The difference between normal anxiety and anxiety disorder

Many New Zealand kids are anxious and teachers are calling for more training on how to support them.

Counsellor Cat Levine runs online workshops for teachers about the risk factors for anxiety and how to help kids become more resilient to it.

Anxiety is regarded as a mental health disorder when the following 4 Ds are present, Levine tells Kathryn Ryan.

1. Disproportionate emotional responses

2. Disruption of day-to-day life

3. Distress that seems impossible to manage

4. Depression due to the ongoing nature of these feelings

In general, anxiety can be a hard condition to pinpoint, Levine says. When her now 17-year-old daughter suffered from severe anxiety, she wasn't really clear on what it was.

"I'm close to 50 and I was very familiar with depression. That was something people talked about and I recognised it in myself and other people…. Depression is kind of a thing that you understand.

'But once I started hearing about this anxiety that my daughter was going through I didnt really have any concept - doesn't everybody feel anxious?"

Anxiety has now overtaken depression as the number one mental health disorder, Levine says.

To try and help these students with well-being and resilience, teachers are calling for resources.

Levine tours schools giving workshops and teaching teachers strategies they can use in classrooms to support young people with anxiety in partnered with life education. Healthy minds …

There are 5 factors that put a child at risk of anxiety, Levine says.

1. Genetic predisposition

If you've got a family member with depression or anxiety, more likely to have it.

2. Brain chemistry

We now know that if a mother is highly stressed during the third trimester of pregnancy the baby's brain is affected and they're more predisposed to anxiety, Levine says.

In the latter stage of her own pregnancy with her daughter who suffers from anxiety, Levine had whooping cough, another of her children had an operation, the family moved house and she sprained her ankle.

"It was just three months of intensity. She was just cooked in this soup of cortisol and adrenaline and right from being born she had that predisposition towards [anxiety]."

3. Whānau

Research has shown the stress levels of mothers can be contagious, Levine says.

"If you bring a child who has anxiety to a psychologist  the first thing they'll ask is 'how's your anxiety level?"

"They're picking up your heart rate, pupil dilation, your breathing rate.

"They're picking up on the environment, they're picking up on our stress levels."

4. Lifestyle

Energy drinks, a sugary diet and lack of sleep can exacerbate anxiety.

5. Social influence

"It's that feeling of 'am I accepted and do I belong with my tribe?'

"To start off with, that's your family. If a child doesn't feel accepted and nurtured and safe in their family environment it is like death at a primal level. Then it's peers... do I have the right shoes? Am I getting enough likes?"

So how can parents and caregivers support a child to be more resilient to anxiety?

Levine recommends 4 Ss.

1. Sleep

"It is a long long journey to get your child sleeping well but keep working on that. Say 'this is my mission in life to get my child sleeping well'.

2. Stress 

If your child is anxious, look at your own stress levels.

Self-care can sound "a bit airy fairy" but the own mask first thing is legitimate.

Adults can counteract stress hormones by increasing their levels of "happy hormones", such as endorphins, oxytocin, and dopamine.

A walk outside in nature is very helpful for de-stressing - or even a picture of a plant as your screensaver.

"If you're wound up and stressed out and overwhelmed you can't calm them down."

Parents also model to their children either healthy or unhealthy coping strategies in the face of stress, Levine says.

It's good to pull back on stimulants like coffee and chocolate and screen use before bed.

"Are we showing 'this is what I do when I'm stressed - I go for a walk, I take some time out' or do they see us with a wine on social media or watching Netflix?"

3. Strategies

Calming strategies, such as deep breathing, can be practised by the whole family like a fire drill, Levine says.

The brain can't concentrate on stress and focus on the senses at the same time, so this naming exercise can be helpful:

"Look for five things they can see, four things they can hear, 3 things they can touch, two things they can smell, and one thing they can taste or that they're looking forward to.

"By you doing that and modelling that to them, it will become second nature [when stress arises].

4. Schedules

Kinds with a tendency to anxiety like events to be written down so they can know what's happening at certain times.

"That will help them rest in the knowledge. If I forget it I can go back and look at that checklist.

"Try not to spring things on them last minute, like, 'woo, lest go to the beach' ... that's so anxiety-inducing for them because they like to know what's happening."

Where to get help:

Free resources for parents and caregivers on Cat Levine's website 

Free resources for parents and caregivers from Anxiety NZ

The Anxiety NZ 0800 number has free counsellors who can guide you on what to do if someone is having a panic attack.

Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.

Lifeline: 0800 543 354 or text HELP to 4357

Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.

Depression Helpline: 0800 111 757 (24/7) or text 4202

Samaritans: 0800 726 666 (24/7)

Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz

What's Up: online chat (3pm-10pm) or 0800 WHATSUP / 0800 9428 787 helpline (12pm-10pm weekdays, 3pm-11pm weekends)

Asian Family Services: 0800 862 342 Monday to Friday 9am to 8pm or text 832 Monday to Friday 9am - 5pm. Languages spoken: Mandarin, Cantonese, Korean, Vietnamese, Thai, Japanese, Hindi, Gujarati, Marathi and English.

Rural Support Trust Helpline: 0800 787 254

Healthline: 0800 611 116

Rainbow Youth: (09) 376 4155

OUTLine: 0800 688 5463 (6pm-9pm)

If it is an emergency and you feel like you or someone else is at risk, call 111.