There is a whole range of mental health problems in children that accompany substance abuse. It’s quite common to see substance abuse in anxiety, but it’s also quite common to see it connected to other kinds of mental health problems.
We are not sure about why substance abuse problems occur with anxiety. Some adolescents may have problems with anxiety, and find that when they use illicit substances they feel that their anxiety gets better.
They’re engaging in behavior that some people call self-medicating. But there are other adolescents who have no problem with anxiety and they begin using an illicit substance and then they develop anxiety that follows directly from the illicit drug use.
It’s really hard to say why this happens. Right now we don’t have any firmly established mechanisms that link the two in most cases.
Some adolescents have problems with substance use and problems with anxiety that are completely unrelated.If someone has an anxiety disorder in childhood, will he or she continue to have the disorder as an adult?
For any mental disorder, we really do not have the ability to confidently state which are going to go on and change very little, which are going to get somewhat better, and which are going to completely disappear.
Some disorders like autism, for instance, tend to be more persistent. Many children with autism will have at least some level of problem throughout their lives.
But the story is very different with anxiety. A large group of children with anxiety will do completely fine when we follow them over time.
And we really do not have a very good ability to predict which children will do better, although there are some things that we think can help us predict this. What do doctors and scientists look for when they try to assess a child’s prognosis?
The kinds of things that do help us are by and large clinical observations, which are more useful, at least right now, than measures of brain function, hormones, or physiology.
For instance, kids with more extreme anxiety problems tend to do worse over time than kids with relatively mild problems, although that’s not an absolute.
Another factor is the level of avoidance. Kids who tend to avoid things tend to have more persistent anxiety, compared to kids who are anxious but will not avoid the situations that make them afraid.
A third factor has to do with the behavior of parents. When parents are particularly encouraging, their kids tend to do better. What kind of encouragement do these parents give their children?
These are parents who can help their kids face the situations that make their children most afraid, and encourage their kids to not avoid the things they’re afraid of.
They are parents who look for situations and circumstances and experiences where kids are going to have to deal with their anxiety.
Those kids tend to do better with their anxiety compared to kids whose parents are doing absolutely everything they can to prevent their kids from ever getting anxious.
What has basic science research revealed about the possible causes or treatments for anxiety? One thing concerns something we just talked about: facing fears. There’s an idea called extinction that people think a lot about in basic science research on anxiety.
Extinction is a process that we study where organisms such as rodents and non-human primates learn how to overcome their anxiety. One of the things we know about extinction is that it’s an active process; to extinguish a fear, organisms have to be exposed to the fear.
Beyond just learning how to cope, maybe one of the reasons why kids who face their fears do better over time is that they have opportunities to develop extinction.
Research on extinction is starting to be helpful because people are coming up with new ideas about how treatments like CBT might be adjusted to increase extinction learning.
We’ve learned that people with anxiety tend to pay undue attention to threats in their environment. This has led to novel ideas about how to treat anxiety, including using things like video games to train attention.
This is something we’ve tested with combat veterans who have post-traumatic stress disorder (PTSD).Are these kinds of extinction and attention bias treatments available to patients yet?
This kind of basic science research has had relatively little impact on how we treat individual patients.
Right now, these are just new ideas, and while they’re promising, the most exciting ideas are not yet ready for prime time, they’re not routine treatments that can be applied in all patients just yet. For instance, in our PTSD study, it’s not clear how robust the findings are.
There’s some concern that if the training is not done in the right way, it could make symptoms worse. We don’t understand those kinds of things well enough.
However, I think one of the nice things about basic research on fear and anxiety is that there’s tremendous “cross-species conservation.”
What that means is that the relationship between brain and behavior in anxiety is very similar in rodents, non-human primates and people.
Because of those similarities, which occur more so in anxiety than in other mental health problems, I think we are getting closer to finding novel treatments for anxiety than we may be in other disorders.
Address: 5636 Lemon Ave.
Dallas TX 75209
Phone: +1 214 5203694