1. Overview

Disorders related to anxiety and depression are common in gifted learners and need consistent support in the classroom. 

Although anxiety & depression were discussed in the 2e part one course, we want to go a bit deeper and discuss how these issues can be supported in the classroom.

If anxiety and depression disorders are severe, they may fall under the umbrella of severe emotional disturbance (SED), but many cases that need support are not that severe. This is when the 504 plan can be utilized.

2. Anxiety & 2e

Definition  - Anxiety is defined as a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.  It is characterized by feelings of tension and worry and sometimes physical symptoms accompany these feelings.

Feeling anxious is a normal emotion for all of us.  Children too go through phases or temporary bouts of anxiety as they move through the various stages of childhood.  However, when anxiety becomes excessive, chronic, and frequent, when it extends beyond a phase and negatively impacts functioning such as when it curtails a child's willingness to go certain places, interact with friends, or to try or do certain things, then it may indicate an anxiety disorder.

“Everyone experiences stress and anxiety at one time or another. The difference between them is that stress is a response to a threat in a situation. Anxiety is a reaction to the stress" (www.ADAA.org).

Current research suggests that most high ability students match the general population of students in how well-adjusted they are, in other words, are no more likely to have anxiety or depression than other students (Martin, et. al., 2010).  The struggles and the imbalance that 2e children experience in their daily lives, however, can cause them to become anxious. An educator experienced in teaching 2e students, Miriam Darnell, describes it this way:

There are also common comorbidities with anxiety, including other anxieties, depression, and substance abuse.  Anxiety also often presents as a secondary condition to other diagnoses, such as ASD, ADHD, learning disorders, and Tourette's Disorder (Doobay, A., Foley Nicpon, M., & Schabilion, K., 2020, Resources and Strategies for Teachers of High Ability Students With Anxiety. NAGC Conference).  As you can see from this list, 2e students with these disabilities/disorders also would be at risk for an anxiety disorder.

Functional Impact of Anxiety

(Credit: Doobay, et. al., 2020)

Anxiety interferes with learning, performance, and behavior

• Disrupts attention, focus, concentration
• Lowers tolerance for frustration
• Forgetfulness
• Self-doubt
• Less efficient cognitive processing
• Task avoidance
• Escape behaviors
• Acting out symptoms associated with panic

Common Signs of Anxiety in High Ability Students:

(Credit: Doobay, et. al., 2020, and Howard, J. 2020.)

• Undue worry, fear, or distress, including about performance (e.g., fear of failure despite high performance)
• Dreading and avoiding situations that might trigger fear or embarrassment including the avoidance of challenge
• Low frustration tolerance
• Irritability / Outbursts / Disruptive behavior
• Report of minor health complaints or discomfort (e.g., headache, stomach ache, increased heart rate, chest pains, sweating, dizziness)
• Problems with concentration and memory
• Problems with sleep or changes in sleep patterns and/or appetite (often a decrease)
• Abrupt change in performance (e.g., "self-sabotage")
• Social withdrawal

3. Types of Anxiety Disorders, Optional

Several types of anxiety disorders exist

There are several types of anxiety disorders, including but not limited to, agoraphobia, generalized anxiety disorder, social anxiety disorder, and selective mutism.  For a list with explanations, please see this document in our Google folder (optional).

4. Characteristics

Generalized Anxiety Disorder (GAD)

In our experience, Generalized Anxiety Disorder (GAD) is one of the most common disorders noted in 504 plans so we will be examining the characteristics of this particular disorder. 

Generalized anxiety disorder symptoms can vary. They may include:

• Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events

• Overthinking plans and solutions to all possible worst-case outcomes

• Perceiving situations and events as threatening, even when they aren't

• Difficulty handling uncertainty

• Indecisiveness and fear of making the wrong decision

• Inability to set aside or let go of a worry

• Inability to relax, feeling restless, and feeling keyed up or on edge

• Difficulty concentrating, or the feeling that your mind "goes blank"

• Fatigue

• Trouble sleeping

• Muscle tension or muscle aches

• Trembling, feeling twitchy

• Nervousness or being easily startled

• Sweating

• Nausea, diarrhea or irritable bowel syndrome

• Irritability

Physical signs and symptoms may include:

Source:  Mayo Clinic

Additional information can be found below:

5. Strategies to deal with anxiety

Here are some general research-based accomodations:

o   Reduce time pressures

o   Identify a support person/safe space in the school

o   Be consistent and predictable, yet flexible

o   Provide choices (in order of completing  tasks)

o   Emphasize effort over outcomes

o   Create opportunities for students to feel special

o   Provide a warm, supportive learning environment

o   Understand that behavioral outbursts can signal anxiety or low mood

o   Behavioral support should always be positive and not punitive

For more information, click on links below (optional):

Classroom Accommodations for Anxiety

How Teachers Can Help Students Cope with General Anxiety in the Classroom

Management of anxiety begins at home   

Understanding the Link Between Empathy and Anxiety in Gifted Children

Classroom Accommodations for Anxiety

6. Depression & 2e

Definition - Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living. -Mayo Clinic

Deception of Depression

7. Types of Depression

TYPES

Persistent depressive disorder(also called dysthymia) is a depressed mood that lasts for at least two years.

Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”).

Postpartum depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth.

Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight.

Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations).

Source: NIMH

For more information click on the following link:

Types of depression: 10 common types

9 types of depression and how to recognize them

8. Characteristics

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.

• In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.

• In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Additional information can be found at the following websites:

9. Strategies to deal with depression

Anxiety & Depression in Children
Existential Depression in Gifted Individuals
Depression in Gifted Children
The Unhappy Intellectually Gifted Child

10. Anxiety, Depression, & Giftedness

Neuropsychological Research

• Gifted learners often present with intensities not seen in typical learners. 

• “Neuroscience research supports the belief that gifted individuals have increased intellectual, emotional, sensory and motor processing capacity.” (Tetreault et al., 2016)

The Columbus Group (1991) created the following definition to explain the cognitive and socio-emotional aspects of gifted learners:

“Giftedness is asynchronous development in which advanced cognitive abilities and

heightened intensity combine to create inner experiences and modes of awareness that are

qualitatively different from the norm. This asynchrony increases with higher intellectual capacity.” 

Overexcitability and the Gifted

Tips for parents: Anxiety, Sensitivities and Social Struggles among Profoundly Gifted Kids

11. Giftedness, Intensity & Risk of Suicide

Research

Although there has not been research to substantiate an increase in suicide by gifted individuals, neuropsychological studies have found that the brain of a gifted individual feel emotions more intensely than typical individuals.

"...highly intelligent individuals are at a significantly greater risk of experiencing psychological and physiological disorders according to the study published in the journal Intelligence, online October 8, 2017" (Karpinski).

“Those with high IQ possess unique intensities and overexcitabilities which can be at once both remarkable and disabling on many levels” (Karpinski, 2017).

New Research

Tracy Cross has started the William & Mary Institute for Research on the Suicide of Gifted Students. Cross states that perfectionism, or a self- or socially inflicted pressure to perform well, is a common characteristic among gifted students and has been found to correlate with suicide ideation in studies of psychiatric and university samples (Spyker, M, 2017).

His concern is that gifted individuals may be more successful in their attempts. Based on journals he has read from several gifted adolescents who died by suicide, he believes this population may be better at planning and carrying out their plans, leading to a higher rate of completion from attempts. He acknowledges, however, it is too early to know if this is true (Spyker, M, 2017).

Video

For more information regarding this topic, please click on the links below:

CDE - Suicide Prevention

In giftedness, is there more darkness?

ADAA Understanding Anxiety & Suicide Prevention 

NCBI - Emotional and Behavioral Characteristics of Gifted Children and Their Families

Hyper brain / hyper body: The trouble with high IQ

Hoagies' Gifted Education - Depression & Suicide resources

11.1. Suicide Prevention

Suicide rates among ages 10-24 has skyrocketed over the past decade. Dr. Tracy Cross and his colleagues have recently opened the William & Mary Institute for Research on the Suicide of Gifted Students to examine this topic and find options for easy intervention.

12. Additional Resource, Optional

Optional resource: 

Anxiety checklist: How do I know if my child has an anxiety problem? (Autism website)

For a spring 2020 presentation by CDE's affective needs and serious emotional disability specialist, Bill Brown: Grief & Growth Cycle 

For Parents:

Screening for an Anxiety Disorder: Children