Dr Frank Salerno, PhD Montreal Psychologist 514.515.9350 Westmount Location

Dr Paula Bennett, PhD Montreal Psychologist 514.482.3327 NDG Location

Menu

Children/Adolescents/Families Psychologist

At the Montreal Psychology Center your child will feel comfortable and motivated to learn new therapeutic strategies. Our specialized psychologists in Montreal provide a warm and caring environment in which to help your child become happier. We help your child overcome anxiety and depression in Montreal by:

To find out more about (a) childhood and adolescent expressions of anxiety and depression, and (b) effective treatment in Montreal options for these difficulties, please read below

What is anxiety?

The word anxiety describes the thoughts, feelings, and behaviours that occur when a child anticipates danger. Your child’s anxiety is about a “might-be” situation. For example, your daughter refuses swimming lessons. She finds swimming pools scary – she fears that she "might-be" immersed in water without being able to reach safety.

Your child’s anxiety can range in both severity and duration. It can be a mild tinge of uneasiness or a full-blown panic-stricken state. Anxiety can last for a few moments or persist for a full day. It can also appear suddenly, “disappear” for a few days, and then re-emerge (e.g., your child’s anxiety may appear at the beginning of the school week on Monday morning, disappear at the end of a school week on Friday afternoon, and then re-appear the following Monday morning). Finally, your child’s anxiety can be specific to particular objects, people, or situations or it can be more generalized.

Thoughts:

Thoughts that emphasize danger or fear in “might-be” situations are Worries.

Younger children may worry about scary monsters in the dark.
Fear: Separation from parents.

School-aged children may worry about the judgements of teachers and peers.
Fear: Being incompetent and /or unlovable.

Adolescents worry about their appearance, the future, and being accepted by their peers.
Fear: Peer rejection.

The brain does not differentiate between reality and an outcome that is imagined. This means your child’s brain reacts to imagined worry as if it is real. This explains why the imagined fears of a young child such as scary monsters provoke genuine anxiety. Younger children can be distracted from imagined fears - adolescents can learn to reinterpret their thoughts in more positive ways.

When a bad outcome actually occurs a child may then worry that this negative event may recur in the future. If the danger is real (and not just perceived) it needs to be addressed. For example, children who experience bullying will develop worries about being teased and suffering bodily harm. In order to stop bullying children need interventions from adults.

Feelings:

Worries cause emotional distress sometimes expressed as physical discomfort. The child can feel discomfort in any part of his body: headache, belly ache (butterflies), pounding heart, sore legs, or shallow, fast breathing. The child may have nose-bleeds, or feel like fainting or throwing up. The child may have trouble sleeping.

Behaviours:

Anxiety may be evident in the child’s behaviours. Anxiety triggers the “fight or flight” response which prepares the body to either fight the danger or to immediately flee to a safe place.

Fight: Children may lash out or have a temper tantrum. Alternatively, you may get defensive, surly responses from your adolescent expressed in a specific verbal tone (“attitude”), and particular body language, for example, eye-rolling and stiff body postures. Even 5-year-old children can exhibit such behaviour. Is the phrase - You are not the boss of me! - familiar? In some cases, aggressive behaviours can become a habitual response to anxiety. This is a serious behaviour problem that needs to be addressed.

Flight: Children may cry or try to withdraw further under their bed covers as a way to avoid facing perceived dangers. In school, they may retreat into their own imagination and appear to be “dans la lune”. Sometimes, children engage in rituals to cope with their unpleasant feelings. Excessive hand-washing and counting rituals are two such examples. Adolescents may flee to drugs, alcohol, sex, engage in self-injurious behaviours such as cutting or develop serious eating problems.

In summary, children get scared. This is normal. However, excessive anxiety can have a devastating impact on the child and his family. If left unchecked, the child may become restricted to a handful of familiar people and activities perceived to be “safe”.

What is depression?

The restrictions anxiety places on a child’s life can make him very unhappy. Imagine he is the only child in his class who refuses to go on a field trip to the Insectarium because he is scared of bugs. Upon their return, his class-mates are laughing and sharing their experiences. He feels sad and disconnected from his peers. He may blame himself (or others) for having such anxieties. Consistent self-blame can lead to a pattern of thoughts, feelings, and behaviours which can eventually cause depression.

Thinking: Thoughts associated with depression revolve around themes of worthlessness and inadequacy: “I am stupid”, “What‘s the point? It‘s hopeless” “It‘s their fault I feel this way”. There may also be suicidal thoughts.

Feelings: Sadness, irritability, guilt, anger are typical.

Behaviours: Isolation and withdrawal from family, friends, and activities formerly enjoyed.

Below are examples of typical triggers for anxiety or depression:

Monsters and Violence

Children with vivid imaginations are certainly blessed with a wonderful gift! However, at times they can scare “their own pants off”. Typically, scary thoughts and images result from exposure to books and television programs that depict violence. If such is the case, it can be helpful to stop reading books about monsters prior to bed-time and to ban all television programs or movies that emphasize violence.

Transitions

Anxiety may be triggered by a profound change in the child’s life (e.g., the birth of a new sibling, parents’ separation). The child may also feel overwhelmed when they are privy to parental conflict.

Parental authority

When there are difficulties with limit-setting and discipline, children are more likely to exhibit anxious thoughts, feelings, and behaviours. In this situation, power struggles between a parent and child may mask the anxiety of both parties.

Peer problems

Children who struggle with peers may lack the basic social skills required to make and maintain friendships. Children who are isolated from their peers feel anxious and are more likely to have poor self-esteem.

Identity issues

Adolescents who describe themselves as “tough”, “bad”, or “different” become trapped between trying to numb their anxious feelings and seeking out understanding and affection from their parents. Children need the affection of their parents. Typically, such adolescents can make parents feel as though they are walking on egg-shells. It may seem as though no matter what you do and how much you try their response is always: “You don’t listen to me and you don’t understand me”. Though you may feel quite frustrated and anxious, remember that your child needs comforting!

Temperament

Our natural tendency from birth to act and respond to people and situations is called temperament. Your child’s usual mood, ability to sooth herself, and activity level all represent temperamental traits mostly shaped by her biology. Over time our temperament is influenced by life experiences. This means that your actions can help a child’s temperament to become more adaptive. Some examples of temperamental traits are:

High Energy:

In a quiet movie theatre, your child is wiggling in his seat, looking around at other people, asking tons of questions, etc...

Slow-to-adapt:

In a group of laughing children watching a puppet show, your child is hanging back at the edge of the group timidly looking at the performers.

Perceptive:

A 10-minute walk predictably turns into 30 minutes as your child stops to explore everything that he sees.

Sensitive:

A fire-truck suddenly startles a dozing toddler. She stays upset for a long time, and has difficulty calming down.

Negative Mood:

Your adolescent is hanging out with a group of friends and enjoying herself. A friend she has not spoken to in months walks by and her mood suddenly becomes sullen. Her enjoyable day is now defined as “the worst day ever in my life“.

Below are strategies that generally do not decrease anxiety and depression nor do they allow the child to experience her temperament in a positive way:

Help your child with any of these strategies:

How can therapy help your child or adolescent?

Four main therapeutic elements are used to help children and adolescents manage their emotions:

  1. Psychoeducation: consists of helping children and their parents understand the “fight or flight” anxiety response. In addition, we focus on educating children on the importance of recognizing, understanding and appropriately expressing emotions.

    Cognitive restructuring: consists of identifying thought errors associated with depressive or anxious thinking and replacing them with more accurate thinking.

    Breathing retraining (relaxation/mindfulness): consists of teaching the child how to quickly calm herself with deeper belly breathing – once calm, she can observe her thoughts and feelings allowing her to feel more in control.

    Behavioral exercises: games, free play and other strategies which allow your child to learn new habits that promote confidence, positive affect, and an optimistic mindset.

Child Therapy & Family Counselling Montreal

If your child or adolescent feels anxious or depressed in Montreal, a professional at Montreal Psychology Center can help.