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Anxiety in today’s children and young adultsMarianne KuzujanakisFirst Published June 18, 2020: INCLUDEPICTURE "" \* MERGEFORMATINET AbstractThis paper addresses the growing crisis of anxiety in today’s children and young adults. It further elucidates specifics associated with gifted children and youth. It describes the issues surrounding anxiety, the risk factors, the complications, and known treatment modalities, while offering further treatment and coping suggestions that may be useful in our increasingly stress-filled world.Keywords?Gifted,?children and youth,?anxiety,?depression,?mental health,?mindfulness,?meditation,?suicide risksYour heart is pounding, faster and faster. A wave of suffocating heat rolls over you. Every breath feels taxing. Your mouth is sticky, the saliva gone, and you can’t seem to speak. Your fingers tingle, you can’t move, and your mind is in lockdown. Time stops. Nausea rises from your gut. Then the chills come. You are alone and helpless. You have just experienced a panic attack.While deeply traumatic, panic attacks are not at all uncommon. The attacks can both occur spontaneously, or be provoked by a precipitating event. They can occur regularly and they disrupt lives. Panic attacks are only one of the five major types of anxiety disorders that include generalized anxiety disorder (GAD), obsessive–compulsive disorder (OCD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD). Phobias, childhood selective mutism, separation anxiety, and hypochondria are a few other recognized anxiety disorders. Anxiety sufferers often have more than one distinct type. A full discussion of all anxiety disorders can be found in the latest edition of the?Diagnostic and Statistical Manual?(DSM-5) (American Psychiatric Association, 2013).The neurobiology of anxiety disorders (Martin et al., 2009) is both complex and an ongoing active area of medical research. Studies center on the imbalances in the neurotransmitter and neuropeptide circuits, these imbalances occurring between the brain’s emotional limbic system and the brain’s higher cognitive and judgment areas. Commonly, we think of anxiety as the “fight or flight” phenomenon. Brain imaging, genetic studies, epigenetics, and examinations of a wide variety of neurotransmitters and neuropeptides (e.g. GABA, serotonin, oxytocin, cortisol, etc.) help researchers further differentiate types of anxiety from depression, and offer clues as to potential natural and pharmacological approaches to treatment.In recent years, the prevalence of anxiety in U.S. children is 5–8%, with a lifetime prevalence of 31.9%, and with a median age of onset of a mere six years of age (Merikangas et al., 2010). Adolescent girls experience anxiety more often and may be twice as likely to experience anxiety than boys (30% vs. 20%). Poor school performance, school phobia, stomachaches, restlessness, irritability, loss of appetite, and difficulty sleeping, can all be some of the symptoms of anxiety. Symptoms must, however, be evaluated to rule out other medical and mental health conditions. Toddlers, even before they begin school, can also exhibit symptoms of anxiety, as well as anxiety’s counterpart—depression.Early in 2020, the world was struck full force by a deadly pandemic of the novel virus SARS-Cov-2 (coronavirus) leading to hundreds of thousands of deaths and millions of cases of Covid-19. The mental health implications were tremendous. The news was inescapable. Even more than the news was the total disruption of life across the world. Many places of business temporarily (or permanently) closed to limit the virus spread, unemployment soared, poverty increased. Children and young adults witnessed first-hand as their schools closed, their colleges closed, their parks and gathering places were closed. Wherever possible, classes, conferences, and jobs soon converted to virtual interactions, but life, as we were all used to, was altered. Children and young adults could no longer gather in groups. Concerts were postponed. Sports were postponed. Even routine medical procedures and appointments were postponed. The world was in near lock-down as it tried to protect those at high-risk from contracting the deadly Covid-19 as well limit overwhelming the hospitals and frontline critical workers who selflessly cared for the ill.Families all over the world saw friends and loved ones fall ill or die alone from the Covid-19 tragedy, isolated from hugs and the human touch of loved ones. Those left behind were frequently stunned with the enormity of the crisis and survivor guilt. Families saw their incomes dry up and financial stability erode, leading to increases in suicide and alcoholism and drug abuse. The Kaiser Family Foundation, in a mid-April 2020 survey, found that nearly 75% of all people felt their lives directly affected either some or a lot by coronavirus, and nearly 75% felt the worst was yet to come. Forty percent of respondents suffered loss of job, loss of income, or reduction of hours and pay as a direct result of the crisis. Those in the frontline, especially the medical professionals, dealt with the constant fear and exhaustion of treating patients with Covid-19, and watching so many die. Anxiety hovered over everyone’s lives, as fears about illness, death, testing availability, treatment options, vaccine development, and the uncertainty about humanity’s new normal all loomed large.Anxiety is perhaps the most common of DSM diagnosed mental health disorders, yet less than one-third of affected individuals ever seek treatment. Ten to fifteen percent of anxious youth can also have comorbid depression, whereas up to 50% of depressed youth have comorbid anxiety (Garber and Weersing, 2010). Untreated, anxiety may easily worsen, leading to the devastating signs of depression such as hopelessness, exhaustion, frequent school absences, social isolation, and negative obsessive thinking, all of which may contribute to the feared possibility of suicide.In just the past decade, anxiety in children and youth combined has risen to an average of 10% overall. Furthermore, in the past decade, suicides have tripled. Suicide is now the second leading cause of death in youth, above homicides, and the tenth leading cause of death in all ages. On average in the U.S., about 130 people of all ages commit suicide per day (with 30 times that number attempting suicide per day). In recent years, over 6,000 young people per year commit suicide. African-American youth are particularly adversely affected, with increases in suicides of 60% in males and 182% in females over the past two decades (Price and Khubchandani 2019).What’s happening is that we are in the midst of an increasing, widespread, multifactorial, and devastating crisis. Not just the coronavirus crisis, but also the crisis of anxiety and depression. With so much left to researchers in expanding our understanding of the brain, why it works, and when it doesn’t, patterns may be present that can help others recognize the presence of these life-altering mood disorders. Research is also underway looking at mitochondrial dysfunction (Allen et al., 2018), oxidative stress, and free radicals as components involved in anxiety and depression, as well other health conditions. Due to more aggressive youth sports as well as childhood physical abuse, society has seen an increase in concussions and traumatic brain injuries (TBIs). The CDC less than a decade ago reported upward of 500,000 U.S. children and youth seen in emergency rooms per year for TBIs (Faul et al., 2010). Brain injuries can cause changes in thinking, learning, judgment, and emotions and lead, in part, to long-term issues with anxiety and depression.We live in a fast-paced world, connected by computers and social media, but increasingly we are personally disconnected. The coronavirus crisis has made this situation far worse. Loneliness is rampant. A large 2018 survey by Cigna demonstrated that 46% of Americans feel sometimes or always alone. The youngest group (Generation Z) felt the most isolated and lonely. Adverse childhood experiences (ACEs) and toxic stress contribute to the rise in anxiety and occur on average in 11% of children and youth. Children living in abusive homes, of being a victim of abuse and/or neglect, of being a witness to violence, of having a parent or guardian with mental illness, or of having a parent incarcerated for a crime or die of suicide, can all contribute greatly to the development of anxiety and depression. Children and youth living in poverty (Ekono et al., 2016) also are at greater risk (almost three times) of having ACEs, and may subsequently develop anxiety and depression. In the U.S., 11% of children live in deep poverty as defined by being below 50% of the federal poverty line, with another 13% between 50–99% of the federal poverty line.Learning disabilities including Attention Deficit Hyperactivity Disorder (ADHD) and autism also may have significantly high levels of comorbid anxiety. Cyber-bullying, school shootings and active shooter drills are all directly linked with childhood and youth anxiety. The climate crisis and vocalized fears by politicians and others can produce existential anxiety and eco-anxiety in children and youth, some of whom sincerely fear the world will end before they even grow up. Educational practices that repeatedly teach to the test and pressure students to become high achievers, embrace perfection, and follow higher education academic paths place undue burdens on children and youth who may never be given a chance to follow their own interests and strengths. Loss of unstructured free time during and after school is also a negative factor. College costs are another focus of anxiety, with the average college debt today exceeding $35,000.Today’s world is vastly complex without an emotion filter or an off button. Television, video, social media, and life itself bring emotions to our lives 24/7/365. We see this in the anger of politics and the increasing impatience on the roads and in personal interactions. We see protest marches in other countries and in our own backyard, and we see no clear end to war. Mass shootings seem an almost daily occurrence, and we see the inequality and sorrow of so many. The coronavirus pandemic brought to the forefront a new and very public and very intense crisis. The news brings us information on “what’s wrong” in the world, and rarely on “what’s right”. We need to turn the messaging around. We must see the good.Parents and adults caring for children and youth should provide first and foremost reassurances and positive mindsets, and not dwell themselves in hopelessness and worry. Parents can also, when appropriate, support their children with opportunities to become advocates for causes their children choose. We see this in kids supporting environmental causes and we also see this in the coronavirus crisis with children and young adults helping to make masks, and collecting money and supplies to help the food banks. But too often parents inadvertently transfer their own anxieties to their children. Children can (and will) read their parents’ and caregivers’ faces and see terror and worry, eventually reflecting those same feelings in themselves. Being strong is difficult in any challenging situation, not just in a worldwide pandemic.Anxiety affects youth of all genders, races, ethnicities, and socioeconomic strata. Yet gifted children and youth, as a whole, are both more prone to anxiety and experience anxiety at higher rates than the general public. An article in?Intelligence?(2018)?showed gifted students having nearly twice the rate of anxiety as the general public (20% vs. 10.9%) (Karpinski et al., 2018). In gifted children and youth who have a second DSM disorder, their rate of anxiety rose to 37.3%. This increase of anxiety in the gifted population is consistent in another large-scale study mentioned in the second edition of?Misdiagnosis & Dual Diagnosis of Gifted Children & Adults?(2016), edited and co-authored by Dr. James T. Webb (Webb et al., 2016).The brain also undergoes massive changes during adolescence. The timing to maturation can vary widely from teen to teen. It’s a growth period where in a single year the number of brain synapses can double, while some areas of the brain also begin to seriously prune back on connections to improve efficiency. The amygdala (the emotion center) now plays a truly powerful role, with a decline in normal serotonin (the relaxation and emotional well-being hormone) during adolescence and a delay in the maturation of the prefrontal cortex and frontal cortex (center of executive functioning and judgment). With adolescents more susceptible to their emotion center, and awash in hormones, anxiety can both increase and lead to other behaviors such as impulsiveness, emotional swings, novelty seeking behavior, sexual feelings, and thrill seeking. With the emotional whirlwind of adolescent brain changes, the feelings of anger, fear, and worry become more commonplace.In the gifted adolescent brain, these brain changes also occur, but in the presence of Dabrowski’s over-excitabilities, these changes may be far more intense. More mood swings, more impulsiveness, more thrill seeking, more anxiety and even a spike in body image conditions such as body dysmorphic disorder, anorexia, and bulimia. Trichotillomania (full body hair pulling) can occur. Depression is also more common. In regard to puberty and gender identification, gifted adolescents tend to be less conforming to gender-role stereotypes (higher rates of androgyny), and the subset who identify as LGBTQ are at much higher risk of bullying and abuse than the general public (some studies say up to 90% or more), thus increasing their risk of anxiety as well as depression.Both internal and external factors can affect the risk of anxiety and even depression in gifted children and youth. An article by Dr. James T. Webb in?The National Register?(2014)?examines these internal and external factors. Internally, gifted youth may suffer with extremes of unrealistic perfectionism and self-criticism that admonishes the self when those unrealistic goals are not reached, asynchronous development making gifted youth feel like misfit outsiders, multipotentiality making decision-making in college and career choices an absolute nightmare for some, intense idealism and moral concerns and sensitivity to world events leading to existential depression (consider reading Dr. James T. Webb’s book entitled?Searching For Meaning: Idealism, Bright Minds, Disillusionment, and Hope?(2013) to gain more insight on this topic), as well as the possibility of comorbid learning disabilities (2e) frustrating the gifted youth when performance does not keep up with their internal expectations.External factors can be just as debilitating. Some parents, however well meaning, may become enmeshed in their gifted children’s lives, living through them and placing undue pressures upon them to achieve greatness. At times, gifted youth are strongly directed into high prestige careers, without input on the gifted youth’s true passions. Without being permitted to strive for self-actualization, gifted youth may later exhibit debilitating feelings of guilt and/or frustration with life. Siblings may also be the cause of anxiety especially if the siblings are not also gifted, or if the gifted child receives much more attention and praise than the other siblings.Additionally, peer relationships, particularly in the highly and profoundly gifted, are a lifelong struggle if the gifted youth are unable to find others with similar intelligence and/or similar deep interests. Social isolation with accompanying loneliness is common. Gifted minorities feel especially isolated, especially if their school system doesn’t support giftedness or properly identify them as gifted. Being targeted by bullies in school is also a frequent occurrence, with some studies stating upwards of two-thirds of gifted children and youth are victims of bullying. For misunderstood and unsupported gifted children and youth, life can be an emotional minefield.There’s a saying some may already be familiar with that states a person must “Maslow before they Bloom” to illustrate the steps from survival to full self-actualization and highest educational potential. Maslow’s hierarchy of needs begins with the human physiological, safety, love, and self-esteem needs that must be achieved before self-actualization. Bloom’s taxonomy of educational goals comprise cognitive, affective, and psychomotor domains to illustrate the transitional steps from lower to higher levels of thinking. Children stuck in Maslow’s lower survival levels may never fully attain their educational potential. Children stuck in their lower survival levels are at high risk of anxiety and depression, while also having never achieved self-actualization. In the midst of the coronavirus pandemic, child abuse calls increased, as children living in dysfunctional households, stuck at home due to school closures, found no viable outlet of escape from abuse. A worldwide pandemic is certainly responsible for why many people, both young and old, feel as if they are now stuck in “survival mode”.College counselors today repeatedly report a massive rise in the number of college students with anxiety. The American Psychological Association reports anxiety concerns upwards of 41% with over one-fourth of U.S. college students on psychotropic medications. A 2019 Pew Study (Horowitz and Graf, 2019) showed 70% of youth reporting stress as a major factor in their lives. Self-inflicted injuries (e.g. poisonings, cuttings, etc.) increased by 5.7% in less than a decade (Mercado et al., 2017). Gifted students are among them. Having the strong academic skillsets to thrive in a higher education setting doesn’t preclude experiencing the debilitating effects of anxiety as well as depression. There are many challenges in the transition from home to college, including fitting in and finding like-minded classmates. Gifted asynchrony can make being on one’s own that much more difficult. Some gifted students also experiment with drugs and alcohol at this time, if only in part to self-medicate their anxiety and/or fit in.Gifted students may also never have learned proper study skills in K-12 if their work was always unchallenging. Confronted with college-level work, these students may struggle and fail to receive their “easy A’s” as they had done for so many years. Some highly or profoundly gifted students may only uncover 2e issues in college, having been able to overcompensate and go for many years without diagnosis. Thinking one is infallible for so long, and then struggling, can cause some gifted youth to believe they are no longer gifted. They become embarrassed and feel as if they are letting others down. Some may drop out. Rebel. Some turn to drugs and/or alcohol or do acts of self-harm like cutting. Either way, anxiety may continue to bubble close to the surface and at times can transition to depression. Some gifted youth later take their lives in suicide.Identifying anxiety is important, and understanding some of the warning signs for suicide is absolutely crucial. The number one helpful step is to always keep an open line of communication with these gifted youth. Parents as well as educators can help by understanding signs of anxiety. Unfortunately, educators rarely receive mental health training despite up to one in five students suffering with any of an array of mental health disorders. Schools also severely lack enough mental health counselors and school psychologists. One school counselor may be responsible for 500 students, whereas one school psychologist may be responsible for up to 1500 students over multiple schools. Parents may also be unaware if they have never known people with anxiety or depression. Education via books, websites, or mental health professionals can help so much.Talking about anxiety is important, as is talking about depression. Sadly, nothing can absolutely prevent suicide, and gifted students can be extremely aware of how their outward behavior is perceived by others. Some even try to protect their loved ones by trying to put on a happy face during their dark periods. But keep in mind only a small minority (10–15%) of those with anxiety also develop depression, and only an extremely small minority of depressed individuals attempt or complete suicide.Knowing the warning signs of suicide can bring some comfort to parents and loved ones who see their gifted children and youth struggle. Is the individual sharing any feelings about hopelessness, purposelessness, internal pain, or feeling out of control? Is the individual apologetically voicing feelings of being a burden or a failure? Is the individual isolating himself or herself from others? Withdrawing from prior interests? Showing a sudden change in school performance and/or attendance? Is the individual sleeping more or acting more frantic or angry or emotionally unstable? Has the individual been using drugs or alcohol regularly? Has the individual gotten into trouble with the law? Has the individual voiced any desire to die or stated a method to do so? Does the individual have access to a weapon or other deadly means? Has the individual unexpectedly given away important and/or sentimental items? While these warning signs are not complete, they can help serve as a guide for loved ones.Be aware of the US National Suicide Prevention Lifeline number and have it handy if any loved one is showing warning signs [1-800-273-TALK (1-800-273-8255)].?The Federal Communications Commission also unanimously approved a plan in December 2019 to proceed ahead to begin to implement, within approximately the next 18 months, a faster and more efficient 3-digit alternative to the full phone number:?988. If you live in a country other than the US, please seek out their national hotline.Addressing anxiety is a multifactorial process. It isn’t uncommon for children and youth who have anxiety to refuse any form of treatment. Denial is sometimes a self-protective measure, meant to lessen the anxious person’s already overwhelming feelings of inadequacy and shame. Societal attitudes have also traditionally been a barrier to mental health treatment, with many believing (falsely) that mental illness is a sign of personal weakness. Move slowly and with absolute unconditional love. Doing so can require every ounce of energy, so please be sure to apply self-care measures for yourselves. Also know that anxiety, especially in males, doesn’t always appear with typical symptoms of anxiety, but rather anger and aggression and violent behavior. Be a tireless advocate for the child or youth with anxiety. Seek professional advice and help when the challenge is too difficult. While it may be tempting at times, never tell an anxious person to simply pull himself or herself together. Be aware that if they could, they would have already done so.Just as some parents only see signs of giftedness in themselves once they have a gifted child, parents may only see signs of anxiety in themselves once they have an anxious child. Seek treatment for your own anxiety and make self-care the standard. Children and youth are more likely to seek treatment and self-care if they see it as a normal and acceptable part of life. One powerful approach to begin addressing anxiety is following the ideas described in the book?The Four Gifts of Anxiety?(Boyle, 2014). While not focused on gifted individuals, the concepts mindfully turn around the negative idea that anxiety means something is broken into a positive idea that there are superpowers of anxiety. Gifted youth with Dabrowski’s over-excitabilities often are told their sensitivities are a problem, when in reality they too are a type of superpower. Seeing anxiety from the standpoint of a superpower can thus feel familiar to gifted individuals.In the book, the author describes the four anxiety gifts of purpose, resiliency, hope, and empathy. Re-directing one’s challenge away from “anxiety is making my life difficult” might be far more affirmative if the individual realizes that the anxiety is actually revealing what is important to that person. Using a variety of meditative and mindful techniques can empower the individual to follow through on actualizing what is important. Finding purpose. Developing resilience. Planting hope. Connecting with others and self through empathy. Awakening our common humanity.Mindfulness and meditation are ideal methods for anxiety reduction. Many resources are available for children and youth through adults. Even the youngest can learn how to be mindful and meditate. Sometimes participating in a physical activity like tai chi or yoga can open up children and youth to specific meditation techniques. Physical activity as a whole can uplift moods. Encourage children and youth to be physically active, although this is a challenge in today’s digital world and as schools eliminate recess and as the pandemic keeps children and youth at home.Be aware that not all children and youth automatically enjoy meditation, and sometimes meditating can make anxiety symptoms worse. The quiet breathing can sometimes make dark thoughts come about, an experience that can be quite frightening. Others may feel highly anxious as if they are falling or detached from reality during a deep period of meditation. Be sure to ask about grounding methods to aid in meditation. Once children and youth better understand meditation and grounding, they may look forward to subsequent sessions. Many studies have shown the positive brain changes that occur with meditation and mindfulness including emotional regulation and anxiety reduction (Tang et al., 2015).Sometimes more treatment is needed. Psychotherapy and talk therapy are valuable options, and finding a specialist who is knowledgeable in giftedness is absolutely crucial. There should be no societal stigma on caring for one’s mental health. Cognitive behavioral therapy (CBT) is a useful method to learn practical techniques to change one’s thinking and behavior when experiencing anxiety and even depression. Guided imagery and visualization training can likewise help. Social skills training may also be of value in some individuals. Additionally, be aware that no single pharmacological or natural treatment is a proven solution in all children and youth. Genetics, environment, and lifestyle all can affect outcomes. Promising new research of the gut microbiome may show the important roles of bacteria in both anxiety and overall health (Evrensel and Ceylan, 2015;?Smith and Wissel, 2019). Some gifted individuals have even reported increased frequencies of autoimmune conditions, some affecting the gut. Also, gifted individuals can sometimes react to drugs in paradoxical ways.?Gifted Research and Outreach?(GRO), a non-profit corporation dedicated to promoting a comprehensive and accurate understanding of giftedness through research and outreach, is actively pursuing biological research to determine if there are differences in the bodies of gifted individuals and if so, how those differences may affect them both physically and psychologically.Ideally, psychotropic medications are the last choice, especially in the youngest children. But sometimes these psychotropic medications may be precisely the solution when all other avenues have been attempted. Be aware that certain types of selective serotonin reuptake inhibitors (SSRIs) can cause suicidal ideation. Benzodiazepines, also used for anxiety, are not a first-line treatment for childhood anxiety, especially on the outpatient basis. Benzodiazepines can also be addictive, and may be gateway drugs to illicit opioid use and abuse. Please discuss all treatment choices in depth with your child’s physician before making any commitments. Some positive research is underway on diet and mood, sleep and mood, and the use of cannabinoids (CBD) found in hemp and marijuana in addressing anxiety. Our brains already contain endogenous cannabinoids acting as neurotransmitters. Exogenous cannabinoids can act in similar ways. CBD (cannabidiol) has shown promise in international studies and may be more treatment-specific with fewer side effects, though further study is still warranted and the purity of commercial brands varies. The FDA has already approved one CBD-containing drug (Epidiolex) initially for the treatment of seizures.Do know that many anxious youth self-medicate with marijuana to calm down, a stereotype repeated in movies and television. Unfortunately, today’s marijuana tends to have much more concentrated levels of THC (the component that is associated with the sensation of feeling “high”). In an individual with anxiety, THC can severely elevate anxious feelings, sometimes to the level of psychosis. Even small amounts of THC can cause adverse symptoms. Anxious youth need to be aware of the risks of THC before they may inadvertently experience terrifying side effects. Alcohol is also used by some youth as a way to numb anxiety as well as depression, and is an especially dangerous risk if the individual is already on prescribed psychotropic medications. Keep open communications at all times to help prevent these consequences. Gifted youth may sometimes feel they know more and can handle things better than others, and have a propensity toward risk-taking. But the consequences can be life shattering.Two well-proven methods to lessen anxiety involve no medications at all, natural or otherwise. First is creativity. Gifted individuals are often quite creative. Creativity (e.g. drawing, painting, writing, sculpting, building, puzzles, singing, movement, programming, etc.) can rapidly help decrease an episode of anxiety. Even enjoying the creativity of others (e.g. museums, concerts, books, movies, gaming, etc.) can help. During the coronavirus lock-down, many museums, concert halls, books, and film were made available virtually as an outlet for reducing anxiety. Art therapy is a proven avenue to treat anxiety and depression through creative expression. Second is information. Gifted individuals are hungry for knowledge and information. If a gifted individual has access to enough novel information, the knowledge gained can provide much relief and greatly fend off panic. Sadly, too often our most gifted children and youth are unchallenged in schools, many wasting a majority of their school days, and this provides the perfect storm leading to anxiety and its complications. Remote learning during the coronavirus pandemic has also broken supportive face-to-face bonds between children and youth and educators, and those students without Internet access were further left behind without opportunities to learn new things.Some research finds success in lessening both anxiety and depression symptoms by performing particular physical activities. First, stimulating the vagus nerve (a cranial nerve felt to be part of the gut-brain axis) produces positive effects on mood, immunity, and pain. Such activities include chewing gum, humming, yawning, and gargling. Hugs also are beneficial in many ways. Physical movement that crosses the midline of the body or simultaneously uses both sides can also be beneficial. Such activities include yoga, running, dancing, drawing large figure eights (either on paper or in the air), textile work (e.g. weaving, knitting, crocheting), or doing tai chi movements. Be aware that some people cannot tolerate too much stimulation. If senses are overwhelmed by too much sensory input, a common finding in gifted children and youth with over-excitabilities or those individuals with sensory processing disorders, meltdowns and worsening anxiety may result. Weighted blankets have been found to be useful for anxiety in such individuals.So what is a good first step plan for addressing anxiety if you suspect anxiety in your child or youth? For this, I developed the acronym R.I.S.E.?RISE?is already the title of the remarkable documentary on the highly and profoundly gifted, produced by?The Daimon Institute?and Dr. P. Susan Jackson.In the acronym for anxiety reduction, R is for recognition. Parents, educators, and individuals themselves need to become educated on the signs, symptoms, multiple treatment options, and complications of anxiety. At the same time, acknowledging that anxiety and fear are normal human emotions is important and empowering. One cannot handle difficulty emotions until one recognizes that emotion as something that exists in all of humanity. An anxious or depressed person must understand that they are never alone nor are they broken. As in any other medical and or mental health situation, not all individuals present with the same symptoms. Learning to be in tune with subtle signs unique to those you come in contact with can both improve and save lives.I is for inhale. While meditation is a most valuable method of centering one’s energy and reducing symptoms of anxiety, inhale is also a message to parents, caretakers, and educators to “take a breath” before responding to someone with anxiety symptoms. This is the classic “put on your own oxygen mask before helping others.” Each inhalation is, in a sense, a new start, as it should be when we work with anxious individuals. Inhaling can also indicate that meditation is not just for those affected by anxiety, but for all loving adults who care for them.S is for self. Self-compassion. Self-love. Self-care. Self-forgiveness. We are human. We are not flawless. Allowing our anxious children and youth to see our flaws and still see us move forward with dignity and strength and love is empowering. Just as we wish them to accept us in all our flaws and uniqueness, we as parents and caretakers and educators must always unconditionally accept them in all their flaws and uniqueness. We must also love ourselves and encourage our children and youth to always love themselves. S is also for self-awareness, focusing the individual on the need to try self-soothing and grounding activities such as those stimulating the vagus nerve or crossing the midline.E is for exhale. The exhalation is the completion of a breath. It’s the moment after our bodies have dispersed fresh oxygen and nutrients throughout our bloodstream. This renewal of the essence of life occurs on average 20,000–25,000 times each and every day. Our breath is what centers us and allows us to fulfill our dreams and our desires. We often ignore our breaths, as they are well controlled by our autonomic nervous system. But we notice immediately when our breaths are irregular or labored. We feel anxious and threatened. We should pay heed to our breath. We are nothing without it. With proper care, you and your loved ones may be able to R.I.S.E. above anxiety.But many unanswered questions still remain. Why do some children and youth, gifted included, never succumb to anxiety? Or if they do, how do some learn to conquer it? What of the brains of the profoundly gifted and their ability (or inability) to conquer anxiety and/or depression? What allows some children and youth to exhibit resilience, grit, hope, empathy, spirituality, open mindsets, gratitude, and purpose, while mastering proper coping mechanisms? How powerful is the influence of positive family and friend relationships? How can some children and youth with adverse childhood experiences rise above them without lifelong effects? How can educators best prevent anxiety in their students? What will future research further reveal about diet, the gut microbiome, exercise, environment, neuroimaging, genetics, epigenetics, and the potential of individualized therapeutic mechanisms of treatment?Be aware that if you or a loved one is having great difficulty with significant symptoms of anxiety and/or depression, please seek professional medical advice. Keep the national suicide prevention lifeline phone number handy.Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.FundingThe author(s) received no financial support for the research, authorship, and/or publication of this article.ORCID iDMarianne Kuzujanakis? INCLUDEPICTURE "" \* MERGEFORMATINET ? HYPERLINK "" \t "_blank" , J, Romay-Tallon, R, Brymer, KJ,?et al.?(2018)?Mitochondria and mood: mitochondrial dysfunction as a key player in the manifestation of depression. Frontiers in Neuroscience 12:?386. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarAmerican Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5?).?American Psychiatric Pub. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarBoyle, S (2014) The Four Gifts of Anxiety: Embrace the Power of Your Anxiety and Transform Your Life.?New York:?Simon and Schuster.Google ScholarCigna, U. S. Loneliness Index (2018). Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarEkono, M, Jiang, Y, Smith, S (2016)?Young children in deep poverty. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarEvrensel, A, Ceylan, ME (2015)?The gut-brain axis: the missing link in depression. Clinical Psychopharmacology and Neuroscience 13(3):?239. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarFaul, M, Xu, L, Wald, MM,?et al.?(2010)?Traumatic brain injury in the United States. Emergency Department Visits, Hospitalizations and Deaths 2002–2006, 2010. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarGarber, J, Weersing, VR (2010)?Comorbidity of anxiety and depression in youth: implications for treatment and prevention. Clinical Psychology: Science and Practice 17(4):?293–306. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarHorowitz, JM, Graf, N (2019)?Most US teens see anxiety and depression as a major problem among their peers. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarKarpinski, RI, Kolb, AMK, Tetreault, NA,?et al.?(2018)?High intelligence: a risk factor for psychological and physiological overexcitabilities. Intelligence 66:?8–23. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarKFF Health Tracking Poll: The Impact Of Coronavirus On Life In America . The Henry J Kaiser Family Foundation. April 2020. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarMartin, EI, Ressler, KJ, Binder, E,?et al.?(2009)?The neurobiology of anxiety disorders: brain imaging, genetics, and psychoneuroendocrinology. Psychiatric Clinics 32(3):?549–575. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarMercado, MC, Holland, K, Leemis, RW,?et al.?(2017)?Trends in emergency department visits for nonfatal self-inflicted injuries among youth aged 10 to 24 years in the United States, 2001-2015. JAMA 318(19):?1931–1933. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarMerikangas, KR, He, JP, Burstein, M,?et al.?(2010)?Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry 49(10):?980–989. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarPrice, JH, Khubchandani, J (2019)?The changing characteristics of african-american adolescent suicides, 2001–2017. Journal of Community Health?1–8. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarSmith, LK, Wissel, EF (2019)?Microbes and the mind: how bacteria shape affect, neurological processes, cognition, social relationships, development, and pathology. Perspectives on Psychological Science 14(3):?397–418. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarTang, YY, H?lzel, BK, Posner, MI (2015)?The neuroscience of mindfulness meditation. Nature Reviews Neuroscience 16(4):?213–225. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarWebb, J (2013) Searching for Meaning: Idealism, Bright Minds, Disillusionment, and Hope.?Tucson:?Great Potential Press.Google ScholarWebb, JT (2014)?Gifted children and adults. Neglected areas of practice. The National Register of Health Service Psychologists The Register Report, pp.?18–27. Available at:? HYPERLINK "" \t "_blank" ?(accessed 2 June 2020).Google ScholarWebb, JT, Amend, ER, Beljan, P,?et al.?(2016) Misdiagnosis and Dual Diagnosis of Gifted Children and Adults: ADHD, Bipolar, OCD, Depression, and Other Disorders.?2nd ed.?Tucson:?Great Potential Press.Google ScholarFurther reading suggestionsAmerican Academy of Pediatrics . (2018).?The Resilience Project.? HYPERLINK "" \t "_blank" ScholarAssociation For Children’s Mental Health :? HYPERLINK "" \t "_blank" ScholarChild Mind Institute . (2018).?Understanding Anxiety in Children and Teens.? HYPERLINK "" \t "_blank" ScholarGRO-Gifted Research and Outreach :? HYPERLINK "" \t "_blank" ScholarJackson, P. S. (2014).?RISE: The Extraordinary Journey of the Exceptionally and Profoundly Gifted. Daimon Institute.? HYPERLINK "" \t "_blank" ScholarKrathwohl, D. R., Anderson, L. W. (2009).?A taxonomy for learning, teaching, and assessing: A revision of Bloom’s taxonomy of educational objectives. Longman.Google ScholarKuzujanakis, M. (2016,?September?14).?The intensities of giftedness [Blog post]. Retrieved from? HYPERLINK "" \t "_blank" ScholarMaslow, A. H. (1943).?A theory of human motivation. Psychological review, 50(4),?370.? HYPERLINK "" \t "_blank" ScholarNational Association for Gifted Children . (2017).?Gifted LGBTQ Toolbox for Educators.? HYPERLINK "" \t "_blank" ScholarNational Council for Behavioral Health . (2019).?Crisis Services Survey Report.? HYPERLINK "" \t "_blank" ScholarRedford, J., Pritzker, K. (2019). Resilience: The Biology of Stress & The Science of Hope.?KPJR Films.? HYPERLINK "" \t "_blank" ScholarSuicide Prevention Lifeline :? HYPERLINK "" \t "_blank" ScholarAuthor biographyMarianne Kuzujanakis?is a retired pediatrician and longtime gifted advocate, with a master degree in public health obtained through Harvard. She has served on gifted advisory boards including SENG (Supporting Emotional Needs of the Gifted), and currently with GRO (Gifted Research and Outreach) and as a contributor to International Gifted Consortium. She has spoken on gifted issues and is a co-author of the book,?Misdiagnosis and Dual Diagnosis of Gifted Children and Adults?[2nd edition, 2016]. ................
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