Parenting a child with a Behavioral/Mental Health Disorder: Anxiety/PTSD

Have you ever wondered if your child’s fears are normal?  I know I have, my daughter still has fears/anxiety about her closet and going upstairs without someone else up there and she is 8 years old.  How do you know what is normal and when you need to seek out help?  I have heard many families pose the questions, is my child’s behavior because of trauma or anxiety?  The answer is likely “yes”—in other words, it is both.  Trauma can lead to anxiety and anxiety can increase the effects of trauma.  Post-Traumatic Stress Disorder is a form of anxiety, but its treatment is specialized and unique in its approach from other forms of anxiety.

Did you know that a child complaining of tummy aches or headaches could be anxious? Did you know diarrhea or constipation can be a sign of anxiety?  Think of a time when you were anxious, what did it feel like?  Did you have physical symptoms?  Did your heart rate increase, palm sweaty?  Imagine what this might feel like on a daily bases.  How would you respond in this chronic state? Would you be irritable, moody, and perhaps a little short in your response to others?  I personally have often wondered how our kids with PTSD/Anxiety find ways to overcome and be successful at home or at school at all. How they actually function in life.  Anxiety can be debilitating!

According to the National Institute on Mental Illness over ¼ of children suffer anxiety at some point in their life and nearly 6% have a severe case. http://www.nimh.nih.gov/statistics/1ANYANX_child.shtml       

What is anxiety and how do I know if it is present? Signs and symptoms:
Anxiety is considered an irrational and excessive fear and worry which has both an emotional and physical response.  Anxiety is a protection your body has, it is a part of your natural fight or flight system.  We all have anxiety sometimes. What are some of the most common symptoms of anxiety?* 

Pounding heart Sweating Stomach upset or dizziness Frequent urination or diarrhea Shortness of breath Replaying trauma through nightmares, play or story telling Feelings of apprehension or dread Trouble focusing Feeling tense and jumpy Anticipating the worst

Tremors and twitches Muscle tension Headaches Sluggish Difficulty Sleeping Clinging to parent Moody, easily angered Fidgety, Restless Hyper vigilant/Watching for signs of danger School refusal/activity refusal

What are common causes of Post-Traumatic Stress Disorder (PTSD)?
To begin with we need to understand what trauma is.  Many of us know that soldiers returning from war can suffer PTSD.  However, a traumatic event does not always have to involve having your life threated and your safety in danger.  It can be any situation that leaves you feeling overwhelmed, fearful, or isolated, even if it does not involve a threat of physical harm or actual harm.  Some common causes of PTSD or Emotional/Psychosocial trauma are:

·         Falls or accidental injury (i.e. blowing a knee out in a sport event)

·         Surgery early in life, not understanding the purpose

·         The severing of a long term relationship (i.e. a break up)

·         The sudden death of someone loved or permanent separation (such as termination of parental rights)

·         A car accident

·         A humiliating, highly embarrassing situation

·         The diagnosis of a severe illness

·         Sexual Abuse

·         Witnessing an act of violence

·         Physical harm caused by another circumstance that increase the likelihood of PTSD/Anxiety

  The following are circumstances that can enhance the trauma effect a person experiences:

·         An event that happens un-expectantly, the individual was unprepared, and individual felt powerless

·         It happened repeatedly

·         It happened with the intent to harm

·         It happened in childhood

   As a parent, you can complete an assessment on your child to see if they meet the criteria for anxiety by doing the SCARED:  Screen for Childhood Anxiety Related Disorders
      http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/SCARED%20Child.pdf 

Intervention
According to Dr. Judith Cohen, MD Medical Director, Center for Traumatic Stress in Children & Adolescents at Allegheny General Hospital in Pittsburgh, Pennsylvania, Any form of child intervention related to anxiety/trauma need to involve parent—the best interventions include the following: PRACTICE
Psycho-education of parents-increase parents knowledge/awareness
Relaxation Skills-for child and family.
Affect Modulation-Identification of feeling using words to describe emotions
Cognitive Coping Skills-understanding the thoughts behind the behavior
Trauma Narrative-having the child share their story
Invio-Mastery of Trauma Reminders
Conjoint Sessions with Parents
Enhancing Safety

Resources:

·         American Academy of Child and Adolescent Psychiatry: Separation Anxiety http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Children_Who_Wont_Go_To_School_07.aspx

American Metal Health Alliance http://americanmentalhealth.com/
Provides a listing of ethical therapist. On the "THERAPIST LOCATOR" page of the website you can locate a therapist or counselor in your area.

·       Anxiety BC http://www.anxietybc.com/resources/ptsd.php How do you know if it is PTSD?         

·         Anxiety and Depression Association of America www.adaa.org        
   

·         Bethany Life Lines Magazine:  Effects of Complex Trauma http://www.bethanylifelines.org/complex-trauma/      

·         *Help Guide www.helpguide.org       

·         National Institute of Mental Illness: Children and Violence http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/children-and-violence.shtml          
 

·        The National Child Traumatic Stress Network: http://www.nctsnet.org/
 

Oregon Post Adoption Resource Center list of Resources for parents on Trauma & PTSD: http://www.orparc.org/library/materials/lists Trauma+Post_Traumatic_Stress_Disorder_%28PTSD%29.pdf  

·         Treating Children with PTSD Pod Cast: http://www.adaa.org/resources-professionals/podcasts/treating-children-with-ptsd    

Books:

What to Do When You Worry Too Much: A Kid's Guide to Overcoming Anxiety (What to Do Guides for Kids) by Dawn Huebner and Bonnie Matthews (Sep 15, 2005) –This is a work book that I used with my daughter and I found it to be really helpful.  She did too.

Freeing Your Child from Anxiety: Powerful, Practical Solutions to Overcome Your Child's Fears, Worries, and Phobias... by Tamar Chansky Ph.D. (Mar 30, 2004) This book was recommended to me by a child therapist I have a ton of respect for, and as a parent I found it helpful.

Anxiety-Free Kids: An Interactive Guide for Parents and Children by Bonnie Zucker (Nov 1, 2008)

The Relaxation and Stress Reduction Workbook for Kids: Help for Children to Cope with Stress, Anxiety, and Transitions... by Lawrence E. Shapiro Ph.d., Robin K. Sprague, Matthew McKay and Matthew McKay PhD (Feb 2, 2009)

Growing Up Brave: Expert Strategies for Helping Your Child Overcome Fear, Stress, and Anxiety by Donna B. Pincus (Aug 28, 2012)

The Anxiety Workbook for Teens: Activities to Help You Deal with Anxiety and Worry by Lisa M. Schab (Apr 1, 2008)

  

Paulette Caswell, LICSW
Branch Director of Pacific Northwest
Bethany Christian Services Of Washington

1501 N. 200^th St. Ste. 103 Shoreline, WA 98133  
O - 206.367.4604  F - 206.367.1860 Direct (616) 254-7719

www.bethany.org/Washington

Regular working hours are Monday to Friday 9 a.m. to 6 p.m.

True devotion, the kind that is pure and faultless before God the Father, is this: to care for orphans and widows in their difficulties and to keep the world from contaminating us. James 1:27