9781422285787

MENTAL ILLNESSES AND DISORDERS Awareness and Understanding

DISORDERS SERIES CONSULTANT ANNE S. WALTERS, PhD Chief Psychologist, Emma Pendleton Bradley Hospital Clinical Associate Professor, Alpert Medical School/Brown University ANXIETY H.W. Poole

MENTAL ILLNESSES AND DISORDERS Awareness and Understanding

A N X I E T Y D I S O R D E R S

MENTAL ILLNESSESAND DISORDERS

Alzheimer’s Disease Anxiety Disorders Attention-Deficit Hyperactivity Disorder Autism SpectrumDisorders Bipolar Disorder Depression

Disruptive Behavior Disorders Drug andAlcohol Dependence Eating Disorders Obsessive-Compulsive Disorder Post-Traumatic Stress Disorder Schizophrenia Sleep Disorders

MENTAL ILLNESSES AND DISORDERS Awareness and Understanding

DISORDERS SERIES CONSULTANT ANNE S. WALTERS, PhD Chief Psychologist, Emma Pendleton Bradley Hospital Clinical Associate Professor, Alpert Medical School/Brown University ANXIETY H.W. Poole

MASON CREST

Mason Crest 450 Parkway Drive, Suite D Broomall, PA 19008 www.masoncrest.com

© 2016 by Mason Crest, an imprint of National Highlights, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, taping, or any information storage and retrieval system, without permission from the publisher.

MTM Publishing, Inc. 435 West 23rd Street, #8C New York, NY 10011 www.mtmpublishing.com

President: Valerie Tomaselli Vice President, Book Development: Hilary Poole Designer: Annemarie Redmond Copyeditor: Peter Jaskowiak Editorial Assistant: Andrea St. Aubin

Series ISBN: 978-1-4222-3364-1 ISBN: 978-1-4222-3377-1 Ebook ISBN: 978-1-4222-8578-7

Library of Congress Cataloging-in-Publication Data

Poole, Hilary W., author.   Anxiety disorders / by H.W. Poole.        pages cm. — (Mental illnesses and disorders : awareness and understanding)   Includes bibliographical references and index.   ISBN 978-1-4222-3377-1 (hardback) — ISBN 978-1-4222-3364-1 (series) — ISBN 978-1-4222-8578-7 (ebook) 1.  Anxiety disorders—Juvenile literature.  I. Title.

  RC531.P66 2016   616.85’22—dc23

2015006689

Printed and bound in the United States of America.

First printing 9 8 7 6 5 4 3 2 1

TABLE OF CONTENTS

Introduction to the Series 7 Chapter One: Nervous Is Normal 9 Chapter Two: When Anxiety Becomes a Problem 16 Chapter Three: Diagnosing Anxiety Disorders 29 Chapter Four: Treating Anxiety Disorders 35 Further Reading 44 Series Glossary 45 Index 47 About the Author 48 Photo Credits 48

Key Icons to Look for:

Words to Understand: These words with their easy-to-understand definitions will increase the reader’s understanding of the text, while building vocabulary skills.

Sidebars: This boxed material within the main text allows readers to build knowledge, gain insights, explore possibilities, and broaden their perspectives by weaving together additional information to provide realistic and holistic perspectives. Research Projects: Readers are pointed toward areas of further inquiry connected to each chapter. Suggestions are provided for projects that encourage deeper research and analysis. Text-Dependent Questions: These questions send the reader back to the text for more careful attention to the evidence presented there.

Series Glossary of Key Terms: This back-of-the-book glossary contains terminology used throughout the series. Words found here increase the reader’s ability to read and comprehend higher-level books and articles in this field.

People who cope with mental illnesses and disorders deserve our empathy and respect.

(istockphoto/digitalskillet)

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Introduction to the Series

According to the National Institute of Mental Health, in 2012 there were an estimated 45 million people in the United States suffering from mental illness, or 19 percent of all US adults. A separate 2011 study found that among children, almost one in five suffer from some form of mental illness or disorder. The nature and level of impairment varies widely. For example, children and adults with anxiety disorders may struggle with a range of symptoms, from a constant state of worry about both real and imagined events to a complete inability to leave the house. Children or adults with schizophrenia might experience periods when the illness is well controlled by medication and therapies, but there may also be times when they must spend time in a hospital for their own safety and the safety of others. For every person with mental illness who makes the news, there are many more who do not, and these are the people that we must learn more about and help to feel accepted, and even welcomed, in this world of diversity. It is not easy to have a mental illness in this country. Access to mental health services remains a significant issue. Many states and some private insurers have “opted out” of providing sufficient coverage for mental health treatment. This translates to limits on the amount of sessions or frequency of treatment, inadequate rates for providers, and other problems that make it difficult for people to get the care they need. Meanwhile, stigma about mental illness remains widespread. There are still whispers about “bad parenting,” or “the other side of the tracks.” The whisperers imply that mental illness is something you bring upon yourself, or something that someone does to you. Obviously, mental illness can be exacerbated by an adverse event such as trauma or parental instability. But there is just as much truth to the biological bases of mental illness. No one is made schizophrenic by ineffective parenting, for example, or by engaging in “wild” behavior as an adolescent. Mental illness is a complex interplay of genes, biology, and the environment, much like many physical illnesses. People with mental illness are brave soldiers, really. They fight their illness every day, in all of the settings of their lives. When people with an anxiety disorder graduate from

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college, you know that they worked very hard to get there—harder, perhaps, than those who did not struggle with a psychiatric issue. They got up every day with a pit in their stomach about facing the world, and they worried about their finals more than their classmates. When they had to give a presentation in class, they thought their world was going to end and that they would faint, or worse, in front of everyone. But they fought back, and they kept going. Every day. That’s bravery, and that is to be respected and congratulated. These books were written to help young people get the facts about mental illness. Facts go a long way to dispel stigma. Knowing the facts gives students the opportunity to help others to know and understand. If your student lives with someone with mental illness, these books can help students know a bit more about what to expect. If they are concerned about someone, or even about themselves, these books are meant to provide some answers and a place to start. The topics covered in this series are those that seem most relevant for middle schoolers—disorders that they are most likely to come into contact with or to be curious about. Schizophrenia is a rare illness, but it is an illness with many misconceptions and inaccurate portrayals in media. Anxiety and depressive disorders, on the other hand, are quite common. Most of our youth have likely had personal experience of anxiety or depression, or knowledge of someone who struggles with these symptoms. As a teacher or a librarian, thank you for taking part in dispelling myths and bringing facts to your children and students. Thank you for caring about the brave soldiers who live and work with mental illness. These reference books are for all of them, and also for those of us who have the good fortune to work with and know them.

—Anne S. Walters, PhD Chief Psychologist, Emma Pendleton Bradley Hospital Clinical Professor, Alpert Medical School/Brown University

CHAPTER ONE

N E R V O U S I S N O R M A L

Words to Understand anxiety: a feeling of worry or nervousness. panic attack: sudden and overwhelming fear, with no real danger present. physiological: relating to the function of the body. response: a reaction to something. trigger: something that causes something else to happen.

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Have you ever felt nervous? Maybe you . . .

• overslept one morning and had to rush through breakfast. You might have felt nervous that you’d miss your bus and get in trouble. • had trouble sleeping because you kept thinking about your team’s important game the next day. You might have worried about playing well. • had to speak in front of your whole class. The thought of everyone looking at you might have made you very nervous. • overheard your parents arguing. The sound of their angry voices might have made you worried, even if they weren’t yelling right at you.

It’s common to have trouble sleeping if you are feeling anxious about something.

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FIGHT OR FLIGHT

Have you ever watched a pet react to a threat—another animal, a passing car, or even a vacuum cleaner? You might see the pet’s body get tense, its ears and tail standing at attention. It might become very excited, pacing around and making noise. This is what is known as the fight-or-flight response . Animals (and that includes us humans) have physiological responses to fear. Our hearts beat faster, we breathe faster, and

blood flow increases. The body is getting ready to face a threat. We might “fight” the threat or we might “flee” it, depending on our personalities and the nature of the threat. But the response—that racing of the heart and tensing of the body—is an ancient safety technique. Like nervousness, the fight-or-flight response is completely normal. But sometimes people have the same feelings when there is no threat. This is when anxiety can become a problem.

These feelings are anxiety . They are all completely normal. Anxiety is just a form of fear, and fear is nothing to be ashamed of. There is nothing more normal for humans than anxiety. Anxiety Isn’t All Bad The ability to feel nervous can be a good thing. Our ancient ancestors were afraid of large animals like bears and lions, and for good reason! After all, the caveman who feared lions lived long enough to have children. But the caveman who felt no

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? DID YOU KNOW? About 25 percent of all teenagers struggle with anxiety at some point. More than 5 percent of teenagers have severe anxiety.

fear of lions often did not live very long at all. Today, a fear of fire or a fear of crossing busy streets can keep you safe in just the same way. Anxiety can do more than just save lives. We now know that a little anxiety sparks extra brain activity. Being a bit nervous about a test is actually a good thing: studies have found that a little anxiety can help your memory. Many skilled performers still feel nervous before they step out on stage. That little jolt of anxiety can create a better performance. However, when it comes to anxiety, there can be too much of a good thing. Large amounts of anxiety actually cause less brain activity. That’s probably why people talk about being so nervous that they “freeze up” and “can’t think.” Scientists believe that a little anxiety speeds the brain up, but a lot of anxiety slows the brain down. Too Much Anxiety? Feeling anxious is part of being human. If you are going through a difficult time in your life—if your mother or father just lost a job, for example, or if you are moving to a new town—you might feel anxious a lot. And that’s okay. When the difficult time passes, you will feel better. But sometimes, people don’t feel better. Sometimes the feelings of anxiety are so strong that they can’t do what they want to do. Some people become so nervous that they begin to sweat and shake, have trouble breathing, and feel sick. These experiences are called panic attacks , and they can be very frightening.

Opposite: If life is stressful in your home, it’s natural that you might feel anxious.

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If these feelings are so strong that they run your life, you may have an anxiety disorder. Sometimes people with anxiety disorders feel nervous because of a particular situation, like a test or a class presentation, but many times there is no specific cause at all. There is no test, no class presentation. They just feel anxious anyway. It seems like the fear is in charge, rather than the person. Anxiety disorders are very common. In fact, anxiety disorders are the most common mental disorder in North

Giving a presentation is enough to make anyone nervous.