THE POWER OF BREATHING

by Annabelle Parr

Whether or not you struggle with an anxiety disorder, we have all found ourselves overwhelmed by stress or anxiety at some point.  We each have slightly different stressors that trigger our body’s natural stress response, but we all know what the response feels like: sweaty palms, racing heart, tense muscles.  This bodily reaction can feel overwhelming, as if it controls us.  It is easy to feel powerless to our biological response to stress, but we have more control than we think.

THE STRESS RESPONSE

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Before we deem our biological reaction to stress bad, let’s talk about what happens and what purpose it serves.  When we get stressed out or anxious, our body begins preparing us to face threat.  Stress activates our sympathetic nervous system, triggering the fight-flight-or-freeze response.  This causes the sweaty palms, racing heart, panicky breathing and muscle tension (McGonigal, 2013).  We often look at the stress response as inherently bad, because it is not healthy to be in the fight-flight-or-freeze mode chronically (McGonigal, 2013).  However, it’s important to remember that when your heart starts racing or your palms get sweaty, your body is just trying to help prepare you.  Nevertheless, these sensations can feel overwhelming, and perpetuate our experience of anxiety.  So how can we calm ourselves down once this cycle is in motion?

DEEP BELLY BREATHING

Using our breath, we actually have the power to activate our parasympathetic nervous system.  The parasympathetic nervous system allows our body to “rest and digest” as opposed to the sympathetic nervous system’s fight or flight response (Hunt, 2016).  While “take a deep breath” is common advice, how we actually take that breath is important.  This is how to use the breath to calm down:

Source URL: http://goodrelaxation.com/2015/05/deep-breathing-for-headaches/

1. Find a comfortable, relaxed seated position with your feet planted on the ground; alternatively, you can try breathing laying down.  Now begin to bring your focus to your breath.
2. With each breath, your belly should rise as you inhale and fall as you exhale. 
3. Your shoulders and chest should remain still.  If you notice your shoulders rise, or your chest move, drop the breath down to the belly.  Breathing into your chest is reminiscent of hyperventilating, which will only further activate your sympathetic nervous system (Hunt, 2016).
4. Now focus on breathing into your belly for four counts.  Hold your breath for a second or two.  Now exhale for five counts and relax (Hunt, 2016).  Repeat this process, focusing on your inhalations and exhalations, and making your belly rise and fall.
5. You may notice that your heart rate speeds up at first.  Don’t panic or give up.  Your body is not used to calming itself down, and is simply adjusting.  After a few cycles of inhaling and exhaling, you should notice your heart rate begin to relax. 
6. If you begin to get distracted or thoughts pop into your mind, simply notice they are there and then come back to focus on the breath. 

Source URL: http://goodrelaxation.com/2015/05/deep-breathing-for-headaches/

See if you can practice doing four or five deep belly breaths a day.  Then see if you can work your way up to thirty seconds at a time.  Then maybe a minute.  Eventually, you will be able to sit in this space with your breath for a long period of time.

Being able to tap into your breath to find a calm, centered space, no matter where you are, is an invaluable resource.  This diaphragmatic breathing essentially turns off your sympathetic nervous system and turns on your parasympathetic nervous system (Hunt, 2016). 

This is not to say that you will never feel stressed again, or that you will never experience the fight-flight-or-freeze response.  But using deep belly breathing can help you to calm your body down and lessen the biological reaction to a stressful situation.

CSAM IS HERE TO HELP

If you or someone you love might benefit from acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), or biofeedback for anxiety, depression, stress, or PTSD, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at csamsandiego@gmail.com.

REFERENCES:

Hunt, M. G. (2016). Reclaim your life from IBS: A scientifically proven plan for relief without restrictive diets. Toronto, ON: Sterling Publishing Co., Inc.

McGonigal, K. (2013, June). Kelly McGonigal: How to make stress your friend [Video File].  Retrieved from: https://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend?language=e

"Mommy, My Tummy Hurts": Anxiety and Kids

by Jan Estrellado, M.A.

No one wants to think about children struggling with anxiety.  However, anxiety disorders are the most common psychiatric disorder in teens and tend to start around the age of 6 (Merikangas et al., 2010). 

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What does anxiety look like in children and adolescents?  Does it differ from adults?  To find out these answers, one can look to the research and to mental health clinicians with experience in these areas.  

How Common is Anxiety in Kids?

Anxiety disorders are the most common psychiatric disorder of 13 to 18 year olds (40.2%; Merikangas et al., 2010).  Of the teens with anxiety disorders, 8.3% are severely impaired by their anxiety disorder.  However, 80% of kids with an anxiety disorder do not receive treatment.  Interestingly, kids tend to develop anxiety disorders at the age of 6 (versus age 11 for ADHD and age 13 for mood disorders, like depression).  

Why might it be that the most common psychiatric disorder in young people goes largely untreated?  One reason may be that parents, caregivers, and teachers may not know some common signs of anxiety in kids.

What Does Anxiety Look Like in Kids?

All kids feel anxious at one time or another, as stress is a normal part of life.  In addition, many kids with shy personalities may tend to feel more nervous in general than their peers.  So how does a parent know when their child’s anxiety becomes a problem?

When stress starts to get in the way of life’s activities, like withdrawing from friends, avoiding school, having trouble sleeping, experiencing difficulty being away from parents, or lashing out at loved ones, then unmanaged stress can damage the child or teen’s physical and mental health.  Kids who suffer from anxiety tend to see their fears as catastrophic (Miller, 2012), which can be puzzling and confusing to some parents.  Children may get extremely upset when parents or caregivers prepare to leave and may cling very tightly to their parents.  

Anxiety in children may look different than in adults because kids may lack skills to express their fears and stressors.  They may experience symptoms that take place in the body, also known as somatic symptoms.  In young children with anxiety disorders, the most common somatic symptoms are restlessness (74%), stomachaches (70%), blushing (51%), palpitations (48%), muscle tension (45%), sweating (45%), and trembling/shaking (43%) (Ginsburg, Riddle, & Davies, 2006).  Children who experience these somatic symptoms are more likely to have severe anxiety and higher levels of impairment.

What can parents and caregivers do?

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Parents often know if their child is facing high levels of anxiety because they observe the child to be more anxious than his or her peers (Miller, 2012).  In addition, the child’s anxiety gets in the way of everyday functioning, such as school, sleepovers, and swim class. Parents, teachers, and significant caregivers play important roles in a child’s ability to manage anxiety successfully.

“The best advice I have for parents is to remain calm and focus on self-care. ”

— Dr. Starr MacKinnon, CSAM psychologist

Parents whose children present with these symptoms may feel their child is being manipulative or lying in order to get out of school or other activities.  Learning more about your child’s fears, what management strategies you can teach your child, and how you can be supportive are successful keys to helping kids overcome their anxiety.  CSAM’s own child/teen specialist, Dr. Starr MacKinnon shares that it’s important for parents to take care of themselves: “The best advice I have for parents is to remain calm and focus on self-care. The truth is, your children will predominantly learn from the model you provide them and are less impacted by your words.  Children and adolescents are sponges and they will often grow up and engage in the same self-talk, behaviors, and coping that you do. So the more that you can take care of yourself and be the person you want your children to be, the better it will be for all of you.”

There are additional strategies parents and caregivers can use when helping kids cope with anxiety (Miller, 2012):

• Explain to the child that his or her feelings of worry or dread are caused by a condition called anxiety.
• Help the child notice the connection between anxiety and shallow, rapid breathing. Teach the child how to breathe slowly and into the belly.
• Encourage the child to replace anxious “red light” thoughts (“that dog will bite me”) with more helpful and realistic “green light” thoughts (“most dogs don’t bite kids”).”

Another way that Miller encourages parents to support children is through gradual learning and patience.  If a child has intense fears about making a speech in front of his or her class, consider having the child read it in front of one parent first, then the family, followed by a few close friends, and so on, until the child feels confident enough to speak in front of a larger group.

If a child’s anxiety symptoms persist despite their caregivers’ best efforts, seeking professional help is recommended.  Mental health professionals who specialize in anxiety treatment with kids can help train the children to develop coping strategies to manage anxiety, but can also coach caregivers to reinforce these strategies while the child is in school and at home.  

Help is Here!

Parents and caregivers are the most important factor influencing whether kids develop effective coping skills to manage anxiety.  The Center for Stress and Anxiety Management is here to help.  Starr MacKinnon, PhD, is a licensed psychologist with a specialty interest in working with children and teens with anxiety disorders.  Dr. MacKinnon shared what she enjoys about working with kids and teens: “I love working with children and teens because often they are more flexible and open to self-exploration and growth…I love helping kids and adolescents to gain insight into who they want to become so that the barriers to living that life can be addressed."

Click here to speak with Dr. MacKinnon or another professional at the Center for Stress and Anxiety Management.  

References:

Ginsburg, G. S., Riddle, M. A., & Davies, M. (2006). Somatic Symptoms in Children and Adolescents With Anxiety Disorders. Journal Of The American Academy Of Child & Adolescent Psychiatry, 45(10), 1179-1187. doi:10.1097/01.chi.0000231974.43966.6e

Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., & ... Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal Of The American Academy Of Child & Adolescent Psychiatry, 49(10), 980-989. doi:10.1016/j.jaac.2010.05.017

Miller, L. (2012).  Early screening for anxiety disorders in children helps prevent mental health concerns: UBC study [Press release].  Retrieved from http://news.ubc.ca/2012/04/16/early-screening-for-anxiety-disorders-in-children-helps-prevent-mental-health-concerns-ubc-study/