Let’s Talk about Mental Health — Tanya Roberts
Andy Knight
Anxiety and Depression in Adolescents and Adults and What You Can Do About it
Tanya Roberts, Program Director with Pyramid Family Behavioral Health
Episode Notes:
Anxiety
Anxiety. What is it? I think we’ve all felt it. It typically involves fear, worry, dread or a sense of impending doom. It interferes with our normal daily function and is difficult to control. It lives in the future and makes us worried about what is to come.
Types of Anxiety
Generalized Anxiety - Overall feeling of being anxious, you may not know what is triggering it and it is a typical uncomfortable feeling.
Social Anxiety - More specific than Generalized Anxiety. It’s when you are in social situations, public spaces or when you have to meet new people. It can also be public speaking in front of people you may not know, or things similar to that. Often involves avoidance of social situations, fear of being inadequate or being scrutinized in an unfair way.
Separation Anxiety - Very common in young children and adolescents, and may cause them to have difficulty going to school or leaving their parents. They feel safer at home with their family, and leaving a trusted person is very difficult for them.
Anxiety often goes along with depression, and a person diagnosed with one might be likely to have the other. Then it is a chicken or egg situation. Were they really anxious and then they became depressed or were they depressed and then began to get anxious? There is no specific answer.
Symptoms of Anxiety
Feeling restless
Feeling on-edge
Feeling irritable. It is very common in adolescents and looks like oppositional behavior, but it is them being easily irritated.
Fear
Easily Fatigued. This is counterintuitive because they are restless at the same time, but because of excess tension in the body it is easy for them to wear themselves out.
Difficulty concentrating. Their mind going blank or losing their train of thought. These are especially pronounced in kids with ADHD, because they already struggle from a lack of concentration anyways. If they have ADHD and develop anxiety on top of that, it appears that they cannot focus at all. This can lead to difficulty paying attention in class, and difficulty in normal conversations, as well as trouble sitting still.
Sleep Disturbance. They could have difficulty falling asleep, or fall asleep easily and be restless throughout the night. They might wake up very early in the morning worrying about things that they can’t identify, or possibly things that they don’t even know at all. Another thing that affects sleep for people across the board but especially children and adolescents suffering from anxiety is the use of screens before bed. Sleep hygiene studies are telling us that you do not need that blue light within 2 - 3 hours before bed. If they are having trouble sleeping and they are using technology up until bed, then it is a definite contributor to their sleep issues. It is especially bad in high school kids who stay up all night on social media. Parents have a difficult time taking the phones away from their kids because of the strong opposition reaction they are met with. When kids are treated in residential treatment programs, they don’t have their devices, and for most kids it takes a week to decompress from the lack and withdrawals of technology. In my outpatient program, we could not prevent them from having their technology at their house, so we made them leave it in the car when they were with us. If not, they would be on it in group time, texting people who were in the same room as them! At my age, I don’t understand it but it is a way of life for today's children. They can suffer severe anxiety if they are not constantly in touch with their peers via social media. Social media apps are great in proper use, but they are designed to keep people engaged. Apps like Snapchat and Instagram have a feature called “streaks” and the whole point is to keep you constantly coming back to it. Kids nowadays need to be able to put down their phone and go talk to someone. The constant sense of being connected causes anxiety, which leads to sleep deprivation.
Racing Thoughts. A thought that no matter what they try, they cannot put it away or stop thinking about it.
Panic Attacks. Can lead to dizziness, shortness of breath, nausea, sweating, shaking, and heart palpitations.
Butterflies in the stomach or stomach aches.
These symptoms do not have to all be present to mean someone has anxiety. It can be a single symptom or multiple, and many people may not have the heart involvement or stomach problems. These symptoms also cross over with adults as well, and are not limited only to kids. Everyone worries about things, but it becomes anxiety when you start to have trouble functioning because of that worry. That might be purposely avoiding social situations, not going to the store or being afraid of going to school because of a test. When it starts affecting your day-to-day life, you should really consider talking to someone. There are many sources for help, like your primary physician or a therapist.
What Causes Anxiety in Kids?
Sadly, there is no clear cut answer. It could be triggered by any or a combination of the following:
Genetics and predisposition
A major life change or event
Move or relocation
New school
Parents’ divorce
Transition between elementary to middle school (or middle to high school)
Leaving their comfort zone
Stress from work or school
Self-judgment towards themselves.
Feelings of insecurity
Who Gets Anxiety?
America is the most anxious nation on Earth. This could stem from pressure to live up to standards by people in our life. Things like grades, work, and all around success.
In general, females get anxiety more than males, but that doesn't mean that males don’t experience it.
Approximately 1/3 of adolescents will be diagnosed with anxiety before 18.
Approximately 1/4 of adults will be diagnosed with anxiety once in their life.
It may not be a lifetime condition, big events can cause it when you are not expecting, but eventually some people can get over their anxiety.
Anxiety disorders have doubled between 2008 and 2014.
When Do You Need Help with Anxiety?
You feel worried or afraid for what feels like no reason
You feel worried about everyday activities, ESPECIALLY if you are purposely avoiding them
You experience the physical symptoms of anxiety (from above)
You continually check yourself. Things like doubting things you definitely did, such as getting out of bed to make sure the door is locked. Obsessive Compulsive Disorder can go along with anxiety, so look for those symptoms.
You are experiencing Depressive Problems
You're unable to function in certain situations (work, tests, social situations, etc.)
Things to Help Anxiety:
Seek professional treatment from a therapist or psychiatrist
Talk about worries with someone you trust, as well as honestly how you are doing
Sharing your struggles with a prayer group or close friends who can support you
Take deep breaths before or during stressful situations
Find time to play or do something you really enjoy
Listen to music
Spend time with family or close friends
Physical activity and exercise
Limiting technology and screen time
Depression
Depression is caused by a combination of genetic and environmental factors, and many of the symptoms and causes are very similar to anxiety, but they are not the same thing.
There are two main types that can be diagnosed and are more specific than general depression:
Major Depressive Disorder
Persistent Depressive disorder.
Signs of Depression in Teens
Feeling sad or hopeless
Feeling worthless or guilty
Isolating from family and friends
Feeling angry or irritable
Always feeling tired
Risk Factors for Depression
Genetics
Stressful events. Death of a loved one, parents divorce, abuse, etc.
Physical or emotional trauma
Chronic illness
Peer conflict and bullying
Intense pressure for work or school
Feelings that you have to be perfect
Not having family support or someone who listens
Being isolated or lonely
High screen time on video games or social media
Medication side effects
Major Depressive Disorder
It is diagnosed by having symptoms in a sever state over the course of a minimum 2 weeks. The symptoms are very similar in both Adolescents and Adults:
Sad mood and general sadness
Anhedonia
Loss of interest in hobbies
Serious change in mood for 2 weeks
Trouble sleeping. Either too much or too little
Changes in appetite
Significant change in body weight
Having a foggy brain. Confusion, disinterest, and unable to remember things
Excessive feelings of worthlessness or guilt
Decline in school performance
Difficulty making decisions
Head and stomach aches
Neglecting appearance or self care tasks
Thoughts of death or suicide (most likely for adults, but teens NOT excluded)
Persistent Depressive Disorder
Symptoms similar to Major Depressive disorder, but much more mild. They are persistent though, and can basically last forever. In order to be diagnosed, you have to have the symptoms consistently for at least 2 months.
Low self worth
Feelings of inadequacy
Trouble sleeping
Poor concentration
Feeling hopeless
Adolescents with Depression
About 20% of adolescents experience depression before adulthood.
An estimated 3.1 million experienced depression in 2016 in the US.
Girls are hit harder by depression than boys.
The majority of teens with depression go untreated.
30% of depressed teens have problems with alcohol or drugs.
Some engage in risky sexual activity as a distraction.
Suicide rates are increasing. The suicide death rate of teen girls doubled and teen boys increased by 37% between 2007 and 2015.
Adults with Depression
30 million people globally suffer from depression, and less than half receive treatment
In the US, 16.2 million adults suffer from depression
The age range hit the hardest is 18 - 25 years old
Women suffer from depression more than twice then men do
Adults whose children suffer with depression are more likely to suffer as well.
Depression and the Link to Suicide
Risk factors may include:
A previous family history of suicide
Substance use or abuse
A history of personal suicide attempts
A history of child abuse or trauma
Isolating from others
A serious and recent personal loss, like a breakup, or being fired from a job.
Poor impulse control
Access to weapons
Important warning signs from teens:
They talk about suicide or death
A large change in personality
Risky or self destructive behaviors
Giving away things that are meaningful, like pets
Making statements that their family or friends would be better off without them
Having no hope for the future
Getting Help for Depression
Getting help can come from lots of places. Things like support groups, therapists and psychiatrists. As parents of struggling teens, you also need help and someone to talk to and discuss how you can best help your teen. Some other good things to do are:
Eat healthier
Get moving
Talk to a doctor
Remember to be kind and compassionate to yourself