Positive Affect Narellan in Narellan, New South Wales, Australia | Medical service

Positive Affect Narellan

Locality: Narellan, New South Wales, Australia

Phone: +61 2 4647 0778

Address: 30/1 Elyard Street 2567 Narellan, NSW, Australia

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25.01.2022 Anxiety in children is terrible. I wish it never happened, but it does and it seems like it's only increasing. It's heartbreaking to talk to a child with anxie...ty who just begins to be able to articulate what they are feeling and to realize they have been experiencing it for years but didn't have the words to express it. Seeing your child anxious can cause you to feel helpless and leave you wondering if you've done something wrong that caused it. I wanted to write a post about anxiety but I wanted to be sure I answered your questions and you guys had some great ones!! I decided to divide it out into 2 categories to help you find what you are looking for... Identification/Diagnosis What symptoms should I be looking for? Symptoms of anxiety in kids can be a little tricky because it's a little more tricky than saying, "I feel nervous." Symptoms can include problems sleeping, irritability or anger, defiance, extreme reactions to seemingly minor issues, persistently negative reactions or some common symptoms. Especially consider anxiety if these symptoms show themselves more during stressful situations. Another common set of symptoms for children and teenagers with anxiety is physical symptoms. Common physical symptoms that can be a sign of anxiety are headaches and stomachaches. How do you diagnose anxiety in children with other conditions like ADHD, autism, etc? Other conditions can make the diagnosis of anxiety more complex. If you child is on treatment for any other condition and their sensitivities do not seem to be improving, it would be reasonable to bring up the diagnosis of anxiety with your pediatrician or psychiatrist. Learn and study your child. You know what the symptoms of their primary condition are. If something is new or different or if you're not seeing the progress you would expect with treatment, consider that something else might be going on. What's the difference between anxiety and tantrums? Tantrums are a common and normal part of child development. Because they can happen at stressful times, it's possible that they could be mistaken for anxiety. For tantrums, the best method of response is ignoring, not giving into demands, and redirection. Considering the triggers can be a good way to determine if a child is having a tantrum vs anxiety. If they are mad because they are not getting something they want or don't want to do something you are asking them to do, it is probably just a tantrum. If those episodes do not resolve quickly or if they persist into older ages (4-5 years), then anxiety could be a factor. Who should we see if we are concerned our child has anxiety? I always recommend starting with your pediatrician for discussion about your child (but I might be biased). They can provide reassurance if the behaviors your are seeing are normal or they should be able to point you towards resources in your community that can help like a counselor or parent group. If they are not comfortable treating anxiety medically, you may end up seeing a psychiatrist. What is causing all the anxiety in our kids? This is a tricky question. One thing is that I think we are more prone to address and identify anxiety now than we used to be. I do believe that stressors are changing as well. School requirements are being driven into younger grades-including a focus on standardized testing. Social media. Technology in general. Early commitment to intense sport activities. All of these are possible factors. Does anxiety run in families? Definitely. There is a strong genetic component to anxiety. Anxiety in parents also creates an environment that could contribute. So, take care of your own mental health first! Does anxiety look different in different children? Definitely! There are definitely different forms of anxiety which can present in different way. Here are just a few of the types: Generalized anxiety-general fear about many aspects of life Social anxiety-fear of others, especially large groups School anxiety-fear of going to school or some aspect of school Obsessive compulsive disorder-need to perform rituals or habits to mitigate feelings of anxiety Summary of identification and diagnosis: Like many things in children, anxiety to some degree is normal. We want our kids to be a little bit nervous around strangers, in new places and in places where they could be at risk for harm. It becomes a problem with those feelings begin to interfere with normal function. If your child is occasionally nervous about school but can eventually get there with some reassurance, you are probably ok. If your child won't get in the car or get sent home by the nurse repeatedly, it's probably anxiety. If your child like to have a stuffed animal in the car with them but can leave it and take care of their regular activities, you are probably ok. If your child needs to have 10 specific animals in their bag and won't leave the house until you have them, that's probably anxiety. If your child is picky but eats a handful of foods, you are probably ok. If your child eats 2 foods on a good day and gags or refuses to try anything else, consider anxiety. Treatment What are the standard treatments for anxiety? The primary treatment for anxiety is going to be behavioral. Avoiding stressors where possible and prudent and helping with coping mechanisms when it's not. Some milder cases can be treated with parental reassurance, breathing techniques (counting in younger ages) and questioning. "Are you concerned that something might happen?" "What do you think would happen next?" If you are struggling with methods for helping, it is best to reach out to a counselor who can provide both play therapy or counseling for the child and parental support coaching for you. Cognitive behavioral therapy is the most common form of therapy as it seeks to replace the negative thoughts of anxiety with positive thinking and behaviors. If working with a counselor does not return function, consideration of medical treatments is an option. Most kids are treated with a class of medications known as SSRIs. Of course, the younger the child, the more cautious we are with starting medications but in some cases, they can be life changing for the child and family. What are the long term effects of starting medications at an early age? As with all medications, we are cautious to weigh the risks vs benefits. There have no studies that suggest long term harm as a results of being on treatment for anxiety but we should always be cautious about starting treatment in younger children. We know that living with anxiety can be a significant problem as well. How do I explain my child's anxiety to them? Using terms and language that is developmentally appropriate is an important part of this conversation. We can talk about worry and fear in younger children with labeling it anxiety. Talking about negative or unhelpful thinking is an important step to help kids realize that it starts with their thoughts which will be a big part of their treatment should they need counseling. As children get older and have a better understanding, calling their problem anxiety should help them learn to take ownership. A specific part answer to this question comes into play whenever we decide to start taking medications for children with anxiety. I do not recommend giving medication under the deception that it is a vitamin or something along those lines. I believe that there is a level of conversation at every stage where you can explain what the goals of the medication are in a way that is developmentally appropriate. How can I help my child cope without rescuing them every time? Balancing challenging your child with nurturing your child is tough on so many different areas but anxiety is particularly challenging. Once your child has developed some coping mechanisms and strategies that work, it is important to begin to allow them opportunities to exercise them. I recommend being a close observer but not right by their side the entire time. Their coping mechanism should allow them to work through what they are feeling without your immediate assistance. If things are out of control, it's ok to take them out of the situation but be sure and debrief according to their level of maturity. What do I say to my child? What should I not say? One that that for sure doesn't work is to scream "calm down" but I know that's where my mind immediately goes. Develop consistent terminology and phrasing that you can practice like, "you're safe" or "I'm here with you" for when your child needs reassurance. Avoid using wording that labels them as their feelings. For instance in the office or with others don't call them a "worry-wort" or even "shy." Instead say, "we sometimes worry about things" or "sometimes we're quiet around new people." Are there natural remedies that have been proven to help with anxiety? Oh man, this is the one where I'd like to drop the bomb and say so and so essential oil works or CBD works but the problem is these aren't really studied in anxiety for kids (or even adults for the most part) so any recommendation would be purely speculation. If your child likes the scent of lavendar and that calms them, great, but I don't think there's necessarily anything magical about it's properties. Can a child outgrow the anxiety? YES!!! Most childhood anxiety is situational and even those that persist into adolescence learn new and different coping skills. Staying connected with your pediatrician or counselor is important as sometimes it comes back up again with new changes, etc but it's very likely your child's anxieties will decrease over time. If they don't medications are getting better and better every day. How much to alter our lifestyle (not taking trips or doing other things that are hard for them)? This is a tough one. Families may need to make some subtle adjustments to their routine to help a child who has anxious tendencies but completely shutting all activity down is not healthy either. Particularly in younger children, I think it can reinforce the idea that the places they are anxious about are unsafe ("see even mom doesn't want to go there anymore"). The bottom line is that we have to be strategic about how we alter our plans and consider modifying but not stopping activities. How to help them deal with something that causes anxiety outside of their control (going back and forth between mom’s house and dad’s house)? Preparation for transitions is critical and giving specific action items to help the child can make a big difference. This is one in particular where our emotions can really play a role in how successful this type of situation is. If we are feeling overwhelmed about whatever is going on, they are likely to feel that as well. So, get help if you are feeling stressed. Then make sure that the child knows the plan for what they are going to be doing while they are away and when the time apart will end. Expectations are key. What about picking nails? Biting lips? Are these signs of anxiety? How do I help them stop? Nervous behaviors like nail picking, lip biting, shirt chewing, hair twisting and many others can simple be habits that are annoying but not reflective of anxiety. Keep in the mind the overall context of the child-are they experiencing anxieties in other venues or showing other symptoms. The best treatments for these behaviors are distraction techniques and alternative behaviors. Things that keep your hands or mouth occupied (stress balls, chewing necklaces etc) not only distract from the concerning habit but many areas have been shown to help with anxiety by themselves. What modifications can we make at school that might help? Being in contact with your child's school is an important part of the overall treatment plan. Having their teacher, counselor and principal up to date with their condition and where they are with anxiety can go a long way to smoothing out the symptoms. If there are significant changes in treatment or other external stressors, it will be important to keep the school as updated as possible. For school related activities, it is important that everyone remain focused on the effort the child is making at school rather than a focus on the outcomes or grades. Children with anxieties are often perfectionists and if the goal is 100, they will fail every time. Instead praise them for effort and energy or creative thinking rather than outcomes. Teachers can help by balancing their need for homework and other extra school activities out with the child's need to have time for free play and an early bed time. Counselors should be made aware of each child's particularly coping mechanism so that they can help should a problem escalate to their level. What are some lifestyle modifications that can affect treatment of anxiety? As with most mental health conditions, there are multiple environmental factors that can play a role in causing or making anxiety worse. Some key factors that people might not think about. Screen time-Use of excessive amounts of screen time can cause problems for any child. Some children who are prone to anxiety might be more sensitive to any screen time use or certain types of screen time content. Sleep-lack of sleep is a big factor when it comes to treating anxiety. Sometimes that can just be because of poor sleep habits that need to be adjusted but often the lack of sleep is a part of their anxiety. Diet-Encouraging your child to eat a balanced diet with plenty of fruits and vegetables. If your child's eating is affected by their anxiety or they have fears around certain foods or textures, seek help from a speech or occupational therapist with an interest in feeding concerns. Here are some resources that might help: I love the Child Mind Institute and they have a whole page devoted to anxiety: https://childmind.org/topics/concerns/anxiety/ Here is another helpful webiste called WorryWiseKids: http://www.worrywisekids.org/ The GoZen program seems to be a solid program for parents and children to help them manage anxiety: https://gozen.com/

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09.01.2022 Positive Affect Narellan is open and operating under recommended guidelines, however if you are experiencing any flu symptoms or unable to leave your home, please contact us on 02 4647 0778 and where possible we can arranged a phone appointment.

08.01.2022 Hi All, We are now registered with the NSW Government as a COVID-19 SAFE organisation.

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