Learn the signs and physiological effects of stress and anxiety. Discover evidence-based approaches, including cognitive behavioral therapy and other techniques that help reduce anxiety and stress. This two-part program will provide a new understanding and awareness of practical skills that can increase your energy and improve daily well-being. Presented by James Korman, PsyD, ACT; Michael Likier, PhD; and Jamie Schwartz, LCSW
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Stress and anxiety in teens and young adults
1. Understand Stress and A i t
U d t d St d Anxiety
In Children, Teens and Adults
Presented by:
James Korman, PsyD, ACT
Michael Likier, PhD
Jamie Schwartz, LCSW
2. Caused or Exacerbated by Stress
Adults
• Heart disease
H t di Chronic i
Ch i pain
Diabetes Migraines
Asthma Ulcers
PMS Heartburn
Obesity High blood pressure
Infertility Skin problems
Autoimmune diseases Irritable bowel syndrome
3. Emotional Reactions
Adults
Feeling
F li angry, irritable or easily frustrated
i i bl il f d
Feeling overwhelmed
Feeling nervous or anxious
Feeling that you can’t overcome difficulties in your life
Having trouble functioning in y
g g your j or personal life
job p
Feeling afraid or worried
Feeling Helpless or Hopeless
Desire to hide or runaway
4. Cognitive Reactions
Adults
• Difficulty Making Decisions
• Confusion
• Difficulty Naming Familiar Items
• Poor Concentration
• Blaming Others
• Memory Problems
• Replaying Events Over & Over
• Thinking the Future is bad
5. Behavioral Reactions
Adults
• Difficulty functioning at work or home
• Withdrawal
• Isolation
• Suspiciousness
S i i
• Working more and being less productive
• Excessive Humor or Silence
• Increased Smoking, Alcohol or Food
• Change in Activity Level
g y
• Angry Outbursts
• Crying Spells
• Sleep
6. Reactions to Stress
Small Children (under 5)
Throwing temper tantrums
Yelling and pouting
Experiencing nightmares
wetting the bed
Clinging on to parents
Thumb sucking or sudden fear of the dark
Crying more than they usually do
Rocking from side to side and biting people
7. Reactions to Stress
5 – 9yrs of age
• Feel lightheaded • Aggressiveness and a
tendency to back answer
• Changes in appetite are
recorded • Having p
g panic attacks
• Stuttering • Not interested in the normal
day to day activities
• Complaining of stomach
problems and headaches • Crying
• Experience restlessness • Become accident prone
• Moody and withdrawn
8. Reactions to Stress
10 – 12yrs of age
• Biting nails, clenching fists, • Exhibit destructive behavior
hair twirling like bullying others
• Develop new fears and • They seem worried at all
worries
i times
ti
• Skipping school often • Having panic attacks
• Loss of concentration • They might seem lazy and
not interested in things
g
• School work starts to
deteriorate
9. Reactions to Stress
Teens
• The majority of their reactions are on an emotional level:
Worried and anxious
Depressed
Negative thoughts and feelings
Lose vitality and self-confidence
Argumentative
Fights against anything and anyone
Skip school
Drugs and alcohol
10. Objectives
j
• What is stress?
• How does it Manifest in Children teens
Children,
and young adults
• What is Anxiety?
• What can be done about stress and
anxiety
11. What is Stress?
Stress is a normal component of the body’s response
body s
to demands that are placed on it.
When demands are in balance with your coping
abilities and resources you do not feel stressed.
When demands are greater than your coping abilities
you feel stressed.
12. Sources of Stress
The Good The Ugly
Family verbal/physical
Promotion to next
violence
grade
The Bad Sexual Abuse
Graduation
Overscheduled Death of family
Getting in to the
g
Tough classes member
musical
Moving Divorce
Meeting new friends
Sibling Ri l
Sibli Rivalry Bullied
Having a new
girl/boyfriend Peer Pressure
Bad Teacher
15. Fight or Flight Reaction
• Productive if you were in a situation where you need
to protect yourself
16. It is a Matter of Perception
Stress and its associated physical reactions is your
body preparing itself for a threatening situation
Wh we perceive Th t we prepare ourselves f
When i Threat l for
action
Very rarely a ac ed by Bears so threat is now:
e y a e y attacked ea s ea s o
Social
Emotional
Financial
Work related
17. Stress is Good in Small Doses
Gives you a burst of energy when you need it
I
Increases your motivation to complete tasks
ti ti t l t t k
Protects you from harm
Prevents you from walking down a dark alley way at
night
19. Anxiety?
• A Fight or Flight Reaction
• Worry or Concern
Often concern about the physical reaction
or its meaning (Perception)
Fear
F
Panic
• Avoidance
20. Understand Stress and A i t
U d t d St d Anxiety
In Children
Presented by:
Jamie Schwartz, LCSW
21. What is Stress vs Anxiety
y
All children experience anxiety when faced with an
unfamiliar or stressful situation such as:
• Illness
• Death
• Parental Separation
• Divorce
Di
• School Issues
• Social Issues
22. Developmentally Appropriate Stress and
Anxiety
• Infancy 0-2 years
Separation Anxiety
S ti A i t
Stranger Anxiety
• Early Childhood 3-6 years
Ghosts and monsters
Darkness
Doctors and Hospitals
Sleeping Al
Sl i Alone
24. Types of Childhood Anxiety Disorders
• Generalized Anxiety Disorder (GAD)- Affects 3 to 4
percent of children. E
t f hild Excessive worry and anxiety th t
i d i t that
lasts at least 6 months.
• Social Phobia-Subtype of specific Phobia. Child is
extremely shy or uncomfortable around people or
situations where performance is the focus.
25. Types of Childhood Anxiety Disorders
• Separation Anxiety Disorder (SAD)-
Having difficulty separating from caregivers or home.
Those with SAD have this problem for at least 4 weeks.
• Obsessive Compulsive Disorder-
Display recurrent obsessions or compulsions that are
severe enough to be time consuming and interfere with
their daily living.
26. What are the signs of anxiety in children?
• Distress out of proportion to the situation
Crying, sadness, anger, frustration, hopelessness,
embarrassment especially in stressful situations
p y
• Repetitive reassurance questions
• Physical complaints (headache, stomachache, too sick
to go to school)
• Anticipatory anxiety
• Difficulty with sleep
27. Signs of Anxiety
• Perfectionism
• Overly responsible, unnecessary apologizing
• Excessive avoidance
• Disruptions of child or family functioning
• Excessive time spent consoling child about distress with
ordinary situations
28. Parental Intervention
• Understand the Illness
• Listen to your child’s feelings
• Redirectingg
• Be careful how you describe
• Set up Worry Time
p y
• Relaxation Techniques
30. Understand Stress and A i t
U d t d St d Anxiety
Teens and Adults
Presented by:
Michael Likier, PhD
31. Adolescence
• Begins at p
g puberty, ends with
y
assumption of adult roles.
• Physical, Cognitive, Social/Emotional
Development.
• Stress and anxiety can be problematic
on each of these domains.
32. Physical Challenges
y g
• Puberty onset age 10-12 girls,13 boys.
y g g y
• Early onset boys > girls.
• Idealized body image
image.
• Emerging sexuality.
• Awkward development.
• Curiosity of alcohol and other drugs.
y g
33. Physical Challenges
Healthy Stress/Concern Unhealthy Stress/Anxiety
• Thoughts, expressions of • Chronic self-critical
concern about bodyy thoughts regarding
g g g
type/shape/size, physical physical appearance.
features. • Interference with
• Desire taking steps to
Desire, social/academic life
life.
improve physique, eating • Extreme, abrupt changes
habits. in eating/exercise habits.
g
• Sudden weight loss/gain.
• Diet pills, steroids.
35. Sex and Drugs
Healthy Stress/Concern Unhealthy Stress/Anxiety
• Curiosity • Interfering with social or
• Exploratory thoughts and academic performance
p
behaviors • Risky sexual behavior
• Struggles around • Any use of cigarettes,
cigarette, alcohol and
i tt l h l d alcohol, other d
l h l th drugs? ?
other drug use • Use that interferes with,
• Struggles around sexual causes negative changes
behaviors in functioning
• Questioning one’s sexual • Fear of sexual orientation
orientation • Bullying
36. Cognitive Development
g
• Imaginary audience: “everyone’s
g y y
watching me”
• Personal Fable: “nobody feels like I do”
nobody do
• Idealism
• A
Argumentativeness
t ti
• Over/underachievement
37. Cognitive Development
Healthy Stress/Concern Unhealthy Stress/Anxiety
• “I can’t go outside with • Withdrawal from activities
this pimple”
p p & peers. ( y
p (Cyberspace)
p )
• “Nobody understands • Depressive symptoms
me” • Obsessive worrying
• “Y ’ such a h
“You’re h hypocrite”
it ” • Incessant arguing
• “I want to do my best at • “I must excel at
all things”
things everything and it’s awful if
it s
• “Why do I have to do my I don’t”
best at all things” • “I don’t care whether or
not I do well”
38.
39. Socioemotional Development
• More complex self understanding
p g
• Peer influence
• Self-esteem
Self esteem challenges
• Gaining skills for independence:
academic, career
d i
• Cultural Identities
40. Social/Emotional Development
p
Healthy Stress/Concern Unhealthy Stress/Anxiety
• Questioning: values, • Chronic arguing
career, religion • Pattern of risky, self-
y,
• Seeking peer over defeating behaviors
parental approval • Hopelessness around
• Concern over ability to adulthood
choose a career • Self downing
• Moodiness • Abrupt negative
• Changing friends, changes re: peers,
styles,
styles interests activities
41. Young Adulthood
The role of the parent is to
launch the child into
adulthood…
43. Challenges Entering College/World of Work
g g g
Healthy Stress/Concern Unhealthy Stress/Anxiety
• Expressions of doubt • Failing classes
• Adjustment struggles • Losing jobs
e.g., d
dorm, campus, • Increase in alcohol
workplace and/or other drug use
• Feeling overwhelmed • Obsessive thoughts
• Financial concerns • Social withdrawal
44. Tips for Parents
• Encourage independence/stay
connected
• Encourage p
g participation in
p
extracurricular activities
• “I” v “You” statements
I v. You
• Active listening
• E
Encourage freedom to disagree
f d t di
• Natural consequences
45. Cognitive Distortions
g
• ways that our mind convinces us of
something that isn’t really true.
• usually used to reinforce negative thinking or
emotions.
• EVERYBODY uses these at times.
• They become problematic when they lead to
depression, anxiety, etc.
• Parents and teens can learn to identify and
change them.
h h
46. Cognitive Distortions
Distortion Reasonable Thought
• All or N thi
Nothing • Sh d of G
Shades f Gray
“If you don’t get straight A’s “Strive to do the best you
your future will be bleak can,
can grades are not the
• Mind Reading sole determinant of your
“Jenny ignored me, she
y g future”
must be mad at me” • Get the Facts
• Overestimating Risk “I wonder why Jenny didn’t
“I’ll never b able t pass
be bl to say hi?
hi?”
that class” • Real Odds
“The only time I’ve failed a
y
class is when I didn’t do
the work”
47. A Word on Medication
• Cognitive Therapy (CT) is the recommended
treatment for anxiety.
• Medication may be helpful with CT.
• SSRI may be used for children and
adolescents.
• Benzodiazapines are not recommended for
children.
• Consult with a psychiatrist if child is not
responding to CT
di CT.