Make your own free website on Tripod.com

welcome to children 101

Generalized Anxiety Disorder, Social Anxiety, Separation Anxiety

Home
about children 101
mental health issues facing children
Mental Health: in the womb & the first year of life....
Mental Health: Two, Three & Four for more!
Mental Health: The Elementary School Child
Mental Health: The Chaos Begins - Almost Teens...
Emotions & Feelings
Attachment
Temperament
Just Love 'Em - What Children Need
Children & Fear
children & anger
Children & Control
Power Struggles
learning to communicate...it's a 2 way street!
Setting Limits & Boundaries
self esteem
Dealing with a bully
Discipline
Character & Values
Social Skills
Children & Friendships
Children Need Extended Family Relationships
Lifestyle Factors
Children & Responsibilities
About School & Education
Sex Education
Spirituality & Children
Gifted Children
Children with Special Needs
Children with Special Problems
children with special gifts
Children & Stress
Child Abuse & Neglect
Dysfunctional Family Life
Children & Divorce
Parenting Tips
An Adoption in the Family
Single Parenting
Same Sex Parenting
Step Families
Foster Families
No Kids? Be A Mentor!
When Kids Self Medicate
When A Parent Dies
When A Sibling Dies
Children & Trauma
coping mechanisms for kids
teaching life skills

welcome to the emotional feelings network of sites

A not for profit network of self-help websites.

Welcome! I hope I can help you find what you're looking for! Anytime you see an underlined word in a different color you're being offered an opportunity to learn more than what you came here for. It's important to understand the true meanings of your emotions and feelings as well as many other topics that are within this network. This entire network is set up to help those who want to help themselves find a sense of peace in their lives - discover who resides within and recover from whatever life has dealt you. Clicking on the underlined link words will open a new window so whatever page you began on will remain waiting for you to get back to it!

 

If you can't find what you're looking for here, scroll down to see an entire menu of what is offered within the emotional feelings network of sites! 

 

kathleen

anxiety disorders....Below you'll find a description of the different anxiety disorders & treatment options for the disorders. Then you'll find a more specific description concerning generalized anxiety disorder, social anxiety disorder, separation anxiety disorder dealing specifically w/children.

children 101 divider

Introduction

Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.1 These disorders fill people's lives w/overwhelming anxiety & fear. Unlike the relatively mild, brief anxiety caused by a stressful event such as a business presentation or a first date, anxiety disorders are chronic, relentless & can grow progressively worse if not treated.

Effective treatments for anxiety disorders are available & research is yielding new, improved therapies that can help most people w/anxiety disorders lead productive, fulfilling lives. If you think you have an anxiety disorder, you should seek information and treatment.

This information will
  • help you identify the symptoms of anxiety disorders,
  • explain the role of research in understanding the causes of these conditions,
  • describe effective treatments,
  • help you learn how to obtain treatment & work w/a doctor or therapist & 
  • suggest ways to make treatment more effective.
The anxiety disorders discussed in this information are

Each anxiety disorder has its own distinct features, but they're all bound together by the common theme of excessive, irrational fear & dread.

The National Institute of Mental Health (NIMH) supports scientific investigation into the causes, diagnosis, treatment & prevention of anxiety disorders & other mental illnesses.

The NIMH mission is to reduce the burden of mental illness thru research on mind, brain & behavior. NIMH is a component of the National Institutes of Health, which is part of the U.S. Dept. of Health & Human Services.

click the link to go to nurture 101!

There's a new site in the network! I am almost finished completing each page, but I can't wait anymore to tell you all about it! Please pay it a visit soon! It's an important topic!

 

nuture 101

Feel free to email me anytime concerning this website with questions, comments or just to say hello!
 
Click here to send me mail now!
 
visit my new personal blog!
 
and you can help support me in my writing ventures by visiting my health and happiness column for the Dayton, Ohio area by clicking here! Even though you don't live in the Dayton area you can get some great health and happiness ideas by reading my column and then looking for something similar in your area!
 
I do appreciate you so much!

children 101 divider
children 101 divider

Generalized Anxiety Disorder

"I always thought I was just a worrier. I'd feel keyed up & unable to relax. At times it would come & go & at times it would be constant. It could go on for days. I'd worry about what I was going to fix for a dinner party, or what would be a great present for somebody. I just couldn't let something go.

"I'd have terrible sleeping problems. There were times I'd wake up wired in the middle of the night. I had trouble concentrating, even reading the newspaper or a novel. Sometimes I'd feel a little lightheaded. My heart would race or pound. And that would make me worry more. I was always imagining things were worse than they really were: when I got a stomachache, I'd think it was an ulcer.

"When my problems were at their worst, I'd miss work & feel just terrible about it. Then I worried that I'd lose my job. My life was miserable until I got treatment."

children 101 divider

Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. It's chronic & fills one's day w/ exaggerated worry & tension, even though there is little or nothing to provoke it.

Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint. Simply the thought of getting thru the day provokes anxiety.

People w/GAD can't seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants.

Their worries are accompanied by physical symptoms, especially fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating & hot flashes. People w/GAD may feel lightheaded or out of breath. They also may feel nauseated or have to go to the bathroom frequently.

children 101 divider

Individuals w/GAD seem unable to relax & they may startle more easily than other people. They tend to have difficulty concentrating, too. Often, they have trouble falling or staying asleep.

Unlike people w/several other anxiety disorders, people w/GAD don't characteristically avoid certain situations as a result of their disorder. When impairment associated w/GAD is mild, people w/the disorder may be able to function in social settings or on the job. If severe, however, GAD can be very debilitating, making it difficult to carry out even the most ordinary daily activities.

GAD affects about 4 million adult Americans1 & about twice as many women as men.2 The disorder comes on gradually & can begin across the life cycle, though the risk is highest between childhood & middle age.2

It's diagnosed when someone spends at least 6 months worrying excessively about a number of everyday problems. There's evidence that genes play a modest role in GAD.13

GAD is commonly treated w/medications. GAD rarely occurs alone, however; it is usually accompanied by another anxiety disorder, depression or substance abuse.2,4 These other conditions must be treated along w/GAD.

children 101 divider
children 101 divider

Treatment of Anxiety Disorders

Effective treatments for each of the anxiety disorders have been developed through research.19 In general, two types of treatment are available for an anxiety disorders: medication & specific types of psychotherapy (sometimes called "talk therapy").

Both approaches can be effective for most disorders. The choice of one or the other, or both, depends on the patient's & the doctor's preference & also on the particular anxiety disorders.

i.e., only psychotherapy has been found effective for specific phobias. When choosing a therapist, you should find out whether medications will be available if needed.

Before treatment can begin, the doctor must conduct a careful diagnostic evaluation to determine whether your symptoms are due to an anxiety disorders, which anxiety disorders(s) you may have & what coexisting conditions may be present.

Anxiety disorders aren't all treated the same & it's important to determine the specific problem before embarking on a course of treatment. Sometimes alcoholism or some other coexisting condition will have such an impact that it is necessary to treat it at the same time or before treating the anxiety disorders.

children 101 divider

If you've been treated previously for an anxiety disorder, be prepared to tell the doctor what treatment you tried. If it was a medication, what was the dosage, was it gradually increased & how long did you take it?

If you had psychotherapy, what kind was it & how often did you attend sessions? It often happens that people believe they have "failed" at treatment, or that the treatment has failed them, when in fact it was never given an adequate trial.

When you undergo treatment for an anxiety disorder, you & your doctor or therapist will be working together as a team. Together, you will attempt to find the approach that's best for you. If one treatment doesn't work, the odds are good that another one will. And new treatments are continually being developed thru research. So don't give up hope.

children 101 divider

Medications

Psychiatrists or other physicians can prescribe medications for anxiety disorders. These doctors often work closely w/psychologists, social workers or counselors who provide psychotherapy.

Although medications won't cure an anxiety disorder, they can keep the symptoms under control & enable you to lead a normal, fulfilling life.

The major classes of medications used for various anxiety disorder are described below.

Antidepressants

A number of medications that were originally approved for treatment of depression have been found to be effective for anxiety disorders. If your doctor prescribes an antidepressant, you'll need to take it for several weeks before symptoms start to fade. So it's important not to get discouraged & stop taking these medications before they've had a chance to work.

children 101 divider

Some of the newest antidepressants are called selective serotonin reuptake inhibitors, or SSRI's. These medications act in the brain on a chemical messenger called serotonin. SSRI's tend to have fewer side effects than older antidepressants.

People do sometimes report feeling slightly nauseated or jittery when they first start taking SSRI's, but that usually disappears w/time. Some people also experience sexual dysfunction when taking some of these medications. An adjustment in dosage or a switch to another SSRI will usually correct bothersome problems.

It's important to discuss side effects w/your doctor so that he or she will know when there is a need for a change in medication.

Fluoxetine, sertraline, fluvoxamine, paroxetine & citalopram are among the SSRI's commonly prescribed for panic disorder, OCD, PTSD & social phobia. SSRI's are often used to treat people who have panic disorder in combination w/OCD, social phobia, or depression. Venlafaxine, a drug closely related to the SSRI's, is useful for treating GAD.

Other newer antidepressants are under study in anxiety disorders, although one, bupropion, doesn't appear effective for these conditions. These medications are started at a low dose & gradually increased until they reach a therapeutic level.

children 101 divider

Similarly, antidepressant medications called tricyclics are started at low doses & gradually increased. Tricyclics have been around longer than SSRI's & have been more widely studied for treating anxiety disorders.

For anxiety disorders other than OCD, they're as effective as the SSRI's, but many physicians & patients prefer the newer drugs because the tricyclics sometimes cause dizziness, drowsiness, dry mouth & weight gain.

When these problems persist or are bothersome, a change in dosage or a switch in medications may be needed.

Tricyclics are useful in treating people w/co-occurring anxiety disorders & depression. Clomipramine, the only antidepressant in its class prescribed for OCD & imipramine, prescribed for panic disorder & GAD, are examples of tricyclics.

children 101 divider

Monoamine oxidase inhibitors, or MAOIs, are the oldest class of antidepressant medications. The most commonly prescribed MAOI is phenelzine, which is helpful for people w/panic disorder & social phobia. Tranylcypromine & isoprocarboxazid are also used to treat anxiety disorders.

People who take MAOI's are put on a restrictive diet because these medications can interact w/some foods & beverages, including cheese & red wine, which contain a chemical called tyramine.

MAOI's also interact w/some other medications, including SSRI's. Interactions between MAOI's & other substances can cause dangerous elevations in blood pressure or other potentially life-threatening reactions.

Anti-Anxiety Medications

High-potency benzodiazepines relieve symptoms quickly & have few side effects, although drowsiness can be a problem. Because people can develop a tolerance to them & would have to continue increasing the dosage to get the same effect, benzodiazepines are generally prescribed for short periods of time.

children 101 divider

One exception is panic disorder, for which they may be used for 6 months to a year. People who have had problems w/drug or alcohol abuse aren't usually good candidates for these medications because they may become dependent on them.

Some people experience withdrawal symptoms when they stop taking benzodiazepines, although reducing the dosage gradually can diminish those symptoms. In certain instances, the symptoms of anxiety can rebound after these medications are stopped. Potential problems w/benzodiazepines have led some physicians to shy away from using them, or to use them in inadequate doses, even when they're of potential benefit to the patient.

Benzodiazepines include clonazepam, which is used for social phobia & GAD; alprazolam, which is helpful for panic disorder & GAD; & lorazepam, which is also useful for panic disorder.

Buspirone, a member of a class of drugs called azipirones, is a newer anti-anxiety medication that is used to treat GAD . Possible side effects include dizziness, headaches & nausea. Unlike the benzodiazepines, buspirone must be taken consistently for at least two weeks to achieve an anti-anxiety effect.

Other Medications

Beta-blockers, such as propanolol, are often used to treat heart conditions but have also been found to be helpful in certain anxiety disorders, particularly in social phobia. When a feared situation, such as giving an oral presentation, can be predicted in advance, your doctor may prescribe a beta-blocker that can be taken to keep your heart from pounding, your hands from shaking & other physical symptoms from developing.

children 101 divider
children 101 divider

Taking Medications
Before taking medication for an anxiety disorder:
  • Ask your doctor to tell you about the effects & side effects of the drug he or she is prescribing.
  • Tell your doctor about any alternative therapies or over-the-counter medications you're using.
  • Ask your doctor when & how the medication will be stopped. Some drugs can't safely be stopped abruptly; they have to be tapered slowly under a physician's supervision.
  • Be aware that some medications are effective in anxiety disorders only as long as they are taken regularly & symptoms may occur again when the medications are discontinued.
  • Work together w/your doctor to determine the right dosage of the right medication to treat your anxiety disorder.

children 101 divider

Psychotherapy

Psychotherapy involves talking w/a trained mental health professional, such as a psychiatrist, psychologist, social worker, or counselor to learn how to deal w/problems like anxiety disorders.

Cognitive-Behavioral & Behavioral Therapy

Research has shown that a form of psychotherapy that's effective for several anxiety disorders, particularly panic disorder & social phobia, is cognitive-behavioral therapy (CBT). It has two components. The cognitive component helps people change thinking patterns that keep them from overcoming their fears.

i.e., a person w/panic disorder might be helped to see that his or her panic attacks aren't really heart attacks as previously feared; the tendency to put the worst possible interpretation on physical symptoms can be overcome.

children 101 divider

Similarly, a person w/social phobia might be helped to overcome the belief that others are continually watching & harshly judging him or her.

The behavioral component of CBT seeks to change people's reactions to anxiety-provoking situations. A key element of this component is exposure, in which people confront the things they fear.

i.e., a treatment approach called exposure & response prevention for people w/OCD. If the person has a fear of dirt & germs, the therapist may encourage them to dirty their hands, then go a certain period of time without washing.

The therapist helps the patient to cope w/the resultant anxiety. Eventually, after this exercise has been repeated a number of times, anxiety will diminish.

children 101 divider

In another sort of exposure exercise, a person w/social phobia may be encouraged to spend time in feared social situations w/out giving in to the temptation to flee.

In some cases the individual w/social phobia will be asked to deliberately make what appear to be slight social blunders & observe other people's reactions; if they're not as harsh as expected, the person's social anxiety may begin to fade.

For a person w/PTSD, exposure might consist of recalling the traumatic event in detail, as if in slow motion & in effect re-experiencing it in a safe situation. If this is done carefully, w/support from the therapist, it may be possible to defuse the anxiety associated w/the memories.

Another behavioral technique is to teach the patient deep breathing as an aid to relaxation & anxiety management.

children 101 divider

Behavioral therapy alone, w/out a strong cognitive component, has long been used effectively to treat specific phobias. Here also, therapy involves exposure. The person is gradually exposed to the object or situation that is feared.

At first, the exposure may be only thru pictures or audiotapes. Later, if possible, the person actually confronts the feared object or situation. Often the therapist will accompany him or her to provide support & guidance.

If you undergo CBT or behavioral therapy, exposure will be carried out only when you are ready; it'll be done gradually & only w/your permission. You'll work w/the therapist to determine how much you can handle & at what pace you can proceed.

A major aim of CBT & behavioral therapy is to reduce anxiety by eliminating beliefs or behaviors that help to maintain the anxiety disorder.

children 101 divider

i.e., avoidance of a feared object or situation prevents a person from learning that it is harmless. Similarly, performance of compulsive rituals in OCD gives some relief from anxiety & prevents the person from testing rational thoughts about danger, contamination, etc.

To be effective, CBT or behavioral therapy must be directed at the person's specific anxieties. An approach that is effective for a person w/a specific phobia about dogs isn't going to help a person w/OCD who has intrusive thoughts of harming loved ones.

Even for a single disorder, such as OCD it's necessary to tailor the therapy to the person's particular concerns. CBT & behavioral therapy have no adverse side effects other than the temporary discomfort of increased anxiety, but the therapist must be well trained in the techniques of the treatment in order for it to work as desired.

children 101 divider

During treatment, the therapist probably will assign "homework"—specific problems that the patient will need to work on between sessions.

CBT or behavioral therapy generally lasts about 12 weeks. It may be conducted in a group, provided the people in the group have sufficiently similar problems.

Group therapy is particularly effective for people w/social phobia. There's some evidence that, after treatment is terminated, the beneficial effects of CBT last longer than those of medications for people w/panic disorder; the same may be true for OCD, PTSD & social phobia.

Medication may be combined w/psychotherapy & for many people this is the best approach to treatment. As stated earlier, it's important to give any treatment a fair trial. And if one approach doesn't work, the odds are that another one will, so don't give up.

If you've recovered from an anxiety disorder & at a later date it recurs, don't consider yourself a "treatment failure." Recurrences can be treated effectively, just like an initial episode.

In fact, the skills you learned in dealing w/the initial episode can be helpful in coping w/a setback.

children 101 divider
children 101 divider

Beyond shyness: Overcoming the fear of social situations

By Mayo Clinic staff

Everyone feels nervous from time to time. Going on a first date or giving a speech often causes that butterflies-in-your-stomach feeling. Or you may initially feel shy at a party among a group of strangers, but then warm up to them.

For some people, though, this sort of normal nervousness is magnified into extreme fear & anxiety. They avoid dating, giving speeches or attending parties altogether. They fear being watched or humiliated while doing something in front of others.

Everyday social activities, even the most mundane, may become virtually impossible. You may not even be able to eat w/others or sign a personal check in public.

children 101 divider

When social anxieties become this extreme & disrupt your life, interfere w/education or work & lead you to avoid certain situations, they may have crossed the line into a condition known as social phobia. (also called social anxiety disorder)

"Social phobia can severely limit dating, academic achievement & career choice," notes Lois Krahn, M.D., a psychiatrist at Mayo Clinic in Scottsdale, Ariz. "It can disrupt much of life's activity."

But the right treatment — counseling, behavioral techniques & medication — can improve the quality of life & open up opportunities that the fear & anxiety had shut out.

Fearful situations

Social phobia, sometimes called social anxiety disorder, isn't the same as shyness or so-called stage fright. In fact, sometimes it's perfectly reasonable to have some fear in certain social situations.

children 101 divider

If you're afraid of being called on in class or at a meeting because you haven't prepared, that's appropriate apprehension or even fear, not social phobia. On the other hand, turning down a job that requires public speaking could be an indication of social phobia.

Similarly, getting the jitters opening night in your first community theater production is normal fear. Avoiding the theater altogether, even if you love it, because you believe others may be critical, could be social phobia.

Sometimes, you may be able to force yourself to endure such events, but only after dreading them for weeks beforehand. During the event, or even for days leading up to it, you may have intense anxiety & a variety of physical reactions, such as:

  • sweating
  • blushing
  • tremors
  • diarrhea 
  • stomach upset

Even the worry about having these signs & symptoms in public can heighten your anxiety and fear, which, in turn, worsens them — a vicious cycle.

children 101 divider

Common, everyday experiences can be a source of social phobia:

  • Using a public restroom or telephone
  • Returning items to a store
  • Interacting w/strangers or w/people of the opposite sex
  • Writing in front of others
  • Making eye contact
  • Entering a room in which people are already seated
  • Ordering food in a restaurant
  • Being introduced to strangers

"These situations are extremely challenging for people w/social phobia because they feel painfully self-conscious," Dr. Krahn explains.

"They believe that others are watching them & expect them to harbor critical thoughts about them. They may feel that onlookers are critical of what they're doing, how they're doing it, what they're wearing & what they're saying to the point that they can't engage in a fairly simple activities:

i.e., talking to a clerk when people are lined up nearby waiting."

children 101 divider

Some of the features that suggest true social phobia rather than normal shyness or reserve:

  • An intense & persistent fear of social or performance situations in which you may not know people or may be judged
  • Avoiding the social situations you fear
  • Fear of being embarrassed or humiliated
  • Fear that others will notice you blushing, sweating, trembling or showing other signs of anxiety
  • The avoidance or distress interferes w/your life
  • Recognizing that your fear is excessive or unreasonable for the situation

There are two types of social phobia. In global social phobia, you have trouble w/virtually all social situations.

In specific social phobia, you have trouble only w/a few situations. Together, both types affect about 4% of U.S. adults, or slightly more than 5 million people.

In either case, social phobia can be debilitating. It can prevent you from making friends and limit your career or educational opportunities. It can be a risk factor for other health problems, such as substance abuse or excessive drinking in an attempt to cope. And it can also lead to depression or suicide.

children 101 divider

Hope thru treatment

Social phobia tends to begin in childhood or early adolescence. Although it typically persists for life, often waxing & waning, treatment can help you control it.

The two most effective types of treatment are psychotherapy & medications, often in combination.

Therapy is often a form called cognitive behavioral therapy. It's based on the premise that your own thoughts — not other people or situations — determine how you behave or react. Even if an unwanted situation hasn't changed — you still have to give that presentation to management, for instance — you can change the way you think & behave in a positive way.

Therapy may also include exposure therapy, in which you face the situations you fear most & gradually become better skilled in coping w/them. And you may also participate in skills training or role playing to practice your social skills & gain comfort relating to others.

children 101 divider

Numerous types of medications may help social phobia, since the condition may be associated w/a chemical imbalance in the brain. The Food & Drug Administration, however, has specifically approved only three medications to treat social phobia:

  • Paroxetine. Paroxetine (Paxil, Paxil CR) is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). SSRI's help balance out a brain chemical called serotonin, which can help relieve symptoms of social phobia. Side effects may include nausea, diarrhea, decreased appetite, sweating, abnormal vision & sexual problems.

  • Sertraline. Sertraline (Zoloft) is also an SSRI. Its most common side effects include upset stomach, sleeping difficulties, diarrhea, dry mouth, sexual problems, feeling sleepy or tired, tremor, sweating, agitation & decreased appetite.
  • Venlafaxine. Venlafaxine (Effexor) is a type of antidepressant called a serotonin & norepinephrine reuptake inhibitor (SNRI). It helps to balance out both serotonin & another brain chemical, norepinephrine. Common side effects include nausea, dizziness, sleepiness, delayed ejaculation, sweating, dry mouth, insomnia, anorexia & constipation.

For some people, the symptoms of social phobia may fade over time & medication can be discontinued. Others may have to take medication for years to prevent a relapse.

Which medication, if any, is best for you depends on your situation. Talk to your doctor about whether medications are right for you.

children 101 divider

Click here to send me an e-mail!

Coexisting Conditions

It's common for an anxiety disorder to be accompanied by another anxiety disorder or another illness.4,5,6 Often people who have panic disorder or social phobia, i.e., also experience the intense sadness & hopelessness associated w/depression. Other conditions that a person can have along w/an anxiety disorder include an eating disorder or alcohol or drug abuse. Any of these problems will need to be treated as well, ideally at the same time as the anxiety disorder.

How to Get Help for Anxiety Disorders

If you, or someone you know, has symptoms of anxiety, a visit to the family physician is usually the best place to start. A physician can help determine whether the symptoms are due to an anxiety disorder, some other medical condition, or both. Frequently, the next step in getting treatment for an anxiety disorder is referral to a mental health professional.

Among the professionals who can help are psychiatrists, psychologists, social workers & counselors. However, it's best to look for a professional who has specialized training in cognitive-behavioral therapy &/or behavioral therapy, as appropriate & who is open to the use of medications, should they be needed.

As stated earlier, psychologists, social workers & counselors sometimes work closely w/a psychiatrist or other physician, who'll prescribe medications when they're required. For some people, group therapy is a helpful part of treatment.

It's important that you feel comfortable w/the therapy that the mental health professional suggests. If this isn't the case, seek help elsewhere. However, if you've been taking medication, it's important not to discontinue it abruptly, as stated before. Certain drugs have to be tapered off under the supervision of your physician.

Remember, though, that when you find a health care professional that you're satisfied with, the 2 of you are working together as a team. Together you'll be able to develop a plan to treat your anxiety disorder that may involve medications, cognitive-behavioral or other talk therapy, or both, as appropriate.

You may be concerned about paying for treatment for an anxiety disorder. If you belong to a Health Maintenance Organization (HMO) or have some other kind of health insurance, the costs of your treatment may be fully or partially covered. There are also public mental health centers that charge people according to how much they're able to pay. If you're on public assistance, you may be able to get care thru your state Medicaid plan.

Strategies To Make Treatment More Effective

Many people w/anxiety disorders benefit from joining a self-help group & sharing their problems & achievements w/others. Talking w/trusted friends or a trusted member of the clergy can also be very helpful, although not a substitute for mental health care.

Participating in an Internet chat room may also be of value in sharing concerns &decreasing a sense of isolation, but any advice received should be viewed w/caution.

The family is of great importance in the recovery of a person w/an anxiety disorder. Ideally, the family should be supportive w/out helping to perpetuate the person's symptoms. If the family tends to trivialize the disorder or demand improvement without treatment, the affected person will suffer.

You may wish to show this informationa to your family & enlist their help as educated allies in your fight against your anxiety disorder.

Stress management techniques & meditation may help you to calm yourself & enhance the effects of therapy, although there is as yet no scientific evidence to support the value of these "wellness" approaches to recovery from anxiety disorders.

There is preliminary evidence that aerobic exercise may be of value & it's known that caffeine, illicit drugs & even some over-the-counter cold medications can aggravate the symptoms of an anxiety disorder. Check w/your physician or pharmacist before taking any additional medicines.

Role of Research in Improving the Understanding & Treatment of Anxiety Disorders

NIMH supports research into the causes, diagnosis, prevention & treatment of anxiety disorders & other mental illnesses. Studies examine the genetic & environmental risks for major anxiety disorders, their course, both alone & when they occur along w/other diseases such as depression & their treatment.

The ultimate goal is to be able to cure & perhaps even to prevent, anxiety disorders.

NIMH is harnessing the most sophisticated scientific tools available to determine the causes of anxiety disorders. Like heart disease & diabetes, these brain disorders are complex & probably result from a combination of genetic, behavioral, developmental & other factors.

Several parts of the brain are key actors in a highly dynamic interplay that gives rise to fear & anxiety.14 Using brain imaging technologies & neurochemical techniques, scientists are finding that a network of interacting structures is responsible for these emotions.

amygdala

Much research centers on the amygdala, an almond-shaped structure deep within the brain. The amygdala is believed to serve as a communications hub between the parts of the brain that process incoming sensory signals & the parts that interpret them.

It can signal that a threat is present & trigger a fear response or anxiety. It appears that emotional memories stored in the central part of the amygdala may play a role in disorders involving very distinct fears, like phobias, while different parts may be involved in other forms of anxiety.

hippocampus

Other research focuses on the hippocampus, another brain structure that is responsible for processing threatening or traumatic stimuli. The hippocampus plays a key role in the brain by helping to encode information into memories.

Studies have shown that the hippocampus appears to be smaller in people who have undergone severe stress because of child abuse or military combat.15,16 This reduced size could help explain why individuals w/PTSD have flashbacks, deficits in explicit memory & fragmented memory for details of the traumatic event.

Also, research indicates that other brain parts called the basal ganglia & striatum are involved in obsessive-compulsive disorder.17

By learning more about brain circuitry involved in fear & anxiety, scientists may be able to devise new & more specific treatments for anxiety disorders.

For example, it someday may be possible to increase the influence of the thinking parts of the brain on the amygdala, thus placing the fear & anxiety response under conscious control. In addition, w/new findings about neurogenesis (birth of new brain cells) throughout life,18 perhaps a method will be found to stimulate growth of new neurons in the hippocampus in people w/PTSD.

NIMH-supported studies of twins & families suggest that genes play a role in the origin of anxiety disorders. But heredity alone can't explain what goes awry. Experience also plays a part. In PTSD, for example, trauma triggers the anxiety disorder; but genetic factors may explain why only certain individuals exposed to similar traumatic events develop full-blown PTSD.

Researchers are attempting to learn how genetics & experience interact in each of the anxiety disorders—information they hope will yield clues to prevention & treatment.

Scientists supported by NIMH are also conducting clinical trials to find the most effective ways of treating anxiety disorders. For example, one trial is examining how well medication & behavioral therapies work together & separately in the treatment of OCD.

Another trial is assessing the safety & efficacy of medication treatments for anxiety disorders in children & adolescents with co-occurring attention deficit hyperactivity disorder (ADHD). For more information about these & other clinical trials, visit the NIMH clinical trials web page, click here or the National Library of Medicine's clinical trials database, www.clinicaltrials.gov.

Childhood Anxiety Often Precedes Eating Disorders

Reuters Health / By Amy Norton / Thursday, December 9, 2004

NEW YORK (Reuters Health) - Many women w/eating disorders may have a history of childhood anxiety disorders, particularly social phobia & obsessive-compulsive disorder, according to a new study.

The findings, say researchers, suggest that childhood anxiety may signal a vulnerability to the development of anorexia or bulimia.

It has long been noted that eating disorders often co-exist w/other psychological problems, including anxiety & depression. Some small studies have also suggested that when anxiety disorders arise, they typically precede the onset of anorexia or bulimia.

This latest study is by far the largest to look at the issue, lead author Dr. Walter H. Kaye told Reuters Health, and the findings confirm & extend those from previous research.

Better understanding of the role of anxiety could improve the treatment of eating disorders, according to Kaye, a psychiatrist at the University of Pittsburgh Medical Center. It could also aid in getting at the biological roots of eating disorders, as the conditions may share some of their genetic underpinnings w/anxiety disorders.

"We're ultimately looking for genes," Kaye said, noting that he & his colleagues are recruiting people for an international study aimed at uncovering the genes that contribute to anorexia. The researchers need to find families in which at least two members have had anorexia.

The current study, published in the December issue of the American Journal of Psychiatry, included 672 individuals, nearly all women, who currently or in the past had anorexia, bulimia or both. A group of healthy women the same age was included for comparison. All of the study participants completed standard questionnaires used to gauge their lifetime incidence of various anxiety disorders.

Kaye & his colleagues found that nearly 2/3 of the eating disorder patients had ever had an anxiety disorder, occurring in the majority of cases before the onset of the eating disorder.

Of the entire group, 23% were diagnosed as having had obsessive-compulsive disorder (OCD) during childhood, before the onset of anorexia or bulimia. Similarly, social phobia arose early on for 13%.

OCD is characterized by recurrent, intrusive thoughts & a compulsion to perform certain rituals, such as constant hand washing or repeatedly checking that doors are locked. Social phobi is marked by an intense fear of being embarrassed or judged by others in social situations; children w/the disorder may be excessively shy & want to avoid school & activities.

According to Kaye & his colleagues, the high rate of childhood OCD -- seen in nearly 1/4 of the eating disorder patients, compared w/the typical population rate of 2 to 3% -- was "most striking."

It's possible, Kaye said, that the findings could eventually help in identifying children at particular risk of developing anorexia or bulimia.

SOURCE: American Journal of Psychiatry, December 2004.

Anxiety Disorders In Children: Parent Training Could Help

Main Category: Pediatrics / Children's Health
Also Included In: Anxiety / Stress
Article Date: 16 Jul 2006 - 10:00 PST
 
Special skills workshops for parents of anxious young children could offer a breakthrough in addressing this difficult problem, according to psychologists at The University of Manchester.

Providing psychological treatments for children under ten with anxiety disorders is problematic for health professionals, as the approaches that are most successful with teenagers and adults are difficult to apply to the very young.

According to researcher Dr Samantha Cartwright-Hatton: "A treatment like cognitive behaviour therapy (CBT) relies on the patient having highly-developed verbal skills, and needs them to understand and reflect on the causes of their symptoms. This is very difficult for younger children, and there is not much evidence that it works with them."

The team is therefore investigating a new approach, which allows parents to be much more involved. "Parents raising an anxious child need a very special set of skills which nobody ever teaches you," Dr Cartwright-Hatton explains, "so we're trying out a course which helps them develop the skills to give their child the best chance of becoming a confident, mature adult."

The team is eager to hear from parents of children under ten who display symptoms of anxiety, such as extreme fears, phobias, frequent worry or distress at separating from their parents. If they participate in the study they will either undertake a weekly two-hour session for ten weeks (starting September) at the Wellcome Trust Clinical Research Facility on Grafton Street in Manchester, or receive a thorough assessment and detailed advice on how to get the right help for their child.

Helping parents develop strategies to both manage their children's problems and help them overcome them has already proved very successful with behavioural problems, with even TV "infotainment" programmes being shown to be a valuable aid. In adapting the approach for anxiety disorders, Dr Cartwright-Hatton hopes that similar benefits will result for the children suffering from them.

"Parents who have already completed the course say they have found it enjoyable and useful, and would recommend it to others," she says. "The therapists are very easy to talk to and the course is designed to be fun - there's no point in being all 'doom and gloom' about these things as people learn new skills best when they are relaxed. So we make sure that we have plenty of laughs along the way."

The course covers techniques for raising children's self-esteem and dealing with fears and worries, as well as offering strategies for managing difficult behaviours like tantrums calmly.

"Child anxiety can carry on into adulthood and stay with people throughout their lives, so we are starting to realise how important it is to sort it out early," Dr Cartwright-Hatton concludes. "Successful treatment could significantly reduce adult anxiety and depression and the behaviours associated with them, which would bring huge benefits for the health and happiness of the population as a whole, as well as for the workforce and economy."


----------------------------
Article adapted by Medical News Today from original press release.
----------------------------
source site: click here

Three Effective Treatments For Childhood Anxiety Disorders Identified By Study

Main Category: Anxiety / Stress
Also Included In: Pediatrics / Children's Health;  Psychology / Psychiatry;  ADHD
Article Date: 02 Nov 2008 - 9:00 PST

Treatment that combines a certain type of psychotherapy with an antidepressant medication is most likely to help children with anxiety disorders, but each of the treatments alone is also effective, according to a new study funded by the National Institutes of Health's National Institute of Mental Health (NIMH). The study was published online Oct. 30, in the New England Journal of Medicine.

"Anxiety disorders are among the most common mental disorders affecting children and adolescents. Untreated anxiety can undermine a child's success in school, jeopardize his or her relationships with family, and inhibit social functioning," said NIMH Director Thomas R. Insel, M.D. "This study provides strong evidence and reassurance to parents that a well-designed, two-pronged treatment approach is the gold standard, while a single line of treatment is still effective."

The Child/Adolescent Anxiety Multimodal Study (CAMS) randomly assigned 488 children ages 7 years to 17 years to one of four treatment options for a 12-week period:

  • Cognitive behavioral therapy (CBT), a specific type of therapy that, for this study, taught children about anxiety and helped them face and master their fears by guiding them through structured tasks;

  • The antidepressant sertraline (Zoloft), a selective serotonin reuptake inhibitor (SSRI);

  • CBT combined with sertraline;

  • pill placebo (sugar pill).

The children, recruited from six regionally dispersed sites throughout the United States, all had moderate to severe separation anxiety disorder, generalized anxiety disorder or social phobia. Many also had coexisting disorders, including other anxiety disorders, attention deficit hyperactivity disorder, and behavior problems.

John Walkup, M.D., of Johns Hopkins Medical Institutions, and colleagues found that among those in combination treatment, 81 percent improved. Sixty percent in the CBT-only group improved, and 55 percent in the sertraline-only group improved. Among those on placebo, 24 percent improved. A second phase of the study will monitor the children for an additional six months.

"CAMS clearly showed that combination treatment is the most effective for these children. But sertraline alone or CBT alone showed a good response rate as well. This suggests that clinicians and families have three good options to consider for young people with anxiety disorders, depending on treatment availability and costs," said Walkup.

Results also showed that the treatments were safe. Children taking sertraline alone showed no more side effects than the children taking the placebo and few children discontinued the trial due to side effects. In addition, no child attempted suicide, a rare side effect sometimes associated with antidepressant medications in children.

CAMS findings echo previous studies in which sertraline and other SSRIs were found to be effective in treating childhood anxiety disorder. The study's results also add more evidence that high-quality CBT, with or without medication, can effectively treat anxiety disorders in children, according to the researchers.

"Further analyses of the CAMS data may help us predict who is most likely to respond to which treatment, and develop more personalized treatment approaches for children with anxiety disorders," concluded Philip C. Kendall, Ph.D., of Temple University, a senior investigator of the study. "But in the meantime, we can be assured that we already have good treatments at our disposal."

----------------------------
Article adapted by Medical News Today from original press release.
----------------------------

The six CAMS sites were Duke University; New York State Psychiatric Institute/Columbia University Medical Center; Johns Hopkins University; Temple University/University of Pennsylvania; University of California, Los Angeles; and the Western Psychiatric Institute and Clinic/University of Pittsburgh Medical Center.

The National Institute of Mental Health (NIMH) mission is to reduce the burden of mental and behavioral disorders through research on mind, brain, and behavior. More information is available at the NIMH website,
http://www.nimh.nih.gov/.

The National Institutes of Health (NIH) - The Nation's Medical Research Agency - includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit
http://www.nih.gov/.

Reference: Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill J, Ginsburg GS, Rynn MA, McCracken J, Waslick B, Iyengar S, March JS, Kendall PC. Cognitive-behavioral therapy, sertraline and their combination for children and adolescents with anxiety disorders: acute phase efficacy and safety. New England Journal of Medicine. Online ahead of print 30 Oct 2008: 359(17).

Source: Colleen Labbe
NIH/National Institute of Mental Health

source site: click here

the following web links are provided for your convenience in visiting the source sites of the information displayed on this page:

Anxiety Disorders

References

1Narrow WE, Rae DS, Regier DA. NIMH epidemiology note: prevalence of anxiety disorders. One-year prevalence best estimates calculated from ECA and NCS data. Population estimates based on U.S. Census estimated residential population age 18 to 54 on July 1, 1998. Unpublished.

2Robins LN, Regier DA, eds. Psychiatric disorders in America: the Epidemiologic Catchment Area Study. New York: The Free Press, 1991.

3The NIMH Genetics Workgroup. Genetics and mental disorders. NIH Publication No. 98-4268. Rockville, MD: National Institute of Mental Health, 1998.

4Regier DA, Rae DS, Narrow WE, et al. Prevalence of anxiety disorders and their comorbidity with mood and addictive disorders. British Journal of Psychiatry Supplement, 1998; (34): 24-8.

5Kushner MG, Sher KJ, Beitman BD. The relation between alcohol problems and the anxiety disorders. American Journal of Psychiatry, 1990; 147(6): 685-95.

6Wonderlich SA, Mitchell JE. Eating disorders and comorbidity: empirical, conceptual, and clinical implications. Psychopharmacology Bulletin, 1997; 33(3): 381-90.

7Davidson JR. Trauma: the impact of post-traumatic stress disorder. Journal of Psychopharmacology, 2000; 14(2 Suppl 1): S5-S12.

8Margolin G, Gordis EB. The effects of family and community violence on children. Annual Review of Psychology, 2000; 51: 445-79.

9Yehuda R. Biological factors associated with susceptibility to posttraumatic stress disorder. Canadian Journal of Psychiatry, 1999; 44(1): 34-9.

10Bourdon KH, Boyd JH, Rae DS, et al. Gender differences in phobias: results of the ECA community survey. Journal of Anxiety Disorders, 1988; 2: 227-41.

11Kendler KS, Walters EE, Truett KR, et al. A twin-family study of self-report symptoms of panic-phobia and somatization. Behavior Genetics, 1995; 25(6): 499-515.

12Boyd JH, Rae DS, Thompson JW, et al. Phobia: prevalence and risk factors. Social Psychiatry and Psychiatric Epidemiology, 1990; 25(6): 314-23.

13Kendler KS, Neale MC, Kessler RC, et al. Generalized anxiety disorder in women. A population-based twin study. Archives of General Psychiatry, 1992; 49(4): 267-72.

14LeDoux J. Fear and the brain: where have we been, and where are we going? Biological Psychiatry, 1998; 44(12): 1229-38.

15Bremner JD, Randall P, Scott TM, et al. MRI-based measurement of hippocampal volume in combat-related posttraumatic stress disorder. American Journal of Psychiatry, 1995; 152: 973-81.

16Stein MB, Hanna C, Koverola C, et al. Structural brain changes in PTSD: does trauma alter neuroanatomy? In: Yehuda R, McFarlane AC, eds. Psychobiology of posttraumatic stress disorder. Annals of the New York Academy of Sciences, 821. New York: The New York Academy of Sciences, 1997.

17Rauch SL, Savage CR. Neuroimaging and neuropsychology of the striatum. Bridging basic science and clinical practice. Psychiatric Clinics of North America, 1997; 20(4): 741-68.

18Gould E, Reeves AJ, Fallah M, et al. Hippocampal neurogenesis in adult Old World primates. Proceedings of the National Academy of Sciences USA, 1999, 96(9): 5263-7.

19Hyman SE, Rudorfer MV. Anxiety disorders. In: Dale DC, Federman DD, eds. Scientific American Medicine. Volume 3. New York: Healtheon/WebMD Corp., 2000, Sect. 13, Subsect. VIII.

Childhood Anxiety often preceeds Eating Disorders

Social Phobia or Social Anxiety Disorder

click here!

Click here to visit the Red Cross page that allows you to access your local chapter of the Red Cross by entering your zip code in the specified box, to see how you can help in your area. You can also call your local Red Cross Chapter that you can find the number for online or in your local phone book to volunteer for any openings that may need to be filled or you can find another way to help others there as well!

 
you've been visiting children 101
please have a great day & take a few minutes to explore some of the other sites in the emotional feelings network of sites! explore the unresolved emotions & feelings that may be the cause of some of your pain & hurt... be curious & open to new possibilities! thanks again for visiting at anxieties 102!
 
 
anxieties 101 - click here!
anxieties 102 - click here!
 
almost 30 sites, all designed, editted & maintained by kathleen!
 
until next time: consider yourself hugged by a friend today!
 
til' next time! kathleen
 
 
**disclaimer**
this is simply an informational website concerning emotions & feelings. it does not advise anyone to perform methods -treatments - practice described within, endorse methods described anywhere within or advise any visitor with medical or psychological treatment that should be considered only thru a medical doctor, medical professional, or mental health professional.  in no way are we a medical professional or mental health professional.