All Posts in Category: General

Separation Anxiety and School Refusal

The summer is waning – it’s almost time for autumn to roll around again, which means school will be starting soon. While most children look forward to this time so they can see their friends and enjoy various school activities, this can be a period of major anxiety for some school-aged children. These kids are extremely unwilling to leave home or be away from major attachment figures such as parents, grandparents, or older siblings. The beginning of the new school year is often seen as a threat to them, resulting in elevated anxiety levels and possible school-related disorders, such as separation anxiety disorder and school refusal.

In some cases the separation anxiety and school refusal follow an infection or illness or can come after an emotional trauma such as a move to another neighborhood or the death of a loved one. The anxiety generally occurs after the child has spent an extended time with their parent or loved one, perhaps over summer break or a long vacation.

Anxiety Definition

A teen or child is said to be suffering from a separation anxiety disorder if they show excessive anxiety related to the separation from a parent or caregiver or from their home, or if they exhibit an inappropriate anxiety about this separation as related to their age or stage of development. School refusal and separation anxiety are not the same: school refusal is not an “actual” diagnosis, instead it is a result of the child or teen having a separation anxiety disorder, panic disorder, post traumatic stress disorder, or social phobia, among other diagnoses.

Separation Anxiety Physical Symptoms

Children with separation anxiety have symptoms which can include:

  • Excessive worry about potential harm befalling oneself or one’s caregiver
  • Demonstrating clingy behavior
  • Avoiding activities that may result in separation from parents
  • Fearing to be alone in a room or needing to see a parent at all times
  • Difficulty going to sleep, fear of the dark, and/or nightmares
  • Trembling
  • Headaches
  • Stomachaches and/or nausea
  • Vomiting

A child who exhibits three or more of these symptoms for more than four weeks is likely to be suffering from a separation anxiety disorder.

Treatment for School Refusal and Separation Anxiety

When treating a child with separation anxiety and school refusal, therapists try to help the child learn to identify and change their anxious thoughts. They teach coping mechanisms that will help the child respond less fearfully to the situations that produce their anxiety. This can be done through role-playing or by modeling the appropriate behavior for the child to see. Medication is sometimes appropriate in severe cases of separation anxiety. Additionally, the therapist encourages child to use positive self-talk and parents help with this therapy by actively reinforcing positive behaviors and rewarding their child’s successes.

Have Questions? Need Help?

To get more information and help for child anxiety, separation anxiety and school refusal, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-223-6568 today.

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Children and the Benefits of Mindfulness Training

Children and the Benefits of Mindfulness Training

These days, children often have stressors that come at them from all directions. Schools are sending more homework and projects home with children, kids are busy after school with extra-curricular sports and activities, and there are video games, social media, and cell phones all competing for their attention. In addition, they may have to deal with being picked on at school or may be coping with the pressures of divorcing parents or the arrival of a new sibling in the home. With all that kids have to contend with, it’s no wonder that children who engage in mindfulness exercises tend to be happier kids who are more able to self-regulate and calm themselves during periods of stress.

What is Mindfulness?

What is mindfulness, anyway? According to experts in the field, mindfulness is defined as “paying attention to something, in a particular way, on purpose, in the present moment, non-judgmentally” (Kabat-Zinn, 2003).

Mindfulness helps with emotional regulation and cognitive focus. It allows children to choose a calmer, practiced response to stressors instead of throwing a tantrum or losing control. It teaches them to be conscious of how their emotions “show up” in their bodies (in the form of headaches, stomachaches, nightmares etc), and helps them understand that their thoughts are “just thoughts.” Children who undergo mindfulness training become adept at recognizing when their attention has wandered and learn to implement tools for impulse control.

How Can Mindfulness Training Help Your Child?

There is a growing body of research that indicates mindfulness training can help children improve their ability to calm down when they are stressed or upset, learn to pay attention and become more focused, increase their ability to concentrate, and learn to make better decisions.

Mindfulness activities for children can also help with:

  • Anxiety and depression
  • Sleep difficulties
  • Anger issues and separation anxiety
  • Coping with increased life stressors
  • Anxiety at school (for example: test taking or athletic performance)
  • Chronic medical conditions
  • Learning compassion and acceptance for themselves and others
  • Breaking the cycle of worry before it turns into full-blown anxiety or panic attacks

Mindfulness Activities for Children

If you would like to help your children learn to become more mindful, there are a few things to take into account when teaching them. First, remember to take the age of the child into consideration and keep the mindfulness sessions short until they get used to practicing it. Also, make the practice times age appropriate – limit them to about five minutes or less, particularly for younger children. Praise your child for the effort they put into their mindfulness exercises and reward them with hugs and cuddles or by doing something they want to do together afterward.

Try these exercises to help your child practice being more mindful:

  • Belly breathing – Have your child put one hand on their tummy and one hand on their heart. Have them take a deep breath in for a slow count of 3 and then breathe out again to another slow count of 3. They should repeat this deep breathing exercise at least three to five times to feel calmer in times of stress. For younger children, it can be helpful to have them lie down and place a small stuffed animal on their stomach while breathing in and out during the exercise. As they focus on watching the stuffed animal rise and fall with their breathing, they learn how to breathe from their belly.
  • “Cool Your Food” breathing – Have your child breathe in through their nose and blow their breath out of their mouth as if they were trying to cool down hot food. Repeat this 5-10 times, very slowly.
  • Listen to the sounds around you – An easy way for children to practice mindfulness is to focus on paying attention to what they can hear. Take a walk and listen to the birds chirping, lawn mowers mowing, or the wind blowing. You can also download phone apps that have calming waterfalls or nature sounds and have your child listen to see what they can hear (for example: are there frogs croaking or birds chirping in the background?)
  • Mindful Playtime – Finger paints or coloring books offer great ways for children to be mindful. As they color, ask your child how the crayons smell or how the finger paint feels against their hands. What do the colors they are using mean to them? Can they hear the crayon or pencil scratching against the paper or the paint swishing as they swirl it across the paper?
  • Ring a bell – or chimes or perhaps strike a note on a piano (or use a phone app that has these sounds on it) and have your child listen carefully to the sound of the tone until it gradually fades away and stops.
  • Practice gratitude – Have your child tell you one or two things they were grateful for today. You can have them do this at dinner time or just before they go to bed. Tell them what you are grateful for, as well!

Learn More

We have mindfulness programs for both adults and children at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. To find out more about these programs, call us at 561-223-6568 or contact us here.

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The Effects of School Bullying

The Effects of School Bullying

It seems like we hear of another bullying-related suicide almost weekly and with the unfortunate increase in suicides, people are becoming more aware of how big of a problem bullying has become. Fortunately, this means programs are being put into place to decrease occurrences, however, this type of harassment still happens quite often so it’s important to understand the effects of school bullying on your child.

Bullying is:

  • The use of power to control or harm someone who either can’t defend themselves or who may have a hard time doing so
  • The goal of causing harm
  • The same person or same group of people harassing the same person repeatedly

Those children who are most at risk of being bullied are those who are less popular than others, who have low self-esteem, have few friends, and are depressed or anxious. The children who tend to be bullies are those with social power who like to dominate others and are concerned about their popularity. In addition, bullies often also have low self-esteem, are aggressive, and tend to be impulsive and easily pressured by their peers.

There are several types of bullying, but the most prominent in-school bullying is social bullying, which includes:

  • Targeting a person’s social status to tear it down
  • Shunning a person
  • Damaging a person’s reputation by spreading rumors
  • Excluding a person from social activities

With the rise of Facebook, Twitter, YouTube, and texting, the problems of school bullying have also risen to high-tech levels. When a bully is no longer forced to face their victim and has the protection of anonymity it’s much easier to shed any sense of empathy they have and to post embarrassing or humiliating videos, pictures, or comments about the person they’re targeting.

The effects of school bullying can lead to childhood anxiety disorders and depression that often continues into adulthood. A person who was bullied in school is more likely to allow themselves to be harassed in the workplace when they get older. Over time they begin to believe what bullies say about them and they start to avoid interactions and situations that could actually be positive. Oftentimes the anxiety they feel will manifest itself physically, by means of:

  • Headaches
  • Stomach aches
  • Aches or pains throughout the body
  • Weight loss
  • Sleeplessness

Fortunately, there is help for the victims of bullying. A psychologist can help examine the situation and develop coping methods that suit the victim’s personality. These coping behaviors will compartmentalize how the child should react in particular situations. Psychologists can help victims rebuild their self-esteem and confidence so that future bullying can be avoided.

If you or someone you know has experienced the effects of school bullying, it’s important to seek help as soon as possible. Ignoring the problem often makes things worse and can lead to greater issues down the line. For more information, call Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida at 561-223-6568 today.

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School Phobia and First-Day Jitters

It’s hard to believe it but it’s that time again: schools are welcoming back students all across the country. The summer weeks have passed and parents everywhere are stocking up on school supplies while their children pick out their favorite lunch boxes.

For many kids, the start of school is exciting. They get to see the friends they’ve missed all summer and there’s a sense of being that much closer to being “all grown up” or becoming an adult. However, some children have a school phobia that can give them the first-day jitters. These children will likely experience increased anxiety with the beginning of school.

School phobia is a complex and extreme form of anxiety. It is also known as school depression or school refusal and can occur for many reasons, including:

  • Starting school for the first time
  • Changing schools and having to make new friends
  • Returning to school after being away for a long time due to illness or an extended holiday
  • Fear of being targeted by a bully
  • Bereavement (of a person or pet)
  • Feeling threatened by the arrival of a new baby
  • Having had a traumatic experience, such as abuse
  • Problems at home, such as a family member being ill
  • Parents’ divorce or separation
  • Violence at home
  • Not having good friends or not having any friends at all
  • Being unpopular
  • Feeling like a physical failure in school sports
  • Feeling like an academic failure

One of the most common triggers of school phobia (first-day jitters) is starting school for the first time. The child experiences separation anxiety because they find it difficult to comprehend being away from their parents for an extended period of time. In addition, if the child is not used to having an entire day organized for them, the schedule at school can add to the stress they feel.

For older children who have been in school for a while, most back-to-school anxiety is directly related to their fears about how they will perform in school. They wonder if they will do well in games, be asked to answer questions, or be asked to read aloud. In addition, some children have been targeted by bullies or have been made fun of in past school years, so they feel anxious about possibly repeating this abuse in the new school year.

When school depression and anxiety starts to creeps into your child’s mind, the symptoms will be fairly obvious. The child will usually suffer from the following school anxiety symptoms:

  • Stomachaches
  • Nausea
  • Fatigue
  • Shaking
  • A racing heart
  • Needing frequent trips to the toilet

You can do some things at home to help with school anxiety in your children, including:

  • Reassuring your child that everything will be fine once they get past the thing they fear.
  • Telling them you love them and letting them know they are brave for going to school despite their fears.
  • Telling them you’re proud of them.
  • Keeping them to a familiar routine to make them less anxious.
  • Finding things, both within and outside of school, that they can look forward to.

If you suspect that your child is developing a school phobia, it’s important to seek treatment as soon as possible: the longer the anxiety continues the harder it can be to treat.

For more help with anxiety treatment for school phobia or the first-day jitters in the Boca Raton area, please contact Dr. Andrew Rosen at 561-223-6568 today.

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Summer Camp Separation Anxiety – Tips for Reducing Child Anxiety

Summer Camp Separation Anxiety – Tips for Reducing Child Anxiety

For many people, memories of going away to summer camp are some of the fondest they will ever have. Camp provides the opportunity to make new friends and share new adventures. When your child is going off to camp for the first time, however, fear of separation can make the experience seem dreadful for both parent and child, especially in the case of sleep-away camps.

Paying close attention to your child’s concerns is the first step in alleviating their anxiety. A child’s summer camp separation anxiety can display itself in a number of ways, including:

  • Unrealistic fear that someone close to them will be harmed while they are away
  • Reluctance to attend the camp
  • Persistent avoidance of being left alone
  • Nightmares involving themes of separation
  • Physical complaints when separated
  • Excessive distress when separation is anticipated

Repeated physical complaints can also be a sign of summer camp separation anxiety. These symptoms could be any of the following:

  • Stomach problems
  • Headaches
  • Cold or clammy hands
  • Nausea
  • Feeling faint
  • Being hot or cold

Fortunately, there are plenty of tips to help parents reduce their child’s separation anxiety. Parents are encouraged to:

  • Remind their child that everyone gets nervous when they go away to camp, especially if it’s their first time
  • Show confidence that they’ll enjoy their time away
  • Remind them about other new experiences they’ve overcome in the past
  • Find out how the camp deals with homesickness so you can be prepared
  • Provide your child with pre-addressed, stamped envelopes, pen, and paper so they can write home whenever they want
  • Provide lots of attention in the days preceding the separation
  • Make goodbyes short and to the point. Dragging them out can make both parties nervous and delay the possibility of moving past the anxiety.

In most cases, the above steps will go a long way in eliminating or reducing separation anxiety that arises before a sleep-away summer camp. In some situations, however, the anxiety may persist despite all efforts. In this instance, parents are encouraged to seek professional help, especially if the child’s symptoms have begun to interfere with their school performance or friends. For more information on summer camp separation anxiety, contact child anxiety therapist Dr. Andrew Rosen at 561-223-6568 today.

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Mood Disorders in Children

Mood Disorders in Children

There is a plethora of information out there regarding mood disorders of all kinds. The public is becoming more and more educated about panic disorder, generalized anxiety disorder, bipolar mood disorder, and the like. But what many people still do not realize is that these disorders are not limited to adults.

A child may experience similar mood disorders, as well. In fact, 7-14% of children will experience an episode of major depression before the age of 15. Out of 100,000 adolescents, two to three thousand will have mood disorders, out of which 8-10 will commit suicide. It is for this reason that the symptoms of mood disorders in children should attract special attention.

Symptoms of mood disorders in children include:

  • Sadness
  • Fatigue
  • Despair
  • Dejection
  • Changes in appetite
  • Loss of interest
  • Difficulty sleeping
  • Hopelessness
  • Sense of inferiority
  • Exaggerated guilt
  • Feelings of incompetence
  • Inability to function effectively

Many children might have one or two of these symptoms at one time or another but it is the presence of several symptoms for an extended period that indicates a mood disorder. There are three levels of mood disorder in children:

  • Severe depression is present when the child has nearly all the symptoms and these symptoms almost always keep them from performing day to day activities.
  • Moderate depression occurs when a person has many symptoms that often limit their regular activities.
  • Mild depression is present when a child has some of the symptoms and it requires extra effort for them to do every day things.

If you or someone you know has a child who might be suffering from a mood disorder, it is important to seek help immediately. The mood disorder will be diagnosed through extensive interviews with the child and his or her caregivers. If a mood disorder is found, it is often treated through medication, psychotherapy, or a combination of the two.

For more information about Mood Disorders in children , diagnostic steps, and therapy for the condition in the Delray Beach, Florida area, contact The Center for Treatment of Anxiety Disorders at 561-223-6568 today.

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