ANXIETY

Does Your Child:

• Bite his/her nails?
• Have difficulties with change or new situations?
• Have repetitive behaviours ?
• Complain of physical symptoms such as diarrhea, nausea, stomach ache, headaches?
• Experience phases of intense anger, inflexibility, tantrums?
• rapid heartbeat, dizziness, shortness of breath or difficulty
• hyper or hypo activity, difficulty sleeping

Your child may be experiencing a degree of anxiety.

What are the different types of anxiety?

• Social Anxiety Disorder ( SAD)
• Separation Anxiety Disorder
• Selective Mutism
• Specific Phobias
• Generalized Anxiety
• Panic Disorder

Why be concerned?

The Top 12 Childhood Concerns according to the 2008 National Poll on Children’s Health done by Knowledge Networks, Inc. for Mott Children’s Hospital at the University of Michigan include:

1. Childhood Obesity
2. Drug Abuse
3. Smoking
4. Bullying
5. Internet Safety
6. Child Abuse & Neglect
7. Teenage Pregnancy
8. Alcohol abuse
9. Attention Deficit / Hyperactivity
10. Sexually Transmitted Infections
11. Harmful Chemicals In the Environment
12. Less Physical Activity

Of these top 12 concerns, many have the common underlying factor anxiety. For example research shows that overweight children may suffer from anxiety as young as the age of 6. (Journal of Applied Developmental Science, U. of Missouri, 1998) Overweight kids suffering from low-self esteem also run the risk of developing future problems, such as eating disorders, people-pleasing tendencies and unhealthy sexual behaviour as adults.

What are the Health Connections related to this trend?

The most significant organs include:
• The Nervous System-Over worry leads to sympathetic overstimulation which in turn leads to anxiety and potentially panic.
• The Adrenal Gland-Initially over produces fight or flight hormones which increase anxiety and then gets tired from overworking. These hormones subsequently fall off often leading to fatigue and depression
• Digestion-Is most commonly affected leading to diarrhea, constipation or upset

• Liver– When unbalanced can lead to headaches

Anatomy of Stress- shows the complete relationship of the organs and the balance in the nervous system, the adrenal gland, the thyroid and their relationship to hormones. The pathway from beginning to end is shown in the Health Wellness Spectrum(HWS)©: (For more details of the HWS © see the April 2008 Newsletter Allergies, Asthma and Eczema)

Top 10 Treatment Options:

1. Regulate and manage blood sugar– often an underlying cause or aggravating factor of anxiety type symptoms. Thus ensure that your child has at least 3 palm size servings of protein daily and does not go longer than 3 hours without a snack. Also watch the glycemic index of foods , as foods that are too high, break down into sugar too quickly and cause a reactive low blood sugar state 1 ½ hours later. Focus on foods lower than 55 on the glycemic index scale . See Addendum 2 For The Glycemic Index of foods .

2. Food Intolerances- Ensure you are eating what is right for you and this will also help regulate blood sugar.

3. Exercise- keeps the natural endorphins balanced.

4. Sleep-Ensure your child gets enough sleep at least 9-10 hours on average

5. Stress Management Techniques and Counselling-“ Loss of Control” is perceived as a lack of structure, too much open space or a feeling of being overwhelmed. Assist your child in creating a framework to help them attach to :
For example if you walk into a room and everything is chaotic. Think about how your stress level feels VS Sorting groups of items and placing in 12 baskets. The structure helps the perception of groups of things to do or a framework to attach yourself to.

In the same token assist your child by using strategies such as :

• § Being clear on expectations
  § Create family traditions- assists in helping them to feel like they belong to a group
  § Create routines ie meals, time for homework, relaxation

• § Helping them with new situations by giving them as much information as possible to help ease how they will feel.
  § Assist them with getting connected to a comfort person either at the new situation or location
  § Practice new roles , tasks
  § Encourage them to know that it takes 10,000 hours to become an expert at a particular field ( Outliers, Malcom Gladwell, 2007) and that it is normal to be at their level for the time they have spent doing it
  § Find things that they do absolutely love doing and a point of inspiration for them
  § Foster their natural talents versus what we wish we could do or want them to do

6. B-complex multivitamin -Studies show that the B’s are natural stress-reducers—the body requires vitamin B6 to make serotonin, for example—and not getting enough of them can contribute to anxiety.

7. Magnesium-researched shows that a deficiency may causes increased levels of adrenaline, which can lead to a feeling of anxiety

8. Botanicals such as:

• • Fennel Tea- Relieves gastrointestinal upset
  • Chamomile– Helps to gently calm nerves

9. Homeopathic Remedies such as:

• • Gelsemium used often for nervousness of up and coming situations
• • Silica is well respected as a homeopathic remedy for timid and fretful children. It may also be recommended for individuals who are sensitive to certain substances and prone to feeling ‘run down’. People who need this remedy are usually nervous, shy, refined, and fragile, with a strong desire for sweets.
• • Aconite is a proven homoeopathic remedy that is manufactured from the herb commonly known as Monkshood. Aconite is used homeopathically for its calming and settling properties and assists with the body’s natural ability to soothe common fear and promote balanced mood, which helps support overcoming shyness in children. Aconite is also recommended to help lessen restlessness, nervousness and agitation.
• • Pulsatilla is a remedy used for a shy child who often can’t make decisions
• • Rhus Tox is a remedy for a very restless child

10. Rescue Remedy– a bach flower remedy for assistance of generalized anxiety

We all feel varying degrees of anxiety and different times of our life. However when it becomes persistent and interferes with daily life, it is important to seek support. An individualized plan is recommended and professional consultation with your Naturopathic Doctor is important to find the right dosing and plan for your child.

Addendum 1- Types of Childhood Anxiety, Age of Occurrence , Behaviour and Common Symptoms Type of Anxiety Common Age of Occurrence Behaviour Common Symptoms Social Anxiety Disorder ( SAD) 5 & 610 & 11 Avoidance of :§ social situations (ie recess, group activities such as birthday parties)§ performance situation (reading aloud in front of a group) § nausea stomachache diarrhea headache§ racing heart dizziness§ defiance§ anger § inflexibility § tantrums § school Refusal/Avoidance § separation Anxiety § selective Mutism Separation Anxiety Disorder 7-918months-3yrs normal4% of children over the age of 4 Avoidance or refusal to go places alone School refusal Refuse sleepovers or camp Demand parent be around Have nightmares when separated from loved ones. Appear in parents bedroom in middle of the night. Selective Mutism ( form of SAD)It is defined as failure to speak in situations where speech is expected or necessary persisting for at least one month. Yet often, these children can be very talkative, even boisterous in a place where they feel comfortable. 4-8 Stand motionless and expressionless (try to be “invisible”) Avoid eye contact or withdraw out of sight Exhibit Separation Anxiety Exhibit anxiety symptoms, both physical and behavioral before social events Exhibit frequent tantrums, inflexibility, sleep problems and extreme shyness. These symptoms can be seen in infancy. Specific Phobias A specific phobia is defined as an intense, irrational fear of a specific object, or a situation that lasts for at least 6 months. And interferes with daily life. Can be anytime Fears Of: · Animals, “monsters”, cartoon characters · Storms, loud noises · Heights, elevators · Pools, bathtubs · Night time or the dark · Needles, or medical procedures, blood Generalized Anxiety Disorder (GAD)It is characterized by excessive worry and anxiety over a variety of things such as performance, family, health, natural disasters, etc. The affected child cannot control his/her worry and it interferes with normal activities. 6-11 Muscle tension and inability to relax: restlessness Fatigue, sleep difficulty Difficulty concentrating, muscle aches § Irritability Children with GAD tend to be hypercritical of themselves and strive for perfection. They may require constant reassurance and approval. Panic Disorder with or without AgoraphobiaPanic Disorder is diagnosed when a child suffers at least two unexpected Panic Attacks, followed by at least 1 month of concern over having another attack, losing control, or “going crazy.” A Panic Attack is defined as the abrupt onset of an episode of intense fear or discomfort, which peaks in approximately 10 minutes. Any Age20’s most common Children often become apprehensive when in situations or places where they have previously had attacks.Agoraphobia can develop when a child begins to avoid situations in which a panic attack previously occurred, or avoids places which s/he feels would not be able to escape if experiencing a Panic Attack. Children can also avoid places or situations in which they fear a symptom attack will occur nauseaheadachedizzinesspalpitations fainting Obsessive Compulsive Disorder ( OCD)Compulsions (repetitive behaviors or mental acts)are performed in an attempt to reduce a feeling of anxiety Any age5 plus § repeated hand-washing, checking, tapping, or mental routines (such as counting backwards from 100)§ An example of an intrusive thought is “I might get sick and die from touching a bathroom door”.

Addendum 2

Food List	Rating	Food Glycemic Index
Bakery Products
*Pound cake	Low	54
Danish pastry	Medium	59
Muffin (unsweetened)	Medium	62
Cake , tart	Medium	65
Cake, angel	Medium	67
Croissant	Medium	67
Waffles	High	76
Doughnut	High	76
Beverages
Soya milk	Low	30
Apple juice	Low	41
Carrot juice	Low	45
Pineapple juice	Low	46
Grapefruit juice	Low	48
Orange juice	Low	52
Biscuits
Digestives	Medium	58
Shortbread	Medium	64
Water biscuits	Medium	65
Ryvita	Medium	67
Wafer biscuits	High	77
**Rice cakes	High	77
Breads
Multi grain bread	Low	48
Whole grain	Low	50
Pita bread, white	Medium	57
Pizza, cheese	Medium	60
Hamburger bun	Medium	61
Rye-flour bread	Medium	64
Whole meal bread	Medium	69
White bread	High	71
White rolls	High	73
Baguette	High	95
Breakfast Cereals
All-Bran	Low	42
Porridge, non instant	Low	49
Oat bran	Medium	55
Muesli	Medium	56
Mini Wheats (wholemeal)	Medium	57
Shredded Wheat	Medium	69
Golden Grahams	High	71
Puffed wheat	High	74
Weetabix	High	77
Rice Krispies	High	82
Cornflakes	High	83
Cereal Grains
Pearl barley	Low	25
Rye	Low	34
Wheat kernels	Low	41
Rice, instant	Low	46
Rice, parboiled	Low	48
Barley, cracked	Low	50
Rice, brown	Medium	55
Rice, wild	Medium	57
Rice, white	Medium	58
Barley, flakes	Medium	66
Taco Shell	Medium	68
Millet	High	71
Dairy Foods
Yogurt low- fat (sweetened)	Low	14
Milk, chocolate	Low	24
Milk, whole	Low	27
Milk, Fat-free	Low	32
Milk ,skimmed	Low	32
Milk, semi-skimmed	Low	34
*Ice-cream (low- fat)	Low	50
*Ice-cream	Medium	61
Fruits
Cherries	Low	22
Grapefruit	Low	25
Apricots (dried)	Low	31
Apples	Low	38
Pears	Low	38
Plums	Low	39
Peaches	Low	42
Oranges	Low	44
Grapes	Low	46
Kiwi fruit	Low	53
Bananas	Low	54
Fruit cocktail	Medium	55
Mangoes	Medium	56
Berries	Low Medium
Apricots	Medium	57
Apricots (tinned in syrup)	Medium	64
Raisins	Medium	64
Pineapple	Medium	66
**Watermelon	High	72
Pasta
Spaghetti, protein enriched	Low	27
Fettuccine	Low	32
Vermicelli	Low	35
Spaghetti, whole wheat	Low	37
Ravioli, meat filled	Low	39
Spaghetti, white	Low	41
Macaroni	Low	45
Spaghetti, durum wheat	Medium	55
Macaroni cheese	Medium	64
Rice pasta, brown	High	92
Root Crop
Carrots, cooked	Low	39
Yam	Low	51
Sweet potato	Low	54
Potato, boiled	Medium	56
Potato, new	Medium	57
Potato, tinned	Medium	61
Beetroot	Medium	64
Potato, steamed	Medium	65
Potato, mashed	Medium	70
Chips	High	75
Potato, micro waved	High	82
Potato, instant	High	83
**Potato, baked	High	85
Parsnips	High	97
Snack Food and Sweets
Peanuts	Low	15
*M&Ms (peanut)	Low	32
*Snickers bar	Low	40
*Chocolate bar; 30g	Low	49
Jams and marmalades	Low	49
*Crisps	Low	54
Popcorn	Medium	55
Mars bar	Medium	64
*Table sugar (sucrose)	Medium	65
Corn chips	High	74
Jelly beans	High	80
Pretzels	High	81
Dates	High	103
Soups
Tomato soup, tinned	Low	38
Lentil soup, tinned	Low	44
Black bean soup, tinned	Medium	64
Green pea soup, tinned	Medium	66
Vegetable and Beans
Artichoke	Low	15
Asparagus	Low	15
Broccoli	Low	15
Cauliflower	Low	15
Celery	Low	15
Cucumber	Low	15
Eggplant	Low	15
Green beans	Low	15
Lettuce, all varieties	Low	15
Low-fat yogurt, artificially sweetened	Low	15
Peppers, all varieties	Low	15
Snow peas	Low	15
Spinach	Low	15
Young summer squash	Low	15
Tomatoes	Low	15
Zucchini	Low	15
Soya beans, boiled	Low	16
Peas, dried	Low	22
Kidney beans, boiled	Low	29
Lentils green, boiled	Low	29
Chickpeas	Low	33
Haricot beans, boiled	Low	38
Black-eyed beans	Low	41
Chickpeas, tinned	Low	42
Baked beans, tinned	Low	48
Kidney beans, tinned	Low	52
Lentils green, tinned	Low	52
Broad beans	High	79