuse in their past.

The effects can be life-changing for many kids. The Rape, Abuse & Incest National Network study reported sexual abuse in childhood makes victims more likely to develop drug problems, PTSD and depression as they reach adulthood.

Adrianne Simeone, executive director of The Mama Bear Effect, said most parents just aren’t aware of the intricacies predators can use online. Her nonprofit exists to spread information that can help parents and children prevent sexual abuse.

“We grew up with AOL Instant Messenger and we’ve had Facebook for 10 years so we think we know what’s going on. We shouldn’t be this naive, but we are,” Simeone said.

Simeone explained the subtle nature of online predators can be so complex; a large number of parents have never learned how to deal with it. Parents who encourage kids to use electronics and play games online as a way to entertain or distract them may not realize that puts them at risk for encountering predators if they don’t know what to look for.

Quinn LaViolette, a 22-year-old from Worcester, Massachusetts, told The Daily Universe that as a teenager, she experienced an online friendship with a man in his twenties after becoming a fan of his band.

At the time, she was a cheerleader with plenty of friends. However, she also recalled her internet access was not regulated at all, with her parents not seeing a need to check her internet history. This led to frequent messages with an older man online that she saw as a close friendship.

For LaViolette, the conversations at the time felt platonic in nature. Looking back, she realizes now there were many times when the messages were suggestive. She also said she didn’t see anything wrong with the age gap in their friendship.

“At the time, I thought nothing of it, I just thought it was cool that a member of my favorite band wanted to interact with me and did interact with me so casually,” LaViolette said.

However, conversations can quickly evolve from discussions about music and movies to discussions about personal lives. With that can come venting about school, family and mental health. Before long, some relationships may become emotionally intimate.

Beyond just emotional connections, some predators will ask to meet up in real life. During their friendship, which continued until LaViolette was a freshman in college, the band member gave LaViolette his personal phone number. He even asked her to meet up with him in Boston, which she said never worked out.

Red flags of a predator

The red flags of predators can be complicated to spot. According to Simeone, the subtlety of these behaviors can be so hard to notice that it takes constant vigilance to catch. However, there are still signs that can be monitored by parents and children when online.

Fight the New Drug is a non-religious and non-legislative organization that provides individuals the opportunity to make an informed decision regarding pornography by raising awareness on its harmful effects using science, facts and personal accounts. According to its research, there are a few things to look out for:

First are flattering comments and behavior. According to Fight the New Drug, this is used to help gain the trust of victims and make them feel important.

Simeone recommended parents teach their children to be reflective about the compliments they receive, who they come from and what the motivations behind them might be.

LaViolette said once she connected with the older man on social media, he would frequently reply to her tweets as well as compliment her on photos of herself. At the time it felt good, but looking back, she realizes it was a major red flag.

Fight the New Drug also points out secret conversations are a way predators learn to keep their victims quiet about what’s going on. Online conversations are often kept away from parents, and children and teens are unlikely to tell their parents about older online friends.

Fight the New Drug also states isolation is a tool many predators use to control victims. Many predators want to take up as much space as possible in a child’s life, resulting in the child becoming detached from friends and family.

“The children who are the most vulnerable are children who don’t feel like they have close connections with physical friends and their families. If they don’t feel like they are loved and don’t have anyone to talk to, internet predators can use that as a lure,” Simeone said.

How Many Christmas Presents Should You Buy Your Children?

How Many Christmas Presents Should You Buy Your Children?

One of the most celebrated traditions of Christmas is sharing gifts with your loved ones. For that reason, Christmas is one of the holidays most favored by children, who are often treated to several toys and other gifts on the day.

Toy sales in the U.S. soared in 2020, with millions of families kept home by the COVID-19 pandemic.

According to a February 2021 statement from the Toy Association: “One silver lining of the pandemic is that it has helped families rediscover the joys of spending time together and find value in bringing play into their daily lives.”

The association projected that this year families would be “seeking new toys that promote togetherness, as well as inclusive playthings that can be enjoyed by kids of varying abilities and interests,” the statement said.

But can these toys and other gifts become dangerous for a child’s health?

Can Too Many Gifts Be Damaging for Your Child?

There are different factors to be aware of when it comes to giving your children gifts during the holidays.

While it is possible that lavishing your child with Christmas gifts can become detrimental, it isn’t likely to “supersede parenting practices that promote resilience,” Dr. David Palmiter, a board certified clinical psychologist, told Newsweek.

Similar to playing video games, spoiling your child is, of course, unhealthy “but not nearly as damning as some might have imagined, especially if other things are going well in the family,” Palmiter explained.

The psychologist said the word “spoiled” can be seen as the opposite of the word “disciplined,” which in America, “appears to have become conflated with butt-kicking—it isn’t,” he said.

The etymology of the word “disciplined” is “to teach” and Palmiter believes that a foundational teaching, “when it comes to the bullseye of the discipline dart board,” is training your children to do things when they don’t feel like it.

“That particular psychological muscle, when well-developed, goes a long way to helping adults to reach their personal and professional goals. At birth, infants are incapable of discipline.

“We hope, as parents, that our child is well capable of it [discipline] by the time they leave home. And, if they are not, they are at high odds to boomerang back home. In this arena, the number of presents a kid receives is unlikely to be a major player,” Palmiter explained.

How Many Christmas Gifts Should Parents Give Their Kids?

The short answer? There is no prescriptive formula and parents cannot be told what’s considered an appropriate amount of Christmas gifts for their own child.

Speaking to Newsweek, David S. DeLugas, the executive director and general counsel of the National Association of Parents (ParentsUSA), said it’s up to the parents to decide “the number of gifts, the extravagance (or lack thereof) of the gifts or the appropriateness of their gifts…so long as the gifts do not cause long-term emotional harm or physical harm.

“We certainly hope parents use their specific knowledge of their child or children to avoid hurting their children by gift giving,” DeLugas said.

Palmiter said: “I don’t believe our science can tell us X number of gifts is adaptive and Y number is problematic,” explaining that “one-on-one time with a parent is much more desirable to most young children than the latest and hottest toy or gadget.”

The magic of the holidays can be captured without spending significant amounts of money, the psychologist said, and advises against stretching your economic resources for presents.

“When parents do this, I’ve found, it’s in service of trying to create a magical experience for their children. But, executed creativity does this much, much better than spent cash,” he said.

Cumulative risk exposure and emotional symptoms among early adolescent girls

From early adolescence, girls and women report the highest rates of emotional symptoms, and there is evidence of increased prevalence in recent years. We investigate risk factors and cumulative risk exposure (CRE) in relation to emotional symptoms among early adolescent girls.

Four risk factors were found to have a statistically significant relationship with emotional symptoms among early adolescent girls: low academic attainment, special educational needs, low family income, and caregiving responsibilities. CRE was positively associated with emotional symptoms, with a small effect size.

Results identify risk factors (outlined above) that are associated with emotional symptoms among early adolescent girls, and highlight that early adolescent girls experiencing a greater number of risk factors in their lives are likely to also experience greater emotional distress. Findings highlight the need for identification and targeted mental health intervention (e.g., individual or group counselling, approaches targeting specific symptoms), for those facing greater risk and/or with emergent symptoms.

In early adolescence, evidence suggests that girls begin to experience greater levels of emotional symptoms (i.e., depressive and anxious symptoms) than boys, typically around the age of 12 years[1].1 Studies show this disparity exists throughout the lifespan; girls and women are twice as likely to report depressive symptoms and disorder from mid-adolescence compared to boys and men [1]. They are also more likely to experience anxious symptoms and disorders, though this fluctuates based on type of anxiety [2]. Depressive and anxious symptoms are distinct but strongly inter-related, with high comorbidity rates among adolescents [3]. Research indicates a significant increase in emotional symptoms and disorder among adolescent girls in recent years, in the United Kingdom [4,5,6,7] and other Western and non-Western countries [8, 9], necessitating urgent research into the factors associated with such difficulties. These studies consistently point to apparent increases in emotional difficulties as a whole (i.e., rather than just depressive or anxious symptomatology) and to increases only among girls, and not among boys in the same cohorts [4,5,6,7,8,9]. Effects have been observed across different points in adolescence, starting in early adolescence [6]. Typically these increases among girls are small, but as noted by Fink et al. [6] the effect is not negligible and warrants attention.

We set out to investigate the risk factors associated with emotional symptoms among girls aged 11–12 years, given evidence that such symptoms are increasing among girls. Furthermore, as risk factors tend to co-occur [10], we also examined whether exposure to a greater number of risk factors corresponds to increased symptoms. We focused on investigating possible factors associated with symptoms among a 2017 sample of adolescent girls, offering valuable insight into epidemiological patterns and levels of exposure for a vulnerable group at a recent timepoint, rather than factors that may be contributing to an increase in such symptoms, which currently are not well understood. We focused on symptoms rather than disorder given the reported increase in general symptomatology among girls [4,5,6,7]. Furthermore, evidence indicates that depression and anxiety symptoms go beyond those specified within constricted diagnostic criteria, suggesting that psychopathology is continuous and not narrowly expressed through distinct disorders [11, 12].