Supporting Teens with Anxiety Disorders

 

4/03/2024

As a parent, you might be wondering what you can do to support your teen who is struggling with an anxiety disorder. Even if your teen has a great therapist who is providing evidence-based treatment for his/her concerns, having a parent who can provide the proper support throughout the process is essential to recovery.

DO:

1. Take them seriously when they tell you that their anxiety is a problem and that they need help. When a teen comes to you asking for treatment, that is typically a sign that they have tried their best to cope with it or mask it to the best of their ability, but it isn't working anymore.
2. Validate their feelings. Saying things like "I can see why this would worry you" or "it makes sense to feel anxious" can be very soothing and help teens feel seen and heard by you.
3. Encourage small steps towards facing their fears. We know that avoidance is most often the biggest factor that maintains anxiety disorders, so encouraging them to be brave in small chunks will help.
4. Pay attention to, and reinforce, when they DO face their fears. Figure out what motivates them and make sure you offer it when they go against their "anxiety voice." Even something as simple as "I am so proud of you for staying in school for the entire day" can be rewarding enough to motivate them to continue being brave.
5. Model healthy coping skills. If you yourself are feeling anxious, it can be helpful to show your teens how you are handling it and working through your problems.

 

DON'T:

1. Undermine or invalidate the seriousness of how the anxiety is affecting them. If you do not take them seriously when they are asking for help, it may worsen to a degree where treatment will be that much more difficult.
2. Reinforce their avoidance behavior. This may be difficult to spot on your own and might require the help of a professional, but it is possible to start paying attention  to ways in which you might be reinforcing the problem. By not encouraging them to face their fears, by letting them off the hook one too many times, you are communicating to them that you do not have confidence that they can live with their anxiety and overcome their avoidance.

 

If you are struggling to grasp any of these steps, it may be worth consulting with a therapist who has experience providing parenting support for teens with anxiety disorders.

 

Be Well,

Dr. Anna Sheedy

 

 

 

 

Living Mindfully for Our Health

 

6/14/2023

Many people have heard of mindfulness. Not only has it become a buzzword in various forms of media, but decades of psychological research have backed up mindfulness as a key component of mental well-being. So what is all the fuss about??

For one, some of the research-backed benefits of mindfulness are:

 

1. Increases pleasure and joy
2. Decreases depression and anxiety
3. Increases compassion for self and others
4. Slows down the nervous system
5. Makes us more efficient and effective at completing tasks
6. Reduces pain and discomfort associated with illness

On top of that - mindfulness is a highly accessible skill that anyone can learn. We can practice it anywhere and at anytime. It can be very challenging at first, but like any skill, it becomes easier over time with practice. With consistent practice, we are no longer "practicing mindfulness." We are simply "living mindfully."

But what IS mindfulness?

Mindfulness is an attentional training tool. It is a way to practice redirecting your attention to the present moment, fully and completely. It is a skill that builds acceptance and tolerance of the present moment; it also helps us slow down enough to reduce reactivity. It helps us live more intentionally and thoughtfully.

Here are some ideas for starting to practice mindfulness:

 

• Turn your attention to your 5 senses. Simply notice what you are observing with your 5 senses.
• Observe the rhythm of your breath for several minutes.
• When you are working, focus on one task at a time. Give it your full attention instead of trying to divide it between multiple tasks (pro tip: research has confirmed that multi-tasking is ineffective)
• Observe the feeling of your feet on the floor for several minutes at a time.
• Download a mindfulness app, like Headspace or Calm, which have many audio-guided mindfulness exercises to choose from.

Why not give it a try today? You will be doing wonders for your physical and mental health. It only takes a few minutes of practice every day to start to reap the benefits.

 

Be Well,

Dr. Anna Sheedy

Cognitive-Processing Therapy for Posttraumatic Stress Disorder

 

3/20/2023

There is a reason the American Psychological Association strongly recommends Cognitive-Processing Therapy (CPT) for Posttraumatic Stress Disorder (PTSD): because it works. Many research studies have backed up its effectiveness in reducing PTSD symptoms and improving overall quality of life.

One of the key ingredients to overcoming PTSD is overcoming avoidance. What maintains the symptoms of PTSD is avoidance of trauma-related stimuli, whether they are external (people, places, things) or internal (thoughts, memories, feelings). Some level of exposure to these things is a common component to most trauma treatments available, including in CPT.

What sets CPT apart from many of the other treatment options is its heavy focus on modifying trauma-related thoughts and beliefs. After experiencing a traumatic event, people typically search for reasons for why the event happens. Those who develop PTSD often develop beliefs about why the event happened that keep them stuck in suffering. They also often develop overgeneralized beliefs about things like trust and safety that inhibit their ability to develop close interpersonal relationships. The trauma-related beliefs often provoke intense feelings of guilt and shame, which further escalate the desire to avoid people, places, and things.

Modifying trauma-related beliefs leads to the "reprocessing" piece of CPT. In other words, individuals are guided by the therapist to gently test their beliefs about why the trauma occurred. They learn cognitive-modification skills that they are asked to practice consistently outside of sessions. With consistent practice, they develop newer, healthier ways of thinking about the trauma, and the normal emotions are allowed to take place (sadness, grief, anger). Guilt and shame typically subside. The avoidance behaviors also subside. Additionally, due to being able to more accurately assess situations in their lives thanks to their new cognitive skills, they often develop better trust in themselves and in others.

If you have experienced a traumatic event and think you may have PTSD, CPT may be right for you if:

• You regularly avoid thinking about the trauma
• You experience nightmares, flashbacks, or hypervigilance (a sense of constantly scanning your environment for threat)
• You feel distant and cut off from other people
• You believe that you are to blame for the traumatic event, or that you could have stopped it from occurring
• You feel stuck in guilt and shame when you think about the trauma
• You are interested in a structured, manualized treatment that involves assignments outside of the therapy session

If you decide that you are ready to receive treatment for PTSD, most importantly, please make sure that you feel as safe and secure with the therapist you plan to work with as you can.

 

Be Well,

 

Dr. Anna Sheedy

"Avoid Avoiding" In Order To Overcome Anxiety Disorders

 

3/7/2023

 

Avoidance is something we talk a lot about here at CFVC. It is such a natural, human instinct to avoid something that is painful, difficult, uncomfortable, or unpleasant. Sometimes, avoidance can be very adaptive; but often, avoidance activates a vicious cycle that is difficult to break free from, further driving us into an anxiety disorder.

 

Imagine that you are feeling anxious about attending a social event. When you think about going, you imagine how "awkward" you will feel. Will anyone try to talk to me? Will I fumble with my words? What will I do with my hands? Will anyone notice how anxious I feel? As these questions parade around in your head, you notice yourself starting to feel things in your body, like racing heart, sweating, upset stomach. You have identified that you are now "anxious" about attending this event. The more you entertain the thoughts and feelings, the more intense the anxiety gets. You then reason with yourself that avoiding this social event is the way to go; after all, you are "too anxious" about it, so staying home is a natural way to reduce the feeling of anxiety.

 

And it works! By making the decision to stay home, all of the unpleasant thoughts and feelings fade away. You feel relieved, and justified in your decision not to attend.

 

The problem with this strategy is that it only "works" in the short-term. The feeling of relief is temporary; the next time you are faced with a social situation, the same images, thoughts, and sensations will return. You will remember how avoiding it provided you with relief, so you will likely make the decision to avoid again. Avoidance is highly reinforcing because it takes away unpleasant and painful feelings; but long-term, it actually increases our level of anxiety.

 

To truly overcome an a anxiety disorder, we need to face the unpleasant feelings and take them with us. It is difficult, but attending the social event while feeling anxious is the way to take some control back. You can learn to do hard things while feeling unpleasant feelings, instead of avoiding doing hard things all together.

 

By facing our fears, we are teaching our brains and our bodies a few things:

 

1. That we can do hard things
2. That we are capable of tolerating unpleasant emotions
3. That the "worst case scenario" rarely, if ever, happens. And if it DOES happen, we can cope with it!

 

Don't allow Big Anxiety to dictate your behavior - you deserve to fully engage in your life and take all of the feelings with you!

 

Be Well,

 

Dr. Anna Sheedy

 

Supporting Teens Through the Transition  to College

 

The transition to college can be both nerve-wracking and exciting for parents and teens alike. Not only are teens preparing to carry heavy courseloads, but they are often preparing to live on their own and do many things by themselves that they may not have had to previously.  Having worked with many college-aged students over the years, I definitely observed some differences between those students who felt more prepared and those that didn’t.

The late adolescent time period is a time of true dichotomy. On one hand, they are largely independent from their parents, and on the other hand, they need them to help guide them through certain tasks that they have never been exposed to before.

As parents, one of the most effective ways to help them through a big transition like this is to make use of scaffolding. Scaffolding is a well-researched concept used in both the educational and psychology worlds. The basic idea is that as a parent, you are providing just enough support to where the teen can learn to challenge themselves and take their learning to the next level. Think of it as the “goldilocks” level of support. Not too much, and not too little. This requires a keen understanding of your teen’s knowledge and grasp of multiple tasks and making a plan with them to acquire the skills necessary to flourish during their freshman year.

Think about when your child was very young, and you had to teach them how to tie their shoes. At the beginning, they were a blank slate. They knew nothing. For a while, you had to do it for them; then, you provided some on-hands assistance. Then, you watched as they gradually mastered the task with less and less support. This concept can be applied to almost any task that you are hoping they will be able to tackle when they are on their own.

Some examples of tasks that some young adults need support in during the transition:

• how to use a credit card
• how to set a budget and stick to it
• how to schedule various appointments (dental, medical, therapy, car maintenance)
• how to do laundry
• how to grocery shop and prepare meals
• how to create a flexible schedule

There are many others that you might think of. Here are some tips to get the process started with your teen:

• Think of growth areas that you are concerned about. Are there tasks that they don’t know how to do at all? Or ones they have a poor understanding of?

 

• Start a conversation with your teen. Ask them directly what their worries are about starting college. This may just turn into a wonderful opportunity to provide validation and emotional support, but it may also turn into a useful assessment of skills they wish to acquire before living on their own.

 

• Make a plan with your teen to start learning the skills. Incorporate the scaffolding into the plan. The more specific and concrete you can be with your teen, the better. Try to make it a weekly commitment to work on the skills until they have mastered it. Some skills may only require a one-time demonstration. Make sure you communicate that mastery does not mean perfection; we want them to feel competent, but we do not want them to get bogged down with more anxiety if they feel like something isn’t “perfect.”

 

• Work with your teen to acquire a list of useful resources around campus. Having the information handy can be great when your teen is busy with their studies. Make sure they know where to find the healthcare center, the counseling center, campus security, the career center, and student advisement. If your teen requires educational accommodations, make sure you are both aware of how to find and contact the disability office.

 

• If your teen is especially prone to anxiety or homesickness, make plans to visit. Before sending your teen off to college, have another visit or two scheduled and on the books. It may help to also make an agreement of how often you two plan to check in over the phone. Having some contact with you scheduled can be comforting to a teen who is working on managing a lot of changes at once.

 

• Communicate to your teen that you believe in them, and that you will always be here for them. This one may sound obvious, but it helps to hear verbal affirmation that they are supported and loved, and that you have confidence in them that they can succeed.

 

Be Well,

 

Dr. Anna Sheedy

 

Anxiety: The Friend You Never Knew You Needed

1/18/2023

You read that correctly! Do you know that anxiety can actually be your friend? You might be having reactions right now like:

“But Dr. Anna, anxiety keeps me up at night!”

“Anxiety gives me migraines and stomachaches!”

“Anxiety is the reason I can’t get anything done!”

All of this is 100% valid and real! I have heard all of these things and more about what a horrible pest anxiety is. However….

Did you also know that anxiety is a hardwired emotion that we all experience? There is a reason we have it, even if it goes haywire sometimes and interferes with our lives.

Two major benefits of anxiety are:

• It warns us of possible danger. You know that churning feeling you have in your stomach that tells you not to walk around at 2am at night? Or those sweaty palms you get when you are about to drive on a very snowy day? That physiological response is trying to communicate something to you: “Pay attention. Possible danger ahead.” Thank goodness we have our friend anxiety to cue us to think twice before taking action! It can actually be life-saving at times.

 

• It can help us perform better. Even though it can be uncomfortable to experience butterflies when performing on stage or being interviewed for a job, those butterflies are most likely helping you put your best foot forward. Research has made it clear that moderate levels of anxiety increase our performance.

 

Anxiety disorders occur when our response to the emotion becomes problematic. When we continually avoid social interactions because we feel too anxious to face them; when we avoid certain people, places, and things because we are afraid of the anxiety itself. For some people who are particularly sensitive to the emotion of anxiety, they feel it intensely and frequently to the point where it truly does interfere with living their best lives.

Part of treatment for anxiety disorders consists of learning to regulate it and also learning to live with it. It may also consist of facing certain stimuli that provoke anxiety in order to learn that we can handle it. We cannot completely control our experience of an anxiety; it is going to happen whether we like it or not. We need to learn to take it with us while we pursue behaviors that serve us. After all, it is an emotion that, while not pleasant, serves an important function that can actually help serve our goals and values.

Be Well,

Dr. Anna Sheedy

The Valued Life: Finding Direction

1/17/2023

Have you ever felt lost? Directionless? Overwhelmed and unsure of what your next step should be? We have all been there at one point or another. The good news is that there are some great strategies to get us back on track to living a life that feels focused and genuine to who we are.

 

One such strategy is to explore what are VALUES are.

 

What is a value? And how does it differ from a goal?

 

Think of values as the blueprints of your life; the skeleton and foundation of what holds you up. If all the material possessions you own suddenly disappeared, what would you be left with? What would keep you going?

 

Modern society often emphasizes GOALS. How many times have you been asked what your goals are? To be clear, goals are 100% necessary to building a life worth living. Goals give us something concrete and manageable to work towards. They have a beginning and an end. The trouble is, we often lose focus and motivation for our goals when they aren’t properly informed by our values.

To break it down simply:

 

Goals answer the what. Values answer the why. We need BOTH to become unstuck and create movement towards the life we want.

 

Why attend that family function when it feels so awkward?

Why bother studying for that difficult exam?

Why ask that person to go on a date?

Why run that marathon?

Having a handle on your why will help you when the going gets tough; when you feel like giving up or giving in. The why can also ensure that we aren’t setting goals that feel like busywork – things that just ultimately distract us and don’t really serve a purpose.

 

Getting started with values exploration

• Begin by brainstorming several words that capture that “foundation” of who you are and what you stand for. Think of the things that matter most to you. Some examples are: self-improvement, physical health, family, achievement, community involvement.

 

• Choose 1 to commit to focusing on for the next week.

 

• Really sit with this word. Take some time to really think about what it means to you.

 

• Ask yourself: How important is this value to me right now in my life? Somewhat, very, not very? If the answer is “not very,” it would be wise to select a different value to work on – one that feels important to your life right now.

 

• Once you’ve settled on a value that feels important to you, ask yourself: how aligned does my current life feel with this value? Are my daily goals and actions consistent with this value?

 

• If the answer to the above questions is “generally yes” then great! Keep doing what you are doing. If the answer is “generally no,” then proceed to the next step.

 

• What is one small, actionable step you can take today to feel more aligned with this value? (ex. I value relationships, so my action step will be to call my grandmother today to check on her). Once you’ve achieved this, celebrate and set another actionable step you can take tomorrow.

Be well,

Dr. Anna Sheedy