MHM Magazine

22 | MENTALHEALTHMATTERS | Issue 3 | 2021 MHM identify, social esteem and self- esteem development. Their ‘at risk’ brain makes them quite vulnerable during this stage of development.   HOW TO CORRECTLY IDENTIFY ANXIETY IN CHILDREN DURING THESE TIMES It is important to consider the child’s age and circumstances surrounding the child’s clinical presentation. It would be a good idea to get more collateral information surrounding a child’s current functioning so that one can get a better idea of clinical symptoms that point to a diagnosis and need intervention. According to the DSM-V, anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioural disturbances. These symptoms interfere with daily functioning and are difficult for a child to control or manage. WHAT KINDS OF INTERVENTIONS SHOULD WE CONSIDER? Early identification is important. Children may present with frequent physical complaints such as sore tummy, headaches, sore throat etc. It is important to put these complaints into context and look at what is going on around them. We can then start to identify what the severity and interference the symptoms have. This will assist in making the correct diagnosis and guide what form of intervention is necessary. A school based intervention may assist a child by getting a teacher or school counsellor to frequently check in with the child and offer support. A child may benefit from some supportive therapy to process their emotions and come up with coping strategies to help them. A child may require psychiatric intervention such as medication and frequent psychotherapy sessions to help them deal with their distressing emotions, thoughts and feelings. HOW CAN YOU AS THE MEDICAL PRACTITIONER ASSIST PARENTS WITH ANXIOUS CHILDREN? It’s important to psycho-educate parents about how anxiety affects children physically, cognitively, emotionally and behaviourally. A simple explanation about how the fight and flight system works in the brain and how anxiety attempts to prepare us to take action helps parents themselves understand that anxiety isn’t bad as an emotion. There are simple techniques that you can teach parents that may help a child deal with distressing emotions: • Name it to Tame that feeling The key step in getting correct help for a child is correctly identifying that they are experiencing anxiety or other distressing emotions. A child (depending on their temperament and stage of development) may not be able to verbalize what they are feeling or may not know what is happening to their body, thoughts or emotions. It is important to assist a child with naming what they feel (using words like “sometimes when we are worried our tummy feels funny inside or you might feel like you want to cry”). When talking to a parent or the child, you can as the clinician use describing words to assist parents with a vocabulary that they can use at home. This allows a child to feel that these sometimes-scary feelings or physical sensations can be ‘tamed’. This together with seeing a calm adult helping them to identify and then talk through ways to feel better will help normalise these emotions. Encourage parents to be open about emotions, including their own emotions, to role play what emotions are and how one can deal with them. • Respond don’t react Remaining calm is paramount to helping a distressed child. Teach parents to remain calm when responding to their child’s anxiety. A simple breathing technique can help parents physically help themselves and their child decompress from the physical effects of anxiety. Belly breathing goes something like this: Breathe in through your nose, into your tummy (imagine your stomach is a balloon and when you breath in your balloon expands) Hold for 2 seconds Put your top lip over your bottom lip and breathe out the warm air slowly over your bottom lip Then repeat this three times with the child • Educate your child about what they are feeling Its important to normalize anxiety for patients and teach them that emotions are normal. Yes some can be uncomfortable and distressing but they only last for a short time and then with time they calm down. All emotions give us information or advice of how to respond to something. For example, if you are worried about an upcoming test, the emotion is simply giving you advice to get started and prepared. Helping a child figure out what advice the emotion is telling them will assist them in finding a solution or coping strategy. References available upon request