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Tips for Kids and Teens on How to Manage Anxiety

Anxiety is a feeling everyone experiences at some point. In some situations, anxiety can be helpful; it keeps us alert, protects us from danger and helps us notice problems around us. But for some kids and teens, that sense of anxiety grows too strong or too frequent and can get in the way of their day-to-day activities, and these tips on how to manage anxiety can help.

One in four adolescents have mild to moderate anxiety, making it the most common mental health disorder among young people, according to the National Institute of Mental Health.

iety can feel different to each person and may or may not seem to be triggered by a specific event or setting.

Whatever the symptom, anxiety can really interrupt your day-to-day life. Knowing what the symptoms are and learning some coping skills can help anxiety feel much more manageable.

Common symptoms of anxiety can include:

  • Feeling overly worried, nervous or afraid
  • Sleep problems
  • Muscle tension
  • Avoiding certain situations
  • Difficulty concentrating
  • Increased heart rate
  • Upset stomach
  • Headaches
  • Irritability
  • Becoming easily tired

Five tips to manage anxiety:

1. Find ways to relax

When you feel anxious, your muscles tense up, your heart rate increases, and your breathing gets shallower. Take deep breaths for a while to try to get your body back to a resting state.

Try This: Pretend your belly is a balloon. Breathe in to make it bigger, then breathe out and watch it shrink. Count slowly to four when you breathe in and then to four when you breathe out.

2. Face your fears

It might sound scary, but facing your fears is proven to help. It’s called exposure, and it involves taking small steps to getting yourself used to things that make you anxious.

Try this: Get the help of a parent or adult you trust and start with something small. They can help guide you through exposure to it until you start to become less anxious. Using the deep breathing exercise above will also help.

3. Take charge of your thinking

The tricky thing about anxiety is that it’s easy to think negative thoughts when you’re anxious. Pay attention to what you are saying to yourself, and avoid thinking negatively, jumping to conclusions or assuming the worst.

Try this: Ask yourself, “What would I tell my friend if they were in this situation?” or try thinking of times you’ve been able to handle a tough problem.

4. Get enough sleep

Anxiety can cause a frustrating cycle. When we’re anxious, it can be hard to sleep. But not getting enough sleep can make us feel more anxious. Try to eliminate the things that keep you awake and focus instead on setting aside some relaxing time before bed.

Try this: Dedicate the hour before bed to quiet time. Stay away from your phone, TV and computer—the bright lights trick your brain into staying awake longer. Try listening to calm music or meditating instead.

5. Get support

You never have to go through anxiety alone. Having people to turn to for support makes a big difference. A therapist, such as a psychologist, social worker or counselor, can help you understand and manage your feelings. This might be through talk therapy (also called Cognitive Behavioral Therapy or CBT), medication or a combination of both.

Always remember to call 911 if you are in a crisis or are feeling like you want to hurt yourself or others. Helplines are available by calling 1-800-273-TALK or texting “CONNECT” to 741741.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

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A day in the life of a mental health nurse

The CHOC Children’s Mental Health Inpatient Center is an inpatient psychiatric center exclusively dedicated to the treatment of children ages 3-17 with mental illness who are in immediate risk of hurting themselves or others. It is the only inpatient facility in Orange County that can treat patients younger than 12. Our doctors and care team are all specially trained to treat children and provide the very best patient- and family-centered care 24 hours a day, seven days a week.

During a child’s stay, he or she engages in daily multidisciplinary therapeutic groups and receives individual therapy, family therapy, brief psychological testing and psychiatric care.

In observance of Mental Health Month, follow along for a day in the life of Madeline, a clinical nurse in CHOC’s Mental Health Inpatient Center.

5:15 a.m. – After fighting my snooze button, I wake up, shower, and drink some much-needed coffee.

6:30 a.m. – My cat yells his goodbyes to me as I give him a treat and leave for work. On the way, I vibe out to music to get pumped up for the day. I’ve worked at CHOC for over a year now. Last year, I was accepted into CHOC’s Registered Nurse Residency program. As a new nurse, I felt called to work in a mental health setting. I am beyond proud to stand alongside the brilliant CHOC team on the frontlines of mental healthcare.  

7:00 a.m. – I join my team in our conference room for a daily briefing report. Together, we review any newly admitted patients, our current population of patients, and any safety concerns. One of the ways we keep kids safe is through trauma-informed care. Upon admission, we work with patients and their families to determine any triggering situations or actions the patients may have, and then learn how strong emotions may manifest outwardly; such as pacing, shaking, or becoming very quiet. This information helps us to rapidly identify when patients are struggling and may need extra support or encouragement to utilize their coping skills. One of my favorite environmental adaptations we can provide for patients is our sensory room. It helps stimulate a few of our five senses to help kids cope and be more present in the moment. Sometimes, just hearing the rhythmic movements of the bubbles can be soothing and have a great calming effect.

7:30 a.m. – Once I have an understanding of our environment, I walk the unit to check on the patients. Most are still asleep, so I then look up my patient’s medications, while verifying medication consents. All pediatric psychiatric medications need parental consent obtained by the patient’s psychiatrist.

8:15 a.m. — Our medication room has a barn door, so I can efficiently and safely administer patients’ morning medications, preform a quick mental status check-in, and obtain vitals.

9:30 a.m. — One of my patients is currently taking a new medication. In order to better understand her body’s acceptance and tolerance of the drug, we need to run labs. Before drawing her blood, I numb a small area of her skin using a J-Tip®. During the blood draw, a child life specialist and I help the patient cope by offering her modeling clay and a hide-and-seek activity book.

10:00 a.m. — Throughout the day, our patients are divided into groups based on age to attend group sessions. This creates a structured environment that promotes the development of coping and social skills they can utilize when they go home. The sessions focus on our various themes of the day that can range from problem solving or emotional regulation to nutrition and wellness. These sessions are led by our team of nurses, social workers, child life specialists, plus and art and music therapists. This morning’s group session is focused on gross motor skills. Our group leaders soak up some sunshine in our beautiful outdoor area while supervising patients socializing and joining in on a game of handball.

11:00 a.m. — I sit down with one of my patients to discuss their day so far and check in on any thoughts of self-harm that we can work through together. Afterwards, as part of the patient care team, I meet with that patient’s psychiatrist Dr. Lavanya Wusirika, and social worker Gaby, to discuss the patient’s care plan.

12:30 p.m. – It’s time for the patients to have lunch. Our patients eat together, so I assist with passing out lunch trays and pouring drinks. One of our licensed vocational nurses, Brenda, has become our unofficial DJ, and she plays music during lunch to help create a fun, therapeutic environment.

1:00 p.m. – I receive a call from a patient’s parent. After addressing their questions, I update them on their child’s plan of care, medications and current temperament.

2:00 p.m. – I use my own lunch break to catch up with my coworkers. We spend a lot of time together, and I’m lucky to have such an amazing work family.

3:00 p.m. – It’s time for one of our patients to head home. Upon admission to the unit, our team begins organizing outside resources and planning ways to increase safety and support at home. This information is built upon throughout their stay and is incorporated into an individualized safety and coping plan. After our social workers discuss the plan for home with the patient and their parent, I review current medication information and additional discharge instructions. Staff members and fellow patients send off their peer with warm wishes and words of encouragement.

4:30 p.m. –As a nurse, it’s my turn to lead one of our nursing groups. After the patients participate in a discussion about favorite coping skills and we do a check-in of their current emotions, we follow a painting tutorial to practice our theme of the day, mindfulness.

6:00 p.m. – I spend time updating my patients’ charts, including their mental status assessments and treatment plans. This way our whole team can see the patient’s progress and any concerns.

6:45 p.m. – During daily community meetings, all of our patients join together, and our staff leads a check-in to summarize what has been learned from our theme of the day. Patients take turns sharing their high and low of the day and how we can build on these experiences for tomorrow.

7:00 p.m. – As our night shift nurses arrive, we take turns giving a report of their patient’s day and mental status. We share new triggers that we have learned from the patients as well as new coping skills that were helpful. Knowing how we can best care for patients before, during and after a crisis or stressful situation is fundamental for trauma-informed care. By caring for every patient as a whole, not as a diagnosis or as someone defined by their trauma or maladaptive behaviors, we are able to better understand and care for them.

8:00 p.m. ― Get home and share a delicious meal with my husband. A long hug and many kisses are bestowed unto my cat Boots. The three of us will cuddle up and watch a show before we head to sleep and start again.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

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CHOC Children’s Mental Health Inpatient Center: A year of progress

Just over a year ago, CHOC Children’s celebrated the completion of its Mental Health Inpatient Center ― the only inpatient psychiatric facility for children younger than 12 in Orange County.

Designed to serve patients ages 3 to 17, the Center has treated more than 650 patients since its opening.

Patient satisfaction is high, with the Center earning a “top box” score of 86% on patient satisfaction surveys. By comparison, 49 to 79% is the average range for other inpatient psychiatric units.

The restraint rate is also extremely low — approximately 0.6%, compared to a national average of 25 to 30% for inpatient psychiatric units.

Dani Milliken, clinical director of the Center, is especially proud of the multi-disciplinary team coming together to support CHOC patients.

“These statistics are only possible because of the team and their dedication and compassion,” she says.

Several factors distinguish the Center from other facilities.

A 3,600-square-foot outdoor play area combined with the 12,000-square-foot unit’s aesthetics and layout create a unique environment designed to promote relaxation and healing. In addition, an eight-week training period for staff before the Center’s opening created clear expectations, as well as programmatic and organizational structure.

“Good outcomes are the result of people, practice and place,” Milliken says. “Without all three, the program cannot be successful.”

Learn more about what makes CHOC’s Center unique:


Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

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8 ways for teens, kids to cope with depression

Even if it’s not uncommon for teens and kids to feel sad
sometimes, those moments can still feel overwhelming.

The good news is there is a lot you can do to help bust
these bummers. Next time you’re feeling down, try some of these tips:

  1. Speak up: Find a trusted friend or adult and tell them what’s on your mind. Staying silent never helps.
  2. Know you aren’t alone. At some point in their lives, at least half of your classmates will feel symptoms of depression. That means there’s a good chance that at least two other kids in your class are feeling the same way as you do right now.
  3. Keep up with friends and fun activities. It might not sound fun, but try to hang out with friends, play sports and join activities. Pushing yourself to stay connected helps.
  4. Do something that makes you feel proud. Even small accomplishments can be mood-boosting. Do your homework, clean your room or help a sibling. Then, notice what a good job you did and feel proud of your awesome work.
  5. Talk back to your sadness. Imagine a friend told you they were sad or had a problem. Think about what you’d say to them – and then say that to your own feelings.
  6. Tell a loved one about scary thoughts and feelings. If you notice yourself thinking a lot about death or dying, talk to a trusted grown-up. They can help.
  7. Don’t skimp on sleep. Being unrested can make it easier to be sad or feel down. About an hour before bedtime, turn off your phone and TV, and try to focus on relaxing.
  8. Reach out for help. Besides your parents, a lot of grown-ups can help you with these feelings. Psychologists, social workers or counselors can help you understand and manage your feelings. Call 1-800-273-TALK (8255) or text CONNECT to 741741 for support. Call 911 immediately if you want to hurt yourself.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

9 ways parents can help kids cope with depression

Watching a child grapple with sadness can be distressing for
parents. The good news is adults don’t need to feel powerless. Here are nine
things parents can do to help their child cope:

  1. Show your love.

Love, empathy and respect can go a long way. Let your child
know you care and think their feelings are important. You can do this simply by
being present with them and offering reassurance.

2. Stick to a routine.

Use schedules and routines to create structure and security.
Depressed children might not want to participate in activities, but it’s
important for parents to maintain routines and schedules.

3. Focus on positive communication.

Be mindful of how many positive and negative comments you
make to your child. Your goal should be to offset every negative remark with
five positive comments.

4. Develop a positive environment.

A positive, loving atmosphere can help children relax. Build
upon that by making a list of fun activities you can do together – and then be
sure to follow through.

5. Take care of yourself.

To take care of others, you also need to take care of
yourself. Find a support group, exercise or hire a babysitter so you can make
time for yourself.

6. Find treatment for your child.

Therapy or counseling and medication could help a depressed
child. A pediatrician can help you decide what is best for your family.

7. Get help.

If your child expresses thoughts about wanting to kill or
hurt themselves or others, call 911 or bring your child to the nearest
emergency department. These feelings and thoughts can be serious.

8. Reassure your child.

Let your child know you are going to help them to feel
better, and that therapy, activity and, in some cases, medication can help.

9. Draw on outside expertise.

Many resources for parents exist. Here’s a quick list:

• “Depressed Child: A Parent’s
Guide for Rescuing Kids,” by Douglas A. Riley

• “Help Me, I’m Sad: Recognizing,
Treating and Preventing Childhood Depression and Adolescent Depression,” by
David G. Fassler and Lynne S Dumas

• “Lonely, Sad and Angry: How to
Help Your Unhappy Child,” by Barbara D. Ingersoll

• “Raising Depression-Free
Children: A Parent’s Guide to Prevention and Early Intervention,” by Kathleen
Panula Hockey

• “The Childhood Depression
Sourcebook,” by Jeffrey A. Miller

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

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