Youth Generalised Anxiety Disorder

Generalised Anxiety Disorder (GAD) affects about 5% of the population. The symptoms of GAD can start at a relatively early age, with one third of people with GAD experiencing symptoms in childhood or adolescence. GAD can last for many years, but may not have big impact on someone's ability to function in daily life. This is why GAD often remains undetected.

The main feature of GAD is excessive anxiety and worry, occurring more than 3 days each week for at least six months. People with GAD worry about a number of events or activities such as sporting performance or study, health, or family issues. The worries are often about a variety of minor issues and events that are unlikely to occur. Realistic anxiety, such as concerns about passing your VCE exams are not signs of GAD. However, consistent, excessive worry about certain events that are unlikely to occur is cause for concern. The person finds it extremely difficult to control the worry. Generally, the worries are future oriented, that is, about what might happen, rather than what is happening. Being uanble to accept uncertainty about the future is common in people with GAD.

The anxiety and worry in GAD is accompanied by other physical and emotional symptoms such as: restlessness or feeling on edge; being easily fatigued; difficulty in concentrating or mind going blank; irritability; muscle tension; shallow, uneven breathing; and sleep disturbance. Other symptoms include an increase in heart rate and blood pressure, sweating, feeling nauseous or sick, trembling and shaking and feeling as though you are going crazy and losing control. In some cases, people deal with the excessive, constant anxiety through the over use of alcohol, recreational or non-prescription drugs.

Deep breathing exercises can be very helpful for people with GAD.

Click on this link to learn how you can use deep breathing.

Trichotillomania for Youth

Trichotillomania or compulsive hair pulling occurs in people of all ages.

In children, it appears there are several behaviours that are important in the hair pulling habit such as

  • feeling the texture of the hair, rubbing fingers along the hair shaft,
  • biting the hair bulb, eating the hair, sucking on hair, or “playing” with the hair in the mouth,
  • rubbing the hair along the cheek, nose or lip.

For many children these behaviours are motivated by touch, which apparently has a self-quieting effect similar to that achieved by rocking, thumb sucking, rubbing a favourite blanket or stroking a stuffed animal.

It is possible that some adult hairpullers began pulling and continue to pull for similar reasons.  Years of practice, however, allow the habit to evolve into a behaviour pattern which is hard to change with complex emotional and situational influences. Over time, the effects of hair pulling can have negative consequences on emotions, self-esteem and social confidence.

The effects of hair pulling

Young children who pull often do not experience the same degree of self-consciousness as pre-adolescent children, adolescents, and adult sufferers. Older children experience more shame and other socially inspired effects of hair pulling.  While hairpulling may be a sign of stress in the child, this is not always the case, and should not automatically be assumed so.  Although severe environmental and interpersonal stressors can certainly contribute to hair pulling behaviour.

Although young children may not experience the same degree of emotional stress as older hair pullers, these children often do have some sense of being different, usually derived from their parents' attention to their hair pulling, the comments of other adults, and the reactions of their peers.  These can negatively affect the child’s emotions and behaviour.  Left unaddressed, it is possible that these feelings can lead to the more severe emotional side effects such as those experienced by many adults with trichotillomania.

How can parents help?

So what can parents do when they discover that their young child has been pulling out hair?  First and foremost, don’t panic! Many parents, particularly if they are individuals who have struggled with hair pulling themselves, tend to be quite sensitive about their children’s interest in their own hair.  It is very common for children to be curious about different textures and to explore their heads, hair, and bodies by touch.  Remember, for some children hair pulling is a brief childhood phase associated with self exploration and self quieting, and will not develop into a clinical problem.  However, if a child's hair pulling has caused substantial damage, or they express a wish to end hair pulling, here are some general approaches a parent might consider.

  • Adopt a non-punishing, non-critical attitude toward the hair pulling.
  • Observe your child’s hair pulling habits.  Determine which activities and what situations seem to increase the likelihood that there will be a pulling episode.
  • Some of these activities might include watching TV, reading,  studying, listening, riding in the car, daydreaming, settling down, and trying to fall asleep.
  • Often children can be helped to establish alternative non-damaging routines while involved in situations that would typically trigger a pulling episode.

You may want to explore with the child a variety of “toys” that may interest your child and distract him/her from hair.  Ones that provide tactile stimulation are particularly useful.  Some examples include koosh balls, nerf balls, stuffed animals, pieces of velcro, felt or velvet, etc.  The list is only limited by one’s imagination!  Introduce one toy at a time in situations where the child is vulnerable.  Be positive and encouraging.  Help your child incorporate handling and playing with the toy into the activities and situations where they are vulnerable.  For example, if your child has typically pulled while watching TV, you might introduce a “TV toy” and encourage your child to play with it while watching TV.  Provide lots of praise for these alternative behaviours until the pattern is changed.  This process could take from a few days to much longer but even a diligent effort may in fact, not succeed.  Be patient and be careful not to nag.  It is perfectly acceptable to drop the effort for a time and reintroduce it later.  If you suspect that your child’s hairstyle and length may be contributing to the problem, it may help to experiment with a different style, particularly one that keeps the hair away from face and fingers.  Remember this is a complex behaviour pattern, the causes of which are as yet unknown.  If you need additional support and/or guidance, don’t hesitate to seek the assistance of a qualified therapist.

Although little has been written about treatment outcome for childhood trichotillomania, early intervention appears to be successful in reducing or eliminating hair pulling in most children. Therapy involving family members, with a learning-based intervention, introduced before there are significant emotional side effects, allows children to gain healthy perspectives of themselves while developing positive self-esteem.  In addition, teaching children about their own unique needs and helping them to develop coping skills within a positive and encouraging atmosphere provides an opportunity for them to learn valuable lessons about gaining control over their own lives and behaviour. A low profile, “wait and see” approach may be ok for preschoolers, however, for some school age children, early intervention can help to ensure that young hair pullers are protected from the potentially devastating problems associated with adult trichotillomania.

Adapted from an article By Ruth Goldfinger Golomb, M.Ed. and Charles S. Mansueto, Ph.D;  Behaviour Therapy Associates, Silver Spring, Maryland. 

Editors Note:  This article originally appeared in “In Touch” a quarterly newsletter of The Trichotillomania Learning Centre

References:

Mansueto, C. (1991).  Trichotillomania in Focus, OCD Newsletter, 5, 10-11.

Swedo, S (1991).  Childhood Trichotillomania Update. OCD Newsletter, 5, 4.

 

For information on our Youth Trichotillomania Support Group click here

Body Dysmorphic Disorder for Youth

Body Dysmorphic Disorder (BDD) is defined as a preoccupation with an imagined 'defect' in appearance.

Most people are concerned about their appearance in some way and some take more care of their bodies and appearance than others, particularly during their teenage years. While they may even feel dissatisfied with something they feel is not quite right it doesn't usually interfer with how they go about their daily lives and they do not have distressing thoughts or feel tormented because of their concerns.

However, a preoccupation about minor imperfections, thoughts about these perceived flaws that persistantly intrude into a person's mind and constant checking of their appearance are some of the signs of BDD. Unfortunately, BDD can cause isolation due to these intrusive thoughts, excessive worry and ritualistic behaviours such as checking in mirrors for imperfections, frequently seeking reassurance from others, and even avoiding going out so that others will not see their flaws.

People with BDD tend to have low self-esteem. If their appearance deviates from 'perfection', they can view themselves as worthless or unlovable. They may even drop out of school, stop working, or avoid social activities altogether. Their attention is almost exclusively focused on their 'flaws' and so they become extremely conscious of any minor changes that deviate from their high standards.

There can be some overlap between BDD and OCD (Obsessive Compulsive Disorder) - sufferers of OCD sometimes have BDD - and vice versa. Like OCD, experts believe that serotonin levels in the brain are related to BDD, although the cause of BDD are still unclear. Treatment for BDD usually includes cognitive-bahavioural therapy with a trained mental health professional to help change the faulty thought processes which create the worrying thoughts about a person's image.

Links to other information pages about BDD:

Reach Out

Your Kids Ed

University of Queensland
OCD Treatment Trial for Adolescents

Do you know someone aged 12-17 who is experiencing symptoms of Obsessive-Compulsive Disorder (OCD) like unwanted and intrusive thoughts or compulsions like repetitive checking, cleaning or counting? 

The University of Queensland is offering a free online OCD assessment and treatment program for 12-17 year olds for a short time only. The 12-week program is supported by a clinical psychologist who is a specialist in treating adolescent OCD. Parents can also access an online program and specialist support. 

Please contact Dr Cynthia Turner at This email address is being protected from spambots. You need JavaScript enabled to view it. if you feel the program would be helpful for your child and family, or visit our Facebook page at https://www.facebook.com/teenocdhelp or our website at https://exp.psy.uq.edu.au/ocd for more information.