Search for tag: "anxiety"

Pandemic fatigue, we all have it. However, it is affecting children more than adults in many cases.

Pandemic fatigue by definition is the mental exhaustion caused by being in a state of heightened awareness and alertness in the face of COVID combined with the uncertainty of how the pandemic will develop. Parents are struggling to continue to juggle working from home and teaching their kids who are doing online school. Healthcare workers are getting burned out from the stress of working with COVID patients and seeing the numbers of infected patients continue to go up.

Kids are becoming more anxious and depressed, not just about isolation and not seeing their friends, but I'm having parents bringing their kids to me about anxiety over things they've never been anxious about before. This is especially true because just as COVID numbers started to increase locally, we also had a major earthquake. I have some patients who if they get a cold are asking me if they're going to die. I have others who are terrified of germs and think they will get COVID if someone touches their dog or they will change their clothes as soon as they get home from being out of the house, even if they just went to a store.

People are tired of wearing masks. People are tired of physically distancing, of not having normal life milestones being able to be celebrated in the way we have done for years. So since this is not showing any signs of slowing down anytime in the immediate future, how can you help your children do the best they can while dealing with COVID in the long haul?

First, continue to make mask wearing fun. I've said it before, and I'll repeat it again. If the mask is something fun, kids will want to wear them more. Have fun characters on their masks. Let the kids have enough variety in their masks that they can coordinate them with their outfits. That's exactly what my younger son does every day. His teachers comment all the time about his cool masks and how they match what he's wearing.

For hand sanitizers, have seasonal scents. If your child doesn't have eczema and they're not sensitive to different fragrances, let them choose what they want to smell on their hands all day long.

Empower kids. Let them know it's okay to tell family members and friends that if they just aren't masked or they're not social distancing, then your kid can't play with them. It's okay to remind others of the rules. Just make sure it doesn't turn into a daily battle and they don't turn into the germ police.

Let kids connect with friends online. I know we didn't use to be a video game family, but when the pandemic hit and schools went online, I caved. I bought an Xbox for my boys and I let them have a certain amount of time to play with friends every day. It helps them still feel connected to their friends, but in a safe way. It also lets them get a break from school and just play and be kids.

Finally, remember that it's okay for them to be bored and figure out new things to do. It's okay to let them cry, even if they can't tell you what they're sad about. It's okay to have breakdowns and just get angry and need you to hug them until they're screaming turns into crying and then I'm sorrys. As long as your child isn't disrespectful or violent, let them express their emotions. Then, if they want to talk about their feelings, if they don't want to, that's okay. Let them have their space. The bottom line is everyone is feeling pandemic fatigue in one way or another. If we all help each other, then we will get through this together.

Dr. Jones: Anxiety in young women is on the rise and is there any wonder why is this happening and what can we do? This is Dr. Kirtly Jones from obstetrics and gynecology at University of Utah Health Care and I'm anxious about anxiety and this is The Scope.

Announcer: Covering all aspects of women's health, this is "The Seven Domains of Women's Health" with Dr. Kirtly Jones on The Scope.

Dr. Jones: Anxiety is a very common and perhaps the most common mental health concern in the United States. About 40 million Americans have anxiety disorders and women are twice as likely to be diagnosed with anxiety than men. College health centers are seeing a dramatic increase in anxiety in their students. One recent study of 63,000 college students found that there were five times as many young adults with high levels of anxiety compared to college students in the 1930s. So are we just more aware of mental health issues? Are young women more willing to seek help and, therefore, get counted?

As the pace of life and social media increased anxiety in young women, the truth is probably all of the above, but let's drill down on some of the causes, the consequences, and what to do. Firstly, there is evidence that the way a child responds to stressors may be both genetic and epigenetic. That means there are inherited genes that can contribute to overreacting the stimulus. But these genes have been around for a long time. So why is there more anxiety now?

The epigenetic story is that genes are modified by early stressors in early fetal development and early childhood development. Moms who are exposed to high levels of stress give birth to babies that are more likely to overreact to stressors. Children who have high levels of stress in their lives, poverty, homelessness, instability in their home life, have an increased chance of having anxiety and attention problems as adolescents.

Secondly, the environment of children and young adolescents is increasingly stimulating social media which may not be very supportive, bullying in schools, TV, increasingly dramatic news coverage, and video games that are violent and stimulating can contribute to high levels of stress hormones. Kids are getting less sleep and consuming more caffeine than ever before. Increasing use of some stimulants for attention disorder may also increase anxiety in kids who may not be taking it appropriately.

Thirdly, there is clearly an awareness in the schools and colleges that more kids have anxiety. Giving it a name lets us count it in adolescents. An increasing availability of medications to treat anxiety allows adolescents to state care. What is the bad part of anxiety for young women? Firstly, it feels awful and limits a young woman's ability to focus on the task at hand: school or work or healthy relationships.

Secondly, young women may self-medicate with alcohol or sedating drugs like opiates or Valium-like drugs that they obtain from friends or a family medicine cabinet. Young women who self-sedate in social settings are more likely to be sexually abused or overdosed.

So what should we do? The first thing is recognition of the problem. This goes back to the RULER project for emotional intelligence. "R" is for recognize. When you feel it, understand that you've felt this way before and you've survived it before. "U" is for understand what the triggers are and if the anxiety is about something that's really dangerous or not really dangerous. Label it. When you give that feeling the correct name, you can learn about it.

Express it. "E" is for express it. Let others know how you're feeling so they can learn more and help you. And "R" is for regulate it. Okay. How do you regulate anxiety? A healthy diet with less bad fats and high-sugar carbs and less caffeine can be helpful, actually, for everything. Eat regularly in small meals. Exercise vigorously four times a week with healthy friends, if possible. Get your sleep. Yes, if you're anxious, you can't sleep. But when you're not so anxious, make sure you get the sleep your brain needs.

Get more phone-free time. Are you addicted? It's time to withdraw from the stimulus of your social media and get some exercise. Every time that little beep goes off or the little buzz in your pocket, it makes your stress hormones go up. Practice mindfulness and deep breathing. Many studies have found that these practices can be helpful for anxiety. The old saying, "just take a deep breath," comes from some basic neurobiology of stress hormones. Take that deep breath and keep doing it for several minutes.

There are many websites to help with mindfulness training and breathing techniques. There are several good websites for young women, girlshealth.gov is one here in the US. One I really like comes from Australia. jeanhailes.org.au is a website for women's health issues. The AU is the Australia part. If you Google "anxiety young women Jean Hailes," you'll get to a terrific website on symptoms and healthy self-treatments for anxiety. anxiety.jeanhailes.org.au, and click on "Young Women."

Get help. Talk therapy can give you skills to break your anxiety. You will probably always have some level of anxiety, but the goal is to give you the toolbox to tune down a level of anxiety hormones so you can live a less stressed life. If your therapist isn't able to help you get control, medication taken daily that isn't addictive can help and it's approved for adolescents. You have the power to feel better and if that isn't working, we can help.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there’s a pretty good chance you’ll find what you want to know. Check it out at TheScopeRadio.com.

Interviewer: Coping with anxiety, we'll talk about that next on The Scope.

Announcer: Health information from expects, supported by research. From University of Utah Health, this is TheScopeRadio.com.

Interviewer: You know there are a lot of things that can happen in this world that can cause fear and anxiety and most of the time they're not really under our control but what do you do about them? How do you cope with them? Maria Reyes is a psychiatrist with University of Utah Health Care and she's going to give us some tips right now on how to deal with anxiety-causing events in your life that you don't have control over.

Maria: To your point about anxiety, as a psychiatrist, and I think this about it, every emotion in general I think the first step in being an emotionally healthy person is acknowledging your feelings and not judging them. So feelings and thoughts are just those - feelings and thoughts - but the first thing you need to do is acknowledge those and put a name on them. Don't ignore them is the bottom line because they will ultimately come to fruition in ways that may not be so pleasant sooner or later.

Interviewer: So it's better to just face up with it and just go, "I'm feeling a little stressed or sad or whatever about this situation."

Maria: Absolutely.

Interviewer: And go, "Okay. I'm feeling it."

Maria: Right. That means you're alive, that means you're a human being.

Interviewer: That's a good thing.

Maria: Yeah. And join the club.

Interviewer: So acknowledging is kind of the first step. Within that what else would you want to do as part of acknowledging it?

Maria: I think what distinguishes humans from primates is the ability in general to articulate our thoughts and feelings and I feel that people that tend to talk about their feelings tend to be more emotionally healthy and so I would encourage people when they do experience anxiety to talk to someone you know and trust. It doesn't have to be myself or a health care professional necessarily, but just being with friends, family and just using them as a sounding board for kind of what you're thinking and feeling.

Interviewer: Find that person that listens to you or that you have a good rapport, some trust with I'd imagine.

Maria: Absolutely.

Interviewer: Would be a big part of that. So acknowledge it, experience that emotion, talk about it. That's kind of the big first step when you're faced with some source of anxiety. What would you do after that?

Maria: After that, I encourage people to step back from their problems. Now I want to make the distinction between stepping back and avoidance. I'm not encouraging avoidance. That actually makes anxiety worse in the long run. However, creating some healthy distance when you feel overwhelmed emotionally is a good thing and it can be helpful in the long run. By that I mean things like engaging in hobbies, exercise, sometimes disengaging from social media if that's something that is anxiety provoking.

Interviewer: Especially if it's a world event.

Maria: Exactly.

Interviewer: You keep diving into more news stories about it or go to social media or go to the comments section.

Maria: Exactly.

Interviewer: So it's healthy to get away from that.

Maria: Right, or going on a news social media cleanse of sorts or just kind of being cognizant of the time you spend in those realms. So part of stepping back, the outcome of that is hopefully just a reframing of the situation. So stepping back could kind of give you the emotional distance to kind of look at a problem from a different perspective, seeing that silver lining around the cloud.

Interviewer: That's a good thing to look for?

Maria: Yes.

Interviewer: It's a healthy thing to do.

Maria: Yes. Our ancestors had it right when they came up with that adage.

Interviewer: So try to find something in the situation that maybe makes it not seem quite so bad or what good could come out of this or . . .

Maria: Absolutely. So just finding what lessons are there to be learned or how could I have done things differently are good ways to think about problems.

Interviewer: So step back and then is there something else you could do to help maybe make it not seem so big and scary?

Maria: Absolutely. Again, I don't want us to get the message that I'm advocating for burying your head in the stand or avoiding your problems. Of course, the step after stepping back would be to re-approach the problem or the precipitator of that anxiety but hopefully now it would be with a clear head. Then the outcome of that, I would hope, is some sort of sense of control over a situation that you may have limited control in. However I think there's always some part of that problem that seems beyond your control that you have a little bit of control over and I encourage people to know the difference between what you can control and what you can't.

Interviewer: And try to find that little piece maybe that you can do to make yourself feel better about it all.

Maria: Exactly.

Interviewer: So how do you know when it's time for an in-person session with a professional?

Maria: I think anytime you have feelings and emotions that interfere with your ability to fulfill your role as a mother, a spouse, a friend or if it's interfering with your ability to work or go to school or function in general. Also I have to throw in there any time you feel that life is not worth living anymore, these should certainly prompt your attention to seeking immediate help.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there’s a pretty good chance you’ll find what you want to know. Check it out at TheScopeRadio.com.

updated: July 31, 2019
originally published: November 10, 2016

Dr. Gellner: Every year, it seems more and more children are coming in to see me and other pediatricians because of anxiety issues. And the kids are getting younger and younger. So what do you do if you have an anxious child? I'll give you some tips on today's Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kid Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: A lot of parents have concerns that their child is developing anxiety. Their child will stress over everything and no matter what they say, nothing seems to be able to calm their child down. Some anxiety is okay. We all have fears. But when this anxiety starts causing a lot of problems, that's when they should come to us.

Some parents want anxiety medications for their children. Others do not. Medications really should be a last resort, as many are not really safe in young children, often not approved use until age 12. And like any medications, they come with their own set of side effects.

So how can you help your anxious child before things get out of hand? There are some things you can try before resorting to medication. I'm going to give you some suggestions that could help change your child's fear-based thinking on both the conscious and subconscious level.

First, let your child know it's okay to feel afraid at times. But don't act too worried. Anxiety gets worse if your child feels anxious about being anxious. Remind your child how strong they are. This will help them believe in themselves. Explain that their anxiety is their body's automatic response to fear because their body thinks they're in danger. Sometimes the body gets tricked and it thinks it's in danger when it really isn't in danger. And that's just the brain's way of trying to protect them.

Have your child close their eyes, focus in the moment. Have them tell you what they're hearing or smelling and pay attention to their breathing. Tell them slow, deep breaths remind the brain that they are safe.

Give them a pillow or stuffed animal or even a box of tissues and tell them to grab it and throw it as far as they can. This can help release the high energy they have. Teach your child that panic attacks are temporary and they have the skills to make it through them.

Remember, if you make a big deal about it, this will make it bigger for them and it only serves to increase the anxiety. Figure out what your child is really afraid or anxious about. Once you understand this, you will understand what they need to help feel better. You will be able to better explain the difference between fears that help and keep us safe and fears that hurt and only cause more anxiety.

Teach your child to ask, "Will worrying about this do any good?" If the answer is no, then it's a fear that hurts. Finally, teach your child relaxation and self-calming skills. I call this their toolbox for when they get anxious. Once they learn how to calm down their fears, remind them that they can do anything.

If your child's anxiety is still keeping them from enjoying the things that children should enjoy, talk to your pediatrician about helping to find a good therapist. By coming to a pediatrician, we can help with figuring out some things to help your child initially. But if things are too complicated, we can find exactly who you need to see and get you a referral to a mental health specialist that will work with your child and do exactly what your child needs.

Tell your child that this is someone that they can talk to that will help with their feelings. And remind your child every day, "You can do this." Empowering them to be in charge of their feelings will give them the courage they need to face their fears.

Announcer: Thescoperadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at thescoperadio.com.

Interviewer: How to help your young child after a traumatic event. We'll talk about what you can do next on The Scope.

Announcer: Health tips, medical news, research and more for a happier, healthier life from University of Utah Health Sciences. This is the Scope.

Interviewer: Dr. Katherine Rosenblum is the director of the infant and early childhood clinic at the University of Michigan. When scary things happen to young children, we're talking about infants, toddlers preschoolers, what can you do to help them through that? Is this something that a lot of parents don't recognize first of all?

Dr. Rosenblum: I think it's something that people often overlook because we think young kids are really little, maybe it won't affect them so much, maybe they won't remember things that happened, and also because it's hard for them to tell us what they're thinking and feeling if they don't have the words for it yet. But in fact little kids are affected by scary things that happen in the environment or that happen to them. So we often think about how young kids actually do experience trauma or stress and what we want people to be thinking about is how we can help them to manage those feelings. I think how we can help them cope.

Interviewer: How do you define trauma or stress to that age group?

Dr. Rosenblum: Little kids deal with little stresses all the time. For example, starting at a new school, Mom or Dad is going to work and we have to adapt to separations. It's hard but kids can learn to manage that. It's a stress and it helps them learn I can manage little stresses.

Trauma, in contrast, is something that's so big that actually it overwhelms the individual's ability to cope effectively, and especially for little kids. When they're faced with something that is traumatic or really, really distressing, then what they need is a lot of help to be able to figure out how to recover from that and to be able to recover from that. It really requires additional support from outside.

Interviewer: So are we talking about emotional trauma exclusively or physical trauma as well?

Dr. Rosenblum: Actually, it can be a whole range of things. One of the most common traumatic experiences for young kids is accidents. They get injured or hurt. And that can be really scary and overwhelming and parents might see that after an accident they're afraid, they're more fearful, they're more clingy, that sort of thing, dog bites, things that can happen in the environment.

Interviewer: Falling off of a play set maybe even.

Dr. Rosenblum: Absolutely right. If it was really a scary experience, maybe they had a broken arm, or they had to have some sort of a medical procedure, those things can be really distressing. But with support they can really recover from that.

Big traumas are things that are just told really overwhelming to to the child. It might be witnessing someone being seriously hurt or injured, or really scary events that happen in the community. Those are things that we really think of as true traumas. They overwhelm that young child's sense of, "I can I can cope." It really creates a sense of intense fear or threat, danger.

Interviewer: Seems like we're talking about a wide range of things like from separation anxiety because a parent is going to work versus a traumatic accident. Are they all kind of dealt with the same way or do they require different strategies?

Dr. Rosenblum: The one thing that's sort of common across all of those things for young kids and the number one thing that young kids need when they're managing things that are challenging is the support and help of their primary caregivers, what we think of as their attachment figures, their parents. Young kids are totally dependent on their caregivers to help them navigate life's challenges, and whether those challenges are small or big they're turning to their primary caregivers for help with coping.

Interviewer: I'm sensing here as a parent a little bit of a struggle because on one hand, I don't want to over . . . because a little bit of stress and that sort of thing's good so I don't want to maybe overprotect or over . . . I mean how do you decide how much?

Dr. Rosenblum: It's really important to on one level follow your child's cues. So your child is going to be showing you, :I need you in some way," and parents have an intuitive sort of sense often of, "When my child needs me, I'm going to go to them and help them." Doesn't mean that you're going to prevent them from having to face challenges. Normative things like going to school, that's really important and you're helping them learn how to balance. But when young kids are experiencing something that a parent knows is really really stressful, then I think it's actually really important for the parents to sort of say, "Hey I'm here. I'm here with you. You're safe right now. I'm going to take care of you. I'm going to protect you"

Interviewer: And what does that interaction look like? Say a child falls off of a play set. You can tell the over the next couple of days there is a big fear there. My dad was a rancher. He'd say, "You get bucked off the horse you get back on". Is that the approach you take or is there a better approach?

Dr. Rosenblum: Let me sort of step back and share something with you that's sort of interesting. We often have people who sort of say, "Hey, I'm worried about spoiling my child. If my child is crying and I pick them up, is that going to spoil them?" What we actually know from the research is that when kids express feelings like being afraid or sad and they have parents who pretty consistently and reliably go to them and help them with those experiences, they actually end up as they get older being more able to cope with life's punches if you will, the hard things that come in life. They can sort of bounce back get up and do things better on their own as well.

So I think two things. One, we want kids to be able to try to sort of manage small things on their own. If your dad saw you sort of fall down and bump your knee, it might be totally appropriate to take a moment, sort of look and say, "Hey, wait a second, is he really hurt? Is he really distressed or is he going to be able to sort of bounce back from this on his own?" That's totally appropriate. But if he sees that you're really crying, that you're really hurt, and you're looking up, that's a time where we really hope a parent is going to say, "Hey buddy. You know I'm here for you. I've got your back. Come here and let me help you."

Interviewer: With an adult I might validate somebody's feelings a bit. "I totally understand why that was a scary experience." Do you do the same thing with kids?

Dr. Rosenblum: Absolutely. "That was really scary. But you know what? I'm here. I'm going to help you and you're going to be okay." Little kids really like to know that someone's there, someone's got their back, someone's going to scoop them up, give them a hug and then help them be able to sort of do that bounce, get back into normal daily routines and experiences. That's another piece that's really important here. I think the other part of your question was, "I don't want to over react." I don't think it's overreacting to really be asking how is my child managing, am I seeing . . . If something scary, something really big happens, use your child as your guide. Look at your child's behavior. Is your child looking more fearful, having trouble sleeping, a little bit more clingy? If all of those things are true then that's a time to give a little bit more. But if your child seems to be doing okay, all right, be a watchful observer. Use your child to help you determine what your child needs.

Interviewer: Would there be a point where you'd visit a counselor?

Dr. Rosenblum: Absolutely. So if your child is continuing to persist in showing more clinginess, looks very fearful, can't sort of do the normal routines, seems really distressed or you're just really concerned about them, trust your gut, talk to the primary and pediatricians are a great resource. They can help you sort out is this something that we can sort of wait and see and sort of watch and wonder? Or is this something where it might actually be helpful to get some extra help?

Interviewer: Do you have a resource if a parent's listening right now on their like, "This is great. I'd like to learn more"?

Dr. Rosenblum: There's a really wonderful website called the National Child Traumatic Stress Network and they have a website, NCTSN.org, and that provides wonderful resources for parents, for teachers of young kids about how to help kids manage really scary or big things. For smaller sort of things, the more every day sorts of occurrences, there are a number of resources that are available as well. The American Academy of Pediatrics has a website dedicated for parents and there's also a wonderful resource called Zerotothree.org. Again, lots of resources to help parents navigate life's challenges with young kids.

Announcer: We are your daily dose of health, science, conversation. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: What are the common mental obstacles athletes face? That's next on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Nicole Deting is a Sports Psychology Consultant, she's worked with Olympic Athletes, most recently the U.S. Ski Teams Free Style Aerialists in Sochi, she has also worked with athletes here at the University of Utah, and is a visiting faculty member in the Exercise in the Sports Science Department at the University of Utah. Let's talk about common mental obstacles athletes face.

Nicole Deting: There's actually two that I...

Interviewer: Just two?

Nicole Deting: Just two.

Interviewer: Okay.

Nicole Deting: That I would say are the most predominant. I've been doing this for 16 years now, and within that 16 years two have risen to the surface in that almost every single athlete I've ever worked with are dealing, or struggling, with these two primary issues.

Interviewer: Alright can I guess?

Nicole Deting: Yes.

Interviewer: The fear of failure, fear of injury?

Nicole Deting: You're very close.

Interviewer: Very close but not right?

Nicole Deting: Very close but not right.

Interviewer: Okay what are they?

Nicole Deting: Well the first one is anxiety, and that anxiety might come from fear of injury, or fear of failure, but anxiety related to performance so, "Am I going to be good enough? Can I do what I'm trying to do?" So whether it's a performance timing anxiety in terms of being good enough that day, or an injury, or a re-injury, or failing, or even a fear of success, it all kind of gets lumped under that anxiety category.

Interviewer: Okay.

Nicole Deting: And that's absolutely one of, actually that one is the most predominant issue I guess I would say that I would deal with, and so there are a lot of mental skills that I'll teach athletes in order to help deal with their anxiety levels before performance.

Interviewer: What's the second one?

Nicole Deting: Second one is confidence, that usually surprises people.

Interviewer: Sure because these athletes sure look confident don't they?

Nicole Deting: Absolutely, I work with some of the best athletes in the world, I mean athletes hear at the University of Utah they're Pac 12 athletes, they've really done well. The Olympic Athletes they're some of the best in the world so when I tell people I deal with a lot of confidence issues they're pretty typically surprised yet I will also tell you that there's confidence issues in all of us regardless of whether we're elite level performers, or...

Interviewer: Tell me about it.

Nicole Deting: ...going to our job every day, right? We all question ourselves, and I think that...

Interviewer: When you leave sometimes you're like, "Oh boy I was just a waste today."

Nicole Deting: Right? Or, "Can I do this?" Or, "Oh my gosh I have all this pressure on me, am I going to be able to do what I've been asked to do?" And so confidence is something that I deal with quite a bit.

Interviewer: So anxiety and confidence are the two big things. So, when you're working with somebody what are some of the things you do to overcome these two things? Are they very different or kind of the same for both issues?

Nicole Deting: Well what's interesting is that they are two very distinct issues but they're very closely related. For example, if you're really nervous about something you're probably not too confident about it. The more confident you feel the less nervous you will likely be so they do influence each other. Does that make sense?

Interviewer: Yes it does.

Nicole Deting: Okay, so there are two separate concepts, there are training methods for each one of them separately to help, but a lot of training methods that I will work with, with athletes helps both of them. So for example, if I'm teaching an athlete methods to deal with their anxiety, and to get themselves under better control, once they learn those they are naturally going to feel more confident to go into their performance because there anxiety is under control.

Interviewer: Got you.

Nicole Deting: So there are ways to kill two birds with one stone, which is a very cool part of our field.

Interviewer: So does this apply to athletes of any age?

Nicole Deting: Any age, all abilities, all sports, both genders, you name it, absolutely.

Interviewer: Sure, so let's talk about, let's go into like a parent that has a child as an athlete for example, you know and they choke when they step up to the plate to play little league baseball.

Nicole Deting: Sure.

Interviewer: What's something that parent could do to help that child?

Nicole Deting: Well first of all I'd ask the parent, "Where did they learn that? Where did they learn to be so nervous?" And the parent...I would challenge the parent to take a hard look at themselves because a lot of anxiety is we don't...We learn how to be nervous we're not born nervous, we're not born with anxiety we learn that, and typically we learn that by watching the most significant people in our lives, whether that be parents, or coaches, or friends, at one point those friends become more significant, so any significant person, and so if I find out that one of the parents has a lot of anxiety then I talk to the parent about their anxiety, and how it manifests, and what they do about it, and I can use some of those similar things with their child. So that's where I'm going to start.

Interviewer: Got you.

Nicole Deting: But then what I'm going to do is talk to that kid and just say, "Okay how does it feel? How do you know you're nervous? What does it feel like?" Typically we're going to get you know, "Oh, I can't breathe and I feel like I'm going to vomit," or you know something like that, and then, "I question whether or not I can do it." And so then I might work on teaching them ways to better control their physiological signs. So to control some of the movements in their body, and if they're shaking how to control that shakiness, but then also giving them some thoughts in their head about why they can perform what they're going to perform. Most likely they're stuck in, "I'm not going to be able to do this." So I'm going to challenge them to give me reasons why they are going to be able to do that, and then really get their mindset in a different space. So dealing with the anxiety, helping them learn to control themselves also increases confidence, and then we can work specifically on confidence as well.

Interviewer: We could talk for a long time about all of this, how long do you work with an athlete generally?

Nicole Deting: My goal with every athlete I work with is to work myself out of a job.

Interviewer: Yeah sure.

Nicole Deting: I want them to become so good mentally they don't need me anymore, so I work really hard to foster independence with each athlete. So when they come to see me I usually give them what I call home fun, not homework, homework sucks nobody likes home work.

Interviewer: See that you're rethinking again, right.

Nicole Deting: Exactly, yup.

Interviewer: So how can I fail, how can I succeed?

Nicole Deting: Exactly, home fun, and so home fun is basically a strategy that I teach them prior to them leaving and they go work on that strategy and become better at it. At the end of the day the athletes are the ones out there competing, I can't be there every single competition for every single athlete at the end of the day it's just them out there and they need to have these strategies in place in order to be more mentally tough. So how long I work with an athlete it depends on what that athlete needs.

Interviewer: Yeah.

Nicole Deting: But I work hard to foster independence as quickly as possible.

Interviewer: Yeah, it's not something you learn overnight.

Nicole Deting: No it's not something you learn overnight. You do have to practice.

Interviewer: Any resources on the web you could point somebody to that might be interesting.

Nicole Deting: My website.

Interviewer: Okay, that's a good place to go what is it?

Nicole Deting: Yeah my website www.headstrongconsulting.com

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah health science's radio.