U.S. task force recommending anxiety screening in kids 8 and older
wbur.org
wbur.org
I believe that I was basically a functioning meth addict for most of my childhood who thought I had never done drugs.
Ironically I think the kind of thinking that decides all kids need intensive psychological screening at 8 is an example of the types of patterns for how we run our society that cause lots of people to develop anxiety issues.
Or who knows, maybe we are just one bureaucratic process away from everyone finally being happy.
I envy countries that focus on Gross National Happiness vs GDP.
If 10% to 21% of kids had some sort of minor physical aliment we wouldn't be content to just treat it and not question why it is happening.
It's almost like the article should highlight the need for prevention as well as screening which (checks) it does.
Teenagers are supposed to be awkward and feel anxiety, amongst endless other emotions in excess. It's a normal part of growing into an adult.
Take away the act of learning how to deal with all this new emotion, and emotional intensity, and a human's growth will be stunted.
However, space needs to be provided to do that growth safely, and in order to that there would need to be massive changes in Sign-up-for-everything parenting culture, A's-or-die school culture, and a myriad of other things in order for this to work. As it is, this culture takes the fire and throws gasoline on it, preventing healthy growth.
Even outside of that, there is a balance to be struck - while some amount of anxiety/awkwardness is expected, if it leads to suicidal thoughts, self harm, lashing out at others, or other destructive behavior, it has gone to far.
Most children are not teenagers.
> Teenagers are supposed to be awkward and feel anxiety
Diagnosable anxiety is not “feeling anxiety” in the common sense any more than diagnosable depression is “feeling sad”.
> Take away the act of learning how to deal with all this new emotion
No one, ever, has argued for that. Where treatment is required for childhood anxiety, talk therapy — often CBT — seems to me the first-line treatment. Which is exactly learning how to recognize and deal with problematic feelings.
The house is made of cards, and there are people running around trying collect more cards than everyone else - even when those are at the base. Meanwhile, someones turned up the AC at one end of the house and the heater at the other, and we've got weird air currents blowing every which way.
I have seen it a lot more of "why even try because our quality of life is going into the toilet" and less of "we are all going to die"
It can be compared to, "How many times can we change the solar system model before it's reasonable to be doubtful of the message? I think there have been at least 4 changes in what we believe to be the center of our universe in my rather short lifetime and there's always a new proposed center after each one is proven false."
It is a science. It is scientifically proven that the damage we have done to our climate is going to eventually cause very bad consequences. The only question is when, which is very difficult to pin down with constantly changing conditions. It's like trying to identify when the next tornado will hit. You don't know precisely when, you might have some false positives, but you know it will happen. You don't get to say, "Well this is the fifth time the meteorologist has told me to evacuate, I have reason to believe this is politically motivated".
That is not to say that ALL predictions are necessarily wrong, but enough to be wary of the fear mongering. Especially since dramatic predictions probably yield more government money.
Uh, really? There are any number of natural disasters that have been made many times worse by climate change, but ignorance is bliss I guess...
If you’re thinking of nukes, we had New START, SALT, NPT, etc. and a shit ton of activism which significantly reduced the threat.
If you’re thinking of past claims that we’re “past the point of no return” for climate change, those claims were correct. We passed the point of no return for avoiding extreme weather due to climate change. Then we passed the point of no return for 1C of warming. Now we are nearing the point of no return for 1.5C of warming. Things are getting worse for the climate, which is why people keep saying that things are getting worse for the climate.
That said, apathy is counterproductive. We need hopeful children and adults to drive political and technological change. Therapy or other tools for reducing anxiety (e.g. exercise) could help people be hopeful.
It’s hard to communicate bad stuff can be bad without it being WWIII kinds of bad. Imagine time traveling before the pandemic to your younger self in say late 2018 and describing what’s going to happen in detail, in such a way that your younger self feels the same way about it as you do right now.
It will be a serious problem that will take big efforts to solve, but on a civilizational level, it will be much more of an inconvenience than a disaster.
>"Everything seems to say..."
What I just wrote above doesn't go viral or generate millions of clicks. For that you need predictions of epic disaster. So epic disaster stories are what go viral, show up everywhere, makes it easy to conclude that "everything seems to say" that.
As for economic development I think the past few years have shown us very well (though whether or not people want to hear the message will remain to be seen) is that optimizing for economic growth and development (namely GDP) means you're not optimizing for things like redundancy and resilience and stability. Growth for growth's sake is the ideology of a cancer cell; it doesn't have to be ours. How many more "once in a lifetime" economic crisis do we get before we take that to heart?
I didn't even make such references, but your snark claiming renewable energy couldn't possibly have ulterior motives makes no sense.
It is also not a given that it reduces pollution. Until very recently, solar panels cost more energy to make than they would yield. I've hear claims it is different now, but I can not yet buy a solar panel for my house that would make economic sense. That seems odd, because if they would yield a net win in energy, it should be available to buy.
In my country they will now also cut down a historic wood to make space for wind power.
Hydrological dams are also famous for wrecking havoc with ecosystems.
Most ecological issues that are attributed to climate change these days are actually caused by humans destroying nature directly - cutting down woods, eliminating safe spaces for animals and insects, messing with rivers, building cities that let the ground sack into the see, stuff like that.
Not sure how active for example "Fridays For Future" is in your country?
Relentless propaganda: if you have kids in school, odds are any event they plan will be littered with climate change stuff, for example. My kids school decided cakes for the next event will have to be vegan because it is better for the climate, for example. Science projects will be about climate something. And that is just school, media is on a whole other level.
The only thing more popular atm is the transgender craze.
bhutan's an absolute autocratic kingdom, it's just that the king is oxford-educated and does a lot of the usual enlightened monarchy stuff and seems a decent enough man. if his son is a little shit or he gets a stroke or something, that all goes down the toilet
1. https://en.m.wikipedia.org/wiki/Bhutanese_refugees
2. https://worldhappiness.report/ed/2022/happiness-benevolence-...
Here's a very troubling example that is happening right now:
Denmark is currently deporting back to syria all of its syrian refugees. They revoked their residency almost overnight and declared that Syria is now safe even if the Civil war is far from over. Considering that the groups that those refugees originally escaped from are still in power (whether it's Assad or the islamists), it basically means certain death for a lot of them (even those lucky enough to avoid reprisals will probably end up forcibly conscripted). They also argue that Damascus is completely safe for refugees who specifically escaped the syrian government security services (gestapo lite)... because that same government is now fully in control and has pacified the entire region.
>In 2019, the Danish prime minister declared that Denmark wanted ‘zero asylum seekers’. That was a really strong signal* >That's really good news," Mr Tesfaye said in February. "Corona, of course, plays a role, but I think first and foremost, it's because of our strict foreign policy. Many of those who come here do not need protection at all." >The government has set a target of zero, arguing that the money saved can go towards welfare[0]
The most troubling part is that all of this is happening under a "moderate" left wing government with pretty wide support and little to no actual backlash. So yeah, I'd be hesitant to use nordic countries as a model for everything. It's a lot of tradeoffs and the welfare state can be sweet for some, but I know that personally as a muslim I'd much rather live elsewhere
This is silly. The US didn't take remotely close to the same amount of refugees per capita in the first place. They just let them die at the border instead.
> all of its syrian refugees.
I'm glad you brought up this topic, but saying "all" is quite an exaggeration, although that doesn't make it any less horrible.
Not sure how that's relevant, neither the article’s nor the more general modern approach is that the “only solution is medication”.
I was therapists for anxiety as a kid. My parents were never recommended meds but I did learn a bunch of skills to help me be more patient and calm.
>Nearly 80% of chronic mental health conditions emerge in childhood
"Normal adult" is relative. Just because a prior generation had to "weather through mental issues" doesn't mean the next one should too.
I also don't know where you got the "doctors whose only solution is medication" idea from. You can click through to the survey linked in the article. Here is the high level summary:
> In particular, CBT [Cognitive Behavioral Therapy] and exposure-based therapy continue to be the most well-established treatments for child and adolescent anxiety. These findings suggest that the class of interventions comprising CBT and exposure-based interventions are supported by a strong and diverse literature base and that clinicians selecting a first-line intervention for youth anxiety might search here first. Within the CBT and exposure-based interventions reviewed here, the treatment protocol that best meets a given client's presentation will likely be based upon multiple unique considerations such as youth and family characteristics, service setting, and treatment format.
Nothing about medication in there.
I once held this view, which changed when I watched my 8yo daughter, who was showing some _very_ troubling anxiety-related behaviors, be almost immediately helped when she was diagnosed with ADHD+Aspergers and given ADHD meds. We'd previously tried child therapists and pretty much everything else under the sun.
Do I wish that she didn't need medication? Of course. But for her the benefit has far outweighed the downsides, at least so far.
Go to your doctor, ask questions, get second opinions. Don't trust random commenters on the internet. I wish I had my ADD treated much sooner. Some disorders are very treatable. Ask for non-drug options.
The pendulum of public opinion on stimulant use with ADHD treatment has always been too fast, resulting in periods of over and under diagnosis. The lifelong negative effect of being treated for ADHD when unnecessary is much less than being undiagnosed, but the delay in the change of outcome makes it difficult to see. People with untreated ADHD tend to perform worse in _every_ aspect of life, from relationship maintenance, financial stability, professional and academic development, and personal happiness.
While it is wrong to simply give a patient the meds without therapy and observation, it is much worse to not do so when the medication is needed.
A preliminary analysis has shown that the above comment exhibits symptoms of at least seven mental disorders, according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Would you like to commit giantg2? [Y] [N]My dad had a class with a psychiatrist. One day the psychiatrist came in late, paced back and forth, and told the class that the only reason someone becomes a psychiatrist is to find out what's wrong with themself. Then he walked out. That was the class for that day.
If there are enough troubling signs, you look into it a little more. It might be nothing, it might be something to work on.
Probably my toxic masculinity showing, but if 1 in 3 children has anxiety, then I'd chalk it up to "that's life". We cannot possibly offer therapy to that many children and medicating the problem away is a chilling suggestion.
> This software is too buggy to improve. We should give up and live with the bugs instead?
1. You can do a full costly rewrite, probably still end up with bugs because we don't have a real solution to inherent complexity. (we don't have a cure for anxiety)
2. You can target the few very bad bugs and fix those (helping the ~5% of children with crippling anxiety, let the "moderate" anxiety learn to live with it).
Article is pointing towards doing 1, I think it's ridiculous and how we end with a significant proportion of kids on antidepressants.
Anytime there is a pattern to bugs, I stop and think about the systemic changes that got us there in the first place. And that's what I'm advocating for here too.
That's actually probably a very good and cost effective solution to part of the problem, despite probably being a typo.
No, it's not.
> I think it's ridiculous and how we end with a significant proportion of kids on antidepressants.
The most common treatment for diagnosable childhood anxiety seems to be talk therapy, not medication (and, anti-anxiety and anti-depreasant are different sets of drugs, anyway.)
1. https://en.m.wikipedia.org/wiki/Bloom%27s_2_sigma_problem
Why not? We expect a healthy child to have a doctor, a healthy child to have a friend group. Why not expect them to have a mental doctor/therapist?
maybe there's value in occasionally seeing a therapist for a "mental health checkup", but weekly one-on-ones obviously doesn't scale to every single child.
An appropriate course of treatment for each child with a diagnosable condition for which it is appropriate certainly does. Maybe weekly sessions 52 weeks a year, every year, for every child regardless of need doesn't, but why would you do that anyway?
Basically for every treatment a certain percentage of patients will get worse, not better. So just like you'd only prescribe drugs when needed due to the risks, prescribing therapy when not needed is a bad idea.
Why not? A 12-16 week course of CBT for even 20% of children, sometime during childhood (so about 1-2% of children per year) would be a rounding error in total healthcare expenditures. It would be a substantial increase in current mental health expenditure, and probably take a several years to get up to capacity for, but its not something radically impossible.
If the source of one's anxieties isn't going to change (like one's neighborhood or family), no amount of coursework or medication is going to help. Exceptional circumstances notwithstanding, there is no way to psychologize, meditate, or drug a kid's problems away. There is no one-size-fits-all solution
I might not have the solution to the problems themselves are, but the chances of proactive intervention damaging a child's life are much higher than if you left them alone. The last thing I would like to see coming back is mass institutionalization, and unfortunately these kinds best-intention suggestions become springboards for later abuses
I've been mentally toying with the idea of an in-house pre-paid school psychologist and mandatory annual screenings for all students. We already do this for hearing and vision screening, and sometimes even dental screening and care.
That or there are other ways to create intervention opportunities. There are many proven mental health therapeutic interventions that could be implemented in a classroom format. Lots of self-journaling to various prompts, etc. The class can focus on stress management strategies, organization, and other sorts of long term planning, reflection, conflict resolution and other life-success skills. Self-assessment quizzes could be administered to screen for depression, anxiety, dark-triad type stuff and then results evaluated by an actual psychologist with appropriate followup as needed. I just about guarantee that would do more to prevent school shootings than any gun control proposals on the table.
For the amount we spend on schools to have school resource officers (like providing extra opportunities for students to have run-ins with the law is helpful?), and all the security and surveillance infrastructure, and ridiculous admin costs, I think it wouldn't be nearly as expensive as you might think.
> Self-assessment quizzes could be administered to screen for depression, anxiety, dark-triad type stuff and then results evaluated by an actual psychologist with appropriate followup as needed.
this part seems misguided. especially if administered through school, I suspect a lot of students would perceive this as an attempt to get them to "tell on" themselves. which it is, at least some of the time.
That's the good news? I guess hoping for a deep dive into the causes and some reasoning about how we got ourselves into this is too much? The pattern of only addressing symptoms is pathologically abundant.
Early on my severe and reoccurring anxiety was dismissed as normal anxiety. It’s still common for people to think the normal worrying we all experience is the same as having anxiety disorder.
Knowing what I was experiencing and how it’s different would have been great for me and my peers.
I would be worried about labeling. Anxiety comes and goes, usually in waves, you can have periods where you're not anxious and periods where you are not
I'd say in that case there's not much to worry about ;)
You get the point
I still have regular anxiety and nervousness. The panic attacks are something completely different though.
It wasn’t until uni that I realised what was going on.
How did you cope with it?
Anxiety for me also affects my stomach. When I’m really anxious I have to avoid certain foods because they make it worse. Other than that I found coping with my anxiety more generally improved the stomach symptoms as well.
Past USPTF recommendations can be found here: https://www.uspreventiveservicestaskforce.org/uspstf/recomme...
Very sensitive, avoids social interactions, negative thoughts ("what is the feeling doesn't go away?") And other hallmarks of anxiety.
We try not to label her, get to speak about what she's feeling, try to give her tools to cope.
But as a parent, seeing this unfold time and time again, each time with some new trigger is tough.
Has anyone gone through something similar with their children and has some advice about what helps and what doesn't help, would love to hear
Therefore we should all think as much as possible. And childhood should be spent getting good at thinking.
But thinking isn't the pinnacle of existence. In fact it's just a very tiny part of existence. So when we spend all our time thinking, in exclusion of all else, we suffer. A kind of starvation.
And it messes us up body and mind.
The messed-up-ness might manifest as anxiety.
Probably, initially, therapy like CBT and school-based awareness and accommodations, if particular geographic, demographic, or other discernable trends show up that indicate systemic rather than merely individual random issues, probably dig deeper to understand the process and causes and address them.
Children are still growing - and it is the easiest time to make changes, just like it's easier to learn a new language. It seems like the best time than to wait until it crystallizes in your twenties in addition to the stresses of being an adult.
How could this possibly go wrong?
/s
Ask a painter how to spruce up your house they'll say paint. Professionals swing with the hammer they have.
this is philosophically and ethically wrong