Depression and Anxiety 101

1. Depression and Anxiety 101 The School Perspective Heather Koster, MSW, LICSW CaylaRother, LSW, MaEd JyotiSinha, MSW, LGSW Nancy VanHorne, MSW, LICSW

2. What does depression and anxiety look like at different ages from a School perspective?

3. The pre-k years

4. Signs and symptoms • Anxiety • Has difficulty stopping worries • Worries he will do something embarrassing or “stupid” in front of others • Keeps checking that he has done things right / needs constant reassurance • Tense, restless or irritable due to worrying • Is scared to ask an adult /teacher for help • Is reluctant to go to sleep without you or to sleep away from you / home • Has trouble sleeping due to worrying • Afraid to talk or write in front of others / class • Worried that something bad might happen to him or a parent (kidnapped, lost, sick, death) so he won’t be able to see you again • Becomes overly distressed about your leaving him at school / daycare (separation) • Physical complaints (head aches, stomach aches) • Depression • Looks bored or listless • Seems left out / rejected • Not interested in activities including play • Not having fun or enthusiastic • Looks sad and tearful • Doesn’t seem to care about anything • Avoids contact with others / rejects others • Seems cranky, irritable or moody • Needs to rest frequently / looks tired • Cries for no apparent reason • Looks angry / argumentative • Hits or fights with others • Physical complaints (head aches, stomach aches)

5. The Elementary Years

6. Signs and symptoms • Anxiety • (generalized anxiety disorder, phobias, social phobias, Obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder) • Absences • Refusal to join in social activities • Isolating behavior • Excessive worry about homework/grades • Physical complaints • Unrealistic, obsessive fears • Tension about everyday life events • Depression • Sadness that won’t go away • Frequent fearfulness • Low self Esteem and guilt • Hopelessness • Irritability • School avoidance • Frequent complaints of aches and pains • Thought of death or suicide • Self-deprecating remarks • Persistent boredom, low energy, or poor concentration • Increased activity

7. The Middle Years

8. Signs and symptoms*In addition to the other symptoms explained in younger ages* • Anxiety • Somatic complaintssuch as; headaches, stomach aches & muscle pain • Excessive worry leads to avoidance behaviors;(assignments, class, attendance, social isolation) • Sleep disturbances • Restless, irritability and frustration • Falling grades • Panic attacks • Frequent bathroom trips • Depression • Poor academic motivation • Flat affect or sad demeanor • Social isolation • Pessimism and feelings of hopelessness • Irritability and overreactions • Sleep changes • Fatigue • Somatic complaints • Appetite changes • Loss of interest in activities or school participation

9. The Teen Years

10. Signs and symptoms • Anxiety • Frequent somatic complaints (headaches, stomachaches, etc) • More visits to the health office • Drop in grades • School avoidance • Panic attacks during the school day • Depression • Difficulty concentrating • Sleeping in classes • Changes in attendance • Drop in grades • Sudden frustration with school • Low energy • Withdrawl from normal school activities • Major behavioral changes (defiant, overly moody, chemical use)

11. Where to go, what to do? • You are the expert when it comes to your child. • However, there are people at your child’s school • who can be helpful, and you should feel comfortable • talking to them. • Why should I talk to someone at my child’s • school? • • School staff members can do a better job of • teaching your child if they know what health • and/or mental health help is needed.

12. Who can I talk to at my child’s school? • Whoever your starting point is, please know that we work together to figure out who is best to work on interventions with your child. • • Classroom teacher • Principal or assistant principal • • School nurse • School social worker • • School counselor • Special education case manager • • School psychologist • Transition teacher or specialist

13. Communication • What does it mean • We are partners. Please know the professional saying this believes your child is displaying behavior not typical to his or her peers. • We are trying to gather information about different settings (home, school, daycare). It helps to determine a course of intervention. • If you are worried about treatment cost, there are resources in the community I might be able to connect you to. • Some parents assume the school professional is asking them to medicate their child. Not the case. Medical professionals have knowledge and access to medical resources that are additional to what a school does. • What I say • I’m concerned • What do you see at home? • Let me know if I can help • Have you discussed it with your pediatrician? Did you bring the specifics up during your visit?

14. What should I expect from the school? • • To be treated as a key partner in your child’s • education and care. • • To get answers to your questions in a • language you can understand, in writing if • you ask for it. • • To be told about any health or behavior or • emotional related problems that happen at • school. • • To have a teacher, school nurse, counselor, • or social worker answer questions about • your child’s needs.

15. ADVOCATE! We want you to be heard. If you don’t feel you have been, please feel free to talk to someone else.

16. What services are available at my child’s school? • -Social Work Services: resource referral ; collaboration with teachers; short term therapeutic interventions • -School Psychologists, Guidance Counselor, School Nurse are also available • We communicate as a team and schools have a process in place for addressing student needs (Student Assistance Teams, Problem Solving Teams, Response to Intervention).

17. What are some of the possible interventions at school to help my child? -Check ins during the day -Assisting with testing environment (small group testing, or quiet area for testing for test anxiety) -Skill teaching/training -Emotional regulation -Break times/break areas -Support strategies recommended by therapist/doctor

18. What if those interventions aren’t enough? When mental health needs are significantly impacting learning, there is a process in every district to review and determine the best plan of action for your child and their needs. -Special Education Evaluation -Section 504 Plan