SAY ni DOK | Separation anxiety disorder, nararanasan ng ilang bata sa pagbabalik-eskuwela
SAY ni DOK | Separation anxiety disorder, nararanasan ng ilang bata sa pagbabalik-eskuwela
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00:00My fellow countrymen, starting this coming Monday, July 29,
00:04the youths are going back to school.
00:07And most of the youths, especially those in Kindergarten, Grade 1, Grade 2, and Grade 3,
00:14this is what we call separation anxiety disorder.
00:21The type of people who don't want their children to be left behind by their parents.
00:25Let's talk about this with our favorite psychiatrist, Dr. Joan May Perez-Rifariel.
00:31Good morning, Doc!
00:33Good morning, Doc!
00:35Hello! Good morning, Sir Audrey! Good morning, Sir!
00:38And Rise and Shine, Pilipinas! Good morning to everyone!
00:42Thank you for having me.
00:44Doc, Joanne, we were all kids when we experienced this.
00:49The first time we went to school, we were left behind by our parents.
00:55Doc, Joanne, what is this called separation anxiety?
01:00Yes, separation anxiety, Sir Audrey, is a part of the normal development of a child.
01:07Usually, when a child is up to 2 or 3 years old, they experience separation anxiety.
01:14They have a fear of being separated from their primary caregiver,
01:20whether it's their mother, father, siblings, or at home.
01:25So, that's normal. It's a part of normal development.
01:29But, it's different, it becomes a disorder later on,
01:34if it continues, because usually, it disappears.
01:38It resolves by 2 or 3 years old.
01:41But, it continues, persists, and causes concerns or consequences in their relationships.
01:51They are afraid to go out because they will be separated from their family, from their loved ones,
01:57or they are afraid to go to school.
01:59For example, if they are in grade school or high school,
02:02sometimes, it extends up to even beyond grade school.
02:09So, this is what we call a disorder.
02:12When symptoms and impairments affect their activities,
02:20be it as a student or at work.
02:22Because in adults, it can also manifest as well.
02:26Doc, this is Patrick.
02:28Is there a way for us to determine if a child has anxiety or trauma?
02:35Yes, good morning, Sir Patrick.
02:38Yes, it's better to make sure that we can determine if a child has trauma or anxiety.
02:47Clinical interview is very important.
02:50We need to be able to talk to them.
02:54Because if we cannot address traumatic experiences of a child,
03:01this could be the reason why they have separation anxiety disorder.
03:08For example, Sir Patrick, some of the causes of separation anxiety disorder are,
03:16number one, for example, there is bullying that happens in school.
03:21They are afraid to leave their house.
03:24They are afraid to go out and enter.
03:26That's why they develop school refusal.
03:28Because they are being bullied in their schools, which can be traumatic.
03:34Another is if the child has family history of anxiety in the family.
03:44If there are mental health concerns in the family.
03:49It can be biological as well.
03:52Another is environment.
03:54Presence of stressors.
03:55Presence of stressors can trigger separation anxiety disorder.
04:04For example, what are these stressors, Sir Audrey and Sir Patrick?
04:08Transition.
04:10If the school is new, the work is new.
04:14Or there are transitions.
04:16For example, there is a break-up in the family.
04:19There is a problem in the family, which will cause fear.
04:22Fear.
04:24Because anxiety in Filipino or in layman,
04:27this is fear, worry of a child.
04:30That's why we need to find out where this fear of a child comes from.
04:35That's why they are afraid to go far from their primary caregivers.
04:42Okay.
04:44Dr. Johan, how can we say that this is a serious case
04:48and it leads to separation anxiety disorder?
04:53Yes.
04:55This is serious.
04:57The red flag that we call, Sir Audrey, that needs to be monitored,
05:01is number one, persistent.
05:03His symptoms of fear are severe and intense.
05:08To the point that a child is very afraid for a period of minimum four weeks.
05:15That's why we call it persistent.
05:16Four weeks of persistent fear, excessive worry, intense.
05:23To the point that they don't want to separate.
05:26They don't want to go far from their primary caregiver.
05:30For example, from their mother or father or siblings.
05:33They don't want to go out.
05:35They don't want to be alone.
05:37So, meaning, if they don't want to go out,
05:40school refusal can be a psychiatric emergency.
05:43Because, of course, we don't want children to not be able to go out
05:49because of this severe separation anxiety.
05:53They have physical symptoms.
05:57For example, they have nightmares about going far or losing their loved ones.
06:03Their fears, Sir Audrey, come from the fear that they might go far from their parents.
06:09For example, something bad might happen to them
06:13or something bad might happen to their parents.
06:17That's why they don't want to separate.
06:19Because they have a lot of thoughts.
06:21What if something happens to my mom while I'm not around?
06:25Or what if something happens to me while my mom is not around to protect me?
06:31Like that.
06:33Physically, they also have body aches and pains.
06:36So, we need to take care of that.
06:39If our children say,
06:41Ma, I don't want to go out because my head hurts, or my stomach hurts, or my back hurts, or my knees hurt.
06:48It can be a sign that they are very anxious.
06:53They are afraid of their children.
06:55That's why they are always absent from school because of this.
06:59So, we give a minimum timeline of 4 weeks.
07:05Their fear is intense.
07:09It's hard for them to reassure that everything is okay, everything is safe.
07:17Next week is the return to school.
07:21For the parents, how can they prepare their children to avoid separation anxiety?
07:30Yes, I agree, Sir Patrick.
07:32What's important here is that preparation is the key.
07:37Preparation means,
07:39you talk to your family first.
07:42Son, there's a return to school next week.
07:45How are you?
07:47Open lines of communication with the child.
07:50We ask, how are you, son?
07:52How are you feeling?
07:54Return to school next week.
07:56Let's acknowledge, recognize their emotions,
07:59feelings associated with school.
08:03If they are afraid and have worries,
08:07let's ask, where do those fears come from?
08:10What's the reason, son?
08:12Why are we afraid?
08:14So that we can address, whatever the root causes of their anxiety,
08:19we can address, we can explain.
08:22We make them feel that we are here.
08:25We are here.
08:27When they go home, for example,
08:29we will take care of them,
08:31we will bring them here.
08:33They don't have to be afraid because when they go home,
08:35they will be at home waiting.
08:37And if possible,
08:39if it's a new student,
08:41in a new environment, in a new school,
08:43of course, it's a risk factor as mentioned earlier.
08:46Anything new, a transition,
08:48it's better to visit the school.
08:51Look at it,
08:52so that the child knows,
08:54so that the child becomes more familiar.
08:56This is my classroom,
08:58these are my teachers,
09:00this is where I will sit,
09:02this is where I will eat snacks.
09:04So that at least, it's part of the preparation
09:06of the child for the upcoming school year.
09:10Okay, Dr. Juan,
09:12how important is the help,
09:14if a child has a case like this,
09:17the help of parents, guardians,
09:19and teachers,
09:20what do we call it,
09:22in the faculty of the school,
09:24so that the child can be guided?
09:26Correct, yes.
09:28This is very important, Sir Audrey.
09:31What we always buy,
09:33or what we encourage,
09:35is that the school also should help them.
09:40That's why collaboration is very important
09:43between the family and the school.
09:46Because in the school,
09:47the majority of the time,
09:49a child is in the school.
09:51So the teachers and the school
09:54need to be ready
09:56to be very welcoming.
09:58They will make the children feel
10:01that they don't have to be afraid.
10:03If there is no mother or father,
10:05we will be the second parents
10:08while they are in the school.
10:10So welcome them,
10:12make sure that if there are new students,
10:14don't give them a body,
10:17what we call it, Sir Audrey,
10:19is a body system.
10:21So that they have someone with them
10:23for the first few months
10:25to teach them where to go,
10:27the places in the school,
10:29so that they do not feel that they are alone.
10:31They don't have to be afraid
10:33because they have friends.
10:35And they can always start their day
10:37with the structure that
10:39how-to sessions are very important,
10:41or play.
10:43So for the children,
10:45play is very important.
10:47They learn social skills
10:49so that they can strengthen
10:51their personality.
10:53They learn how to be more sociable,
10:55don't be afraid to face people,
10:58different types of personalities.
11:01And that's where they learn
11:03how to open up,
11:05share, take turns.
11:07So of course,
11:09schools still have
11:11that opportunity
11:13for the children to play.
11:15There, Dr. Joanne.
11:17You know, when I was a child,
11:19it's a good thing I didn't experience
11:21this separation anxiety.
11:23But I had classmates
11:25who were really having a hard time
11:27when I was about to enter.
11:29Anyway, there are still a few days
11:31for our parents,
11:33teachers, and children to get ready.
11:35Again, thank you very much,
11:37Dr. Joanne Mae Perez-Refarial
11:39for answering our medical questions.
11:41Thank you very much,
11:42Sir Patrick, Sir Audrey,
11:44and Rise and Shine Pilipinas.
11:46Stay healthy, stay safe, everyone.
11:48Good morning. Thank you.