- Posted by Dr. Eric Lund
- On May 2, 2017
- 0 Comments
I often hear from parents that their child exhibits a specific behavior because they are nervous or anxious. When presented with this information I need to try to understand what the parent is reporting.
In my experience, parents may describe anything from hyperactivity or inattention to misbehavior or self-stimulating behavior as anxiety.
A general state of excessive anxiety or over reactivity is very genetic. If someone has a genetic propensity for excessive anxiety there are two main strategies for treatment; they are medications or exposure.
Unfortunately, the most common treatment attempted first is medication with an SSRI or an anti-anxiety medication. This is a legitimate solution for treatment and will often result in less anxiety. The problem with this strategy is that it often leads to a lifetime of medication for the condition.
The second general strategy from a behavioral perspective is programmed and systematic exposure. If people expose themselves to the feared object it becomes familiar and causes less anxiety.
If the anxiety is genetic both of these strategies and sometimes the combination of these strategies will lead to some level of success and decreased anxiety.
For many people who suffer with anxiety symptoms, their anxiety is not genetic. It is the result of being overwhelmed and confused. When people are in an environment or situation that they do not understand, they likely have not developed a strategy that has worked in the past for resolving the confusion. Remember, all behaviors that occur, occur because they work. In other words, when we have a strategy that has worked in the past for a current situation we will rely on that strategy in the current situation to resolve confusion.
What happens if you have never been in the current situation? You will rely on strategies from similar situations in the past. If those strategies do not work you will stay in a state of confusion. This state of confusion will lead to the subjective feeling of anxiety and the person will try random strategies that have been successful in the past for relieving the anxiety.
This is the behavior that parents are reporting. Hyperactivity, inattention, misbehavior, off task behavior and self-stimulating behavior are often strategies that have worked in similar situations in the past. So parents are partially right when they describe these behaviors as being driven by anxiety. But this is usually not a genetic anxiety. This anxiety is caused by confusion.
When this is the case, and it usually is, the solution is not medication or exposure! The solution is skill building, developing new behaviors which lead to a fuller understanding of the world and how to live comfortably in a fast changing, verbal and social world.