Giving Parents Therapy Can Help Their Anxious Children

This week in science: a new approach to brain stimulation for hard-to-treat depression, and how parents could inadvertently be encouraging their kid's anxiety.

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17 March 2019, 1:12am

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Each week, we read what's going on the world of science and bring the wildest findings straight to you. Scroll through for the latest:

How parents inadvertently perpetuate their kids’ anxiety

On March 13, the New York Times’s Upshot published results from a survey on parenting that found that moms and dads are still very involved in aspects of their grown children’s lives.

76 percent of parents “reminded their adult children of deadlines they need to meet, including for schoolwork,” 74 percent “made appointments for them, including doctor’s appointments, 15 percent “called or texted to make sure they did not sleep through a class or test,” while 14 percent “told them which career to pursue.” This kind of parenting can backfire, the article wrote, “by leaving young adults ill-prepared for independent adult life.”

And what about when kids are younger? Having parents that over-accommodate could be perpetuating pre-existing anxiety disorders. In a new study in the Journal of the American Academy of Childhood and Adolescent Psychiatry, researchers found that offering treatment to parents of kids with anxiety disorders was just as helpful as treating the kids themselves—by helping them cool it on certain behaviors.

“Children naturally rely on parents when they are feeling scared and parents naturally want to protect their children and to help them to be safe and to feel good,” says Eli Lebowitz, the associate director of the Anxiety and Mood Disorders Program at the Yale Child Study Center and first author of the study. These over-accommodations could include answering a question reassuringly from a worried child over and over, speaking up for a kid who is socially anxious, taking part in elaborate nighttime rituals, or taking a kid to unnecessary doctor’s appointments because they think they’re sick.

“There are really endless possible examples,” Lebowitz says. “Every child anxiety symptom is likely to have a matching accommodation on the part of the parents. These accommodations are well-intentioned but tend to lead to more anxiety over time and to greater impairment for both the child and the family overall.”

In the study, they randomly assigned children diagnosed with anxiety disorders to receive cognitive-behavioral therapy, and other kids not to have therapy but for their parents to participate in something called “Supportive Parenting for Anxious Childhood Emotions” or SPACE. In SPACE, the parents learned to reduce their accommodations, while still supporting and acknowledging the difficulties their children were facing.

“For example, in the case of the parent who is responding to many repetitive questions throughout the day, the parent may learn to say, ‘I see how anxious you are and I know how hard and uncomfortable that feels for you, but I know that you can be ok and that I am not helping you by answering all these questions, so I am not going to answer anymore,’” Lebowitz tells me.

After 12 weeks, the kids who received therapy themselves had just as much benefit as those who got no treatment, but whose parents did. “That means that children whose parents did SPACE and who never directly met with the therapist felt they had as much benefit as children who met directly with a skilled therapist for 12 sessions,” Lebowitz says.

Since some kids don’t do well in therapy, or find parts of it, like exposure therapy, challenging and scary, knowing that outsourcing treatment to mom and dad can be similarly effective could be a great way to address anxiety disorders early on— before you’re that adult whose mom still makes all their doctors appointments.

People with hard-to-treat depression could one day find success with a new kind of brain stimulation

People with major depressive disorder have usually tried every medication and therapy that’s out there, and have been unable to find relief from their symptoms. After medication, there are newer treatments they can try, including noninvasive brain stimulation, which seeks to change the behavior of the brain from outside the skull using electrodes placed on the scalp.

One strategy for this is called transcranial direct current stimulation, or tDCS, which targets areas of the brain, but in a new double-blind, placebo study in Translational Psychiatry researchers attempted instead to target a specific kind of brain rhythm, called alpha oscillations, that can be abnormal in people with depression. The new method is called transcranial alternating current stimulation, or tACS.

Our brains are electric organs, and the way that brain cells talk to each other is through electric signaling. When brain cells are active, they synchronize and fire together in rhythmic patterns, or brain waves, that scientists can record from outside the skull. One type of brain wave is called an alpha oscillation. Alpha oscillation requires a sophisticated brain to generate them, says Flavio Frohlich, associate professor of psychiatry at the University of North Carolina at Chapel Hill and senior author on the new study. “Humans have it, but small mammals, for example, don't.”

Alpha oscillations seem to represent internal processing; they are particularly prominent when we close our eyes, daydream, meditate, or dwell on ideas. “If you're decoupled from the environment around you and the brain is more in this internally focused state, these rhythms are generated and they're more pronounced,” he says. “There's growing evidence that they play an important role in our internal maintenance of our feeling of self. Perhaps not surprisingly, there is quite substantial evidence that this rhythm is pathologically altered or is impaired in patients with depression.”

People with depression may have too much of this rhythm in a part of the brain called the left frontal cortex. We don’t know why that is, Frohlich says, but we could speculate that this imbalance of alpha oscillations might contribute to depression symptoms.

TDCS uses a constant current to increase or decrease overall neural activity in areas of the brain, whereas Frohlich and colleagues’ new approach delivers electricity in a rhythmic way designed to interact only with the alpha oscillations.

In the study, they found that the tACS was able to reduce the elevated alpha oscillations in the left frontal cortex, a result they didn’t find in the placebo group and another control group that was stimulated with a different wave. Significantly more of the people who got the treatment targeting the alpha oscillations ended up with at least a 50 percent reduction in depression symptoms, compared to the other groups.

“A few of the participants had such dramatic decreases that Frohlich's team is currently writing case-studies on them,” a press release says.

So will this prove to be more effective that TDCS or other noninvasive stimulation options? It’s too early to say, but it’s promising that both are showing potential for people for whom medication doesn’t work.

“it's just one more demonstration that smartly applied, very weak electricity can alter brain function,” Frohlich says. “It can alter brain function in a way that even awhile after stimulation, we still see this effect.”

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This article originally appeared on VICE US.