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Tackling Teen Anxiety (as seen in Diablo Magazine, June 2017)

A Fremont native’s new book helps parents of teens struggling with anxiety.

BY LOU FANCHER

When he was 13, Jon Patrick Hatcher began cutting himself, and he wrestled with years of substance abuse and panic attacks. As his parents struggled to understand him, they decided their son would benefit from professional help. Talk therapy—and Hatcher’s instinctive sense of humor—were key to helping him accept, acknowledge, and manage his anxiety.

Decades later, Hatcher, who got an M.A. from Cal Poly, San Luis Obispo, met Thomas McDonagh, Psy.D., a clinical psychologist in San Francisco. It was a perfect matchup that led to their new book, 101 Ways to Conquer Teen Anxiety: Simple Tips, Techniques, and Strategies for Overcoming Anxiety, Worry, and Panic Attacks.

Hatcher writes with a touch of humor, a tool he still uses to combat the anxiety he will never completely eliminate. We talked to the Fremont-raised author about his new book, why talk therapy is so effective, and practical things parents can do—and not do—to help their teenagers struggling with anxiety.

Q: Why did you write 101 Ways?

A: You can survive is really my message. If you look at the most brilliant minds on the planet, people like Einstein, they suffer a double-edged sword of depression and anxiety. The premise I want to get out is that it’s OK: Anxiety doesn’t define the rest of your life, and there are therapies designed to get you through it. If this reaches one kid out there and helps [him or her], that’s my mission.

Q: What should parents know about teen anxiety?

A: When teens react in an anxious state, they perceive the world in a vastly different, threatening way. A teen might act like a ferocious animal. If they self-
medicate, that might add to the out-of-control impression. What works isn’t telling a teen to calm down; it’s empathy and diplomacy that work best.

Q: What are some things parents can do to help their kids cope with anxiety?

A: Pay close attention to your [children’s] symptoms and what they might be telling you, while not discounting their feelings. Remind your [teens] that anxiety is what they’re feeling and not who they are. Keep in mind that anxiety is not an indicator of poor parenting. Anxiety disorders affect over 25 percent of all teens. Try to keep your fears to yourself and present a positive—or at least neutral—assessment and attitude of the situation. Consider adding some humor where you’re able. Humor is proven to help us deal with disappointments and uncertainties.

Model positive behavior and good self-care. If you take care of yourself, your child will learn that self-care is an important facet. Promote good sleep. A lack of sleep alone can lead to problematic anxiety. Help them get into a routine that prepares them for relaxation. This can include simple meditative breathing exercises or guided meditations. After asking them to share their fears and anxieties, prompt them to problem solve what is causing them anxiety, and help them to develop an actionable plan to counter their distress. Once you have implemented some of the aforementioned, keep the momentum [going]. Only through repetition of anxiety management techniques will your child learn how to counter and manage future stressful scenarios or periods of anxiety—particularly if the anxiety is long-term or chronic.

Q: What should parents not do?

A: Avoid making the problem worse: If parents haven’t had anxiety themselves, they might unintentionally create more anxiety by telling their teen that there’s dangerous stuff out there. Don’t overreact to teen drama. Remember, the teen brain is undergoing constant change. Offer empathy and help from a mental health professional.

Q: Why did you use humor in this book, and in what ways do you find humor useful – or even necessary?

A: The most successful, inadvertent coping technique I developed to alleviate anxiety in my own life is by sourcing the humor in the angst. That said, it definitely does not take away from the serious nature of the subject. Nor does it trivialize anyone’s suffering. It simply makes the material more approachable and relatable.

Q: How can teens avoid becoming overwhelmed?

A: The media show dramatic situations; news headlines make it seem like the world is falling apart; social media is like a mental filter that causes misperception. [Limit] time spent on social media platforms. Start with creating phone-free times. Parents might consider spending time offering their children specific alternatives to daily social media use that include school- or community-based sports, academic and social clubs, pursuing creative or artistic interests, and even volunteering. Engaging in talk therapy with a licensed psychologist [is also] important for managing extreme anxiety.

Q: What are your thoughts on medicating kids who suffer from anxiety versus using talk therapy?

A: I do feel we’re overmedicating kids. Parents [often] demand it, physicians feel put on the spot, and teens aren’t getting the skills they need in therapy. That said, there’s definitely a place for medication in chronic anxiety and depression—especially if a teen talks of suicide and practices self-harm. A pill is easy, and the effect is quicker than acquiring the skills of therapy. But the skills are going to last longer and have fewer side effects. I emphasize therapies and say always bring in a medical professional for medication and a licensed psychologist for mental health support.

Q: Therapy can be effective in managing teen stress, but what can we do about the stigma attached to mental health issues like depression and anxiety?

A: We’ve come a long way, but kids are still bullied, mental health is played down, and kids are told they’re flawed. Cutbacks in programs to help people who need mental health support have made it worse. A lot of people play down the suffering of any mental illness. The brain is an organ like any part of the human body. We don’t say the person with diabetes suffers insulin shock on purpose. We have to have more empathy.

Q: What other types of therapies have you found to be most helpful?

A: Evidence-based therapies that are the most researched and effective that helped me are cognitive behavioral therapy and dialectical behavioral therapy. Cognitive breaks down anxiety into thoughts, behaviors, and physical symptoms. It involves identifying and disputing irrational thoughts. Dialectical builds on the foundation of cognitive to help enhance it’s effectiveness and address specific concerns.

Q: What should a teen experiencing extreme anxiety do immediately? 

A: Go to an adult to ask for help. If teens feel different, if they think bad thoughts and don’t know why, they need to talk to an adult who is close. For immediate relief, they should use the four-by-four-by-four breathing technique recommended in my book. [Breathe in for four seconds; hold for four seconds; breathe out for four seconds. Do it four times.] It is clinically proven to calm the body. stateofanxiety.com.

I Don’t Feel Like Peopling: 10 Ways to Slay Social Anxiety (as seen in Reader’s Digest, June 2017)

At home and on social media, you’re an extroverted badass. In public, you become an isolationist dodging eye contact and handshakes, with a tendency towards agoraphobia and a general excitement over cancelled plans. Your favorite party trick is not going.

What is Social Anxiety?

The most common of all the anxiety disorders, social anxiety is an extreme fear of being scrutinized and judged by others in social or performance situations. A little social anxiety is normal for everyone. However, when social anxiety becomes abnormal, it’s a self-serving, narcissist hell-bent on your full attention – like Kim Jong-un or Miley Cyrus.

Social anxiety disorder is an enigma in that it comprises a general distaste for peopling, with an opposing internal need for … people. But on your terms, and in limited doses. Social anxiety can save you money on all the fun things you would otherwise go out and do. The downside includes a sadistic focus on all things that can go wrong; nervously blurting everything you never wanted to say aloud just to fill conversational lulls; and performing extensive post-interaction analyses to scrutinize your perceived collective flaws.

How Does One Get Social Anxiety?

Social anxiety is contagious. Sort of. Researchers are learning that anxiety disorders run in families, and that they have a biological basis, much like allergies, diabetes, and bad taste. Anxiety disorders typically develop from a complex set of risk factors that include genetics, brain chemistry, personality, and life experiences.

Neurosis Loves Company: The Social Anxiety Numbers

Anxiety is the most common mental illness for adults, and the number one mental health issue in North America (source: NIMH). Of all the anxiety disorders, social anxiety is the most common, with 15 million American adults suffering a social anxiety disorder, or 13 out of 100 people. The malady is equally common among men and women, and typically begins around age 13. Anxiety disorders are highly treatable, yet only about 1/3 of those suffering receive treatment.​

All of this supports a rationale for keeping a blank social calendar from an underground doomsday bunker. However, you can get out there and thrive. Here are 10 ways how:

  1. THROW A COUNTERPUNCH. Do not give in to what the anxiety is driving you to do. Instead, acknowledge it and say, “Hey, inner angst, I’m the shot caller and I came to party!” Whatever it is that counters the anxiety, do it. Each time you parry your fear, you are “rewiring” your brain and weakening anxiety’s hold on you. No one overcomes social anxiety who consistently avoids. Author and clinical professor of psychology at Weill-Cornell Medical School, Robert Leahy, Ph.D. stresses that, left untreated, social anxiety is associated with an increased risk foralcohol abuse, depression, loneliness, decreased occupational advancement and the increased likelihood of remaining single. Drunk, idle, sad, and alone is no way to live. Feel and face your anxiety – sober. You can actually do things while anxious and realize nothing bad happens.
  2. EXPOSE YOURSELF. Many studies demonstrate the efficacy of exposure-based therapies for anxiety disorders, as summarized in several published meta-analyses according to Johanna S. Kaplan, PhDand David F. Tolin, PhD in Psychiatric Times. (“Exposure Therapy for Anxiety Disorders,” September 2011). We avoid what frightens us and, in return, are frightened by what we avoid. Expose rather than avoid by creating an exposure hierarchy. Write down scenarios that cause you anxiety in order of severity. Perform the easiest behavior first, and move down the list. Your hierarchy might start with asking a stranger for directions, and end with asking your boss for a raise. It doesn’t matter if s/he laughs you out the door. It matters that you actually asked. Social anxiety wants you timid and poor.
  3. BECOME AN ASKHOLE. According to Mark Tyrell, therapist and co-founder of Uncommon Knowledge, asking questions makes for great social lubricant when you otherwise have nothing to say in a social setting. Ask open-ended questions such as, “How do you know the host?” Alternatively, try soliciting advice asking something like, “Does anyone have any good movie/book/sushi recommendations?” Ask follow-up questions that take the conversation deeper. Asking where the restroom or vodka is located, or when the party ends doesn’t count.
  4. GIVE YOURSELF LICENSE TO CHILL. The more you worry and let anxiety rule your days, the more you wire your brain to continue worrying and being anxious, while continually linking anxiety to specific events. Instead, consider yoga, tai chi, or visualization to prepare yourself. In Psychology Today, Eric R. Maisel Ph.D. emphasizes a visualization technique to lessen anxiety. Create a mental picture of relaxing. It could be at a beach sunset, watching a forest gently sway to a breeze, leaves falling silently in your backyard, etc. When you visualize, engage your other senses as well. What does the place smell and feel like? What do you hear? Do it every day for long enough that it becomes as natural as staring at your smartphone.
  5. PLUG YOUR NOSE. Try alternate nostril breathing. This is a simple, natural breathing technique for managing stress and anxiety. Close one nostril by placing your thumb gently over it. Breathe out then in through the uncovered nostril. After each breath cycle, switch sides. A breath cycle is one out-breath and one in-breath. Leading with your out-breath, do one out-breath followed by one in-breath through each nostril. Repeat this series, alternating nostrils after each inhalation. According to Ayurvedic medicine, alternate nostril breathing brings the body and mind into a state of balance and neutrality, and has been used by elite athletes for decades. It will likely be easier to breathe through one nostril than the other. You’re not deformed – it’s normal.
  6. PUMP-UP YOUR JAM. According to Dr. Lisa Legault of Clarkson University, “Practitioners who are interested in using self-affirmation as an intervention tactic in academic and social programming might be interested to know that the strategy produces measurable neurophysiological effects.” Pick a mantra, slogan, or verse to incite yourself prior to an event or performance.Psalm 55:22 is an example calming scripture: “Cast your cares on the Lord and he will sustain you; he will never let the righteous be shaken.” Alternatively, to get motivated to conquer, consider AC/DC’s “For Those About to Rock.” Find your own song or chant that calms or inspires confidence as you head to a gathering or performance. Remember, anticipation of a worrisome social situation is usually worse than the actual event. Unless it’s going to prison.
  7. SILENCE “BOO.” Boo is the cruel cynic in your head relentlessly booing you, filling you with worry and doubt. Like a mother in law, but invisible. Dispute Boo’s negative rants with truths such as, (1) you are more than capable of nailing the upcoming marathon/wedding toast/hostage negotiation; (2) there are at least as many reasons things will go right for you; and (3) you are competent, skilled, and deserve to be happy! Ben Martin, Psy.D. presents four main types of challenging questions to negative thinking: (1) What evidence do you have for this thinking? (2) Are there any other ways you could look at this situation? (3) Is this situation as bad as you’re making it out to be? And, (4) What can you do to help yourself solve the problem or to feel better?
  8. STOP GIVING A #%@! what others think. Social anxiety is tied to feelings of being judged. The judgements and opinions of others have no reflection on your worth or talents. Social anxiety treatment includes learning to be flawed, while detaching approval from external sources. Being a perfectionist is fine in rocket science, but not when bringing Chex™ Mix to Bunco night. According to an American Psychological Association study, we consistently overestimate how much, and how badly, others think of us, causing us to be more inhibited and less impulsive and happy than we could be (“Do others judge us as harshly as we think? Overestimating the impact of our failures, shortcomings, and mishaps.” Savitsky, Kenneth; Epley, Nicholas; Gilovich, Thomas / Journal of Personality and Social Psychology, Vol 81(1), Jul 2001, 44-56).
  9. PRESS LEVER FOR SNACK. Rather than berating yourself in post interaction analysis, practice self-reward. Not with rounds of tequila or tattoos. But commend yourself for attending the event, for being present, and for facing down your anxiety. Each time you counter your anxiety, you whittle away its power over you, while gaining confidence to step in the ring again. You are taking your life back one endeavor at a time. A tenet of CBT (Cognitive Behavioral Therapy) is the importance of rewarding yourself for exposing yourself to your fears. You deserve the adulation, and you will be more motivated to do it again if there are some self-high-fives or frozen yogurts on the back end.
  10. PHONE A FREUD. See your doctor or a mental health provider if anxiety disrupts your life or daily activities. You may need treatment to get better. Like a receding hairline, social anxiety happens gradually and initially without much notice. Cognitive Behavioral Therapy (CBT) is an effective treatment for social anxiety. Self-medicating is not. You can find a therapist HERE.

Anxiety hates to dance. So get out there and dance.

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