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 is Posttraumatic Stress Disorder (PTSD)?
Posttraumatic stress disorder
(PTSD) is a psychiatric disorder that can occur in people who have experienced
or witnessed a traumatic event such as a natural disaster, a serious accident,
a terrorist act, war/combat, rape or other violent personal assault. PTSD is a
real illness that causes real suffering.
What are common causes of Posttraumatic 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 threatened 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
·
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 threatened 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.
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
Symptoms of PTSD?
u
Specific symptoms can vary in
severity. (DSM V)
u
Intrusive
thoughts such as repeated, involuntary
memories; distressing dreams; or flashbacks of the traumatic event. Flashbacks
may be so vivid that people feel they are re-living the traumatic experience or
seeing it before their eyes.
u
Avoiding
reminders of the traumatic event may include
avoiding people, places, activities, objects and situations that bring on
distressing memories. People may try to avoid remembering or thinking about the
traumatic event. They may resist talking about what happened or how they feel
about it.
u
Negative
thoughts and feelings may include ongoing and distorted
beliefs about oneself or others (e.g., “I am bad,” “No one can be trusted”);
ongoing fear, horror, anger, guilt or shame; much less interest in activities
previously enjoyed; or feeling detached or estranged from others.
u
Arousal
and reactive symptoms may include being irritable and
having angry outbursts; behaving recklessly or in a self-destructive way; being
easily startled; or having problems concentrating or sleeping.
u
Many people who are exposed to a
traumatic event experience symptoms like those described above in the days
following the event. For a person with PTSD, however, symptoms last for at
least a month and often persist for months and sometimes years. Many
individuals develop symptoms within three months of the trauma, but symptoms
may appear later. For people with PTSD the symptoms cause significant distress
or problems functioning. PTSD often occurs with other related conditions, such
as depression, substance use, memory problems and other physical and mental
health problems.
People with PTSD continue to have intense, disturbing
thoughts and feelings related to their experience that last long after the
traumatic event has ended. They may relive the event through flashbacks or
nightmares; they may feel sadness, fear or anger; and they may feel detached or
estranged from other people. People with PTSD may avoid situations or people
that remind them of the traumatic event, and they may have strong negative
reactions to something as ordinary as a loud noise or an accidental touch.
A diagnosis of PTSD requires exposure to an upsetting
traumatic event. However, exposure could be indirect rather than first hand.
For example, PTSD could occur in an individual who learns that a close family
member or friend has died accidentally or violently.
The following are
some things to consider:
Have you had your child seen by a physician? What level of
neglect or physical trauma did they suffer?
Could they have a brain injury from trauma, whether it be blunt force
trauma or even exposure to led or other toxic chemicals (post birth or
prior). It is really important to
consider have they child evaluated by an Adoption Specialist Physician—we have
two amazing resources here in the Pacific Northwest. The University of Washington Center for
Adoption Medicine (http://adoptmed.org/ )
and the Oregon Health Science University Adoption Health Services (http://www.ohsu.edu/xd/health/services/family-medicine/specialized-services/adoption-health-services.cfm) . Both programs will do pre-placement/matching evaluations
of a potential adopted child by reviewing medical, mental health, and academic
paperwork for a fee.
How does your personal past trauma effect parenting a child
who has suffered trauma? Do
some self-reflection: Does your child’s behaviors or trauma history trigger
you? Is it possible that maybe you might need some help in dealing with your
past (remember childhood trauma effects you for the rest of your life)? I have found for many parents reaching out
for help for yourself can make you more present and aware for your own
kids. It can help you be the best
possible parent your child can have. Do
they not deserve that?
How do you know
if trauma is the root cause of your child’s behaviors? There is no way to be 100% certain of the cause of a
child’s behaviors, but professionals can make some pretty clear assessments by
learning about your child’s history, past experiences and through behavior
observation. Some common symptoms of
behaviors caused by trauma are:
·
Avoiding bedtime/going to sleep/sleep disturbance-night time fears are quite common for many abused and
neglected children. The dark is when repeat trauma could have taken place
or it is the place where kids remember.
Their past can cause them to have nightmares or night terrors. This can
cause the children to be tired in the morning or throughout the day.
·
Eating issues-controlling
food, not wanting to eat certain foods, food avoidance, eating disorders
(anorexia, bulimia, or gorging.)-food can be a comfort to some kids while for
others it can be a trigger. Textures can
effect some kids differently. Not having
their food touch on their plate or they won’t eat it. Once again, trying to take control in a
chaotic world.
·
Seeking attention/affection of strangers—kids who started life not
knowing who to trust or children who were abused by someone that was supposed
to protect them, need to learn how to protect themselves and find comfort. They often don’t know who to trust and can either
completely avoid adult interaction for comfort completely or be indiscriminate
in their affection. This can be really
alarming to adoptive parent.
·
Difficulties regulating their emotional response to
situations. Kids who have a trauma history may
be completely unpredictable in their behavior and you may not understand why
your child is acting a certain way, examples of this are hitting, biting,
kicking or yelling for no apparent reason. This can be inconsistently or
maybe even always. At school they may do these things to get a toy or to
hurt another child who has been receiving attention from a cared for
adult. This can be very alarming to
parents, but it is not uncommon.
·
Difficulties in school
including school refusal (not wanting to go to school), learning challenges,
and behavioral problems. Many kids who have trauma are not even able to focus
on school or have not had an opportunity to learn prior to this. Perhaps their behaviors and the schools
response may impact a child’s academic success even though they have the
intellectual capacity to learn.
·
Poor social interaction-including
isolation from peers (no friends when age appropriate), poor peer interactions
(trying to control play, hitting, biting, yelling, etc...), or hanging out with
the "wrong" crowd.
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
Seeking Help: There are so great
guidelines for what to look for in treatment.
However, a couple of the best forms of treatment are Trauma Focused
Cognitive Behavioral Therapy (TFCBT http://tfcbt.musc.edu/)
or ADOPTS (Addressing Post-Traumatic Stress in Adopted Children http://www.bethany.org/main/adopts-program) or Karyn Purvis and her team at Empower to Connect has a
great curriculum for parents on parenting an adopted child who has suffered
trauma (http://empoweredtoconnect.org/). This is a resource many of our families have loved and is
worth exploring. There are some great
videos on the site.
Individual Queries for
Clinical Guidance
The
National Child Traumatic Stress Network provides information on its website and
through its publications as a public service. We cannot respond to specific
questions regarding personal situations, appropriate diagnosis or treatment,
professional resources available in your area, or otherwise provide any
clinical opinions. We understand, however, that people may have arrived at
NCTSN.org because they are looking for such help. Please consider the
following.
If
you believe you might benefit from the services of a mental health
professional, consider using these resources to locate the services you need:
Your insurance provider:
Contact your insurance company or "behavioral health care
organization" for a list of mental health care providers included in your
insurance plan.
Resources:
·
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 and
Depression Association of America www.adaa.org
·
Books:
Video:
Director,
Bethany Christian Services
Serving children and families throughout
the Pacific Northwest
1501 N. 200th St. Ste. 103 Shoreline, WA 98133
O – (206) 367-4604 x7972 F – (206)
367-1860
Regular working hours are Monday to Friday 9 a.m. to 6 p.m.
In all things I have shown you…the Lord Jesus,
… said, ‘It is more blessed to give than to receive.’ Acts 20:25
