Better Health - September 2023

Better Health

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An xiety

and children

For some, anxiety is driven by the a new school year brings.

unknowns

By C ori U rban Special To The Republican

Everything that is new about the beginning of a school year — new teacher, classroom, schedule, subjects, friends, bus route, lunch and recess routine — can be exciting for some children, but for others, it can all just be a source of anxiety.

“Anxiety is a normal response to life stressors. We need anxiety to help us focus on important things; to keep us safe in the face of danger, to help us focus and accomplish critical tasks,” explained Jean A.Fater, program director for Children and Youth Outpatient Services at BHN WellBeing Center for Community Behavioral Health in Westfield. “It becomes a serious concern when we cannot control it and it becomes excessive, interfering with our normal functioning.”

Anxiety is defined as excessive worry, or apprehensive expectation, about events or activities that one finds difficult to control. For someone to receive a diagnosis of anxiety the symptoms must occur more days than not for at least six months, and it must cause some impairment in daily functioning. Often people will feel anxious for a short time in anticipation of an event such as the first day of school, but it doesn’t reach the level of a disorder.

Fater has one young client transitioning to a new elementary school who recognized that his anxiety was keeping him up at night. He likes little notebooks and practicing his new ability to write. He decided that when he is worried at bedtime, he will write his wor-

ries in a notebook kept at his bedside so they will be there to discuss with his mother in the morning and he doesn’t have to think about them all night. “He has been able to use the notebook to prompt conversations with his family and create plans to address his concerns about the bus schedule and lunch,” Fater said. “For some children, anxiety is driven by all the unknowns a new school year brings.”

There is no definitive cause of anxiety. “It is likely to involve a combination of environmental, genetic,

trauma,” she added.

Anxiety is diagnosed by a clinician after a comprehensive assessment of a person’s biopsychosocial history including his or her functioning across life domains. The assessment might include a standard measure such as the GAD-7 for General Anxiety Disorder. The criteria consider the intensity and duration of feelings of distress and the negative impact on functioning across domains. One can be diagnosed with General Anxiety Disorder or a specific anxiety disorder such as social

address sleep disturbance,” Fater said. “That and feelings of restlessness and muscle tension and general fatigue can wear down the immune system and leave children subject to illness.”

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ages dealing with stress and anxiety. Even a short walk can make a difference.”

them. They lose that sense of connection with peers.”

The National Institutes of Health reported a correlation between diet and anxiety, noting associations between high anxiety and high fat, high sugar and highly refined carbohydrate diets. “A similar association was found between lower anxiety and higher fruit and vegetable consumption, eating breakfast and consuming omega-3 fatty acids (found mostly in fish). More research is needed in this area,” she added.

“School performance is also impacted by lack of quality sleep. Even if the anxiety is not causing a child to have difficulty concentrating, humans don’t learn well when we are tired and irritable, and we don’t get along well with others.”

Jean A. Fater - Program Director for Children and Youth Outpatient Services at BHN in Westfield

developmental and psychological factors,” said Fater, who has a master’s degree in Mental Health Counseling and Expressive Arts Therapies from Lesley University in Cambridge. “It does seem to run in families, so genetics is considered a risk factor.”

Environmental factors include stressful or traumatic events which have been associated with anxiety disorders.

“We see anxiety quite often in children and adolescents who have experienced complex

anxiety disorder, separation anxiety disorder or agoraphobia.

Anxiety can look different for each person, but some of the common manifestations are restlessness or edginess, fatigue, difficulty concentrating, unusual irritability, muscle tension and sleep disturbances. Children may also try hard to avoid the situation that is causing anxiety.

“We know that quality of sleep is important to good health so it’s important to

If anxiety is causing a child to have difficulty concentrating, the child is not going to absorb new academic material. “School performance is also impacted by lack of quality sleep. Even if the anxiety is not causing a child to have difficulty concentrating, humans don’t learn well when we are tired and irritable, and we don’t get along well with others,” Fater said.

Diet and exercise must also be considered when dealing with anxiety. “There is a great deal of research that shows exercise as beneficial in reducing stress, improving sleep and mood. Exercise has been shown to decrease sensitivity to the body’s reaction to anxiety. Exercise is also a proactive way to release tension,” Fater said. “We always promote movement and playful activity to folks of all

If children are anxious about new situations and events, they may also refrain from participating in activities they might actually enjoy and miss opportunities to engage and learn. “A big part of school performance is social and emotional education. When we are tired, we lose our patience, we don’t follow directions well, and our decision making is impaired,” Fater said. “Children can become very reactive and then ostracized when others avoid

Her general approach is to teach children what is going on in their brain when they are anxious. “We listen to their concerns, validate them and ask the child to figure out a plan or response so they learn to be empowered,” she said, adding that children are taught grounding skills — so they have a way to regulate when they feel out of control — and to anticipate the distress, put a name to it, and increase their capacity to tolerate it. Children are reminded that anxiety is a normal fact of life and how to use it wisely.

Anxiety is not something she tries to cure. “A measure of anxiety keeps us safe, teaches us about our limits and is necessary for motivation. We strive to teach folks how to anticipate it and to limit anxiety’s negative impact on functioning. They can learn to cope with these feelings and to thrive,” she said.

Parents and caregivers can help themselves and an anxious child by planning something fun, getting exercise, being well rested and allowing extra time to deal with conversations about what is causing the worry. Anticipate some of the concerns your child might have and create plans as a family. Solicit input from the children. Prepare yourself. “And remember that you are not alone. Reach out to other families or school resources if you need support. Back-toschool is a community event,” Fater said.

For more information, go to bhninc.org.

Overcome mental fatigue

Fatigue and exhaustion are often discussed in terms that characterize the physical effects that they have on the body.

However, mental fatigue can be just as draining as physical exhaustion, even if its symptoms are not as evident as achy muscles or tired feet.

The online medical resource WebMD notes that mental fatigue typically arises when individuals focus on mentally challenging tasks for extended periods of time. Many individuals also experienced mental fatigue during the pandemic. Pandemic-related restrictions forced individuals across the globe to confront a number of unforeseen, unexpected challenges, including a sudden shift to remote work and school closures that forced working parents to juggle the rigors of their careers with the difficulties of remote learning. That upheaval con-

tributed to prolonged mental fatigue for many individuals. Much like athletes need routine breaks from exercise to let their muscles recover, individuals need to look for ways to give their overworked minds a chance to recuperate from fatigue. Each person is different, but these strategies can help people overcome mental fatigue.

Take breaks from the news

Overconsumption of news is one potential contributor to mental fatigue. That’s especially so in the digital age, when the latest headlines are never further than a smartphone away. The Johns Hopkins Women’s Mood Disorders Center notes that limiting news consumption during stressful times can be an effective way to reduce symptoms of stress, including mental fatigue.

Schedule time to relax

The pressure to feel as if you should always be doing something, whether it’s working, taking care of your family or tackling a to-do list around the house, can contribute to mental fatigue. Sched-

ule time to relax and make a concerted effort to keep that time open. Avoid using scheduled relaxation time to work on household chores or check work emails. Instead, use this time to do something you find genuinely relaxing, even if that activity feels like you’re doing ‘nothing.’

Spot the signs of mental fatigue

Another way to overcome mental fatigue is to learn to recognize its symptoms. Recognition of these symptoms allows individuals to use them as alarm bells that alert them when it’s time to take a step back and unwind. WebMD notes that mental fatigue symptoms include mood-related issues like increased irritability or anger; difficulty concentrating that makes it hard to finish tasks; zoning out; difficulty sleeping; and engaging in unhealthy behaviors, including overconsumption of alcohol.

The signs of mental fatigue may not be as instantly recognizable as the symptoms of physical exhaustion. But mental fatigue can be just as dangerous as physical tiredness if left unchecked.

Signs of worsening behavioral health

The prevalence of mental health issues garnered significant attention in the early days of the COVID-19 pandemic, when many people acknowledged lockdowns and other restrictions and uncertainties were adversely affecting their thoughts and outlook. Though those restrictions were ultimately lifted and life returned to something closer to normal for people across the globe, mental health has remained both a hot topic and a concern.

The organization Mental Health America¨ reports that, as of 2022, just under 20 percent of adults in the United States are experiencing a mental illness. The issue of mental health is perhaps an even bigger concern in Canada, where a 2022 report from the Angus Reid Institute noted one in three Canadians indicated they are struggling with their mental health.

Such statistics are troubling, though increased public dialogue surrounding mental health has done much to remove the stigma long attached to conditions such as depression and anxiety. That stigma affected certain

groups more than others, including women. In fact, a report from the United Kingdom-based Mental Health Foundation indicated that women are three times more likely than men to experience common mental health problems. And that problem is worsening, as the MHF notes that women were two times more likely to experience

The organization Mental Health America¨ reports that, as of 2022, just under 20 percent of adults in the United States are experiencing a mental illness.

such issues.

Learning the developing signs of mental health issues may compel women to take action more quickly. Prompt treatment can increase the likelihood that women overcome mental health issues, which could lead to more positive short- and longterm results. The American Psychiatric Association¨ notes that it can be useful to contact a mental health professional if several of the following symptoms are occurring.

• Changes in sleeping habits or appetite changes. Changes in sleep

and appetite can be dramatic or may contribute to a decline in personal care.

• Mood changes marked by a rapid or dramatic shift in emotions or depressed feelings. Individuals may also become notably irritable.

• Emerging mental health issues may be marked by recent social withdrawal and a loss of interest in activities that were previously enjoyed.

• An unusual drop in functioning at school, work or social activities, such as quitting sports, failing in school or difficulty performing familiar tasks.

• Mental health issues can contribute to problems with concentration, memory or logical thought and speech. These problems can be hard to explain.

• A heightened sensitivity to sights, sounds, smells, or touch. Some people even avoid over-stimulating situations.

• Mental health issues may contribute to apathy marked by a loss of initiative or desire to participate in any activity.

• Some people experience a vague feeling of being disconnected from oneself or one’s surroundings; a sense of unreality also may develop.

• Illogical thinking is another potential sign of an emerging mental health issue. This thinking many involve unusual or exaggerated beliefs about personal powers to understand meanings or influence events. Adults may exhibit an illogical or ‘magical’ thinking that is more typical of a child than an adult.

• A sense of nervousness characterized by a fear or suspicion of others. A strong nervous feeling also may be present.

• Some people with mental illness exhibit odd, uncharacteristic or peculiar behavior.

• A change in school or work marked by increased absenteeism, worsening performance and/or difficulties in relationships with peers and coworkers.

Data indicates women are more likely to experience mental illness than men. That makes recognition of mental health symptoms an especially significant component of personal health care for women across the globe.