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Anxiety, Depression & LD

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By Jill Harkavy-Friedman, Ph.D.

Anxiety and depression are feelings that everyone experiences at various times in their life. Concerns arise, however, when those feelings persist for weeks or months and interfere with routine functioning. Anxiety and depression—which often go hand-in-hand—may start off in one situation and gradually bleed into other aspects of life, leading at worst to extreme behaviors ranging from tantrums to attempted suicide.

 

For a child, it’s time to get help when she begins to avoid daily activities, withdraws socially or otherwise limits her life


Reasons for Anxiety and Depression with LD/ADHD

Children with learning disabilities may be more vulnerable to anxiety and depression than others for several reasons:

    • Processing deficits may make the environment feel overwhelming. The familiar is comfortable; but the unfamiliar can be a nightmare for some children. For the child with LD/ADHD, walking into a restaurant can feel like being a young child in Times Square on New Year’s Eve: too many people, too much noise, and the feeling of being trapped can lead to panic. Next time the child is expected to go out, he begins to worry hours before. By the time he’s ready to leave, he anticipates the worst, and would rather stay where he feels he can cope than venture into the unknown. Because no one else knows why he is so upset or understands his discomfort, the result is that he feels isolated and alone.

 

  • Frequent feelings of embarrassment and humiliation in school may introduce depression and anxiety. Think what it feels like to be a child with dyslexia who is required to write an in-class essay about the book she has read. Perhaps her book was a little less advanced than the other kids’ or she hasn’t been able to finish it. She knows that her spelling and punctuation will be full of mistakes, and the likelihood that she might produce a coherent essay in one class period is slim to none. She feels embarrassed, diminished by her difficulties, ineffective, and enormously stressed.

 

  • Underlying biological mechanisms such as brain transmitter dysfunctions or a family history of depression or anxiety can also precipitate these issues. Cortisol is a chemical substance that the body naturally increases production of during times of stress. It’s responsible for the “fight or flight” response, enabling people either to face an aggressor or to flee. The production of excessive amounts of cortisol when a child is stressed may relate to increased depression and anxiety. For this reason, learning to cope with stress and to use relaxation techniques can be a very effective antidote to these negative feelings. The body cannot be both relaxed and tense at the same time. Children who learn how to relax their minds and bodies can invoke what they have learned in times of stress to alleviate feelings of tension and anxiety. Another possible source of relief is medications that work on the cortisol system as well as on other brain chemicals.

 

Dealing with Depression and Anxiety

Ignoring feelings of anxiety and depression can cause the feelings to deepen and ultimately lead to social and academic failure. It’s important to work with a mental health professional to determine the most appropriate combination of strategies for a particular child. For example, reframing negative thoughts can be useful, as can applying effective learning strategies such as taking one’s time, or breaking information into smaller bits.


For more intense situations—when depression and anxiety lead to school and social problems, lack of sleep, changes in appetite or weight, low energy and feelings of hopelessness or worthlessness—medication may play a key role.

Children (and adults) who feel empowered to take positive action to improve and maintain their sense of wellbeing are more likely to act when faced with feelings of anxiety and depression. Working to enhance self-esteem and a sense of mastery in some areas may protect children against anxiety and depression, or help them to meet successfully the inevitable challenges life brings.

 

Signs of Anxiety

Signs of Depression

Generalized anxiety Persistent, intense feelings of sadness
Unrelenting, general state of worry and fear Low mood or lack of interest
Panic attacks Feeling or acting irritable
Sudden bursts of panic or fear Feelings of worthlessness
Thoughts of “going crazy” or impending death Poor concentration
Increased heart rate, sweating, trouble breathing Sleeping too little or too much
Shaking/trembling, or dizziness Increase or decrease in appetite or weigh
Stomach or chest pains and nausea Difficulty making decisions
Phobias Low energy and/or fatigue
Intense fear that leads to avoidance Wish to be dead or suicidal thoughts or gesture
Social withdrawal
Decline in grades or work productivity