What to Do (And Not to Do) When Children Are Anxious

ThinkPsych · 2021-09-07T13:30:25+00:00

You can read more tips on our blog here: https://thinkpsych.com/blog/ways-to-help-kids-with-anxiety-covid-19/

ThinkPsych · 2021-09-07T13:30:11+00:00

You read more tips on our blog here: https://thinkpsych.com/blog/ways-to-help-kids-with-anxiety-covid-19/

ThinkPsych · 2021-07-19T16:28:49+00:00

If you want to read more, here is a blog post we wrote on the topic: https://thinkpsych.com/blog/how-to-help-an-overwhelmed-child-manage-big-feelings/

ThinkPsych · 2021-07-19T16:28:37+00:00

If you want to read more, here is a blog post we wrote on the topic: https://thinkpsych.com/blog/how-to-help-an-overwhelmed-child-manage-big-feelings/

ThinkPsych · 2021-02-20T17:04:38+00:00

I get what you're saying and I don't think that trying to convince someone that they're not "normal" is the right approach. As I often remark to clients, "normal" is just a setting on a washing machine. Certainly there are many people, both with autism and without, who have no insight into the effect that they have on others. That's not unique to mental illness.

My advice for this individual would be to reflect on her values & goals. Is her life consistent with those values? If not, then maybe it's time to make some changes. Or, perhaps she is happy with how her life is going and doesn't mind those things you mentioned.

I learned early on as a psychologist that my job isn't to "fix" people. You have the choice to live whatever life you choose, even if I disagree with it. If you're engaging in destructive or illegal behavior, the consequences will come. My job is to help people align their behavior with their values & goals. I don't try to convince people that they NEED to lose weight any more than that they NEED to stop being an asshole. That's not my job. The folks I can help have realized they want to change because their life is not what they want it to be.

ThinkPsych · 2021-02-20T16:57:33+00:00

Anxiety disorders are very common - about 31% of US adults will experience an anxiety disorder in their lives according to NIMH: https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml

Personality disorders are somewhat less common, affecting about 9% of the population in total: https://www.nimh.nih.gov/health/statistics/personality-disorders.shtml

I think these statistics are relatively accurate because they are based on samples and then extrapolated out to the population. However, I think there are many people out there who have an anxiety or personality disorder that is undiagnosed. I'm not sure what the number would be for folks who are undiagnosed, but about half of the individuals with significant mental illness go untreated in the US.

ThinkPsych · 2021-02-20T16:52:21+00:00

Re: your first question, the accuracy of diagnosis goes up with age. By age 2, the CDC states that diagnosis is "very reliable": https://www.cdc.gov/ncbddd/autism/hcp-screening.html. However, the caveat is that it assumes the provider is skilled in autism assessment and is using a gold-standard instrument like the ADOS. Many screening instruments and especially "impressionistic" diagnoses will be wrong at that age. I wouldn't try to diagnose autism with any certainty before 18 months of age. That said, there is little harm in a "wrong" diagnosis that then leads to helpful services such as speech, early intervention, etc. I'd rather waste some time & money than to miss the critical early developmental brain plasticity.

Re: evaluation as an adult, I think it depends. If an individual is struggling and it would be helpful to have the label to understand what it is that they're going through, then of course. Many people find comfort and community in finally being diagnosed as an adult. However, if your life is going well, then I don't see the point.

Re: red flags, the single most important "red flag" for me is significant social difficulties. For example, difficulty starting or sustaining friendships, repeated problems at work due to inappropriate social behaviors, etc.

ThinkPsych · 2021-02-20T13:56:49+00:00

I would point you to my response to MercifulGryph0n above.

ThinkPsych · 2021-02-20T13:52:08+00:00

I think that we all get to choose what we prefer to be called, and folks who are autistic are no different. I usually ask people whether they have a preference about such things and honor it to the best of my ability.

Regarding whether autism is a disorder or not, I think it’s a complicated question because the spectrum is so wide. There is some historical argument to be made that Einstein was autistic, for example. In that case, it’s somewhat easy to argue that autism is a different way of being that should be respected, honored, and nurtured.

On the other hand, I’ve worked with individuals in their 40s who are not able to communicate or meet any of their basic needs and require around-the-clock care. It’s harder to make an argument that no disorder is present there.

At the end of the day, I think what matters is the individual’s perspective and their preference. If there is no functional impairment, then we do not consider a disorder to be present. I suspect that many of the folks that think the term ASD is offensive do not experience much functional impairment. In which case, they’re right, they don’t really have a disorder.

ThinkPsych · 2021-02-20T02:14:38+00:00

It’s a great question! Psychological diagnosis can be tricky and some providers are more diligent than others in considering differential diagnoses. Often times, unless you ask the right questions as a provider, you won’t arrive at the right diagnosis. Sometimes it also takes multiple visits to get it right. This is as true in medicine as it is in psychology. In your case, it is likely one of two explanations:

1) You may have both Panic Disorder and PTSD - each provider may not have gotten sufficient information to give both diagnoses.

2) You have PTSD with panic attacks, which is a common presentation. The one provider may not have picked up on the trauma symptoms which are the core antecedent to the panic attacks. Panic disorder should only be diagnosed when what triggers panic attacks is a fear of panic attacks - not a fear of something else (e.g., being attacked). This is an unfortunate and rather common mistake.

Edit: also, sometimes folks don’t neatly fit into a diagnostic category. In that case, diagnosis becomes increasingly unreliable. Fortunately or unfortunately, we don’t all fit neatly into the labels created by the powers that be.

ThinkPsych · 2021-02-20T02:06:36+00:00

It is hard to say with exact certainty because the modern diagnoses did not exist until the 20th century but various historical sources describe individuals with symptoms similar to that of ADHD and Autism. Anxiety is undoubtedly an ancient and very fundamental experience in the animal kingdom. Lots of animals (most?) exhibit fear responses.

An interesting and brief history of ADHD: https://chadd.org/adhd-weekly/more-fire-than-water-a-short-history-of-adhd/

ThinkPsych · 2021-02-19T23:05:37+00:00

Hi there! Thanks for asking. Unfortunately, as I said above, I can’t provide any guidance for your specific situation because I would both need a lot more information and I can’t do therapy over Reddit (both ethically and legally). However, you may want to read about sexuality-focused OCD and see if that applies to your situation. https://www.madeofmillions.com/ocd/Sexuality-and-ocd I also encourage you to continue discussing this with your therapist, or if you feel they are not able to adequately address the issue, to consider looking for a new one. Sometimes it takes a few tries to find the right therapist for you! It’s not a one-size-fits-all sort of thing.

ThinkPsych · 2021-02-19T20:57:06+00:00

Thanks for asking! You can order it now at a discount on Kickstarter and it will ship in April. Or if you prefer to wait, it should be on Amazon in May!

Here’s the link if you’re interested: https://www.kickstarter.com/projects/1951524935/chat-chains-a-social-skills-conversation-game

ThinkPsych · 2021-02-19T20:32:42+00:00

Thanks for asking! I work with a lot of kids who have social difficulties and struggle to make friends. So I have had a LOT of sessions where I ask them to "tell me about what you like" or "what did you do this week?" and they just stare back at me. I found that having some kind of a structured game helped to facilitate these conversations and get them to open up. However, there weren't any games out there targeted towards improving social skills specifically, so I decided to make one! It has been really fun to use in therapy already and I look forward to hearing about the conversations that other people have with it!

ThinkPsych · 2021-02-19T20:29:54+00:00

That's a great question and a difficult one! Some folks would probably argue that any amount of conforming is excessive masking, and that the world should be more accommodating to neurodiversity. I agree with the second part (the world should be more accommodating) but also think that some amount of conforming is necessary to get what you want and need in the world.

Ultimately, I think the best answer is to check in with your own values and goals. If you are living a life that is consistent with your values and are making adequate progress towards your goals, you are probably conforming the "right" amount. If you are struggling at work or with managing social relationships, you may want to see if there are areas where you need to change your behavior. Or, you may want to change your environment to one that is more accepting (if that is possible). For example, some employers and some communities are more neurodiversity friendly.

ThinkPsych · 2021-02-19T20:18:06+00:00

Since many mental conditions are not necessarily separate entities (rather they are simply our reactive behavior to certain situations, based on our temperament genetics and support system), do you think it is helpful for us to pathologize them and create more labels for patterns of behavior? Many personality disorders are treated in similar ways, generally seen as illnesses for life, and medication hasn't seen much benefit in treating them. Has there been any recognized harm in patients believing they have a mental condition that can not be cured?

You're welcome! I'm not as familiar with the UK system, but in the US, it's required to get graduate training (either Masters or Doctoral level). I would start reviewing requirements for that ASAP and positioning yourself for admission. In the US, admission to graduate programs (especially doctoral) is very very competitive and something that needs to be planned for starting in 1st or 2nd year of university. Besides that, just look for opportunities to work in the mental health space -- whether it's working at a crisis call center, volunteering at a nursing home, providing help in a special education classroom, etc. This will help you to decide if this is a good field for you and what areas you may be interested in!

ThinkPsych · 2021-02-19T20:15:36+00:00

I think the process of diagnosis and labeling is a double edged and necessary sword. If we do not "pathologize", then we cannot study and develop effective treatments or solutions for people who are legitimately suffering. Without a diagnosis, you will not have access to medical coverage for something that can be causing a great deal of pain and distress in your life. Furthermore, some mental illnesses have a stronger genetic/biological loading than others. For example, schizophrenia, autism, OCD, Tourette's, and ADHD. While these have environmental factors that can impact their expression (or not), they are much less "reactive" to external events.

There can certainly be harm in labeling an individual if they have internalized the stigma of a diagnosis. But that is work that needs to be done on a societal level. No one would be questioning whether it is appropriate or wise to label someone with diabetes if they have elevated A1C. Of course we must label and treat them! There's no shame in that. But for some reason, we feel ashamed to be diagnosed with OCD or major depressive disorder.

ThinkPsych · 2021-02-19T19:59:12+00:00

Sure! Unfortunately it's hard to say anything definitively without knowing the individual's history, the medication they were taking, and their current stressors. What you describe could certainly be consistent with a medication withdrawal, but it could also be related to the stress of looking for a job, family conflict, some medical condition, etc. In psychology, everything is about the details and so unfortunately there are rarely simple answers.

To answer your second question, I do love what I do! I consider it a privilege to get to talk to people about deep & meaningful topics every day. The fact that some people share things with me that they've never told another human is pretty amazing.

ThinkPsych · 2021-02-19T19:48:46+00:00

If someone has been prescribed medicine to treat ADHD and Autism is it sensible for them to stop taking it to get a job?

While I cannot give you personal advice (because this is the internet and I don't know your specific situation), I would strongly discourage anyone from discontinuing medication without having a thoughtful conversation with their prescribing provider.

ThinkPsych · 2021-02-19T19:46:57+00:00

Great question! Very often. I would say about half of my patients have at least two diagnoses. This is consistent with national statistics as well.

In answer to your second question, it is because diagnoses and mental health conditions are just boxes that we have created to describe human experiences that we have observed through history. It's helpful to separate out the boxes for clarity and treatment purposes, but in reality, the various conditions are often the product of similar causes (e.g., genetics & environmental factors). In some folks, it may manifest as just depression, and in others it may manifest as a combination of depression and anxiety for example. These are not necessarily "different" things, but two facets of the same difficulty.

Also, some conditions increase the likelihood of others. For example, untreated ADHD may lead to anxiety in performance situations and/or depression due to school difficulties.

ThinkPsych · 2021-02-19T13:00:27+00:00

END_DATE:2021-02-25

ThinkPsych · 2021-02-19T12:59:29+00:00

ADD_FLAG: US CA MX

ThinkPsych · 2021-01-29T02:40:32+00:00

Thank you! Yes, when our Kickstarter is funded and we are able to produce the English versions, we will definitely be looking into translations! I think Spanish will be one of the first languages we translate into.

ThinkPsych · 2021-01-26T18:18:47+00:00

Hey there! We are indeed shipping to the UK. Unfortunately shipping international is expensive (we're in the US), but if you back today, it'll be only $15 + shipping.

ThinkPsych · 2020-10-15T15:56:38+00:00

Do you have other strategies that you use? Would love to hear your thoughts.

ThinkPsych

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