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Anxiety in Teens is Rising: What's Going On?

Anxiety in Teens is Rising: What's Going On?

According to the National Institutes of Health, nearly 1 in 3 of all adolescents ages 13 to 18 will experience an anxiety disorder. These numbers have been rising steadily; between 2007 and 2012, anxiety disorders in children and teens went up 20%.
These stats combined with the rate of hospital admissions for suicidal teenagers also doubling over the past decade leaves us with many concerning questions.
What's going on? While we don't know for sure, there are a number of factors that could be contributing. In addition to genetics, brain chemistry, personality, and life events, take the following into consideration:

High expectations and pressure to succeed. Between standardized testing and a culture of achievement, today's youth can feel pressure to succeed in ways previous generations did not. A survey done every year by Higher Education Research asks incoming college freshmen if they feel overwhelmed by all they have to do. In 2016, 41% of students said "yes" compared with 28% in 2000 and 18% in 1985.

A world that feels scary and threatening. We've seen an increase in school shootings, with resultant drills and lockdowns in schools. We've seen shootings in public places. There have been terrorist attacks here in the US and around the world taking many lives. From just watching or reading the news, it is reasonable for anyone to feel afraid in public spaces that previously would have felt safe.

Social media. Today's children and teens are constantly connected to social media. It's not surprising that their self-esteem―and worldview ―becomes connected to responses to social media posts. It's hard for them not to compare their life and social connections to what they see others posting on social media.

There are also some children who have unexpected and disproportionate reactions to normal developmental experiences like going to school, going to a party, doing a sleepover or going to camp; children who worry excessively about everyday life activities. This often starts in the years right before puberty.

Whatever the cause, this rise in anxiety is a real problem for our youth.
Chronic anxiety can lead to serious mental health problems―depression, substance use, and even suicide. It can interfere with the ability to focus and learn causing school problems that can have lifelong impact. It can also lead to physical problems, such as headaches, chronic pain, digestive problems, and later heart disease.

Anxiety disorders cut across all demographics―suburban, urban, and rural. They affect those who are college-bound and those who are not.

So, what can parents, teachers, and anyone else who interacts with children and teens do?
Be aware of the signs of anxiety. Sometimes children may say that they are anxious, but other times it is less clear―especially as they may not even realize it themselves. Signs can include:

Recurring fears and worries abo ut routine parts of every day life
Changes in behavior, such as irritability
Avoiding activities, school, or social interactions
Dropping grades or school avoidance
Trouble sleeping or concentrating
Substance use or other risky behaviors
Chronic physical complaints, such as fatigue, headaches, or stomachaches.

Talk with kids about potential stressors. Try to see the world the way they do—and help them to keep perspective and find ways to cope.

Be mindful of the expectations you set for children and teens. High expectations can help children reach their potential, but they need to be realistic ones. Not only that, remember that kids need time to relax, play, and be with friends—all of which are crucial for their mental and physical health. And it's important for all of us to remember that there is more to life than achievement.

Talk with kids about their social media use. Help them take breaks—and help them think critically and rationally about the effect of social media on their lives. See How to Connect with Your Teen about Smart & Safe Media Use.

The world is a challenging place.
As parents (or anyone else who interacts with young people), you have a very important role in helping children take on new challenges, build coping strategies, and learn the resiliency skills they need to adapt in the face of adversity.

If you are noticing signs of anxiety in your child or are worried that something you are seeing could be related to anxiety, talk with your pediatrician.

How pediatricians screen kids for anxiety:
At visits―whether they are well child visits or appointments made because of a concern―pediatricians ask questions about a child's physical complaints, mood, behavior and activities, as well as what is going on at school, at home, and in other areas of life.

Pediatricians also use screening tools such as the Pediatric Symptom Checklist (PSC) that look for signs of various different mental health problems, including anxiety. Pediatricians often refer to mental health professionals, as well, in order to more fully evaluate children when there is a concern.

Know anxiety is treatable!
According to the Anxiety and Depression Association of America, 80% of kids with a diagnosable anxiety disorder are not getting treatment―and anxiety disorders are highly treatable! As with most problems, the earlier it is diagnosed the easier it is to treat.

The most effective treatments with for anxiety disorders are cognitive‐behavioral therapy (CBT) and SSRI medications.
CBT focuses on changing how the child thinks about his fear, increasing exposure to feared situations, and relaxation strategies such as deep breathing, muscle relaxation, and positive self‐talk (repeating positive or reassuring statements to oneself). Exposure therapy, a type of CBT, focuses on increasing exposure to feared objects or activities.

SSRIs (selective serotonin reuptake inhibitors) ―commonly prescribed antidepressants―are the medications most frequently used for treating anxiety disorders in children.

Studies have found a combination of CBT and medication for 12 weeks yields a positive response in 80% of children with anxiety disorders. In fact, 65% of those children had no or minimal anxiety symptoms after the 12 weeks of treatment. With CBT alone, 60% had a positive response―about 35% of those children having no or minimal anxiety symptoms. However, it is important to note that SSRI medications can be administered safely and be an important part of child's anxiety disorder treatment.

As with any mental health disorder, anything that supports general wellbeing is an important part of anxiety disorder treatment―regular sleep, exercise, meditation, relaxation apps or yoga can be helpful. However, these are not a substitute for CBT or medication.

The most important thing is to be aware of your children's mental health, ask questions, and ask for help! The number of teens with anxiety disorders has been rising steadily―along with hospital admissions for teens who are suicidal. This leaves parents, teachers, and anyone who interacts with these kids with many concerning questions. Read on. 


For children born between 1994 and 2018, vaccines will prevent an estimated 936,000 deaths and 419,000,000 illnesses in their lifetimes.

Learn more about how you can protect your child from 14 serious diseases by age 2:

Dr. Mann with her patients that she has seen since birth - and who now both tower over her. ❤️
(used with permission)

Its time to schedule your child's annual physical for summer and 2019-2020 school year. Summer can be a busy time at RPA and schedules fill up quickly. Be sure to book ahead.

The Journey of Your Child’s Vaccine

This video describes the journey of a vaccine for children from development through post-licensure monitoring. Learn about the three phases of clinical trial...

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CDC reports 695 measles cases in the United States- the highest since measles was eliminated from this country in 2000. Stopping these measles outbreaks is a priority for CDC and we are working 24/7 to protect Americans from this contagious disease. Vaccination is the best way to protect against measles. Today, the overwhelming majority of parents choose to protect their children with vaccines.

CDC continues to encourage parents to speak to their family’s healthcare provider about the importance of vaccination. CDC also encourages local leaders to provide accurate, scientific-based information to counter misinformation.

Dr. Joel Madrid, M.D. | Reston Pediatrics | Care Your Child Can Count On

Meet Dr. Joel Madrid! He has been with RPA for over six months now and our patients love him. Dr Madrid has 22 years of pediatric experience and we are thrilled to have him on our team.
If you'd like to meet Dr. Madrid, please call 703-450-8660 to schedule a meet and greet with him, or simply book an appointment with him.
For more please visit Dr. Joel Madrid D.R.S. is Board Certified by the American Board of Pediatrics with over 22 years of clinical experience in direct patient care. Dr. Madrid’s areas of interest include allergy and asthma, and dermatology.

Bugs, including mosquitoes, ticks, fleas, and some flies, can spread diseases such as malaria, yellow fever, Zika, dengue, chikungunya, and Lyme, all of which have risk of severe and lasting consequences. Several diseases spread by bug bites cannot be prevented or treated with vaccines or medicine, such as Zika, dengue, and Lyme. Reduce your risk of getting these diseases by taking steps to prevent bug bites.

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[04/11/19]   Spring break soon! Book your child's annual physical. Call to schedule. 703-450-8660

Next week is spring break! Use the time to catch up on your child's annual well check visit - we still have availability.
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Bullying on the Bus: How Should Parents Handle It?

How to tell if your child is being bullied on the bus:
Children being picked on aren't always comfortable telling others about it or asking for help. But there is also something called "parent's intuition"—knowing when something is bothering your child. If you're not sure, try asking some of these questions.

You may not suspect something is wrong until your child starts coming up with excuses to not take the bus or starts avoiding school entirely. This is a red flag; see School Avoidance: Tips for Concerned Parents.

Bullying can also cause stress-related physical symptoms such as headaches, stomachaches, nausea, and dizziness. Realize that kids don't have conscious control over these symptoms―and they're definitely not them making them up.

Kids may worry that if they report the bullying, it will lead to more bullying (retribution). Sometimes, younger children may not even recognize bullying behavior for what it is or know what to call it. Of course, some bullies will make outright threats about what may happen if a child tells someone.

Step 1: Learn your school's bullying prevention policies.
School buses are an extended part of the school environment, so they likely are covered in your school's bullying prevention policy.

The bus driver, other adult staff, and the school have a legal and ethical responsibility to ensure children feel safe, valued, and welcome on the bus.

Step 2: Follow the proper chain of command―this usually means communicating with the bus driver directly as a first step.
Although bus drivers can't always step in when bullying happens, many are very aware of the interactions between their young passengers and can provide some helpful context. Talking with your child's bus driver in the middle of a route can be difficult, but a call to the school can help in setting up time that isn't so awkward. ​​Many of us have our own childhood memories of bus bullies, but as parents the situation presents new challenges in knowing how best to handle the situation and help our children. Here are some tips for handling the situation.

Keep Kids with Autism Safe from Wandering: Tips from the AAP

Anyone who's been a parent long enough has felt that panic—often only temporary—when a child wanders out of sight. Kids can get lost anywhere—at an amusement park, in a store, in a crowd, and sometimes even right in your own neighborhood. Many parents of children with autism spectrum disorder (ASD) know this feeling all too well.

The Scope of the Problem:
The first study to quantify the scope of the problem was published in Pediatrics in 2012. Results were significant. Of the 1,218 children with ASD who were studied, almost half of those children had wandered off from home, school, or another safe place at least once after age 4. Many were missing long enough to cause concern, were in danger of drowning, or were at risk of being hurt by traffic.

What Parents Can Do:
There are things parents can do to protect their children with ASD from this very real and scary danger.

Here are tips from the American Academy of Pediatrics:
Know wandering triggers. Children with ASD can be impulsive and typically wander or bolt from a safe setting to get to something of interest, such as water, the park, or train tracks—or to get away from a situation they find stressful or frightening, such as one with loud noises, commotion, or bright lights.

Secure your home—regardless of your child's age. Shut and lock doors that lead outside. Consider putting alarms on doors to alert you if a door has been opened.

Drowning is the cause of death for almost 3 in 4 children with autism who wander off alone.

Reinforce water and swimming safety. Home swimming pools should be surrounded by a fence that prevents a child from getting to the pool from the house. There is no substitute for at least a four-foot-high, non-climbable, four-sided fence with a self-closing, self-latching gate. Pool alarms and door alarms are also protection products that may have some benefits. Note, however, that swimming lessons are not enough to prevent drowning; swimming lessons in wet clothes and shoes could be suggested for children with ASD who tend to wander.

The American Academy of Pediatrics (AAP) recommends a family supervision plan for children with autism and other special needs. Have a checklist of nearby ponds, lakes and pools to search if a child wanders. Download an emergency plan here.

To find swim lessons, contact your local parks and recreation facility or YMCA. Many communities have free or low-cost programs. Swim programs are tailored to meet cultural, religious, physical and mental health needs. Local faith-based organizations also can offer suggestions on swim accommodations that meet your family’s beliefs and traditions.

Work on communication and behavior strategies. Teaching your child strategies to self-calm when stressed and appropriately respond to "no" can make a big difference. Make sure your child's teachers and other family members understand how important it is to keep your child engaged and busy to reduce his or her urge or opportunity to wander.
Set expectations. Before going out in a public place, communicate the plan with your child and other family members—including the timeline and rules to follow. Consider noise-canceling headphones if noise is a trigger, and use the "tag team" approach to make certain your child is always supervised by a trusted adult.

Consider monitoring technology and identification. More than 1/3 of children with ASD who wander are never or rarely able to communicate their name, address, or phone number. It may be helpful to have things like GPS devices, medical alert tags, and even their name marked in clothing. Project Lifesaver and SafetyNet Tracking or other programs may be available through your local law enforcement agencies.

Rest. Children with ASD may be less hyperactive and less likely to wander during the night if they have a sleep management plan and a regular sleep schedule. Caregivers who get enough sleep are also more vigilant. ​Anyone who's been a parent long enough has felt that panic—often only temporary—when a child wanders out of sight. Many parents of children with autism spectrum disorder (ASD) know this feeling all too well.​

Measles | Home | Rubeola | CDC

Measles starts with fever, runny nose, cough, red eyes, and sore throat. It’s followed by a rash that spreads over the body. Measles is highly contagious and spreads through coughing and sneezing. Make sure you and your child are protected with measles, mumps, and rubella (MMR) vaccine. Measles is a highly contagious virus that starts with fever, runny nose, cough, red eyes, and sore throat, followed by a rash that spreads all over the body.

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