The Drama of the Anxious Child

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September 30th, 2013

Childhood anxiety is on the rise at every level, from fear of monsters under the bed to severe anxiety disorders

When I was first studying psychology, thirty years ago, I learned that about 10-20% of children are born with a temperament that is highly reactive to anything new and unfamiliar. Some of these children go on in life to be anxious, timid, or shy (or, as we shy people like to say, “slow to warm up.”) A much smaller number of children, about 1-5%, were diagnosed at that time with a full-fledged anxiety disorder.

Nowadays, there are still 10-20% with that reactive temperament, but the number of children with a diagnosable anxiety disorder has skyrocketed, up to 25% according to the National Institute of Mental Health. A report from the National Institutes of Health adds, “There is persuasive evidence from a range of studies that anxiety disorders are the most frequent mental disorders in children and adolescents….” These new numbers must be viewed skeptically, of course, because of the trend towards looser and broader definitions of mental illness. Many commentators have linked this trend to the influence of pharmaceutical companies on diagnosis and prescription patterns.

Despite these caveats, however, I believe that childhood anxiety is indeed on the rise at every level, from fears of monsters under the bed to phobias and panic attacks to severe anxiety disorders.

Last year I gave a lecture on childhood anxiety to parents at a public elementary school. I heard about children who couldn’t be in a different room from their parents, even to use the bathroom, children who were too afraid of the water to swim or even take a shower, and children who were too afraid of making a mistake to function well in the classroom.

Of course, these were parents who chose to attend a lecture on childhood anxiety, but many teachers have told me that they now have a number of highly anxious children in every class. What struck me most in this group was that none of these children was in therapy, and none had received an “official” diagnosis of an anxiety disorder (though I did give out a few business cards).

In my practice I have seen more and more children who have too much social anxiety to go to school, too much stress about grades to enjoy life, and too much separation anxiety to achieve independence as they grow older. My colleagues report the same rise in fears, worries, and anxieties.

What’s going on?

Anxiety is an alarm system—we need a little jolt of it so we will look both ways before crossing the street, but we also need an all-clear signal when the danger has passed. I think our constantly wired world has drowned out the all-clear signal. We hear instantly about every disaster, and we are bombarded with graphic images that repeat on a loop—first onscreen and then in our minds.

Another way to think of anxiety is as a simple formula: Add up all the things that cause us stress, and then subtract all of our abilities to cope. The net result is our anxiety level. This formula makes it clear why childhood anxiety is on the rise. Schools are more competitive and stressful, children are more overscheduled, parents are worried about finances and safety, and our society is based on a win-lose model, where only a few children will be able to succeed. Meanwhile, coping mechanisms are disappearing: Children don’t get enough time outside, either experiencing nature or running around in their neighborhoods. Children don’t spend nearly enough time doing “nothing,” enjoying the downtime necessary to process all their new experiences. Instead, they are desperately engaged in a drive to never be bored. I think many parents have put themselves—and their children—into an anxiety-producing corner. They want their children to be academically successful and always happy and creative and socially/emotionally intelligent. It’s an impossible demand, and the inevitable result is anxiety and burnout.

In order to change this, we first need to look to ourselves. What are we doing to manage our own anxiety? I have lost count of the number of parents who tell me they don’t pressure their high-strung children. Let’s get real. I’ve been observing a strange mix of avoidance and pressure in today’s parents. They say things like, “You don’t have to swim (or go to birthday parties, or play soccer) if you don’t want to,” but at the same time they are distraught about their child not having a best friend or the right playdates in kindergarten.

As parents, we need to focus on the opposite of worry, anxiety, and fear. In terms of the body, that means relaxation, physical activity, roughhousing, and outdoor time. In terms of overprotectiveness, that means letting children have adventures that are scary, fun, and safe. In terms of specific phobias, the opposite is a gentle nudge towards facing the feelings and overcoming the fears. And for us parents, the opposite of worry is trust: trust in the power of development, trust in the resilience of children, and trust that the world is a good and safe place for our children to grow up.

Why you shouldn’t go to work sick

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September 26th, 2013

By Dr. Jennifer Shu, Special to CNN

he average adult gets a cold about two or three times a year, with each one lasting up to a week, or sometimes longer.

Staying home from work every time you are sick could add up to a lot of missed days. In fact, it has been reported that up to 40% of lost time from work is due to the common cold, totaling about 23 million missed days per year.

Even though it can be tempting to go to work while you’re sick, here are some reasons why you are better off staying home:

You’ll get other people sick

Germs can spread from direct contact with a sick person or his or her secretions (such as from handshakes or touching shared objects like doorknobs). Some viruses can live on the skin or other surfaces for at least a few hours and continue to infect others.

In addition, viruses can spray a few feet following a cough or sneeze. Especially in the earliest part of illness, when you are most contagious, stay home if you work in close quarters with other people or if you handle food.

It’s also important not to go to work if you work with young children, the elderly or people with weak immune systems. The relatively minor illness you experience may cause more severe symptoms in these groups of people.

You’ll be less productive

It is hard to know the exact financial and physical toll that an illness takes on an individual or employer. Sure, you’ll be more productive than if you stayed home and didn’t do any work at all, but you may not be as sharp or efficient when suffering from a cold.

It may take longer to recover

Pushing yourself and working too much in the early stages of illness may actually prolong your recovery time. Studies have shown that lack of sleep can weaken your immune system and make you more susceptible to colds.

Conversely, getting enough sleep can boost infection-fighting cells and antibodies so you can get well faster. Do yourself a favor and stay home and rest.

Ideally, we would all be able to rest and recuperate during a cold. If that’s not possible, see if you can work from home so at least you won’t spread your germs.

If you must go to work, try to keep your distance from others, wash or sanitize your hands often, and cover coughs and sneezes with a sleeve or elbow. You can also cover with a tissue but be sure to throw it away immediately and then wash your hands.

Disinfect touched objects such as phones, doorknobs, and computer keyboards, and consider avoiding sharing items such as pens.

Why Videos Aren’t the Best Way for Kids to Learn

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September 26th, 2013

DVDs and educational programs on TV have a growing place in helping young children to learn. But there’s new evidence that they may not be as effective as old fashioned conversation.

Even before birth, children hear sounds and words and can babble a variety of noises that will eventually coalesce into into language. “Before nine months of age, a baby produces a babble made up of hundreds of phonemes from hundreds of languages,” Elisabeth Cros, a speech therapist with the Ecole Internationale de New York told TIME in April. “Parents will react to the phonemes they recognize from their native tongues, which reinforces the baby’s use of those selected ones.”

It’s that dynamic interaction between the infant and her caregiver — a back-and-forth that static videos and television programs can’t provide — that is critical for efficient language learning. And a group of researchers from the University of Washington, Temple University and the University of Delaware explain why.

The scientists studied 36 two-year-olds who were randomly assigned to learn verbs in three different ways. A third of the group trained with a live person, another third learned through video chat technology like Skype, and the final third learned by watching a pre-recorded video of a language lesson from the same person.

Their results, published in the journal Child Development, showed that kids learned well in person and in the live video chat, likely because both scenarios allowed for an interaction between the child and the teacher, allowing the youngsters to be more responsive and therefore retain more from their experience. The children using the recorded videos, by contrast, did not learn new vocabulary words by the end of the 10 minute learning and testing task.

The findings confirm previous work that connected live conversations with better vocabularies among young children, but add another layer of understanding about why one-on-one interactions are so important to a developing brain. Nerve connections responsible for language building requires repetition and reinforcement, which can help to strengthen the correct and appropriate words or sounds and discard extraneous or inappropriate ones. It’s not that educational programming or DVDs are harming young minds; it’s more that they aren’t maximizing the infants’ ability to absorb and learn and pick up words and verbal skills more efficiently. So parking a child in front of screen for a few minutes isn’t going to hamper his ability to talk, but interspersing those videos with some one-on-one time engaging  in conversation could help to speed along the learning process.

@acsifferlin

Alexandra Sifferlin is a writer and producer for TIME Healthland. She is a graduate from the Northwestern University Medill School of Journalism.

Why New Mothers Stop Breast-Feeding

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September 24th, 2013

While nearly all mothers start breast-feeding their newborns, about half stop after a few weeks. The latest study explains why.

A team of researchers conducted over 2,700 interviews with 532 first-time mothers multiple times after they gave birth, starting 24 hours after delivery and ending at 60 days postpartum, about their breast-feeding choices. They report in the journal Pediatrics that women who worried from the start about their ability to nurse their infants were more likely to switch to formula sooner than those who didn’t have these concerns.

By the third day after delivering, over half of these women were worried about their babies’ ability to latch on, while 44% were concerned about breast-feeding pain, and 40% about their capacity to produce enough milk to nourish their infants.

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5 tips for recovering from emotional pain

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September 19th, 2013

By Guy Winch, Special to CNN

Editor’s note: Guy Winch holds a doctorate in clinical psychology and has a private practice in Manhattan. He is the author of “Emotional First Aid: Practical Strategies for Treating Failure, Rejection, Guilt, and Other Everyday Psychological Injuries.”

We sustain psychological injuries such as rejection and failure as we go through life just as often as we do physical injuries. But while we have access to ointments and bandages to treat cuts and sprains, we have no such tools to treat emotional pain.

In my book, I discuss the impact of seven common psychological injuries on our emotional well-being — rejection, failure, guilt, loneliness, rumination, loss and bouts of low self-esteem — and offer science-based treatments that ease the pain, accelerate healing and minimize long-term risks to our mental health.

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