HealthyPlace Articles are Up!

If you aren’t familiar with www.healthyplace.com, it’s “the largest consumer mental health site,” and it’s a truly wonderful resource for anyone who suffers from or knows someone who suffers from mental illness. I’ve just had two pieces published on the site: tips about school refusal, and a guest blog post on their new Your Mental Health blog! Please check out both pieces, especially if you have a child who suffers from school refusal.

Thanks!

Coming soon…My Worst Teaching Mistake

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When a Cold is a Catastrophe

I’m sick.

Over the weekend, I got a fairly nasty cold, and I’m still recovering. To an adult who has control of her anxiety, a cold is an annoyance. For anxious children, however, even minor illnesses can be terrifying.

Children prone to catastrophic thinking are often extremely creative in their fears, especially if they don’t have a good understanding of relevant anatomy.  Sinus pressure is likely to make an anxious young child worry that his head is going to explode, but it may also make him worry that worms have crawled into his nose in the night.  As long as you’re respectful and compassionate, I think it’s okay to sometimes poke gentle fun at your child’s most adorable fears.

To keep things playful instead of traumatizing, acknowledge the child’s fear, explain that the fear itself is a symptom (of anxiety or an anxiety disorder), and make sure the child knows you are on her side and will protect her.  Most importantly, keep even gentle teasing one-on-one; a beloved teacher or parent joking about nose-worms could be comforting and sweet, but additional participants may intentionally or unintentionally humiliate or bully the child.  Also, be careful about joking about plausible consequences of symptoms, such as an ear infection leading to a ruptured eardrum.  Most anxious kids won’t find that sort of “joke” funny.

Below is a list of common cold symptoms and the fears they may inspire in anxious children and adolescents.  Some of the fears are silly, but it’s important to realize that intelligence does not necessarily protect children from anxiety.  A child or teen who knows her fears are unfounded may still be plagued by them.  If your child or student complains of one of the following fears, explicitly disprove his unfounded fears (“sinus pressure will NEVER make your head explode, no matter what) and deemphasize any real risks that don’t require action.

Being able to predict some of your child or student’s fears may help you to better remove those fears.  Just make sure you never inadvertently suggest a new fear: “Ooooh, ear pressure? Don’t worry, I’m sure your eardrums won’t explode!”

Symptom Possible Fears
Cough Suffocation, lung cancer, internal bleeding due to violent cough
Headache Tumor, concussion, meningitis
Pressure, ears Eardrum rupturing, deafness
Pressure, eyes Eyes “popping out”/exploding, blindness
Pressure, sinuses Head exploding, tumors, burst blood vessels
Sore throat Losing the ability to speak
“Stuffy nose” Suffocation, anosmia
Swollen glands Hodgkin’s lymphoma

Parents, note that many over the counter and prescription cold medicines can cause anxiety or panic in individuals with anxiety disorders.  Talk to your pediatrician for more information.  Curious about alternative cold remedies? Read this informative article from Mayo Clinic.

Antibiotic Safety Information
Colds are caused by viruses, NOT bacteria.  Therefore, antibiotics will NOT help prevent, mitigate, or cure a cold.  The misuse of antibiotics helps create resistance strains of bacteria (such as MRSA), and taking antibiotics when you don’t need them can sometimes hurt you. Your body is full of “good” bacteria that helps you digest foods and fight off infection. Children and adults should only take antibiotics when they are prescribed by a real medical doctor.  Always take antibiotics exactly as prescribed.

Separation Anxiety, Part 3

Teachers–if you have a student who is suffering from Separation Anxiety Disorder, you may struggle with predicting and managing his or her anxiety attacks.  Below are some situations that may inspire fear or panic in students with Separation Anxiety Disorder, plus suggestions for helping students cope with each situation.

Substitute Teachers 
If your student relies on your presence to help manage her anxiety, a substitute teacher may trigger feelings of abandonment and vulnerability.  Whenever possible, warn students in advance about your upcoming absences.  Since most of your absences are likely to be unexpected, talk to students early in the year about procedure for substitute teachers.  Consider having another trusted teacher (or the school nurse, perhaps) check in on your anxious student during your absence.

Field Trips 
Most children find field trips exciting, but students with any type of anxiety disorder can have difficulty in new situations. Students with separation anxiety may worry that their parents won’t be able to find them during the trip or will take too long to arrive if there’s an emergency. Provide ample information about the field trip in advance, and casually but clearly explain that, if a student becomes ill or upset, you can easily contact his parents. Consider inviting parents on the field trip or allowing them to drive their own children.

Late Parents  
A student with separation anxiety is likely to panic when her parent is late for pick-up. She may worry that she has been abandoned, or she may suspect that her parent has been injured or killed. A panicking child may cry or hyperventilate, but she may also become very quiet, pace by herself, or begin speaking loudly. She may complain of stomach pain, nausea, or a headache. If you suspect that your student is panicking about her parent’s tardiness, offer gentle reassurance and distraction. Privately remind your student that her fear is a symptom, not a premonition, and that releasing her fear will not increase the likelihood of catastrophe.

Drop-off
When students have difficulty separating from their parent at morning drop-off, offer immersive distractions and persistent reassurance. Do NOT encourage parents to sneak away. Instead, suggest one brief but satisfying “goodbye” before enthusiastically calling the child’s attention to something else. If a student continues to cry or panic, offer nurturing reassurances that he is safe and that you will be looking out for him.

Absent Friend
Many anxious students use close friends as parent-substitutes. In Kindergarten, I made Sara D. come with me every time I went to the bathroom. Thanks, Sara! If you notice a student with separation anxiety becoming dependent on one friend, occasionally push her to bond with other students. When your anxious student’s best friend is absent, take extra care to help her integrate into other groups, and subtly check on her at lunch and recess.

Children typically dislike being perceived as different or weird, so be subtle when helping your anxious students. Also, please remember that these tips are meant to mitigate separation anxiety during minor crises and are not long-term solutions or treatment plans. Parents, if you suspect that your child has an anxiety disorder, please contact your pediatrician.

Fearless Learning offers information, advice, and support for students with anxiety. Contact me for more information.

Separation Anxiety, Part 1
Separation Anxiety, Part 2

Separation Anxiety, Part 2

My own experiences with childhood anxiety inspired me to become a teacher of anxious students.  The anxiety disorder I see most frequently in my work is Separation Anxiety Disorder.  Remember, separation anxiety is perfectly normal in toddlers, and many young children have some difficulty in new situations.  Separation Anxiety Disorder is characterized by extreme or inappropriate separation anxiety and must be diagnosed by a doctor or mental health professional.  Read part 1 of this separation anxiety series for my experience with the disorder.

If you suspect that your child has Separation Anxiety Disorder or any other anxiety disorder (people often have more than one), please contact your pediatrician.  Note that helping your child overcome separation anxiety will take patience and incremental change. (Fearless Learning offers customized online coaching and consultation for students with anxiety.  Contact me for more information.  And, if you live in New York City, check out my services for anxious students!)

If you have a student who may be suffering from an anxiety disorder, consult with his or her parents to create a plan to help your student cope with his or her anxiety, and read on for tips and information.

Separation Anxiety Disorder can impede academic success in two major ways:  First, students may resist attending school.  Between 2 and 5 percent of school-age children suffer from anxiety-related school refusal.  Second, students with Separation Anxiety Disorder who are able to attend school may spend the day distracted by their anxiety.  In order to help students with Separation Anxiety Disorder, it’s important to understand their fears.  Very young children may not have specific fears and may instead simply feel uncomfortable, anxious, or panicked when separated from loved ones.  Older children and gifted youngsters are likely to have more specific concerns.  Like many children with Separation Anxiety Disorder, I was terrified of losing my mother.  Other children worry about getting lost or being kidnapped.  Extreme and inappropriate anxiety is hereditary, so don’t assume that children’s fears are the result of past experiences.  Instead, think of each fear as an arbitrary symptom of a disease.   Ideally, your student will learn to think of his fears similarly.

When one of your students expresses anxiety about being separated from a loved one, listen to her fears and offer appropriate reassurance.  Calmly assure students that their parents are safe and have neither abandoned them nor become injured, and stress that fear is not a predictor of catastrophe.  It may be helpful to explicitly explain that fear about losing a parent is not an indication that the parent has been harmed, a fallacy that even gifted students with anxiety may consciously or subconsciously entertain.   Anxious students may also worry (subconsciously, perhaps) that failing to worry about loved ones will result in the loss of those loved ones.  This type of magical thinking is common in individuals with Obsessive-compulsive Disorder but may be present in children with other anxiety disorders.

As always, treat anxious students with respect, compassion, and patience.

Tomorrow: the final installment of my separation anxiety series, including problem-solving tools for separation situations.