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Valid

By Aliza Shapiro, LMSW

The debate of nature versus nurture has long influenced the way that we, as scientists, therapists, and people, understand our unique personalities and our mental health. Marsha Linehan, the founder of Dialectical Behavior Therapy (DBT), discusses the connection between biology (nature) and environment (nurture) in and illustrates clearly that it is the combination of these factors molds an individual’s experience of emotions, relationships, and life. More importantly, the transactional relationship between nature and nurture reveals an unexpected, yet crucial, link in the chain: The impact of validation.

Dr. Linehan explains that the experience of consistent, environmental invalidation can impact our biology, and the interaction of these factors can contribute greatly to emotional disorders (especially for those born with a natural predisposition towards emotional sensitivity). However, when we receive validation – when our feelings, thoughts, and behaviors are affirmed as understandable and not judged – we can thrive even if we have a biological vulnerability for mental distress.

People who are raised in invalidating environments are not necessarily abused or neglected. Rather, they are subtly taught that their emotions are not important and should be ignored (or that their feelings “don’t really matter” or are “just plain wrong.”) No parents are perfectly validating, but when children experience invalidation on a constant basis they lose out on crucial learning opportunities to label, identify, and trust their emotions. Perhaps most importantly, they don’t learn how to cope with strong emotional experiences.

Importantly, validation does not mean that one necessarily approves of or agrees with what another person is saying or doing. Rather, validation sends the message that the way that someone feels is legitimate and valid and that the listener comprehends the level of pain/distress that the other is going through. Validation creates a space of emotional safety for the listener. This makes all the difference when experiencing strong emotional experiences; problem-solving and emotional support is made possible by increasing feelings of non-judgment, understanding and closeness/intimacy.

How do we validate? Once we recognize how important validation is, we can start to practice it in our relationships with friends, children, and partners. DBT outlines the six primary aspects of validation through which we can start incorporating this practice into our relationships and everyday lives:

  1. Pay Attention: Simply being present when someone is sharing a painful event is more challenging than it sounds. This first level of validation stresses the importance of putting our phones away and avoiding multi-tasking of any kind when we are in moments of an intimate or difficult conversation. Acting interested is a lot more powerful than saying we are interested.

  1. Reflection: The second level of validation is to understand what the other person is saying, without invoking our own interpretations, assumptions or judgments. Using phrases such as “it sounds like…” or “what I am hearing is…” without criticism can be highly validating since it is an effective way of communicating about emotionally charged topics.
  2. Read Minds: Emotionally sensitive individuals may have difficulty expressing the extent of what they are feeling. They may even have a tendency to mask their emotions because they are unsure if these emotions can be trusted. Tuning into body language, voice tone, and posture can be helpful when someone is in distress but having a hard time putting words to their feelings. Using phrases such as “I’m guessing you’re probably feeling pretty hurt,” can help someone accurately label their feelings (however, make sure you are open to being corrected if your interpretation is off).
  3. Understand the Cause: In level four of validation, we focus on how a person’s life history may contribute to their emotions and behaviors. What experiences have they had which shaped their current emotions? This can be communicated directly. For example, sharing “Given your history of X, how could you be feeling/experiencing anything other than Y?!” can validate a person’s distress and help them see where the emotion has come from.
  4. Normalize: For an emotionally sensitive person, hearing that it is perfectly normal to have a specific emotion in a given situation can be comforting. Try using a phrase such as: “If I were there, I would probably have felt the same way.” Keep in mind, emotions can be understandable and valid, but still ineffective. For example, it can make sense that someone feels angry towards a parent, but acting on that anger by running away from home may not be safe. We, therefore, focus on validating the “what” (feeling angry), but not the “how” (running away from home)
  5. Be Genuine: The final aspect of validation is showing a radical genuineness in communication with the other person. We focus on not treating the other as fragile or inadequate, rather we express that we can relate the other as an equal and that we believe in their capacity to execute emotionally healthy and effective responses to life’s challenges.

Validation is a powerful tool in all relationships: With children, spouses, friends, and work colleagues. When we use these strategies, we cultivate an environment that strengthens relationships, emotional resilience, and a strong sense of emotional identity both within ourselves and those around us, and everyone benefits regardless of their nature.

The post Nature vs. Nurture & Why Validation Matters appeared first on Center for Anxiety.

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By Thanos Nioplias, LMHC

Most people believe that the primary symptom of depression is sadness.  Even though this perception is somewhat accurate, depression is, in reality, a much more complicated state that includes not only negative emotions but also physiological changes, such as disturbances in appetite and sleep, as well as changes in the individual’s self-concept- the way one sees themselves. 

Even in this mental-health friendly age, many people still believe that one can “snap out” of depression. The reality is that depression is a complicated emotional state that includes not only sadness but also physiological changes, such as disturbances in appetite and sleep efficiency, as well as changes in an individual’s self-concept – the way we see ourselves. Once a person is in the midst of a depressive episode, they are often literally unable to see themselves in a positive light or regulate their bodies.

However, small behavioral changes over time can definitely make a huge difference for depressed individuals and help them to recovery from depressive episodes and prevent future lows. This is because depression tends to create struggles in two main life areas: Decreased levels of pleasure in everyday life activities (anhedonia), and negative judgments about oneself including endorsing beliefs like “I am not good enough” and “I can’t do anything right,” among others.  Having this awareness can be helpful in understanding and managing depression. Since depression can significantly affect our experience of pleasure and sense of self, engaging in pleasurable activities and striving for mastery can be an antidepressant.

To clarify: These strategies are not ways to “snap out” of depression, but they are tried and tested methods to manage the long-term course of depressive mood states.

P is for Pleasure

We live in a society that glorifies busy-ness, productivity and financial success. As a result, time for relaxation, leisure, and joy is considered secondary and may even be completely neglected. The price that we pay for this attitude can be very significant: When humans go through several weeks or even days without engaging in any kind of pleasurable activity, we begin to experience a sense of emotional deprivation, stress and increasing physical exhaustion. In a nutshell, neglecting pleasurable experiences is the recipe for unhappiness. For individuals battling depression it is important to schedule activities that typically increase positive emotions on a daily basis, even if one doesn’t “feel like” doing them. Pleasant activities can be as simple as seeing a good friend, visiting a place that is soothing, or artwork. It is crucial to remember to keep an open, non-judgmental mind while engaging in pleasurable activities.  For instance, if the activity is not truly fun, try again tomorrow and then again the day after. And if the activity isn’t fun day after day for 3-5 days, don’t judge yourself for feeling blah rather find another activity that is very stimulating and immersive, such as sports, movies, or even trivia games that leave little time for worry. Last, if you cannot think of anything that sparks positive emotions for you currently, continue exploring and experimenting and keep active anyway. Simply doing “pleasure” activities (even if they don’t feel fun) can change our emotions over time.

M is for Mastery

As mentioned above, depression also interferes with how we perceive our competencies. Needless to say, when we think negatively about ourselves, we tend to withdraw and avoid important day to day tasks. Mastery refers to the effort of striving for small accomplishments every day (e.g., paying bills, going grocery shopping, mowing the lawn, running errands), and it can have a huge impact on depression. When building mastery, it is helpful to set goals that are not too easy, but also not too hard, in order to slowly and steadily increase our self-esteem and confidence. Scheduling activities that are mildly to moderately challenging yet doable is generally the most effective way to make yourself accountable and to also set yourself up for small successes. Similar to pleasure activities, building a sense of mastery is a journey that requires patience, persistence and a non-judgmental stance, and also consistency. If at first you don’t succeed, try and try again…

In my clinical practice, I have observed that individuals who experience depression struggle significantly in two main life areas: they experience decreased levels of pleasure in their everyday lives, while they also have negative judgments about themselves, endorsing beliefs like “I am not good enough” and “I can’t do anything right,” among others.  Having this awareness has helped both my clients and myself to better understand depression and take steps to manage it.  In other words, if depression can significantly affect one’s experience of pleasure and their sense of competence, what if striving for activities that bring pleasure and mastery is an effective antidepressant? 

P is for Pleasure

We live in a society that glorifies busy-ness, productivity, and financial success, whereas the time for relaxation, leisure, and joy is considered secondary or it is often completely neglected.  The price that we pay for this attitude is rather significant: when humans go through several days or weeks without engaging in any kind of pleasurable activities, we begin to experience a sense of emotional deprivation, stress and increasing physical exhaustion.  In a nutshell, neglecting pleasurable experiences is the recipe for unhappiness.

For individuals battling depression, it is important to schedule activities that increase positive emotions on a daily basis.  Pleasant activities can be as simple as seeing a good friend, visiting a place that is soothing or doing art.  It is also crucial to remember to keep an open, non-judgmental mind while engaging in pleasurable activities.  For instance, if the activity was not as fun as initially anticipated, try again tomorrow and then again the day after; if you cannot stop thinking of all the things that are expected from you after the pleasant activity is over, try to find an activity that is very stimulating and immersive, such as sports, trivia games and art, that would leave little time for worry.  Last, if you cannot think of anything that sparks positive emotions for you currently, continue exploring and experimenting – think outside the box- until you find an activity that is joyful and meaningful to you.

M is for Mastery

As mentioned above, depression also interferes with people’s perception of their competencies.  Without a surprise, negative beliefs about oneself along with difficulty concentrating often leads an individual with depression to withdraw and avoid tasks that are important.  Building mastery refers exactly to the effort of striving for small accomplishments every day to buffer this challenge.  When building mastery, it is helpful to set goals that are not too easy, but also not too hard, as neither would increase our self-esteem and confidence.   Instead, scheduling in your calendar activities that are challenging yet doable would be the most effective way to make yourself accountable and to also set yourself up for small successes.  Similar to seeking pleasure, building a sense of mastery is a journey that requires patience, persistence, and a non-judgmental stance.

The post Depression: Why we can’t “just snap out of it” and what can we do? appeared first on Center for Anxiety.

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By Dovid Spinka, LMSW

I have so much to do today! Emails to respond to… Appointments to coordinate… Errands to run… All in addition to things like eating, sleeping, exercise, getting dressed…

If you are like most New Yorkers, within the first few minutes of waking up your brain has made a staggering number of decisions. In the days of old, most people ate and wore what they had, and worked at the jobs that they could find (not the ones they wanted), and there simply weren’t many opportunities to choose anything. But today, we have so many options and at each choice point there is a decision to be made. In order to cope with the incredible breadth of options that we have today (as one example, have you noticed that most grocery stores carry more than 10 types of ketchup?!) most people turn to cognitive multi-tasking – the process of rapidly switching attention between tasks and activities. Cognitive science research suggests that computer-users switch tasks well above 300 times during each working day.

Regardless of how intelligent you may be, it taxes the brain to make decision after decision. In modern psychology, that tax is called “Decision Fatigue” and it negatively impacts our ability to make effective, efficient, and optimal choices. In a recent study published in the highly influential National Academy of Science, it was reported that judges ruling over criminal cases were substantially more likely to grant parole for cases they judged in the mornings relative to cases heard in the afternoons. Simply sitting and deliberating to make decisions can be fatiguing.

Needless to say, decision fatigue can also impact our relationships with ourselves and others.  The more cognitively tired we are, the harder it is to recognize and meet our basic needs, and be connected to others.

What can we do to prevent and mitigate the effects of decision fatigue? Here are five strategies:

  1. Plan your day the night before – Spend a few minutes before going to bed each night to develop an outline of tomorrow’s tasks and events. Simplify this into morning, afternoon and evening slots, and create a “to do” list for the day ahead.
  2. Prioritize your most important tasks for earlier in the day when mental energy is at its peak. 
  3. Have set times for checking work/personal emails – try limiting checking your email to 4 times per day at fixed hour intervals. Warning: For those of us who are addicted to our devices this will be extremely challenging! If you are one of these people, try scheduling email time just one or two days a week at first, and building up over time.
  4. Utilize the power of mindfulness to recharge your mental resources. Take regular mini breaks from whatever you are doing and just mindfully observe the world through your five senses of sight, touch, smell, taste and sound. 
  5. Exercise – take 30 minutes out of each day to engage in some form of physical activity. Brisk walking and choosing the stairs over the elevator at work are two quick ways of accessing the physical and mental restorative effects of exercise.

The post Overcoming Decision Fatigue appeared first on Center for Anxiety.

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By Ben Johnides, MA

Getting a good night’s rest is very important. Sleep helps us maintain the energy and concentration to meet the needs of everyday life. It is also a key factor in regulating our mood: Recent research suggests that improvements in sleep help people to feel less anxious and depressed. For this reason, addressing sleep concerns is one of the first steps in treatment for individuals struggling with emotional concerns.

If you are not sleeping well, there are plenty of behavioral strategies that you can use to get your sleep schedule back on track, without using medication.

  • A bedtime: Going to bed (roughly) the same time each night is important because our circadian rhythms operate on a 24-hour clock. Going to bed more than an hour later or earlier than usual creates an effect which is equivalent to jetlag.
  • A wake-time: Similar to the above, it’s important to get up roughly the same time every day. A little weekend sleep in of 60-minutes or less won’t make a big difference, but more than that can throw off our circadian rhythms.
  • A bedtime routine: Just like children, adults need a bedtime routine to prepare themselves for sleep. For most people, 30 minutes is a good amount of time for an effective bedtime routine, which may include reading, meditating, or other calming activities in preparation for bed, and of course no screen time.
  • Create a sanctuary: When our bedroom is too cold or too hot or noisy or when our bed is uncomfortable, it can be hard to sleep. A high-quality mattress and pillow, a nice duvet, light-blocking blinds, and a noise machine can make a huge difference.
  • Bed is for sleep: When we do work (even emails!) in bed, or stay in bed tossing and turning, our body subconsciously associates our bed with being awake. Therefore, it is important that the bed only be used for sleep and romantic activities. This helps our bodies to establish an association between the bed and falling sleep.
  • Don’t sleep too much: Sleep researchers recommend that we only get as much sleep as we need to feel refreshed. Oversleeping decreases the quality of sleep, which makes sleep less restorative (and enjoyable). Relatedly, napping during the day is a “no-no” because it tends to throw off our sleep cycles.
  • Physical exercise: Daily physical exercise helps us to feel tired at night, which can make a big difference for sleep quality (and quantity). However, know your body: Some people struggle to sleep if they exercise late in the day.
  • Diet: Going to bed too hungry or too full can impact sleep quality. Ditto for going to bed too thirsty or after drinking a lot of liquids. And of course, having caffeine anytime in the afternoon can make it very hard to get to sleep.
  • Don’t bring problems to bed: Worrying in bed is a great way to teach your body to stay awake. If you tend to worry, write down your concerns in a pad of paper and then try to let them go until the morning.
  • Don’t try too hard to sleep: Sleep is a natural process that ALL people do. Forcing the process of sleeping just creates stress and ironically makes it harder to sleep. If you cannot sleep and are feeling frustrated, remember that one or two night’s without sleep isn’t ideal but usually isn’t the end of the world.

Have a good night!

The post Ten Strategies for a Good Night’s Sleep (Without Medication!) appeared first on Center for Anxiety.

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By Aliza Tropper, LMHC

Scrolling through social media you’ve surely noticed an overwhelming amount of content around “hustling” (as if it’s a new trend to push hard at work). Nicely designed graphics, encouraging comments, and creative posts flood our feeds with the same message – you’ve gotta #hustle. Immediately, we feel that we’re not doing enough and should be working more.

Let’s take a step back for a minute and examine the facts. Does hustling really bring in more revenue and increase productivity? Or is it increasing stress and anxiety, and leading to burnout? Is all the hype about hustle well founded, or is it an illusionary trap??

In today’s business climate there is an unavoidable pressure to constantly be available. The rise of mobile technology had rendered the 9-5 job a rarity. Responding to 11pm emails, attending after hours meetings, and running around to networking events on weekends is the new norm. And on top of all those demands, instead of using the few minutes that we’re not busy to just breathe, we’re stuck with the feeling that we’re wasting our time and should be grinding harder.

There is no question that our non-stop culture is leading people to become anxious overachievers. Without a healthy work life balance, burnout is inevitable and creates a clear risk for anxiety, depression, and medical problems.

More centrally, our pressure to hustle may actually be a result of anxiety. It’s true that some people like pushing themselves to achieve because they like a challenge or because they simply have lots of goals for themselves. But many (most?) people today are more driven by negative reinforcement: That is, they feel pressure to always be achieving, and they feel anxious and uncomfortable taking a break.

The reality is that working more doesn’t necessarily mean more success. In fact, in addition to the personal emotional and physical toll of chronic stress, sometimes people make costly decisions because they are overly stressed. Ask yourself: Have you ever regretted what you wrote when you responded to an email late at night? Did you ever make a bad business decision because you were too tired or overwhelmed at the time? Has your health suffered, or your relationships, because you are working too hard? All of these are indicators that you’ve gotta STOP #hustling instead of pushing harder.

To that end, here are some concrete tips to preventing burnout in the workplace:

● Set time limits with yourself and others: Pick a reasonable time each evening when you will turn off noficiations and stop responding.
● Take care of your physical health: Eat three meals each day (especially breakfast!), drink plenty of non-caffeinated fluids throughout the day, and exercise at least 3-4 times a week.
● If you have a desk job, take small breaks every 90-120 minutes to get up and stretch.
● Connect and spend time in person with family and friends, at least every 36-48 hours.
● Devote significant time each week to something else besides work (e.g., a hobby).
● Be mindful when you are doing too much and STOP yourself.
● Accept and love yourself unconditionally. Learn to be ok with your own limits. Speak up and articulate your needs at work.
● Set attainable goals and be flexible when it doesn’t go as planned
● Tolerate your mistakes when you mess up: You’re a human being, it happens!
● Celebrate your accomplishments, big and small.
● Seek out help from others and mental health professionals when necessary.

The post You’ve Gotta #Hustle: Managing Anxiety in your Career appeared first on Center for Anxiety.

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By Becca Brodoff, PsyD.

  1. Panic attacks are dangerous.

If you have ever experienced a panic attack, you know that the symptoms of panic are real and intense. Some people have a whole-body reaction, with physical changes like choking sensations, dizziness, sweating, urgency to use the bathroom and a racing heart. Many people rush to the hospital the first time they have a panic attack, convinced they’re dying or going crazy. Although panic attacks are uncomfortable, they are NOT harmful. Actually, panic attack symptoms demonstrate that your body is functioning properly. This probably seems absurd, but it’s not. When your body starts to panic it is doing exactly what it’s supposed to do when it perceives danger – your body’s “fight or flight” response is activated to keep you safe. The only problem is that panic attacks usually occur when there is nothing truly dangerous. So, the next time your body begins to misfire, just accept the panic and allow the misfiring to happen, barely giving the symptoms any credence. The more we can accept panic without labeling it as dangerous, the more tolerable the sensations become and the quicker it will end.

  1. Having a full-fledged anxiety disorder is rare.

An “Anxiety Disorder” involves clinical levels of anxiety which cause “significant distress and/or impairment” such that professional treatment is warranted. Many people feel like an outsider after being diagnosed with an anxiety disorder, but in fact, such diagnoses are extremely common. According to the National Institute of Mental Health (NIMH), anxiety disorders are the most common mental disorders with nearly one in five (19.1%) of American adults meeting criteria in every given year. That’s more than 40,000,000 people! Does that seem rare to you??

  1. Avoiding stress and stressful situations is necessary to feel better.

Avoiding what makes us nervous is a common response to fear and anxiety. It makes intuitive sense to want to avoid the very situations that send us into a panic since the very act of avoiding helps us feel calm for the time being. Although escaping what you fear works to keep anxiety at bay in the short run, the more we avoid what we fear, the stronger and more long-lasting this fear will become. How does this work? It’s simple. When we avoid, we never get a chance to disprove our anxious predictions. For example, if we’re afraid that we’re too awkward to make a good impression and avoid social situations, we never learn that we have more social skills than we think. Or if we’re terrified of passing out in an elevator due to fear and we always take the stairs, we never learn that we can tolerate high levels of anxiety without fainting. In a nutshell: The best way to get cope with your anxiety is to lean into fear, not avoid it.

  1. I’m weak and incompetent for being anxious.

Many people feel that something’s inherently wrong with them for feeling anxious. Not only is this just flat out wrong, it’s also cruel. Anxiety is a natural part of being human. In fact, it’s an emotion that we need to protect and motivate ourselves. While intense anxiety can be uncomfortable and interfere with daily functioning, too little anxiety is even worse! Anxiety, among other things, motivates us to study for exams, prepare for big interviews, and otherwise push beyond our limits. So, telling yourself that you’re weak, stupid, or incompetent for being anxious is just a lie. And by the way, it won’t do you any good to berate yourself when you feel anxious, in fact usually it only discourages people further. When we feel anxious it’s our body’s way of saying “I need support” so compounding stress with guilt and shame just makes things worse. Many people believe that putting themselves down will give them motivation to overcome anxiety. Unfortunately, it doesn’t work like that. A better approach is to treat yourself like you would treat a good friend—with empathy and care. Try to understand, and be curious about why you’re feeling anxious. This understanding will go a long way in helping you devise a plan of action and overcome anxiety in the long run.

  1. The only way to beat anxiety is with medication.

While medication can be helpful for anxiety especially in the short term, it is not the only way to see results. Cognitive-Behavioral Therapy (CBT) is a form of psychotherapy and is the gold standard for anxiety disorder treatment. CBT works by helping people identify their worries, see things in more helpful and realistic ways, and confront anxiety-provoking situations head-on. At times, medication can be an important component of treatment, such as when anxiety prevents someone from engaging in CBT. So, taking medication may be an important first step. But, in the long-run taking medication can actually reinforce the idea that anxiety is bad or harmful, and interfere with the processes of learning to overcome our fears.

The post Five Common Myths about Anxiety Dispelled appeared first on Center for Anxiety.

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By Hudi Kowalsky, LMHC

For many people, the Holiday season comes with mixed emotions.

Some of the pro’s include crisp winter mornings, holiday cheer, great retail sales, and festive spirit all around.

But the holidays can also create considerable tension, stress, and anxiety. First, holidays often come with a break from routine which can be disruptive and complicated to navigate. And for those who need to travel things can be even more complicated, and expensive. Second, there is family stress. While spending time with loved ones can be a great blessing, complicated dynamics often play out especially during the holiday season. And for some individuals spending time with family members can trigger unwanted memories, as well as habits which no longer serve us well. Third, is the vice of social comparison: Looking at images all over of other “happy” people can leave many wondering why they are feeling so sad, anxious, and alone. And for those who don’t have families to share the holidays with, such feelings can be even more compounded. It’s very easy to look around and see what others appear to have and be quick to judge ourselves harshly and curse our fate.

What are some tools that we can utilize to have a happy and NOT anxious holiday season? How can we maintain a sense of equilibrium and peace from late November through the start of January? To rephrase that question in the language of clinical science: What are the most effective ways to manage our emotions and increased vulnerability to anxiety during this season?

Here are our seven favorite ideas:

  • Keep up a healthy and regular routine as possible. If you need to travel or attend a family gathering or holiday party, try not to wake up or go to bed more than 60-90 minutes later than usual. The body has its own rhythm that needs to be maintained.
  • When you need a break from work, really take a break and let things wait until you’re back at work.
  • Keep up your fitness and try to stick to your regular diet/calorie intake as much as possible. If you miss a workout or overeat a bit here and there, just try to get back on track.
  • A drink here or there with friends and family is usually fine, unless your doctor has told you otherwise. But if you’re feeling sad or anxious be sure to go easy and not overdo it. Drowning away sorrows tends to bring them back with a vengeance down the road.
  • When you’re spending time with family that you care about, turn off your cell phone for at least part of the time together. When we’re not distracted by our phones a new world of curiosity and possibilities in relationships opens up.
  • If you’re in therapy, ask your therapist if you can contact him/her while you’re away as needed during the holiday season when things come up. And if you’re taking medication, make sure you have an adequate supply so you’re not running to a random pharmacy for a refill mid-Thanksgiving meal.
  • If you’re not in therapy, make sure you have a close friend you can call or lean on if things get tough. Sometimes, there is no greater medicine than having a shoulder to cry on.

Happy Holidays (seriously)!

The post Tips to Managing Stress and Anxiety Over the Holiday Season appeared first on Center for Anxiety.

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By Mark Staum, LCSW

The months of October and November bring new weather patterns, new daylight schedules and new challenges for children. Exams, projects, and papers are back in full swing. Some children may experience some level of anxiety, in preparation for an exam or during an exam. Test Anxiety is a form of anxiety that can be anticipatory and/or performance related. In anticipatory test anxiety, a child may be anxious about the preparation necessary for an exam. When performance related, a child may experience anxiety during the exam itself.

Research shows that test anxiety is related strongly to time management and preparation. Even the most prepared/organized child may have some normal ‘jitters’ on the day of a big exam. However, generally speaking, children who prepare, plan ahead and studies for exams tend to feel more capable of handling any stressors that may arise on the day of the exam. By contrast, children who attempt to cram the night before tend to be more anxious. With that said, some children who study and know their material very well still get very anxious. Also, children with anticipatory exam anxiety may push off studying because doing so makes them think about their exams, which is unpleasant and anxiety-inducing, and as a result, they are less prepared, which begets even more anxiety.

To help children manage test and exam anxiety, teachers and parents should pay careful attention to children’s behaviors. Let’s look at three examples:

  1. A child tells you that before a Math exam, her body became ‘frozen’ and it felt like she was confused and disoriented.
  2. A child says that he reviewed the material for his History test an extra five times because he felt nervous that he really didn’t know the material well.
  3. A child mentions that before her most recent Science exam, she was so nervous that she could not study, and then during the exam, she felt very tired and had difficulty concentrating.

In all these cases, adults can assist children in navigating through these discomforts. In example #1, the child can take a practice test in advance of the exam, and then use breathing, relaxation, and light muscle exercises to relax the body directly prior to and during the exam. In example #2, we can help the child to recognize why it is that he is concerned about not doing well, and to be more accepting that sometimes we try our best and still don’t achieve what we want. In example #3, we can reinforce good study habits, especially when the child prepares for her test despite her anticipatory anxiety.

In all of these cases, feeling of anxiety can be worked through to build resilience and growth in your child. The above are sample strategies and professional assistance may be necessary. Typically, test and exam anxiety is highly treatable with evidence-based psychotherapy such as Cognitive Behavioral Therapy, and children can see benefits within just four to six weeks.

The post Test and Exam Anxiety appeared first on Center for Anxiety.

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By Sara Berlin, LMSW

It is common for people, especially children, to struggle with transitioning to the fall season. At the start of each school year, many children present as shy and struggle to interact with peers and teachers. While the majority of such children will “open up” over the first month of school, some children remain sheepish such that their parents and teachers become concerned. At what point is shyness “too shy”?

Intense shyness that lasts beyond the typical 1-month adjustment period to school may be a sign of Social Anxiety Disorder, an anxiety disorder that affects 4-9% of children and adolescents, or approximately 1 in 10-20 children. While feelings of anxiety in social situations are a normal part of life (and even healthy in some cases!), Social Anxiety Disorder is characterized by persistent and excessive fears about being negatively evaluated by others, which causes notable distress or impairment in everyday life. Children with Social Anxiety Disorder often struggle to attend school, perform as required, and/or socialize with peers, since they tend to be overly quiet and avoid activities that may draw attention to themselves.

In other cases, children may show signs of Selective Mutism, another anxiety disorder in which children refuse to speak in situations where talking is expected or necessary. Children with Selective Mutism may turn their heads away when others approach them or chew/twirl their hair in order to avoid eye contact. They may also stand motionless and expressionless or withdraw into a corner to avoid talking. Interestingly, children with Selective Mutism can be talkative and display normal behaviors at home or other places where they feel comfortable, such that parents are sometimes surprised to learn from a teacher that their child refuses to speak at school.

Here are some practical tips for parents with children who are struggling with social anxiety or selective mutism:

 Understand Your Child’s Intentions

Know that socially anxious or selectively mute children are not trying to be troublesome by ignoring friends and teachers. In fact, such children are usually highly compliant, since they are afraid of being judged or evaluated negatively by others. Avoidance of social situations or speaking are simply (maladaptive) ways of not feeling distressing feelings of anxiety. Almost all socially anxious children would do anything to stop being so anxious and “difficult!” So, be compassionate and validate their feelings of anxiety and fear.

 Give Praise (even) for Small Social Interactions!

Overcoming social anxiety and selective mutism involves a child gradually facing their fears and interacting more with others over time. As such, give your child praise right away whenever they try to interact with or communicate to others (verbally or even non-verbally). Any baby steps your child takes towards overcoming their anxiety should be reinforced. So, when you see your child struggling to speak in spite of their fear, make sure to praise them right away! And needless to say, refrain from making negative comments when you see them struggling. Punishing good behavior (trying to interact with others) can make things much worse, since socially anxious kids tend to be very sensitive to criticism. In addition, it is very important to identify and “label” your child’s specific behavior as you praise them. For example, if you see your child struggling to speak, instead of giving a generic praise such as “great job” you can say something like “I can see how hard it is to speak to these unfamiliar people in your class, and I’m proud of how you made sure to ask the entire question.” In sum, (1) praise your child ASAP after they do something hard, (2) be as specific as possible when praising, and (3) do it often.

 Don’t Probe, Validate

Parents naturally want to ask children questions about their fears (probe) when they start noticing them getting tense in certain social settings. Believe it or not, asking questions to children to alleviate anxiety can actually have the opposite effect, since it directs a child’s thoughts even deeper into their anxiety. Instead of probing, ignore the negativity and focus on praising positive behavior. With that said, it’s important to validate your child’s anxiety, especially if he feels overwhelmed. For example, note that they are overcoming an emotional challenge when they resist the urge to avoid. For example, you can say, “I know that speaking with your classmate was really hard for you today and I am proud that you are practicing your bravery.”

 Resist the Urge to Speak for Your Child

When you see that your child is feeling uncomfortable and anxious, it’s common to want to intervene and speak on their behalf. After all, what parent wants to see their child in distress?! However, saving your child from anxiety will make it harder for them to learn how to speak – if you communicate for them when they are anxious they will never learn to manage their anxiety! Instead, try to encourage them to speak or, if they are really struggling, you can tell guests that your child is working on bravely talking and he’ll try again in a minute or two. Just make sure you do in fact come back to it a minute or two later, though! If you don’t, and you simply “save” your child from speaking, it will reinforce their silence by preventing them from ever having to learn to speak for themselves.

 Make Talking Fun!

There are some games you can play that encourage continued speech, like Go Fish, Battleship, Surveys of “Favorites,” Hangman, Spot It, and Tell Tale. Be patient and positive as your child finds new ways to cope! Secure attachment and strong social support are huge protective factors for all children, particularly those experiencing anxiety disorders. Continue to provide a warm, safe, loving, and fun environment for your child!

 Seek Help

Finally, and perhaps most importantly, childhood anxiety disorders are easily treated and many families can benefit from consulting a mental health professional. A therapist can help assess, diagnose, and treat the anxiety disorder and help you create a plan to help your child cope and overcome their fears. Cognitive-behavior therapy (CBT) is the gold standard to treat childhood anxiety disorders as it helps children learn new ways to think in anxiety provoking situations, and teaches them concrete techniques to manage and tolerate their anxiety. If you are concerned about your child’s anxiety, seek help from a trained professional who can help you and your child.

The post The Quiet Child: At What Point is Shyness… “Too Shy?” appeared first on Center for Anxiety.

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By Tonya Swartzendruber, MA

For many families, the fall represents a significant transition period. Returning to a school schedule can be daunting for kids and parents alike. Earlier bedtimes, packed morning routines, performance expectations, and more time away from parents are just a few changes kids face during the school year. A little planning can go a long way to help your family make this transition a smooth one.  Here are a few tips to consider:

Establish a school-like schedule gradually a week or two before the first day of school.

During the summer, many families relax bedtime, wake time, and meal schedules. Changing all of this at once on the first day of school can be a challenge. Try to gradually adjust sleep and wake times and bring more structure to the day 1-2 weeks before school starts. This can help the back-to-school transition feel more natural by the time Labor Day comes around.

 Address school-related anxieties with your child.

Even for kids that have already been in school for several years, the transition to a new grade can bring anxiety. Ask children about how they are feeling, listen carefully to any concerns they raise, and see if any can be addressed ahead of time. Normalize these concerns for your kids. Convey that transitions are hard for most people. At the same time, help them to refocus on what they are excited about in order to get into a positive space to face the challenges of school.

Involve kids in preparing for school.

This could be as simple as buying school supplies and new clothes together. The night before the first day of school, involve your kids in packing backpacks, lunches, choosing what to wear, and laying out their clothes. This will make the first morning of school much less hectic and stressful for everyone.

Convey excitement and confidence about this transition!

Kids are keen observers of their parents. They often take their cues from their parents to help them know how to feel about and prepare for new challenges. If you, as a parent are feeling anxious or uptight about any upcoming school challenges, find support and a place to talk about this with people other than your children. That way you can convey excitement and confidence about the new school year.

The post Back to School appeared first on Center for Anxiety.

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