It’s no secret that advances in technology have changed life as we know it. While these changes have brought more opportunity for education, communication, transparency and other benefits, we’ve also seen the harmful impacts, such as cyberbullying, more pressures to “keep up with the Joneses,” and increased self-doubt.
KVC Hospitals provides psychiatric treatment to youth struggling with depression, anxiety, suicidal ideation, the effects of trauma, and other behavioral health challenges. Dr. Vishal Adma serves as Medical Director for KVC Hospitals and oversees services for the youth psychiatric inpatient and residential treatment facilities. Additionally, he provides psychiatric care to children and families. Dr. Jyotsna Adma is a Child Psychiatrist for KVC Hospitals. She works with a wide range of patients and specializes in ADHD, childhood mood disorders and childhood anxiety disorders.
In a recent interview, Dr. Vishal Adma and Dr. Jyotsna Adma discussed what parents can do to help their children regarding anxiety and increased pressures. Married for many years and both experts in this field, they provided answers from a combined perspective and could often finish each other’s thoughts. Overall, their response wasn’t that parents should limit their child’s use of technology or monitor their interactions, but that they should educate themselves about the technology and social platforms their child is using so that they can talk about it.
It’s happening, and no one can change that. This is the future for the current generation of children and the children to come. The best thing parents can do is educate themselves about the changes happening, and talk to their children. — Dr. Vishal Adma
Our interview below discusses how to know if your child is experiencing anxiety, and what parents need to understand about anxiety to best help their child.
Q: Many people think of anxiety and depression as interchangeable. What’s the difference between the two? If someone has one, do they always have the other?
Drs. Vishal and Jyotsna Adma: In the Diagnostic and Statistical Manual of Mental Disorders, which is considered a key resource in the psychiatry field, anxiety and depression are two separate diagnoses with different diagnostic criteria, symptoms and treatments. When someone is depressed, their symptoms include feelings of sadness, hopelessness, and helplessness, and they can experience crying spells and a sense of guilt. As these feelings become more serious, a person might become suicidal.
On the other hand, anxiety is classified as a diagnosis with a disorder spectrum because there are various types of anxiety and they have different triggers and indicators—a few examples are panic disorder, generalized anxiety, social anxiety, obsessive-compulsive disorder and post-traumatic stress disorder (PTSD).
While anxiety and depression are diagnostically very different, they can coexist in a patient. In fact, 50% or more of patients with depression also show symptoms of anxiety. One can trigger the other and they are very closely linked in the brain.
One way I describe this to patients and their families is anxiety is one person and depression is one person, and they’re very close friends. They live separately but rely on each other. If depression is at a party and anxiety isn’t there, depression misses its friend and calls on anxiety to join. — Dr. Jyotsna Adma
Once someone gets in a cycle of the two occurring together, it can be difficult to tell which one is triggering the other and which one to treat first. Also, depression doesn’t always come first; it can be the other way around. It’s different for every person, and not every person with depression or anxiety will experience the other.
Q: If someone is diagnosed with anxiety, how do you know when their response to a situation is becoming elevated?
It’s different for everyone. Some individuals have higher thresholds than others, and it takes more before they start to react in a way that triggers anxiety or an anxiety attack. For example, war veterans see many traumatic events, but they don’t all develop PTSD or respond the same way. A person’s response is very dependent on their personal resilience and to what extent their brain can tolerate something. Everyone has their own capacity. There also isn’t only one reason people get anxiety. It can come from various aspects of a person’s life, whether it’s genetic/biologic, psychological, environmental or a combination of factors.
Q: What should a parent understand about their child’s anxiety to help them?
Parents need to understand that this is a medical condition, and it’s very common in youth. Schools have become a big trigger of stress for teenagers, which can lead to anxiety. It’s important for parents to be aware that anxiety can happen to any child and to be open to having a conversation with their child about what they’re feeling. If you notice something different in your child’s actions or behaviors, having that open conversation is key. Normalize those feelings for your child, don’t shame them and don’t make them feel blame or guilt. Help your child feel comfortable being open and honest with you. Also, this is not a sign of bad parenting, and blaming yourself can then trigger your own anxiety.
There’s still a stigma about psychiatric diagnoses, so parents need to recognize that mental illness is like a physical diagnosis, such as asthma. It can be lifelong, but it’s also treatable. Once a parent understands this, they can transfer that understanding to their child to help them cope with a diagnosis and recognize that it can be managed.
“You wouldn’t tell a child having a seizure to just stop seizing, or a child with diabetes to control their pancreas, just as you can’t tell a child with anxiety or depression to stop the feelings they’re having.” — Dr. Jyotsna Adma
Q: Do you often see parents who don’t want to put their child on medication? How do you work through that with them?
We often see parents hesitant to put their child on medication for a mental illness. We try to explain that it is a medical condition and help them see it in comparison to other medical conditions, such as diabetes or cardiac problems. Not every child we treat needs to be on medication. It’s based on the criteria for each patient: how serious their symptoms are and how it is impacting their ability to function. Some children do well with only therapy, and some children respond best to a combination of therapy and medication. Treatment is not one size fits all.
Q: If school is a trigger for a child to the point they try to avoid going, how can a parent help their child safely return to school?
School is becoming a bigger trigger for children, especially those of high school and college age. Today, there are more expectations on kids from parents, schools and peer pressure. If your child is avoiding school, you need to first and foremost talk to them about what’s going on and don’t be afraid to ask questions. Then work with your child to come up with a plan and discuss what you can do before they jump back into school. Start by doing what you can to solve the problem at home. You can also approach the school or school counselor to tell them what symptoms you’re seeing and what struggles your child is having, and see if the school can help come up with a plan to address the issues. Schools are seeing this trend and many are doing more specialized training and creating protocols to better watch children and identify signs of anxiety and depression.
Q: Technology continues to advance, creating more access and increased peer pressure for teens. How can families overcome this and help keep their child healthy with all of these external impacts?
There are recommendations by the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry about the use of electronics and social media and how they’re impacting children with regard to cyberbullying and everything else. Using educational resources such as these to learn more and think of a strategy that will apply best to your own child is important. What kind of modifications can you make as a parent that works best for your family and helps keep your child happy and healthy?
The norm and expectation are to keep up with everything happening in technology. Understanding that and letting your child go through this normal phase of their generation is a good thing. You must stay open, connected and communicate as a family to know what’s happening with your child and consistently plan family activities and time together.
There is research out there about social media and how it’s impacting anxiety in children and even adults. Studies show that the rate at which anxiety symptoms are increasing in teens and college students is at a much faster pace than they’re seeing with depression. This tells us that social media is having a direct impact on anxiety more so than depression. Social media isn’t going away, though, and it won’t help your child to make them feel isolated from these communication platforms. There comes a point in your child’s life when it is OK to be their parent and their friend. Help them be comfortable opening up to you as they would a friend their own age. This is especially healthy as your child enters their teen years, and you especially want this open dialog before your teenager leaves for college.
We hear many parents say, “if my child needs something, they’ll come to me.” An alternative approach is to ensure, not assume, that a child feels safe and comfortable reaching out to their parents when in a situation they need assistance with. — Dr. Vishal Adma
Anyone who believes in healthy childhoods can help us by donating, volunteering or working with us. We need more people to help more children and teens going through crisis. If you would like to provide a meaningful impact in the lives of children, teens and families consider joining our team! View positions and apply at www.kvc.org/careers.