You might dismiss anxiety as no big deal, a normal part of the human condition, the coddled snowflake’s problem.
You’d be flat-out wrong.
You might insist that everyone feels a little uncertain at least part of the time, and that the person who floats through life with blithe self-confidence doesn’t exist.
You’d be understating and undercutting a real and growing problem that can and must be faced.
Anxiety — feeling stressed or nervous, either in general or about specific situations; being unable to do the tasks that make up your life, or doing them only through feelings that range from discomfort through to acute misery; shutting down friendships, activities, and sources of pleasure because they are becoming disablingly threatening; developing a range of physical ailments — gastroenteric problems, migraines or tension headaches, back or neck or other pains; thinking about suicide — is a problem that is both serious and trending upward. It can affect anyone, cutting across all socioeconomic boundaries, and it goes after people of all ages. Even children are not immune. In fact, children are particularly prey to it.
Englewood Health and the Wellness Network, a volunteer group affiliated with the Jewish Federation of Northern New Jersey, are sponsoring a program on the evening of Monday, October 28, devoted to learning about anxiety, particularly in middle-school and high-school students, and in discussing ways to combat it. (See box.)
After a documentary called “Angst,” featuring teenagers who’ve battled anxiety and the professionals who have helped them, a panel of local experts will help bring both the problem and the solutions home.
One of those panelists, Jennifer Yanowitz of Tenafly, who helped put the program together, is an Englewood Health social worker who has spent a great deal of time looking at statistics. “My title is community specialist, and my role is to look at our environment,” she said. “I look at data about our community that we get from our community health needs assessment.” That’s a survey that the federal Affordable Care Act mandates that hospitals must conduct every three years. Bergen County’s hospitals do it together. “It’s a huge project,” Ms. Yanowitz said. “From it, we get to see all this information on the wellness spectrum, including social determinants and access to health care, access to food; it’s broken down by socioeconomics, by geography, by ethnicity,” and by a wide range of other factors.
“We are so rich in data,” she said. “We can see where people are struggling.”
The 2019 survey has just been concluded, and it shows that “no matter what your socioeconomic status is, mental health is a driving issue. Behavioral health-related issues are one of the most dominating areas of need and care and support at all ages, across every economic status and every ethnicity.”
What do the numbers show? “Anxiety disorders are affecting 25.1 percent of children between the ages of 13 and 18,” Ms. Yanowitz said. “This is national data. Eighty percent of childhood anxiety sufferers do not get treated — and yes, there is treatment.
“One in five children between the ages of 13 and 18 will experience a depressive episode before graduating high school. More of them are girls than boys.” The data show that 38 percent of girls and 26.1 percent of boys will have that experience. (There is a difference between anxiety disorders and depression, although they are related, but this is the way the results are worded.)
The incidence of anxiety disorders has been trending up, Ms. Yanowitz continued. “Anxiety is the leading mental health issue among American youth. Children between the ages of 6 and 17” — 6 year olds! — “have experienced a 20 percent increase in diagnoses of anxiety between 2007 and 2012.” And it keeps going up.
“There are so many factors,” Ms. Yanowitz said. “Many of them are external. This is such a volatile environment, with lockdowns in schools; terrorist attacks; the increased presence of social media; sports that aren’t just one season anymore but can last the whole school year; the family’s financial pressure, the pressure to get into college — it’s everywhere. And it just keeps getting dialed up.
“So if we as adults are stressed, if we are finding it difficult to cope — we have a lifetime of experience to draw on. But younger people, who are just developing a sense of self, who are just learning how to manage their time, who are evolving their identities and developing their relationships, who are just growing into themselves — their ability to tolerate, to regulate, to manage this pressure, all this stress — it’s even harder for them.
“That’s the landscape we’re facing.”
The federation and the hospital are joining to show the documentary “Angst” in response to that landscape, Ms. Yanowitz said. “It is about 55 minutes, and it features young people who range from middle school to high school, of different ethnicities and socioeconomic statuses. The unifying thing is that they all have experienced anxiety to the point where it really has impacted them in their lives.
“In the film, the young people and their family members talk about their anxiety, and professional therapists talk about what they are seeing in their patient populations, and they share coping skills.”
The film’s goal is to get people talking. “To see that it’s okay to talk about anxiety. To normalize talking about it. To see that it’s okay not to be okay. And to talk about how to deal with it.
“We also have to acknowledge that up to a point, anxiety is healthy and normal, and that everyone experiences it. It is part of our makeup. But when the scale tips to the point where it is damaging,” it has to be acknowledged. “There are ways to screen for that,” Ms. Yanowitz said.
Is your child giving things up? “Are they missing out on things that they used to do? Are they skipping school? Not going to a party because they can’t tolerate the anxiety?”
“Are you lying awake at night?” she asked, switching pronouns to address the teens directly. “Does it cause you physical pain? Stomach aches? Headaches? Are you obsessing? Thinking only about the anxiety?” The anxiety can be specific, she said — “It can be about taking a test, or giving a speech” — or it can be “a generalized state of anxiety that can manifest itself in many ways. But has the anxiety gone too far? Is the young person being compromised by anxiety?”
Not only is anxiety provoked by the outside environment, it also can tend to run in families, and to be transmitted through parenting. “Typically there is a parent in the house who may experience anxiety, and they aren’t aware of it,” Ms. Yanowitz said. “Is it nature? Is it nurture? It really can be both.”
Englewood Health’s “objective is to seek out and partner with organizations so we can connect to young audiences — ages 11 plus — and their families so we can take away the stigma and secrecy around anxiety,” she said. “To name it, to talk about it, so that everyone is aware of it, and that people who need help, whether now or down the road, feel comfortable getting the help they need.
“We want to teach parents how to talk to kids about it, and to teach kids how to talk to the grownups.”
“After we screen the film, we will have an opportunity for dialogue,” Ms. Yanowitz said. “We also will provide materials that we have created, including an informational packet with an anxiety survival guide for parents and teens. And there also are numbers for contact information. There is a connection to care.
“Anxiety can be treated in so many ways, whether it is seeking out a professional therapist or the introduction of some change in behavior, with exercise, mindfulness, yoga, getting enough sleep, better time management. There can be a need to talk to someone — it doesn’t have to be a professional — and to develop coping skills, so that you have a toolbox.”
One of the most versatile tools in the box is communication, she added. If the evening will encourage parents and their children to talk to each other, it will have been immensely successful.
Englewood Health has a license to show “Angst” five times; those showings are aimed at different communities, and the panels will be specific to them.
For the Jewish community, it’s partnering with the Wellness Network, a group of Jewish Federation of Northern New Jersey-connected professionals who work in a wide range of wellness-connected fields. “We are all women in the health care, wellness, and education fields, mainly in private practice, who all are likeminded, with the goal of giving back to the community, one of its co-founders, Casey Halper of Demarest, said.
“The initial idea for the network was social,” Ms. Halper said. She is an occupational therapist; she and the other co-founder, Audrey Kent, a speech therapist who lives Tenafly, met, became friends, and then bonded even more closely when they both went on a trip to Israel led by their rabbi, David-Seth Kirshner of Temple Emanu-El of Closter. Soon, working with the federation, they founded the Wellness Network, which provides them not only with the chance to spend time and share ideas with other women in similar fields, but also to give back to the community that has provided them with so much.
The network members — occupational, speech, physical, and behavioral therapists, social workers, psychologists, a learning specialist, a nutritionist, and others in similar fields — all had seen how deeply anxiety had worked its way into the community’s children. They embraced the idea of working with Englewood Health on screening “Angst.”
“The goal is to create a forum for communication,” Ms. Halper said.
The federation’s role is vital, she said. “I see that with my own family, a way to start to feel better is to connect with other people.” She cited Mitzvah Day, when the federation offers families, even the ones with young children, the chance to work together on projects, ranging from the simple ones to more complex undertakings, that will help other people. It’s direct and hands-on, and it makes a strong connection between giving and receiving help, and promotes the understanding that everybody both gives and takes. (This year’s Mitzvah Day is set for November 24.)
“When we work as a family, doing good together, it helps us feel better,” Ms. Halper said. “It helps us feel better by connecting with other people in our community.”
It’s not as if treating anxiety is that easy — just go and put together a few packages, and presto! — but it’s both a practical task and a metaphor for the way that small things done with other people can help lift the lighter clouds. The heavier ones need much heavier intervention. That’s one of the many ways the panel comes in, helping parents and their kids understand which is which.
“It’s a nice building block,” Ms. Halper said. “If someone needs professional support, getting it is key, but a nice piece of the puzzle is staying connected.”
“We are all parents,” Ms. Kent said, so the idea of the Wellness Network working with Englewood Health on “Angst” resonated with them.
“Our kids are moving into that demographic, and it is a prevalent issue. Anxiety isn’t always a severe issue — sometimes it’s a more minor one — so we felt that giving parents tools and resources is really important.
“It’s also important to show the film to adolescents, to say that this is normal. The goal is to normalize talking about anxiety, so that it is not such a taboo subject. People shouldn’t be scared to talk about it. They should feel that they have trusted adults who they could go to. We should be able to provide strategies and find ways to get it under control before it starts being a bigger issue.”
Anxiety is a huge issue, Rabbi Kirshner said; he will speak at the screening. “You can’t find two families in our synagogue without at least one of them having a child who is dealing with depression, anxiety, or some other form of angst,” he said. “It’s being created, or at least exacerbated, by social media, plus many other factors in our society.
“As a rabbi, people confide in me, and I work with their children as they become bar or bat mitzvah, so I know that this really is big stuff.
“There are many levels of anxiety. Some of our kids have been hospitalized, and some are on very serious meds. It is a real epidemic. And I see that it has gotten worse. It has trended up, and we know that teen suicide has trended up. Suicide is a topic sadly near and dear to me.” (Rabbi Kirshner’s older brother killed himself, a tragedy that has changed Rabbi Kirshner and has made the understanding of the signs of impending suicide, as well as how survivors deal with it, one of his life’s goals.)
“Being able to talk about anxiety is so important,” he continued. “I talked about it on Rosh Hashanah, with the Hineni prayer.” Hineni — literally “Here I am,” a statement made infrequently but to hugely important effect in the Torah — is the prayer that the shaliach tzibur, the community’s representative, generally the cantor, makes, in the first person, before going on to plead on the community’s behalf during Musaf on the High Holy Days. “The author of it starts off by announcing his warts,” Rabbi Kirshner said. “In the world in which we live, showing off our scars instead of hiding them may help us all heal.”
Who: Englewood Health and the Jewish Federation of Northern New Jersey
What: Partner to screen the documentary “Angst” and follow it with a discussion by experts and with the community
When: On the evening of Monday, October 28, with refreshments from 6:30 to 7, and then the film and the discussion, with local panelists, from 7 to 8:30.
Where: At the Chiang Auditorium at Englewood Health, 350 Engle Street, Englewood. (Note that it’s the complex that used to be called Englewood Hospital and Medical Center.)
For whom: Everyone — adults and kids 11 and older
How much: It’s all free, including parking
To make reservations or for information: Go to englewoodhealth.org/angst