Stress and Anxiety

in Students
January 15, 2019

Dr. Christina Conolly, NCSP

Director
Division of Psychological Services
Participants will gain:
◦ An understanding of what stress is
◦ Effects of stress and school
performance
Intended
◦ An understanding of what causes Outcomes
anxiety disorders
◦ Steps families can take to
decrease stress for students

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Youth Mental Health
by the Numbers

Did you know…

◦1 in 5 students experience a
mental health disorder

Source: CDC, 2018 3

Youth Mental Health by the Numbers
CDC Data collected between the years 2005-2011 show:
◦ Children aged 3-17 years currently had:
◦ ADHD (6.8%)
◦ Behavioral or conduct problems (3.5%)
◦ Anxiety (3.0%)
◦ Depression (2.1%)
◦ Autism spectrum disorders (1.1%)
◦ Tourette syndrome (0.2%) (among children aged 6–17 years)
◦ Adolescents aged 12–17 years had:
◦ Illicit drug use disorder in the past year (4.7%)
◦ Alcohol use disorder in the past year (4.2%)
◦ Cigarette dependence in the past month (2.8%)
Source: CDC, 2018 4
Why do we talk about mental health?
Mentally healthy children are more successful
in school and life.

◦ Research demonstrates that students who receive social–emotional and mental

health support achieve better academically.
◦ School climate, classroom behavior, on-task learning, and students’ sense of
connectedness and well-being all improve as well.
◦ Mental health includes social, emotional, and behavioral health and the ability
to cope with life’s challenges.
◦ Left unmet, mental health problems are linked to negative concerns such as
academic and behavior problems, dropping out, and delinquency.
Source: NASP, 2016 5
STRESS
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What is Stress?
◦ Definition of Stress:
◦ Any uncomfortable "emotional experience accompanied by
predictable biochemical, physiological and behavioral changes."
◦ Some stress can be beneficial at times, producing a boost that
provides the drive and energy to help people.
◦ However, an extreme amount of stress can have health
consequences and adversely affect the immune, cardiovascular,
neuroendocrine and central nervous systems.

Source: http://www.apa.org/helpcenter/understanding-chronic-stress.aspx; Anderson, N.B.

(1998).; Baum, A. (1990)
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 GOOD STRESS/Bad Stress

§ Can make you feel energized

and motivated
§ Encourages us to deal with
challenges
§ Increases strength
§ Increases speed
§ Increases stamina

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 Good Stress/BAD STRESS
§ Feeling Overwhelmed
§ Over/Under Sleeping
§ Over/Under Eating
§ Headaches
§ Stomachaches
§ Feeling Jittery
§ Impatience
§ Decreased Strength

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Reasons Students May Feel Stress
ü School Performance ü Family, community, national violence
ü Peer Pressure ü Childhood abuse
ü Family issues/expectations ü Dating abuse
ü Death of a loved one/pet ü Injuries or severe physical illness
ü Loss of a friend ü Appearance
ü Move to a new home ü Finances
ü Media ü Commercialism
ü Bullying ü Mental Illness

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Even MORE Reasons Students Feels Stress
§ Not understanding how grades are earned
§ Concerns and assumptions about what others think about them
§ Snapchat/Instagram/Twitter/etc.
§ Immediacy of cell phones
§ Girl/boy drama
§ Pressure for boys to handle problems physically
§ Hormonal changes/puberty/ZITS
§ Feeling the need to be high school ready in middle school…
and college ready their freshman year
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 12
Source: https://www.youtube.com/watch?v=7pwKxVQon50
ANXIETY DISORDERS
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What is a mental health disorder?
◦ Serious changes in the ways students typically learn, behave,
or handle their emotions.
◦ Symptoms usually start in early childhood, although some
concerns may start during the teenage years. However, some
children with a mental disorder may not be recognized or
diagnosed as having one.

Concerns can be treated and managed.

Source: CDC, 2018 14

What is Anxiety?
◦ Anxiety is one of the most common experiences of children
and adults
◦ An adaptive reaction. Creates a level of arousal and
alertness to danger
◦ Primary Characteristic:
◦ Worry
◦ Fear that future events will have negative outcomes
◦ Anxiety can be a normal reaction to stressful situations
Source: https://www.nasponline.org/resources-and-publications/resources/mental-
health/mental-health-disorders/anxiety-and-anxiety-disorders-in-children-information-for-parents
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What is Anxiety?
◦ Infancy and Preschool
◦ First appears at 7-8 months of age as stranger anxiety
◦ Age 12-15 months: Separation Anxiety
◦ Associated with fears of: strangers, dark, new situations, animals, loud noises,
etc.
◦ School Age
◦ As the child gets older, anxiety is associated with social and abstract
concepts:
◦ Social Acceptance
◦ The Future
◦ Moves to a New School
◦ Etc.
In most cases, students cope well with this situations.
Severe or Chronic Anxiety is not common.
Source: https://www.nasponline.org/resources-and-publications/resources/mental-health/mental-health-disorders/anxiety-and-
anxiety-disorders-in-children-information-for-parents 16
Anxiety Disorders
◦ Separation Anxiety Disorder
◦ Persistent or Extreme fears about leaving familiar people.
◦ Refusal to leave home, attend school
◦ Generalized Anxiety Disorder
◦ Pervasive and high levels of anxiety across a variety of situations
◦ Most common childhood anxiety disorder
◦ Concerned about doing things well; Perfectionistic
◦ Worries frequently about relatively minor things
◦ Appear stressed much of the time

Source: https://www.nasponline.org/resources-and-publications/resources/mental-
health/mental-health-disorders/anxiety-and-anxiety-disorders-in-children-information-for-parents
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Anxiety Disorders
◦ Social Phobia
◦ Excessive fear about being in social situations and being
evaluated by others
◦ Fear of social situations is out of proportion to the actual situations
◦ Typical age of onset is in adolescence or early adulthood
◦ Posttraumatic Stress Disorder (PTSD) ***
◦ Distress as a result of a traumatic situation.
◦ Common types of trauma: exposure to violence, auto accidents,
home fires and injuries, natural disasters, adverse childhood
experiences
Source: https://www.nasponline.org/resources-and-publications/resources/mental-health/mental-health-
disorders/anxiety-and-anxiety-disorders-in-children-information-for-parents 18
Effects on School and Social Performance
◦ Struggle with various demands of school
◦ Inattention
◦ Perfectionistic
◦ Forgetful or unwilling to participate due to concerns about failure
or embarrassment
◦ Avoids difficult tasks
◦ Does not volunteer or participate in classroom activities
◦ Withdrawal from others or situations
◦ Perceived as unmotivated, lazy, uninterested in school
Source: https://www.nasponline.org/resources-and-publications/resources/mental-health/mental-health-
disorders/anxiety-and-anxiety-disorders-in-children-information-for-parents
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Source: https://www.youtube.com/watch?v=FAvrNLsgl4c
PROVIDING
SUPPORT
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How can students address concerns?
◦ Talk with a trusted adult
◦ At home, in school, with community groups
◦ Build Up Resiliency

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Positive Interventions for Home & School
• Have predictable routines
• Set clear and reasonable expectations
• Break down tasks into manageable units (e.g. homework, chores,
classwork, etc.)
• Pair anxious students with peers who are confident and supportive
• Give the student special responsibilities to help build confidence
• Give time to relax when anxiety becomes high.
• Provide breaks
• Reduce or avoid unexpected situations

Source: https://www.nasponline.org/resources-and-publications/resources/mental-health/mental-health-
disorders/anxiety-and-anxiety-disorders-in-children-information-for-parents 23
Positive Interventions for Home & School
• Reduce time constraints, if possible
• Have the student work in a quiet setting with fewer distractions
• Be consistent with how you handle problems and administer
discipline
• Be patient and be prepared to listen
• Avoid being overly critical, disparaging, impatient, or cynical
• Maintain realistic, attainable goals and expectations for your child
• Do not communicate that perfection is expected or acceptable
• Encourage participation in ”fun” and stress-free activities
Source: https://www.nasponline.org/resources-and-publications/resources/mental-health/mental-health-
disorders/anxiety-and-anxiety-disorders-in-children-information-for-parents
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Positive Interventions for Home & School
• Accept that mistakes are a normal part of growing up. No one is
expected to do everything well.
• Everyone has strengths and weaknesses
• Praise and reinforce effort, even if success is less than expected.
• Teach students how to practice and rehearse upcoming events
like giving a speech or other performances
• Teach the student simple strategies to help with anxiety
• Organizing materials and time
• Learning how to relax under stressful conditions (e.g. mindfulness)

Source: https://www.nasponline.org/resources-and-publications/resources/mental-health/mental-health-
disorders/anxiety-and-anxiety-disorders-in-children-information-for-parents
25
Positive Interventions for Home & School
• Maintain consistent but flexible routines at home and school
• Avoid punitive and negative attitudes
• Do not treat feelings, questions, and statements about feeling
anxious as silly or unimportant
• Often, reasoning is not effective in reducing anxiety.
• Do not criticize your student for not being able to respond to
rational approaches
• Seek outside help if the problem persists and continues to interfere
with daily activities

Source: https://www.nasponline.org/resources-and-publications/resources/mental-health/mental-health-
disorders/anxiety-and-anxiety-disorders-in-children-information-for-parents
26
When to Get Help
◦ Student’s behaviors are interfering with life activities
◦ Student causing significant/repeated disruption in classroom
◦ Student escalating others’ behavior
◦ Student self-injuring
◦ Student is withdrawn and is avoiding activities
◦ Student becoming suicidal/threatening others

◦ Things to consider:
◦ Length of Time
◦ Frequency
◦ Intensity 27
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Common Myths about Youth Suicide
◦ Asking questions or talking about
suicide with children and
adolescents will increase the
probability that suicide will occur.
◦ Research actually suggests that youth
who are able to openly and candidly
discuss the topic of suicide with trusted
adults typically have more beneficial
outcomes.
◦ Parents/caregivers are cognizant
of their child’s suicidal behavior.
◦ One study indicated that 86% of parents
were unaware of the suicidal behavior
including suicide attempts.

Source: Miller (2011)

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Suicide Prevention: Suggestions for students

◦Do not be afraid to talk

A.C.T.:
to your friend.
◦Know the warning signs. Acknowledge
◦Make no deals to keep Care
anything confidential.
◦Tell an adult. Tell a Trusted Adult

Source: Screening for Mental Health (2016)

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Does My Child Have a Disability?
◦ Contact the school to schedule:
◦ Educational Management Team Meeting
◦ IEP Meeting
◦ 504 Meeting
◦ Only a IEP or 504 Team can determine if an
educational disability exists

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Where to Get Help
◦ Contact:
◦ Building Administration
◦ Teacher
◦ School Counselor
◦ School Psychologist
◦ Pupil Personnel Worker
◦ Parent Community Coordinator

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Stress Reducing Techniques
Five Minute Mindfulness

Source: https://www.youtube.com/watch?v=9A0S54yAgEg 33
Questions

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Contact information

Dr. Christina Conolly

Director, Division of Psychological Services
Montgomery County Public Schools
850 Hungerford Drive
Rockville, MD 20850

Christina_N_Conolly@mcpsmd.org

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References
◦ CDC study
◦ https://www.cdc.gov/childrensmentalhealth/features/kf-childrens-mental-health-
report.html
◦ Miller, D. N. (2011). Child and adolescent suicidal behavior: School-based
prevention, assessment, and intervention. The Guilford Press, New York.
◦ National Association of School Psychologists
◦ http://www.nasponline.org/resources-and-publications/resources/school-safety-
and-crisis/preventing-youth-suicide/save-a-friend-tips-for-teens-to-prevent-suicide
◦ http://www.nasponline.org/resources-and-publications/resources/mental-
health/school-psychology-and-mental-health/school-based-mental-health-
services
◦ http://www.nasponline.org/resources-and-publications/resources/mental-
health/prevention-and-wellness-promotion/building-resiliency-helping-children-
learn-to-weather-tough-time
◦ https://www.nasponline.org/resources-and-publications/resources/mental-
health/mental-health-disorders/anxiety-and-anxiety-disorders-in-children-
information-for-parents 36