STORY TO BE TOLD

Baldness or hair loss is usually something only adults need to worry about. But in a few cases, teens lose their hair, too — and it may be a sign that something's going on.

Hair loss during adolescence can mean a person may be sick or just not eating right. Some medications or medical treatments, like chemotherapy treatment for cancer, also cause hair loss. People can even lose their hair if they wear a hairstyle that pulls on the hair for a long time, such as braids.

Losing hair can be stressful during a time when you're already concerned about appearance. Most of the time, hair loss during the teen years is temporary. With temporary hair loss, the hair usually grows back after the problem that causes it is corrected.

Hair Basics

Our hair is made of a type of protein called keratin. A single hair consists of a hair shaft (the part that shows), a root below the skin, and a follicle, from which the hair root grows. At the lower end of the follicle is the hair bulb, where the hair's color pigment, or melanin, is produced.

Most people lose about 50 to 100 head hairs a day. These hairs are replaced — they grow back in the same follicle on your head. This amount of hair loss is totally normal and no cause for worry. If you're losing more than that, though, something might be wrong.

If you have hair loss and don't know what's causing it, talk to your doctor. A doctor can determine why the hair is falling out and suggest a treatment that will correct the underlying problem, if necessary.

What Causes Hair Loss?

Here are some of the things that can cause hair loss in teens:

• Illnesses or medical conditions. Endocrine (hormonal) conditions, such as uncontrolled diabetes or thyroid disease, can interfere with hair production and cause hair loss. People with lupus can also lose hair. The hormone imbalance that occurs in polycystic ovary syndrome can cause hair loss in teen girls as well as adult women.
• Medications. Some medications that have hair loss as a side effect may be prescribed for teens. These include acne medicines like isotretinoin, and lithium, which is used to treat bipolar disorder. Diet pills that contain amphetamines also can cause hair loss. Chemotherapy drugs for cancer are probably the most well-known medications that cause hair loss
• Alopecia areata. This skin disease causes hair loss on the scalp and sometimes elsewhere on the body. It affects 1.7% of the population, including more than 5 million people in the United States. Alopecia areata (pronounced: al-uh-pee-shuh air-ee-ah-tuh) is thought to be an autoimmune disease, in which the hair follicles are damaged by a person's own immune system. (In autoimmune diseases, the immune system mistakenly attacks healthy cells, tissues, and organs in a person's body.) Alopecia areata usually starts as one or more small, round bald patches on the scalp. These can get bigger, and in a small number of cases, can progress to total hair loss. Both guys and girls can get it, and it often begins in childhood. The hair usually grows back within a year, but not always. Sometimes people with alopecia areata lose their hair again.
• Trichotillomania (pronounced: trik-o-til-uh-may-nee-uh). Trichotillomania is a psychological disorder in which people repeatedly pull their hair out, often leaving bald patches. It results in areas of baldness and damaged hairs of different lengths. People with trichotillomania usually need professional help from a therapist or other mental health professional before they are able to stop pulling their hair out.
• Hair treatments and styling. Having your hair chemically treated, such as getting your hair colored, bleached, straightened, or permed, can cause damage that may make the hair break off or fall out temporarily. Another type of baldness that results from hair styling actually can be permanent: Wearing hair pulled so tightly that it places tension on the scalp can result in a condition called traction alopecia. Traction alopecia can be permanent if the style is worn for a long enough time that it damages the hair follicles.
• Poor nutrition. Poor eating can contribute to hair loss. This is why some people with eating disorders like anorexia and bulimia lose their hair: The body isn't getting enough protein, vitamins, and minerals to sustain hair growth. Some teens who are vegetarians also lose their hair if they don't get enough protein from non-meat sources. And some athletes are at higher risk for hair loss because they may be more likely to develop iron-deficiency anemia.
• Disruption of the hair growth cycle. Some major events can alter the hair's growth cycle temporarily. For example, delivering a baby, having surgery, or going through a traumatic event can temporarily cause shedding of large amounts of hair. Because the hair we see on our heads has actually taken months to grow, a person might not notice any disruption of the hair growth cycle until months after the event that caused it. This type of hair loss corrects itself.
• Androgenetic alopecia. Among adults, the most common cause of hair loss is androgenetic (pronounced: an-druh-juh-neh-tik) alopecia, sometimes called male-pattern baldness. This condition is caused by a combination of factors, including hormones called androgens and genetics. Sometimes, the hair loss can start as early as the mid-teen years. It also can occur in people who take steroids like testosterone to build their bodies.

What Can Doctors Do?

If you see a doctor about hair loss, he or she will ask questions about your health and family health (called a medical history) and check your scalp. In some cases, the doctor might take hair samples and test for certain medical conditions that can cause hair loss.

If medication is causing hair loss, ask the doctor if you can take a different drug. If your hair loss is due to an endocrine condition, like diabetes or thyroid disease, proper treatment and control of the underlying disorder is important to reduce or prevent hair loss.

If your doctor recommends it, a product like minoxidil that can speed up hair growth also might be helpful. Alopecia areata can be helped by treatment with corticosteroids. If nutritional deficiencies are found to be causing your hair loss, the doctor might refer you to a dietitian or other nutrition expert.

Catastrophic Hair Loss

Hair loss can be the first outward sign that a person is sick, so it may feel scary. Teens who have cancer and lose their hair because of chemotherapy treatments (especially girls) might go through a difficult time.

It can help to feel like you have some control over your appearance when you're losing your hair. When getting chemotherapy, some people like to cut their hair or shave their heads before the hair falls out. Some even take the hair they cut off and have it made into a wig. Many options can help disguise hair loss — such as wearing wigs, hair wraps, hats, and baseball caps. For most teens who lose their hair, the hair does return — including after chemotherapy.

Taking Care of Your Hair

Eating a balanced, healthy diet is important for a lot of reasons, and it really benefits your hair.

If you're losing hair, some doctors recommend using baby shampoo, shampooing no more than once a day, and lathering gently. Don't rub your hair too vigorously with a towel, either. Many hair experts suggest you consider putting away the blow dryer and air drying your hair instead. If you can't live without your blow dryer, try using it on a low heat setting.

Style your hair when it's dry or damp. Styling your hair while it's wet can cause it to stretch and break. And try to avoid teasing your hair, which can cause damage. Finally, be careful when using chemicals — such as straighteners or color — on your hair, and avoid frequent use of chemical treatments.

Reviewed by: Larissa Hirsch, MD
Date reviewed: January 2008
Originally reviewed by: Eliot N. Mostow, MD, MPH

source taken from: http://kidshealth.org/

We have about 100,000 hairs on our heads. Each hair shaft has three layers, with the cuticle, or outside layer, protecting the two inner layers.

Shiny hair is a sign of health because the layers of the cuticle lie flat and reflect light. When the scales of the cuticle lie flat they overlap tightly, so the inner layers are well protected from heat, sun, chlorine, and all the other hazards that can come from living in our environment. When hair is damaged, though, the scales may separate and hair can become dry. Because the scales on dry hair don't protect the inner two layers as well, hair can break and look dull

The type of hair a person has — whether it's straight or curly — can also affect how shiny it is. Sebum, which is the natural oil on the hair, covers straight hair better than curly hair, which is why straight hair can appear shinier.

Depending how long a person's hair is or how fast it grows, the end of each hair shaft can be a couple of years old. So the hair at the end of the shaft could have survived a few summers of scorching sun and saltwater and winters of cold, dry air. How well you care for your hair from the time it emerges from the root plays a role in how healthy it looks.

Caring for Hair

How you take care of your hair depends on the type of hair you have, your lifestyle, and how you style your hair.

Your hair type. People with dry, curly hair have different hair care needs than people with straight, fine hair. But all hair needs to be treated gently, especially when it's wet. Wet hair can stretch, making it more vulnerable to breakage or cuticle damage. That's why using a hot blow-dryer (or other heat styling products) on very wet hair can damage it.

Some people find that their hair gets oily in their teen years. That's because the hair follicles contain sebaceous glands that make sebum, which moisturizes the hair and skin. During adolescence, the sebaceous glands may become overactive, producing more oil than needed. As with acne, oily hair is usually a temporary part of puberty.

Many teens care for oily hair by washing it once a day — or more if they're active. As long as you treat your hair gently when it's wet, frequent washing shouldn't harm it. If you have acne, it's a good idea to keep the hair around your face clean so hair oils don't clog your pores.

If you're washing your hair every day or more, it may be better to choose a mild shampoo instead of a shampoo designed for oily hair. For some people — especially people with fine, fragile, or combination hair (hair that's oily at the crown but dry on the ends) — shampoos for oily hair can be too harsh. If you have oily hair and want to use a conditioner, choose one that's made for oily hair.

If your hair is dry, it's a good idea to wash it less frequently. Some people only need to wash their hair once a week — and that's fine. Many people who have curly hair also have dry hair. Curly and dry hair types are usually more fragile than straight hair, so you'll need to be especially careful about using heat styling products. Shampoos made for dry hair and hair conditioners can help.

Your activity level and interests. Do you play sports or spend a lot of time at the beach? These kinds of things can affect your hair. For example, if you're an athlete with oily hair, you may want to wash your hair after working up a sweat during practice and games. But if you're a lifeguard or a swimmer, sun and saltwater (or the chlorine in pool water) can dry your hair out, no matter what your hair type. If you're exposed to sun, wind, or other elements, you may want to use a shampoo designed for dry hair or use a conditioner. It's also a good idea to wear a hat to protect your hair when you're outdoors.

Your hairstyle. Heat styling products like curling and straightening irons can dry out even oily hair if they're used too much. Follow the instructions carefully, and don't use them on wet hair or high settings, and give your hair a vacation from styling once in a while. Ask your hair stylist or dermatologist for advice on using heat styling products.

Chemical treatments can also harm hair if they're not used properly. If you decide you want a chemical treatment to color, straighten, or curl your hair, it's best to trust the job to professionals. Stylists who are trained in applying chemicals to hair will be able to evaluate your hair type and decide which chemicals will work best for you.

Here are some things to be aware of when getting chemical treatments:

• Relaxers. Relaxers (straighteners) work by breaking chemical bonds in curly hair. Relaxers containing lye can cause skin irritation and hair breakage. Although "no lye" relaxers may cause less irritation, both types of relaxers can cause problems if they are used in the wrong way (for example, if they're mixed incorrectly or left on the hair for too long). Scratching, brushing, or combing your hair right before a chemical relaxing treatment can increase these risks. And don't use relaxers — or any hair treatment — if your scalp is irritated.
  
  If you decide to keep straightening your hair, you'll need to wait at least 6 weeks before your next treatment to protect your hair. Relaxers can cause hair breakage when used over a period of time, even when they're used properly. Using blow-dryers, curling or straightening irons, or color on chemically relaxed hair can also increase the risk of damage.
• Perms. Perms take straight hair and make it curly. The risks are similar to those associated with relaxers.
• Color. There are two types of color: permanent (which means the color stays in your hair until it grows out) and semi-permanent (the color washes out after a while). Some semi-permanent coloring treatments, like henna, are fairly safe and easy to use at home. Some people get a condition called contact dermatitis (an allergic reaction with a rash) from henna and other "natural" products, so be sure to test a small area first.

  Other color treatments — especially permanent treatments — can cause hair loss, burning, redness, and irritation. A few types of coloring treatments can cause allergic reactions in certain people, and in rare cases these can be very serious. So talk to your stylist if you are worried that you may be sensitive to the products. Also, talk to your stylist about doing a patch test before using a product. And never use hair dyes on your eyelashes or eyebrows.

Regular haircuts are one of the best ways to help keep hair healthy. Even if you have long hair or you're trying to grow your hair, a haircut can help protect the ends of your hair from splitting and damage. In fact, cutting may actually help your hair grow better because it's healthy and not breaking off.

Dealing With Hair Problems

Here are some common hair problems — and tips on how to deal with them.

Dandruff

Dandruff — or flakes of dead skin — can be noticeable in a person's hair and on clothing. No one really knows what causes dandruff, although recent studies seem to show that it may be caused by a type of fungus.

Dandruff isn't contagious or dangerous. Over-the-counter shampoos containing salicylic acid, zinc, tars, or selenium sulfide can reduce dandruff flakes. When shampooing, massage your scalp (but don't scratch) for at least 5 minutes, loosening the flakes with your fingers. Rinse your hair well after washing. If your dandruff doesn't improve, see your doctor. He or she may prescribe a prescription shampoo and possibly a lotion or liquid to rub into your scalp.

Hair Breakage

Hair can break when points in the hair thicken or weaken. Sometimes this happens near the scalp so a person's hair never grows very long. When hairs break at the ends, they're called "split ends," and the splits can travel up the hair shaft.

A major cause of hair breakage is improper use of chemical hair treatments, like the treatments described above. But brushing or combing hair too frequently or in the wrong way (such as using a fine-toothed comb on very thick, curly hair or teasing hair) can lead to breakage. Hair extensions and braids can also cause breakage. Leaving them in too long or pulling them out without professional help can cause hair and scalp damage or even hair loss.

Sometimes hair breakage and dry, brittle hair are signs of a medical problem, such as hypothyroidism or an eating disorder. If your hair is breaking even though you don't treat it with chemicals or other styling products, see a doctor.

Hair Loss (Alopecia)

It's normal for everyone to lose some hair. In fact, we lose about 100 hairs each day as old hairs fall out and are replaced with new ones. With hair loss, though, hair thins at a rate that can't be replaced. When hair falls out and isn't replaced by new hair, a person can become bald or have bald patches. Hair loss can be temporary or permanent, depending on the cause. If changing your hairstyle or other treatment doesn't help, see a doctor. He or she may prescribe a drug to slow or stop hair loss and to help hair grow.

As with the rest of our bodies, hair is healthiest when we eat right, exercise, and protect it from too much sun.

Reviewed by: Patrice Hyde, MD
Date reviewed: December 2008

source taken from: http://kidshealth.org/

It's natural to feel self-conscious, nervous, or shy in front of others at times. Anyone can have a racing heart, sweaty palms, or fluttering stomach when trying out for chorus, asking someone on a first date, or giving a class presentation.

Most people manage to get through these moments when they need to. But for some, the anxiety that goes with feeling shy or self-conscious can be extreme. It can seem so unbearable that they might feel too nervous to give answers in class, be unable to make eye contact with classmates in the hallway, or avoid chatting with others at the lunch table.

When people feel so self-conscious and anxious that it prevents them from speaking up or socializing most of the time, it's probably more than shyness. It may be an anxiety condition called social phobia.

What Is Social Phobia?

Social phobia (also sometimes called social anxiety) is a type of anxiety problem. Extreme feelings of shyness and self-consciousness build into a powerful fear. As a result, a person feels uncomfortable participating in everyday social situations.

People with social phobia can usually interact easily with family and a few close friends. But meeting new people, talking in a group, or speaking in public can cause their extreme shyness to kick in.

With social phobia, a person's extreme shyness, self-consciousness, and fears of embarrassment get in the way of life. Instead of enjoying social activities, people with social phobia might dread them — and avoid some of them altogether.

The Fear Reaction

Like other phobias, social phobia is a fear reaction to something that isn't actually dangerous — although the body and mind react as if the danger is real. This means that the person feels physical sensations of fear, like a faster heartbeat and breathing. These are part of the body's fight–flight response. They're caused by a rush of adrenaline and other chemicals that prepare the body to either fight or make a quick getaway.

This biological mechanism kicks in when we feel afraid. It's a built-in nervous system response that alerts people to danger so they can protect themselves. With social phobia, this response gets activated too frequently, too strongly, and in situations where it's out of place. Because the physical sensations that go with the response are real — and sometimes quite strong — the danger seems real, too. So the person will react by freezing up, and will feel unable to interact.

As the body experiences these physical sensations, the mind goes through emotions like feeling afraid or nervous.

People with social phobia tend to interpret these sensations and emotions in a way that leads them to avoid the situation ("Uh-oh, my heart's pounding, this must be dangerous — I'd better not do it!"). Someone else might interpret the same physical sensations of nervousness a different way ("OK, that's just my heart beating fast. It's me getting nervous because it's almost my turn to speak. It happens every time. No big deal.").

What Are People With Social Phobia Afraid Of?

With social phobia, a person's fears and concerns are focused on their social performance — whether it's a major class presentation or small talk at the lockers.

People with social phobia tend to feel self-conscious and uncomfortable about being noticed or judged by others. They're more sensitive to fears that they'll be embarrassed, look foolish, make a mistake, or be criticized or laughed at. No one wants to experience these things. But most people don't really spend much time worrying about it.

How Social Phobia Can Affect Someone's Life

With social phobia, thoughts and fears about what others think get exaggerated in someone's mind. The person starts to focus on the embarrassing things that could happen, instead of the good things. This makes a situation seem much worse than it is, and influences a person to avoid it.

Some of the ways social phobia can affect someone's life include:

• Feeling lonely or disappointed over missed opportunities for friendship and fun. Social phobia might prevent someone from chatting with friends in the lunchroom, joining an after-school club, going to a party, or asking someone on a date.
• Not getting the most out of school. Social phobia might keep a person from volunteering an answer in class, reading aloud, or giving a presentation. Someone with social phobia might feel too nervous to ask a question in class or go to a teacher for help.
• Missing a chance to share their talents and learn new skills. Social phobia might prevent someone from auditioning for the school play, being in the talent show, trying out for a team, or joining in a service project. Social phobia not only prevents people from trying new things. It also prevents them from making the normal, everyday mistakes that help people improve their skills still further.

Selective Mutism

Some kids and teens are so extremely shy and so fearful about talking to others, that they don't speak at all to certain people (such as a teacher or students they don't know) or in certain places (like at someone else's house). This form of social phobia is sometimes called selective mutism.

People with selective mutism can talk. They have completely normal conversations with the people they're comfortable with or in certain places. But other situations cause them such extreme anxiety that they may not be able to bring themselves to talk at all.

Some people might mistake their silence for a stuck-up attitude or rudeness. But with selective mutism and social phobia, silence stems from feeling uncomfortable and afraid, not from being uncooperative, disrespectful, or rude.

Why Do Some People Develop Social Phobia?

Kids, teens, and adults can have social phobia. Most of the time, it starts when a person is young. Like other anxiety-based problems, social phobia develops because of a combination of three factors:

• A person's biological makeup. Social phobia could be partly due to the genes and temperament a person inherits. Inherited genetic traits from parents and other relatives can influence how the brain senses and regulates anxiety, shyness, nervousness, and stress reactions. Likewise, some people are born with a shy temperament and tend to be cautious and sensitive in new situations and prefer what's familiar. Most people who develop social phobia have always had a shy temperament.
  
  Not everyone with a shy temperament develops social phobia (in fact, most don't). It's the same with genes. But people who inherit these traits do have an increased chance of developing social phobia.

• Behaviors learned from role models (especially parents). A person's naturally shy temperament can be influenced by what he or she learns from role models. If parents or others react by overprotecting a child who is shy, the child won't have a chance to get used to new situations and new people. Over time, shyness can build into social phobia.
  
  Shy parents might also unintentionally set an example by avoiding certain social interactions. A shy child who watches this learns that socializing is uncomfortable, distressing, and something to avoid.

• Life events and experiences. If people born with a cautious nature have stressful experiences, it can make them even more cautious and shy. Feeing pressured to interact in ways they don't feel ready for, being criticized or humiliated, or having other fears and worries can make it more likely for a shy or fearful person to develop social anxiety.
  
  People who constantly receive critical or disapproving reactions may grow to expect that others will judge them negatively. Being teased or bullied will make people who are already shy likely to retreat into their shells even more. They'll be scared of making a mistake or disappointing someone, and will be more sensitive to criticism.

The good news is that the effect of these negative experiences can be turned around with some focused slow-but-steady effort. Fear can be learned. And it can also be unlearned, too.

Dealing With Social Phobia

People with social phobia can learn to manage fear, develop confidence and coping skills, and stop avoiding things that make them anxious. But it's not always easy. Overcoming social phobia means getting up the courage it takes to go beyond what's comfortable, little by little.

Here's who can support and guide people in overcoming social phobia:

• Therapists can help people recognize the physical sensations caused by fight–flight and teach them to interpret these sensations more accurately. Therapists can help people create a plan for facing social fears one by one, and help them build the skills and confidence to do it. This includes practicing new behaviors. Sometimes, but not always, medications that reduce anxiety are used as part of the treatment for social phobia.
• Family or friends are especially important for people who are dealing with social phobia. The right support from a few key people can help those with social phobia gather the courage to go outside their comfort zone and try something new.
  
  Putdowns, lectures, criticisms, and demands to change don't help — and just make a person feel bad. Having social phobia isn't a person's fault and isn't something anyone chooses. Instead, friends and family can encourage people with social phobia to pick a small goal to aim for, remind them to go for it, and be there when they might feel discouraged. Good friends and family are there to celebrate each small success along the way.

Overcoming Social Phobia

Dealing with social phobia takes patience, courage to face fears and try new things, and the willingness to practice. It takes a commitment to go forward rather than back away when feeling shy.

Little by little, someone who decides to deal with extreme shyness can learn to be more comfortable. Each small step forward helps build enough confidence to take the next small step. As shyness and fears begin to melt, confidence and positive feelings build. Pretty soon, the person is thinking less about what might feel uncomfortable and more about what might be fun.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: July 2007

source taken from: http://kidshealth.org/

The roller coaster hesitates for a split second at the peak of its steep track after a long, slow climb. You know what's about to happen — and there's no way to avoid it now. It's time to hang onto the handrail, palms sweating, heart racing, and brace yourself for the wild ride down.

What Is Fear?

Fear is one of the most basic human emotions. It is programmed into the nervous system and works like an instinct. From the time we're infants, we are equipped with the survival instincts necessary to respond with fear when we sense danger or feel unsafe.

Fear helps protect us. It makes us alert to danger and prepares us to deal with it. Feeling afraid is very natural — and helpful — in some situations. Fear can be like a warning, a signal that cautions us to be careful.

Like all emotions, fear can be mild, medium, or intense, depending on the situation and the person. A feeing of fear can be brief or it can last longer.

How Fear Works

When we sense danger, the brain reacts instantly, sending signals that activate the nervous system. This causes physical responses, such as a faster heartbeat, rapid breathing, and an increase in blood pressure. Blood pumps to our large muscle groups to prepare the body for physical action (such as running or fighting). Skin sweats to keep the body cool. Some people might notice sensations in the stomach, head, chest, legs, or hands. These physical sensations of fear can be mild or strong.

This response is known as "fight or flight" because that is exactly what the body is preparing itself to do: fight off the danger or run fast to get away. The body stays in this state of fight–flight until the brain receives an "all clear" message and turns off the response.

Sometimes fear is triggered by something that is startling or unexpected (like a loud noise), even if it's not actually dangerous. That's because the fear reaction is activated instantly — a few seconds faster than the thinking part of the brain can process or evaluate what's happening. As soon as the brain gets enough information to realize there's no danger ("Oh, it's just a balloon bursting — whew!"), it turns off the fear reaction. All this can happen in seconds.

Fears People Have

Fear is the word we use to describe our emotional reaction to something that seems dangerous. But the word "fear" is used in another way, too: to name something a person often feels afraid of.

People fear things or situations that make them feel unsafe or unsure. For instance, someone who isn't a strong swimmer might have a fear of deep water. In this case, the fear is helpful because it cautions the person to stay safe. A person could overcome this fear by learning how to swim safely.

A fear can be healthy if it cautions a person to stay safe around something that could be dangerous. But sometimes a fear is unnecessary and causes more caution than the situation calls for.

Many people have a fear of public speaking. Whether it's giving a report in class, speaking at an assembly, or reciting lines in the school play, speaking in front of others is one of the most common fears people have.

People tend to avoid the situations or things they fear. But this doesn't help them overcome fear — in fact, it can be the reverse. Avoiding something scary reinforces a fear and keeps it strong.

People can overcome unnecessary fears by giving themselves the chance to learn about and gradually get used to the thing or situation they're afraid of. For example, people who fly despite a fear of flying can become used to unfamiliar sensations like takeoff or turbulence. They learn what to expect and have a chance to watch what others do to relax and enjoy the flight. Gradually (and safely) facing fear helps a person to overcome it.

Fears During Childhood

Certain fears are normal during childhood. That's because fear can be a natural reaction to feeling unsure and vulnerable — and much of what children experience is new and unfamiliar.

Young kids often have fears of the dark, being alone, strangers, monsters, or other scary imaginary creatures. School-aged children might be afraid when it's stormy or at a first sleepover. As they grow and learn, with the support of adults, most kids are able to slowly conquer these fears and outgrow them.

Some kids are more sensitive to fears and may have a tough time overcoming them. When fears last beyond the expected age, it might be a sign that someone is overly fearful, worried, or anxious. People whose fears are too intense or last too long might need help and support to overcome them.

Phobias

A phobia is an intense fear reaction to a particular thing or a situation. With a phobia, the fear is out of proportion to the potential danger. But to the person with the phobia, the danger feels real because the fear is so very strong.

Phobias cause people to worry about, dread, feel upset by, and avoid the things or situations they fear because the physical sensations of fear can be so intense. So having a phobia can interfere with someone's normal activities. A person with a phobia of dogs might feel afraid to walk to school in case he or she sees a dog on the way. Someone with an elevator phobia might avoid a field trip if it involves going on an elevator.

A girl with a phobia of thunderstorms might be afraid to go to school if the weather forecast predicts a storm. She might feel terrible distress and fear when the sky turns cloudy. A guy with social phobia experiences intense fear of public speaking or interacting, and may be afraid to answer questions in class, give a report, or speak to classmates in the lunchroom.

It can be exhausting and upsetting to feel the intense fear that goes with having a phobia. It can be disappointing to miss out on opportunities because fear is holding you back. And it can be confusing and embarrassing to feel afraid of things that others seem to have no problem with.

Sometimes, people get teased about their fears. Even if the person doing the teasing doesn't mean to be unkind and unfair, teasing only makes the situation worse.

What Causes Phobias?

Some phobias develop when a person has a scary experience with a particular thing or situation. A tiny brain structure called the amygdala (pronounced: uh-mig-duh-luh), keeps track of experiences that trigger strong emotions. Once a certain thing or situation triggers a strong fear reaction, the amygdala warns the person by triggering a fear reaction every time he or she encounters (or even thinks about) that thing or situation.

Someone might develop a bee phobia after being stung during a particularly scary situation. For that person, looking at a photograph of a bee, seeing a bee from a distance, or even walking near flowers where there could be a bee can all trigger the phobia.

Sometimes, though, there may be no single event that causes a particular phobia. Some people may be more sensitive to fears because of personality traits they are born with, certain genes they've inherited, or situations they've experienced. People who have had strong childhood fears or anxiety may be more likely to have one or more phobias.

Having a phobia isn't a sign of weakness or immaturity. It's a response the brain has learned in an attempt to protect the person. It's as if the brain's alert system triggers a false alarm, generating intense fear that is out of proportion to the situation. Because the fear signal is so intense, the person is convinced the danger is greater than it actually is.

Overcoming Phobias

People can learn to overcome phobias by gradually facing their fears. This is not easy at first. It takes willingness and bravery. Sometimes people need the help of a therapist to guide them through the process.

Overcoming a phobia usually starts with making a long list of the person's fears in least-to-worst order. For example, with a dog phobia, the list might start with the things the person is least afraid of, such as looking at a photo of a dog. It will then work all the way up to worst fears, such as standing next to a person who's petting a dog, petting a dog on a leash, and walking a dog.

Gradually, and with support, the person tries each fear situation on the list — one at a time, starting with the least fear. The person works on each fear until he or she is comfortable. The person takes as long as needed to feel comfortable and isn't forced to do anything.

A therapist could also show a person with a dog phobia how to approach, pet, and walk a dog, and help the person to try it, too. The person may expect terrible things to happen when near a dog. Talking about this can help, too. When people find that what they fear doesn't actually turn out to be true, it can be a great relief.

A therapist might also teach relaxation practices such as specific ways of breathing, muscle relaxation training, or soothing self-talk. These can help people feel comfortable and bold enough to face the fears on their list.

As a person gets used to a feared object or situation, the brain adjusts how it responds and the phobia is overcome.

Often, the hardest part of overcoming a phobia is getting started. Once a person decides to go for it — and gets the right coaching and support — it can be surprising how quickly fear can melt away.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: August 2007

source taken from: http://kidshealth.org/

When you look at your friends and classmates, you might see the tall, lanky nerd who always gets straight As, the popular senior who is always laughing and smiling, or that classmate who seems to have everything under control. Sometimes this is all they will allow you to see.

And that's a shame.

Because what you may have heard before is trite but true: Nobody's perfect. In a world where people may seem perfect — or at least in control and normal — we often see ourselves as abnormal or not good enough. Whether they show it or not, though, everybody has problems of one kind or another.

The First Signs

It was the spring of my junior year of high school — a particularly stressful time for many students. I had schoolwork to do, APs to study for, nightly soccer practice, and pit band rehearsal for the school musical. To put it lightly, I was overloaded.

One night while I was sitting in my final dress rehearsal for the school play, I started thinking about my boyfriend. We'd been dating since the beginning of the school year, and because he was my first boyfriend, I was very inexperienced when it came to relationships. As I was sitting in rehearsal that night, thoughts about our relationship just kept popping up in my head. Where was our relationship going? Was it a good, healthy relationship? What was it really based on?

While these were normal questions for anyone to ask, my reactions to them were both mentally and physically overwhelming. I couldn't focus on playing my music, and I started breathing too quickly and trembling, convinced that my boyfriend would dump me and my world would fall apart. I kept imagining only the worst outcomes from this situation, until finally I couldn't sit with the band anymore. I had to leave the auditorium during the last full dress rehearsal and run to the bathroom, where I began retching in one of the stalls.

Falling Deeper

After that night, things began to worsen sharply. I missed the next 3 days of school because I told my mom I was too sick to go. And while this was true — I couldn't keep any food down for 3 days — I knew it was more because of my fears than because of any physical illness.

During those 3 days I lay in bed and constantly worried. I tried thinking through what was bothering me, and decided that any relationship that bothered me that much couldn't be good. I broke up with my boyfriend, figuring that would help, but once I had done that I still felt worried. I figured something else was wrong with my life, maybe that I was too stressed. I quit the soccer team and hoped that would help.

It didn't, and now I felt even worse. There was even more to worry about — what did my now ex-boyfriend think of me? Did he hate me? How could he still want to get back together with someone as messed up as me? Would my soccer coach think that I was just a quitter? Was I a quitter?

I started to notice that I became easily distracted from my work. In classes I would zone out of discussions completely, constantly worrying about my friends and my life, and wondering if I was normal. My psychology class was especially hard to sit through. I was sure that once we started learning new material, people would find out that I was weird or maybe even insane. What if everything I was experiencing was due to schizophrenia? I was sure I'd end up in an institution, crazy, lonely, and forgotten by all.

Over the next few weeks things improved, only to worsen again during summer vacation. My heart would race, and with all my worries I'd be too jittery to sit still. At my worst I was so nervous that anything I'd eat I'd just throw up again because I was so worried.

My parents started to worry that I was anorexic, and I only felt more misunderstood. I wanted to eat, I wanted to feel full and healthy, but my body wasn't letting me. "Just stop worrying," my parents would tell me. "You're not trying hard enough. If you just try harder you can make this stop."

But I had been trying so hard — did they think I wanted to be like this? This wasn't me at all. The me I knew was happy, fun, and lighthearted if not carefree. Now I just cried and worried, steadily lost weight, and withdrew from my friends so they couldn't find out what was happening to me. My parents knew something was very wrong and that they had to intervene. And so, for the first time ever, I ended up seeing a psychologist.

Seeing a Psychologist

I begged my parents not to make me go, and when they refused, screamed at them for forcing me to go against my will. When we showed up I was ready to hate my psychologist and show my parents how pointless this was.

And then I actually met the psychologist and found out he wasn't such a bad guy. He was there to help me — not to report back to my parents, not to have me committed to an institution, not to force any action at all — just to talk.

So we talked. Over the next few months he told me that I had generalized anxiety disorder (GAD), and we worked on techniques to help me overcome my worries, such as breathing, not jumping to catastrophic conclusions, and thinking rationally. But as hard as I tried to fight this, I just couldn't kick the worrying habit. My psychologist suggested I see a psychiatrist who would be able to prescribe medication to help me. Although when we first met I said I would not go on medication, I was so ready to be myself again that I willingly agreed.

Starting Anew

With my psychiatrist's recommendation and prescription I began taking an anti-anxiety medication that's approved for teens. I also continued therapy with my psychologist. And gradually over the next few weeks my overwhelming anxiety became manageable. Nobody's life is ever completely worry-free, but my concerns were now realistic and didn't control my whole life. My parents had me back, my friends had me back — but most important, I had me back. I was me again.

So I'm not perfect, and I would never claim to be — but I'm not crazy either. Around 40 million American adults have an anxiety disorder in any given year, which doesn't take into account people under age 18 or those who may have had an anxiety disorder in the past! Knowing this helps me feel less alone; other people are going through the same thing I did.

Dealing with my anxiety has been one of the greatest challenges of my life, but as I go into my sophomore year in college, I am a better, stronger, and more confident person for everything I have gone through. I learned that living a life of fear is not living at all, and while obstacles may arise more than I'd like, there is no problem that I can't handle. I've learned to take some risks and face my challenges head on. The rewards of trying, whether I succeed or not, are always better than letting my worries run my life or wondering what would have happened if I'd only had the courage to try.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: October 2008

source taken from: http://kidshealth.org/

Everyone has feelings of anxiety, nervousness, tension, and stress from time to time. Here are 5 ways to help manage them.

Note: When anxiety or worry feels extreme, it may be a sign of an anxiety disorder. For someone who has an anxiety disorder, getting proper care from a heath professional is important. The tips below can help too, of course. But professional treatment is the only way to shake an anxiety disorder.

1. Become a relaxation expert. We all think we know how to relax. But chilling out in front of the TV or computer isn't true relaxation. (Depending on what you're watching or doing, it could even make you more tense.) The same is true for alcohol, drugs, or tobacco. They may seem to relieve anxiety or stress, but it's a false state of relaxation that's only temporary. What the body really needs is a relaxation technique — like deep breathing, tai chi, or yoga — that has a physical effect on the mind. For example, deep breathing helps to relax a major nerve that runs from the diaphragm to the brain, sending a message to the entire body to let go and loosen up.
   
2. Get enough sleep, nourishment, and exercise. Want your mind and body to feel peaceful and strong enough to handle life's ups and downs? Get the right amount of sleep for your needs — not too much or too little. Eat well: Choose fruit, vegetables, lean proteins, and whole grains for long-term energy (instead of the short bursts that come from too much sugar or caffeine). And exercise to send oxygen to every cell in the body so your brain and body can operate at their best.
3. Connect with others. Spend time with friends or family. Organized activities are great, but just hanging out works too. Doing things with those we feel close to deepens our bonds, allowing us to feel supported and secure. And the fun and sharing that go with it allow us to feel happier and less upset about things. If you feel worried or nervous about something, talking about it with someone who listens and cares can help you feel more understood and better able to cope. You'll be reminded that everyone has these feelings sometimes. You're not alone.
4. Connect with nature. Heading out for a walk in the park or a hike in the woods can help anyone feel peaceful and grounded. (Choose somewhere you feel safe so you can relax and enjoy your surroundings.) Walking, hiking, trail biking, or snowshoeing offer the additional benefit of exercise. Invite a friend or two — or a family member — along and enjoy feeling connected to people as well.
5. Think positive. A great way to keep our minds off the worry track is to focus our thoughts on things that are good, beautiful, and positive. Allow yourself to dream, wish, and imagine the best that could happen.

For more on this topic, check out the box below.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: November 2007

source taken from: http://kidshealth.org/

What Is Anxiety?

Liam had always looked out for his younger brother Sam. But whenever Sam took the late bus after soccer practice, Liam worried about him so much he couldn't concentrate on his homework. Liam watched the clock, worrying and imagining the worst — picturing bus accidents and fearing, for no particular reason, that Sam might be injured or dead. Only when Sam arrived home safe could Liam finally relax.

It's completely normal to worry when things get hectic and complicated. But if worries become overwhelming, you may feel that they're running your life. If you spend an excessive amount of time feeling worried or nervous, or you have difficulty sleeping because of your anxiety, pay attention to your thoughts and feelings. They may be symptoms of an anxiety problem or disorder.

Anxiety is a natural human reaction that involves mind and body. It serves an important basic survival function: Anxiety is an alarm system that is activated whenever a person perceives danger or threat.

When the body and mind react to danger or threat, a person feels physical sensations of anxiety — things like a faster heartbeat and breathing, tense muscles, sweaty palms, a queasy stomach, and trembling hands or legs. These sensations are part of the body's fight-flight response. They are caused by a rush of adrenaline and other chemicals that prepare the body to make a quick getaway from danger. They can be mild or extreme.

The fight-flight response happens instantly when a person senses a threat. It takes a few seconds longer for the thinking part of the brain (the cortex) to process the situation and evaluate whether the threat is real, and if so, how to handle it. If the cortex sends the all-clear signal, the fight-flight response is deactivated and the nervous system can relax.

If the mind reasons that a threat might last, feelings of anxiety might linger, keeping the person alert. Physical sensations such as rapid, shallow breathing; a pounding heart; tense muscles; and sweaty palms might continue, too.

Normal Anxiety

Everyone experiences feelings of anxiety from time to time. Anxiety can be described as a sense of uneasiness, nervousness, worry, fear, or dread of what's about to happen or what might happen. While fear is the emotion we feel in the presence of threat, anxiety is a sense of anticipated danger, trouble, or threat.

Feelings of anxiety can be mild or intense (or anywhere in between), depending on the person and the situation. Mild anxiety can feel like a sense of uneasiness or nervousness. More intense anxiety can feel like fear, dread, or panic. Worrying and feelings of tension and stress are forms of anxiety. So are stage fright and the shyness that can come with meeting new people.

It's natural for new, unfamiliar, or challenging situations to prompt feelings of anxiety or nervousness. Facing an important test, a big date, or a major class presentation can trigger normal anxiety. Although these situations don't actually threaten a person's safety, they can cause someone to feel "threatened" by potential embarrassment, worry about making a mistake, fitting in, stumbling over words, being accepted or rejected, or losing pride. Physical sensations — such as a pounding heart, sweaty hands, or a nervous stomach — can be part of normal anxiety, too.

Because anxiety makes a person alert, focused, and ready to head off potential problems, a little anxiety can help us do our best in situations that involve performance. But anxiety that's too strong can interfere with doing our best. Too much anxiety can cause a person to feel overwhelmed, tongue-tied, or unable to do what they need to do.

Normal Anxiety

Everyone experiences feelings of anxiety from time to time. Anxiety can be described as a sense of uneasiness, nervousness, worry, fear, or dread of what's about to happen or what might happen. While fear is the emotion we feel in the presence of threat, anxiety is a sense of anticipated danger, trouble, or threat.

Feelings of anxiety can be mild or intense (or anywhere in between), depending on the person and the situation. Mild anxiety can feel like a sense of uneasiness or nervousness. More intense anxiety can feel like fear, dread, or panic. Worrying and feelings of tension and stress are forms of anxiety. So are stage fright and the shyness that can come with meeting new people.

It's natural for new, unfamiliar, or challenging situations to prompt feelings of anxiety or nervousness. Facing an important test, a big date, or a major class presentation can trigger normal anxiety. Although these situations don't actually threaten a person's safety, they can cause someone to feel "threatened" by potential embarrassment, worry about making a mistake, fitting in, stumbling over words, being accepted or rejected, or losing pride. Physical sensations — such as a pounding heart, sweaty hands, or a nervous stomach — can be part of normal anxiety, too.

Because anxiety makes a person alert, focused, and ready to head off potential problems, a little anxiety can help us do our best in situations that involve performance. But anxiety that's too strong can interfere with doing our best. Too much anxiety can cause a person to feel overwhelmed, tongue-tied, or unable to do what they need to do.

How Anxiety Disorders Affect People

For people dealing with anxiety disorders, symptoms can feel strange and confusing at first. For some, the physical sensations can be strong and upsetting. For others, feelings of doom or fear that can happen for no apparent reason can make them feel scared, unprotected, and on guard. Constant worries can make a person feel overwhelmed by every little thing. All this can affect someone's concentration, confidence, sleep, appetite, and outlook.

People with anxiety disorders might avoid talking about their worries, thinking that others might not understand. They may fear being unfairly judged, or considered weak or scared. Although anxiety disorders are common, people who have them may feel misunderstood or alone.

Some people with anxiety disorders might blame themselves. They may feel embarrassed or ashamed, or mistakenly think that anxiety is a weakness or a personal failing. Anxiety can keep people from going places or doing things they enjoy.

The good news is, doctors today understand anxiety disorders better than ever before and, with treatment, a person can feel better.

What Causes Anxiety Disorders?

Experts don't know exactly what causes anxiety disorders. Several things seem to play a role, including genetics, brain biochemistry, an overactive fight-flight response, stressful life circumstances, and learned behavior.

Someone with a family member who has an anxiety disorder has a greater chance of developing one, too. This may be related to genes that can affect brain chemistry and the regulation of chemicals called neurotransmitters. But not everyone with a family member who has an anxiety disorder will develop problems with anxiety.

Things that happen in a person's life can also set the stage for anxiety disorders. Frightening traumatic events that can lead to PTSD are a good example.

Growing up in a family where others are fearful or anxious can "teach" a child to view the world as a dangerous place. Likewise, if a person grows up in an environment that is actually dangerous (if there is violence in the child's family or community, for example), he or she may learn to be fearful or expect the worst.

Although everyone experiences normal anxiety in certain situations, most people — even those who experience traumatic situations — don't develop anxiety disorders. And people who develop anxiety disorders can get relief with proper treatment and care. They can learn ways to manage anxiety and to feel more relaxed and at peace.

How Are Anxiety Disorders Treated?

Anxiety disorders can be treated by mental health professionals, or therapists. A therapist can look at the symptoms someone is dealing with, diagnose the specific anxiety disorder, and create a plan to help the person get relief.

A particular type of talk therapy called cognitive-behavior therapy (CBT) is often used. In CBT, a person learns new ways to think and act in situations that can cause anxiety, and to manage and deal with stress. The therapist provides support and guidance and teaches new coping skills, such as relaxation techniques or breathing exercises. Sometimes, but not always, medication is used as part of the treatment for anxiety.

What to Do

Getting the problem treated can help a person feel like himself or herself again — relaxed and ready for the good things in life. Someone who might be dealing with an anxiety disorder should:

• Tell a parent or other adult about physical sensations, worries, or fears. Because anxiety disorders don't go away unless they are treated, it's important to tell someone who can help. If a parent doesn't seem to understand right away, talk to a school counselor, religious leader, or other trusted adult.
• Get a checkup. See a doctor to make sure there are no physical conditions that could be causing symptoms.
• Work with a mental health professional. Ask a doctor, nurse, or school counselor for a referral to someone who treats anxiety problems. Finding out what's causing the symptoms can be a great relief.
• Get regular exercise, good nutrition, and sleep. These provide your body and brain with the right fuel and time to recharge.

Try to stay patient and positive. It can take time to feel better, and courage to face fears. But letting go of worry allows space for more happiness and fun.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: November 2007

source taken from: http://kidshealth.org/

Most teens need about 8½ to more than 9 hours of sleep each night. The right amount of sleep is essential for anyone who wants to do well on a test or play sports without tripping over their feet. Unfortunately, though, many teens don't get enough sleep.

Why Aren't Teens Getting Enough Sleep?

Until recently, teens were often given a bad rap for staying up late, oversleeping for school, and falling asleep in class. But recent studies show that adolescent sleep patterns actually differ from those of adults or kids.

These studies show that during the teen years, the body's circadian rhythm (sort of like an internal biological clock) is temporarily reset, telling a person to fall asleep later and wake up later. This change in the circadian rhythm seems to be due to the fact that the brain hormone melatonin is produced later at night for teens than it is for kids and adults. This can make it harder for teens to fall asleep early.

These changes in the body's circadian rhythm coincide with a time when we're busier than ever. For most teens, the pressure to do well in school is more intense than when they were kids, and it's harder to get by without studying hard. And teens also have other time demands — everything from sports and other extracurricular activities to fitting in a part-time job to save money for college.

Why Is Sleep Important?

This sleep deficit impacts everything from a person's ability to pay attention in class to his or her mood. According to the National Sleep Foundation’s 2006 Sleep in America poll, more than one quarter of high school students fall asleep in class, and experts have been able to tie lost sleep to poorer grades. Lack of sleep also damages teens' ability to do their best in athletics.

Slowed responses and concentration from lack of sleep don't just affect school or sports performance, though. More than half of teens surveyed reported that they have driven a car drowsy over the past year and 15% of students in the 10th to 12th grades drive drowsy at least once a week. The National Highway Safety Traffic Administration estimates that more than 100,000 accidents, 40,000 injuries, and 1,500 people are killed in the U.S. every year in crashes caused by drivers who are simply tired. Young people under the age of 25 are far more likely to be involved in drowsy driving crashes.

Lack of sleep has also been linked to emotional troubles, such as feelings of sadness and depression. Sleep helps keep us physically healthy, too, by slowing our body's systems enough to re-energize us after everyday activities.

How Do I Know if I'm Getting Enough?

Even if you think you're getting enough sleep, you may not be. Here are some of the signs that you may need more sleep:

• difficulty waking up in the morning
• inability to concentrate
• falling asleep during classes
• feelings of moodiness and even depression

How Can I Get More Sleep?

Recently, some researchers, parents, and teachers have suggested that middle- and high-school classes begin later in the morning to accommodate teens' need for more sleep. Some schools have already implemented later start times. You and your friends, parents, and teachers can lobby for later start times at your school, but in the meantime you'll have to make your own adjustments.

Here are some things that may help you to sleep better:

• Set a regular bedtime. Going to bed at the same time each night signals to your body that it's time to sleep. Waking up at the same time every day can also help establish sleep patterns. So try to stick as closely as you can to your sleep schedule even on weekends. Don't go to sleep more than an hour later or wake up more than 2 to 3 hours later than you do during the week.
• Exercise regularly. Try not to exercise right before bed, though, as it can rev you up and make it harder to fall asleep. Finish exercising at least three hours before bedtime. Many sleep experts believe that exercising in late afternoon may actually help a person sleep.
• Avoid stimulants. Don't drink beverages with caffeine, such as soda and coffee, after 4 PM. Nicotine is also a stimulant, so quitting smoking may help you sleep better. And drinking alcohol in the evening can also cause a person to be restless and wake up during the night.
• Relax your mind. Avoid violent, scary, or action movies or television shows right before bed — anything that might set your mind and heart racing. Reading books with involved or active plots may also keep you from falling or staying asleep.
• Unwind by keeping the lights low. Light signals the brain that it's time to wake up. Staying away from bright lights (including computer screens!), as well as meditating or listening to soothing music, can help your body relax. Try to avoid TV, computer and telephone at least one hour before you go to bed.
• Don't nap too much. Naps of more than 30 minutes during the day may keep you from falling asleep later.
• Avoid all-nighters. Don't wait until the night before a big test to study. Cutting back on sleep the night before a test may mean you perform worse than you would if you'd studied less but got more sleep.
• Create the right sleeping environment. Studies show that people sleep best in a dark room that is slightly on the cool side. Close your blinds or curtains (and make sure they're heavy enough to block out light) and turn down the thermostat in your room (pile on extra blankets or wear PJs if you're cold). Lots of noise can be a sleep turnoff, too.
• Wake up with bright light. Bright light in the morning signals to your body that it's time to get going.

If you're drowsy, it's hard to look and feel your best. Schedule "sleep" as an item on your agenda to help you stay creative and healthy.

Reviewed by: Mary L. Gavin, MD
Date reviewed: May 2009
Originally reviewed by: Mena T. Scavina, DO

source taken from: http://kidshealth.org/