Carmel Clay Middle School
Parent Presentation
Presenters: Amy Daly, LCSW & Laura Guzzi, LCSW
St. Vincent Carmel Medical Social Work
What is Anxiety?

Anxiety is normal. Everyone experiences anxiety at some point in time.
For example, it is normal to feel anxious when on a rollercoaster or
before an exam. Young children can experience stranger anxiety and
older children often get nervous performing in front of their peers.

Anxiety is not dangerous. Although anxiety feels uncomfortable, it is
temporary, and will eventually decrease.

Anxiety is adaptive. Anxiety helps us prepare for real danger, such as
crossing a busy street. It can also help us perform at our best, and
motivate us to study for an exam or practice for a big game. When we
experience anxiety, it triggers our "fight-flight-freeze" response, and
prepares our body to react. For instance, our heart beats faster, to pump
blood to our muscles, so we have the energy to run away or fight off
danger. Without it, we would not survive.
How is anxiety triggered?
The amygdala is an almond-shaped structure deep in the brain that is believed to be a
communications hub between the parts of the brain that process incoming sensory signals and
the parts that interpret these signals.
It can alert the rest of the brain that a threat is present and trigger a fear or anxiety response.
The amygdala is a filter that regulates our emotional states. When we are in a positive emotional
state the filter is open and able to send information to the prefrontal cortex, where our higher
level thinking and reasoning take place.
When the amygdala is stressed, information is not transferred. Information is then processed
directly by the amygdala which in turn triggers our fight or flight response. When information is
not transferred to the prefrontal cortex, there is not an opportunity to make good decisions for
ourselves…we just react.
Research has shown that our flight or fight response is equally triggered by events that vary
greatly in significance. For example, missing a light in traffic and losing your job both trigger the
release of cortisol and other hormones.
Stress can become like a drug; something we are addicted to. It revs us up like a hot engine,
but also revs up hormones and that can cause inflammation and other changes in our body.
What do Middle Schoolers worry about most
often?
Several studies indicate that the top five worries for Middle
School Students include:
1. Having friends and being liked by peers
2. Fitting in, both in terms of physical appearance and social
acceptance
3. Getting good grades and managing the demands of school
4. Fretting over being “a failure” or disappointing someone
5. Family issues including finances, relationships, etc.
At the Crossroads
Middle School Students are in a unique position:
At no other stage of development do they encounter so many
differences in themselves and others at a time they most want to
belong to a peer group and individuate from their parents.
In addition, the Middle School setting encourages students to live
within a more complicated and demanding system (as opposed to
Elementary School) at the very time adolescents are determined to
act more independently.
While there can be a heightened sense of anxiety, there are also
wonderful opportunities to experience a sense of mastery.
Children, Teens and Adults often experience anxiety
in one of three ways:
Physically - what we feel in our body
Mentally - what goes through our mind like worrisome
thoughts
Behaviorally - what we do or our actions, such as avoid or
seek-reassurance
Manifestations of Anxiety:
Physically - Anxiety is felt in the body. Often, when young children feel anxious, they
do not actually recognize or describe it as anxiety or nervousness. Instead, they may say
that they feel sick, or have a sore tummy. Teens may complain of headaches, insomnia,
nightmares or stomachaches.
Mentally - Anxious children and teens worry! These worries can be about a current
situation or about some future event. Young children may not be able to identify any
anxious thoughts even when they are very anxious.
What if the other kids don't like me?
What if I fail my algebra test?
Behaviorally - Some children become anxious that they alter their behavior to protect
themselves from experiencing anxiety. For example, some children have rituals they
perform as a means of protecting themselves (handwashing) or some may refuse to sleep
over at another child’s house. Or some may act out in other ways as a means of avoiding
an uncomfortable situation.
What Warrants a Closer Look?
Sometimes the behaviors of anxious children and teens can seem
unreasonable to others. These children and teens may be labeled as
"difficult", "stubborn" or "too sensitive". Indeed, their actions can be very
frustrating for the entire family! It is important to remember that an anxious
child or teen who lashes out, cries, and avoids situations is, in fact,
responding instinctually to a perceived threat. Like other animals, your child
is reacting by either fighting (e.g. yelling, tantrums), fleeing (e.g. avoiding),
and/or freezing (e.g. mind going blank).
Anxiety disorders last at least 6 months and can get worse if they are not
treated. Each anxiety disorder has different symptoms, but all the symptoms
cluster around excessive, irrational fear and dread.
Types of Anxiety Disorders:
Generalized Anxiety Disorder, OCD, Panic Disorder, PTSD, Social phobia or
social anxiety disorder
Talking with Kids about Anxiety:
Use the Smoke Alarm analogy to help kids understand what
is going on in their bodies:
“An alarm can help protect us when there is an actual fire, but sometimes a
smoke alarm is too sensitive and goes off when there isn’t really a fire (e.g.
burning toast in toaster). Like a smoke alarm, anxiety is helpful when it
works right. But when it goes off when there is no real danger, then we may
want to fix it.”
Tools and Tips:
Take a Deep Breath and Count to Ten!
One of the greatest tools we can offer to children is to
teach them the power of anchoring or grounding
themselves. Learning to become aware of your breath is a
powerful tool to interrupting negative thoughts and in turn
accessing your prefrontal cortex…so you can then refocus
and have time to respond to a stressor, rather than react to
it.
10 Ways you can help your Children Cope with Anxiety
1) Establish routines and structure
As parents, it is helpful to establish consistency in schedules and discipline.
Anxious children cope more effectively if they have an idea of what to expect. It is
important for them to have limits and consequences on behavior.
Be mindful of your children’s basic needs to prevent fatigue and hunger. Twelve
step programs encourage members to be aware of self-care by using the acronym
HALT:

H – hungry

A – angry

L – lonely

T – tired
If your child is hungry, angry, lonely , or tired, he/she is not likely to handle stress
well.
2) Help your child(ren) identify feelings and provide opportunities for them
to discuss feelings
By talking about their feelings, children are better able to self-monitor when their anxiety
might be ramping up. You might ask, “In what part of your body do you feel anxiety?”
(Examples are: stomach, chest, head)
Here are two exercises that might help you get started:

High/Low
At the dinner table or in the evening when the family has time to gather, have each
family member talk about the high point and low point of his/her day. Other family
members can ask questions about how they felt, handled the situation, etc.

Feeling Cards
Use card stock or index cards and write a feeling on each one (happy, anxious, jealous,
sad, angry, etc). We have about 10 of them or so. Each person draws a card and talks
about the last time they experienced the feeling on the card. Again, other family
members can ask questions.
The benefit of these activities is two-fold: First, they help the child talk about feelings.
Second, parents can be role models in showing children that it’s okay to talk about your
feelings and that parents do not always know how to handle their feelings and struggle,
too.
3) Comfort and Soothe Your Child:
Sometimes we, as parents, think it’s babyish to cuddle with are children or
show them affection. Preteens/Teens do not often seem receptive to it,
either. However, they are often needing to be held and soothed.
4) Model positive coping behaviors:
Children look to their parents for guidance, even when we do not know they
are watching us. It is important that we take time to engage in relaxation
ourselves and set a positive example. It is helpful if parents are able to be
confident in themselves and their children in varying situations. A very
important message parents can give their child is that they have confidence
in their child and have confidence that their child can handle the situation.
5) Encourage engagement in activities they enjoy and even
those that might be uncomfortable
When children can have a sense of mastery, it helps build confidence. Gently
coax them to do things that might be outside of their comfort zone,
particularly with their anxiety. For example, we enrolled my 17 y/o son in a
summer academy camp at Hanover College last summer. He spent a week
at the college with a group of about 10 other high school students studying
cinematography. Prior to leaving, he was extremely anxious and did not
want to go. At the end of the week, I went to the school to see pick him up.
His group had become good friends in a short amount of time and he came
away with a CD containing plays and skits the group had performed. Now
when he is nervous about meeting new people, we remind him of his success
at Hanover.
6) Teach problem solving
Rather than being helicopter parents and swooping in to fix their problems, it will
be a lifelong benefit to them if we instead help them with problem-solving.
Solving their problems with some independence gives them confidence and a
sense of control.
7) Monitor your child’s social group
Are they supportive of one another? Do they tear each other down? Helping your
child recognize patterns of interaction can be helpful as they continue to develop
friendships with new peers.
8) Help your child identify helpful adults and/or friends in their
peer group and have a plan in place
It’s often helpful to let your child’s guidance counselor know that your child
is struggling with anxiety and the guidance counselor can talk to your child
and get to know him/her. If your child has more anxiety in certain social
settings, maybe there is another parent or coach they can see if things get
difficult. Sometimes it’s helpful if your child’s close friend is aware and the
two have a code word for when your child gets overwhelmed. For example,
my 14 y/o daughter’s best friend knows Savannah has difficulty in choir class
so Savannah told that if she ever has to leave the room quickly, it’s because
of anxiety and the friend can let the teacher know. My daughter also has a
“hot pass” that she can show to the teacher which automatically allows her
to leave the room. This is helpful because it serves as an escape strategy.
Children’s anxiety is often heightened if they do not have a plan or they are
fearful of having a panic attack in front of their peers.
9) Encourage a healthy lifestyle
Exercise, diet, sleep, avoid caffeinated beverages
10) Challenge unhelpful thoughts
Anxious children and adults often catastrophize, for example. Your
child might think of all the things that could go poorly during an
important event. What if I blank out during the test?, for example. It
is helpful to encourage the child to stay in the present. Unhelpful
thoughts sometimes include absolutes, like always and never. “I always
mess things up.”, Challenge that by reminding your child of a time he or
she did well.
Be a detective. Look for patterns. Have your child track when,
where, and in what situations they experience anxiety and what
makes them feel good.
Coping Strategies
Relaxation
 Breathing (diaphragmatic or deep belly)
 When we are anxious or in pain, we often engage in shallow
breathing without even realizing it. If we focus on our breathing, it
can help calm us down.
 Progressive muscle relaxation
 Meditation
These strategies can be done anywhere but they are more of
preventative in nature.
For example, I take Vitamin C every day to try to prevent getting a cold
and I brush my teeth to avoid getting cavities. In the same way, it is
helpful to practice relaxation regularly. Research shows that these
types of practices reduce stress. Often you can download free guided
meditations, relaxation tracks from the internet or purchase CDs. One
of the most well-known experts in the field is John Kabbat-Zinn.
Stay in the present
When one starts ruminating about the past or thinking about the future,
he/she will usually become more anxious.
Journal
Journaling about daily events or stressors can help us better recognize
patterns of coping that may or may not be helpful. It can help us devise a
plan of how we would like to react to specific stressors. This is particularly
helpful if you can encourage kids to keep a “Gratitude” Journal to keep
record of a few (3-5) things each day that they are grateful for. There are
many ways to journal that include writing, collage or photo journaling.
Listen to music, play an instrument
Music can be an incredible way to help us relax or re-energize, depending on
the music we choose to listen to. Playing an instrument can help us
articulate things in a different way than we can with words alone.
5) Practice positivity

Avoid the news

Reflect on gratitude—List on paper or in your prayers/meditation the
things for which you are grateful.
6) Draw, color, doodle, scribble
7) Read a book, magazine article, etc, that is uplifting.
As we mentioned in the beginning, each of us struggles
with some anxiety each day. Teaching our children at a
young age how to better manage daily worries will be a
huge benefit to them as they grow to become the adults we
know they can be.