Category: Wellbeing

Test and Exam Anxiety

By Mark Staum, LCSW

The months of October and November bring new weather patterns, new daylight schedules and new challenges for children. Exams, projects, and papers are back in full swing. Some children may experience some level of anxiety, in preparation for an exam or during an exam. Test Anxiety is a form of anxiety that can be anticipatory and/or performance related. In anticipatory test anxiety, a child may be anxious about the preparation necessary for an exam. When performance related, a child may experience anxiety during the exam itself.

Research shows that test anxiety is related strongly to time management and preparation. Even the most prepared/organized child may have some normal ‘jitters’ on the day of a big exam. However, generally speaking, children who prepare, plan ahead and studies for exams tend to feel more capable of handling any stressors that may arise on the day of the exam. By contrast, children who attempt to cram the night before tend to be more anxious. With that said, some children who study and know their material very well still get very anxious. Also, children with anticipatory exam anxiety may push off studying because doing so makes them think about their exams, which is unpleasant and anxiety-inducing, and as a result, they are less prepared, which begets even more anxiety.

To help children manage test and exam anxiety, teachers and parents should pay careful attention to children’s behaviors. Let’s look at three examples:

  1. A child tells you that before a Math exam, her body became ‘frozen’ and it felt like she was confused and disoriented.
  2. A child says that he reviewed the material for his History test an extra five times because he felt nervous that he really didn’t know the material well.
  3. A child mentions that before her most recent Science exam, she was so nervous that she could not study, and then during the exam, she felt very tired and had difficulty concentrating.

In all these cases, adults can assist children in navigating through these discomforts. In example #1, the child can take a practice test in advance of the exam, and then use breathing, relaxation, and light muscle exercises to relax the body directly prior to and during the exam. In example #2, we can help the child to recognize why it is that he is concerned about not doing well, and to be more accepting that sometimes we try our best and still don’t achieve what we want. In example #3, we can reinforce good study habits, especially when the child prepares for her test despite her anticipatory anxiety.

In all of these cases, feeling of anxiety can be worked through to build resilience and growth in your child. The above are sample strategies and professional assistance may be necessary. Typically, test and exam anxiety is highly treatable with evidence-based psychotherapy such as Cognitive Behavioral Therapy, and children can see benefits within just four to six weeks.

Staying Cool in Summer Heat

By Yoni Sobin, PsyD

In the winter, we face an increased risk of flu and seasonal depression, so we stay vigilant for contagions, stay warm, and keep engaged in activities with others (see my previous article on loneliness – http://www.centerforanxiety.org/2016/12/20/loneliest-time-year/). We typically overlook seasonal risks in the summer, but here are two concerns to be mindful of as the temperatures rise:

Dehydration

Almost everyone knows the value of protecting our skin against the sun, but protection against dehydration is equally important and often neglected. During the summer, the average adult loses over two liters of water daily through sweat (we have over two million sweat glands!) and other bodily functions. And this can impact our mental health – dehydration is associated with mood lability, poor concentration, depression, and anxiety.

A key strategy to combatting dehydration is using mindfulness to observe our body sensations and noticing early signs when we are running low on water. Low-grade headaches or muscle cramps, fatigue, lightheadedness, difficulty concentrating, and reduced urination or darker/yellower urine are some indications.

Behaviorally speaking, drink eight to ten glasses of water daily throughout the summer to facilitate an optimally focused and healthy mind. Eating foods like cucumber and watermelon are also excellent ways to stay hydrated. Sports drinks help restore electrolytes and body salts such as sodium and potassium. And if you’re exercising outdoors, drink at least 6 ounces of additional fluids each 30-minutes, and try to schedule activities in the mornings or afternoons when it is cooler outside. For beachcombers, while catching the sea breeze is a great way to cool down, remember to bring at least two liters of water per person since the sun’s reflection on the water surface significantly increases dehydration risk and ultraviolet ray exposure.

Lethargy

While seasonal depression tends to decrease during warmer months, many individuals still experience depressive episodes in the summer. One reason is that is easy to stay indoors and watch television or read a book in an air-conditioned room, and by contrast, the most effective tools for staving off depression are remaining active and maintaining interpersonal connections.

If you’re feeling blue during the days of sun, try to attend events or concerts outdoors. Go to a beach or find a water-based activity. Attend or even host a barbeque. Take a weekend vacation getaway with a friend or on your own. Google “free things near me today” and do one or two things that pop up. Try one new activity each week. Spend time in nature (while remaining hydrated, of course) and give yourself time to decompress your mind. Whatever you do, engage with your activities mindfully. Take note of sounds, sights, smells, sensations, and tastes.

If the weather is too hot to comfortably enjoy the outdoors and you find yourself binge-watching the West Wing or Big Bang Theory while sitting on the sofa, be sure to take at least a 10-minute break after each episode to walk around the block or call a friend. Research shows that sedentary activities increase depression risk, and punctuating the day with active blocks can make a big difference.

On the whole: While summer is a great time to relax, it’s important to remain mindful and never relax attitudes towards protecting our physical and mental health!

The Science of Acceptance (and How to Get “Unstuck”)

By Aliza Dinerstein, LMSW

Throughout life, many of us experience periods of time when we find ourselves feeling stuck. We may feel stuck in an unfulfilling job, stuck in a conflict with a good friend, or even stuck in our own feelings of depression, panic, or fear. Understandably, our instinctual response is to try everything in our power to fight the reality as it is, in the hopes of rewriting the past and present according to the script of what we feel reality should be. Although on the surface this approach appears to be constructive, it is often the very act of not accepting the facts of reality which can cause us to become even more fastened to the problems that we are trying to rid ourselves of.

What is Acceptance?

Acceptance, the willingness to fully experience reality as it is, is a fundamental aspect of evidence-based psychotherapy. Acceptance and Commitment Therapy (ACT) is a behaviorally oriented approach to psychotherapy that places emphasis on the combination of acceptance and behavioral change. Within the ACT framework, acceptance is considered the impetus of change in regards to our actions, thoughts, and feelings. Similarly, Dialectical Behavior Therapy (DBT) also focuses heavily on “radical acceptance” as a primary intervention for tolerating, decreasing suffering, and increasing our capacity for change.

Why is accepting reality so important?

When we reject reality we focus our energies on trying to change things that are beyond our control, which then causes us to feel stuck and helpless. Non-acceptance leads us to getting tangled up in our distressing thoughts and feelings, and we may notice ourselves trying to undo the past and control the future. Furthermore, refusal to accept our challenges causes us to avoid experiences of pain or fear, and before we know it we are no longer able to do the things that matter to us most. This concept is illustrated with the following metaphor (adapted from ACT): Imagine that you were blindfolded and placed in a large field, and you were given a small bag with some items to help you in the darkness. Unbeknownst to you, this very field was full of large holes, and soon after you began walking around the land you fall into a deep pit. You don’t know how to get out, so you take out your bag and find a shovel. You feel a sense of relief knowing that you have found the “perfect” tool, and you began to dig. However, as time passes, you realize that not only are you still in the hole, but it is actually much bigger. You continue to dig, even more fervently, but somehow the hole just continues to grow… Non-acceptance of reality may seem like the only tool we have, but it only creates the illusion that we are working towards solving our problem while we are actually just digging ourselves deeper into a hole.

How can I start to work on Acceptance?

Here are four steps you can take today:

  1. Accept with your whole self. Instead of just thinking, practice acceptance by engaging your heart and your body, as well as your mind. Use relaxation techniques (such as mindfully counting your breath), prayer, or go to a place that makes you feel calm while you think about the challenge of fully accepting reality for what it is.
  2. Use an acceptance (or self-acceptance) statement. Choose a phrase that helps you feel closer to accepting reality such as “this is what it is”  or “I accept myself as I am.”
  3. Fake it until you make it. List the things you would actually do if you were more accepting, and then act as if you have already accepted the unpleasant realities in your life. Choose one thing on the list and do it each day, even if you don’t feel motivated in the moment.
  4. Ride the wave. Allow sadness, disappointment, and/or grief to rise within you, while acknowledging that life can be worth living, even with pain. Often, after the emotions heighten they will naturally fall again, just like a wave.

Accepting reality is both a choice and a skill. The more we engage in the practices of acceptance we can build resilience to handle life’s challenges without getting “stuck,” and increase our capacity to not only tolerate difficulty but to grow through it as well.