Anxiety and Sensory Processing Disorder – Which Comes First?

So today we’re talking about sensory processing disorder and anxiety and which comes first. Is it sometimes that we get anxious and therefore we become sensory reactive and super sensitive or under aroused or is it that our sensory causes the problem and this is a really good question and it’s a really important one to address well so we’re really just going to introduce some of the concepts just now and bring some things into the room that we need to think about we’re not going to solve all the problems that this question brings up because that would take days. So let’s give it a go – from an occupational therapy perspective when we think about sensory processing disorder and anxiety we’re really starting to wonder if the distress that our client is carrying is really secondary to the sensory processing disorder the challenges that that brings and so that’s really where I’m going to speak to today and we will bring in a psychologist later to talk about when anxiety is the primary part of the picture and more of the root cause of what’s going on. So if we think about the sensory systems and really try and unpack them and go deep with what it might mean to have a dysfunction in one or many of them then we can start to understand that it would naturally, be a cause of anxiety because movement needs to be organized and under our control to feel safe our sensory systems have a very primitive function of keeping us alive as well as helping us to move, move beautifully, move with finesse, navigate spaces, and become social creatures. The first piece though is this safety – keeping us alive Our sense of balance, our vestibular sense – that spirit level of the liquid in the inner ear and crystals that tells us if we’re upright against gravity or where we are – that system, its first function is to keep us alive and if we get turned upside down real quick it’s gonna make all the alarms go off and it’s going to be telling us that we need to change something pretty quick so we go into a state of flight or into a state of fight or even more severe into a frozen state when this system sends all the alarms are off. Also when the system isn’t getting enough information it starts to wonder if I’m safe and alarm systems, alarm bells start to ring. So for example, if you’ve ever been in an elevator and there’s that moment before you can really tell if you’re moving yet or not, there’s that moment and people start to look at each other like “are we okay? what’s about to happen here?” because we’re not getting enough data enough information from our vestibular system to really assess if we’re safe if the situation is okay – which way we’re moving. And again that sense of alarm that you get when you’re on a public transport, maybe a bus and the bus next to you – which one’s moving is it me or the bus next to me? My visual system and my vestibular system are in conflict and I can’t tell what’s going on, I go into alarm. So these are just examples trying to help us empathize with individuals who struggle with their vestibular information on a day-to-day basis and that state of heightened alarm, arousal that they get into or that they exist in for most of the day, which would look like an anxiety disorder but it’s not – it’s not clinical anxiety in those situations, it’s anxiety that’s caused by a lack of integration of the vestibular system with perhaps other systems competing for information, not enough information and being too quickly and too often in a state of fight or flight or freeze. The same goes for our position sense – our proprioceptors which are predominantly in our joints and when we get compression or when we get traction on our joints, we know where we are in space. I often would fall asleep on my arm and go to that point past pins and needles when my arm is just like – is it even there?! and that – if you’ve ever experienced that – is really alarming, the alarm systems go off and your body starts to say this is not okay, I’ve lost a whole limb here and you know what’s happened is that there’s that blood flow has been a problem, the proprioceptors aren’t functioning very well. Your sense of proprioception keeps you locked and grounded in your own body and when that the system is unreliable, it’s inconsistent, it’s not giving you great the information then your arousal goes up and you start to have alarm bells going off in your lower brain saying I’m not safe, I need to be wary, I need to orient to everything that’s going on around me and that looks again that vigilance, that anxiety. But it’s got a sensory root in these cases, but we don’t call these anxiety disorders, we’re calling that a response to what’s going on with the sensory systems and we could go on with example after example. A really an important one to think about is the child who really has trouble with multiple sensory systems at once and the most challenging environment for that the child generally speaking is school because the school environment is loud, it has bells, it has visual clutter, there are things hanging from the ceiling, there are Mobile’s, there are posters, there are Halloween displays, there are echoes in the cafeteria, children are completely unpredictable and they knock you and they push you and your nervous system is constantly vigilantly trying to keep you alive and you look like an anxious child an aggressive child a child with behaviors but it come back down to sensory processing. So this is where we start to say with some of our children is the sensory or is this anxiety? When this child’s at school they cannot cope, their tolerance for stress is minimal because they’re using all their resources just to get through the day, or are they so stressed that they’re reactive and we need to figure out which one comes first. And some of these children where the multi-sensory piece is the problematic piece – so what we do with those kids is we reduce as much stress as possible, we cater to their sensory systems, we nourish their sensory systems, we put them in the right therapy, we look at the other stresses in their life – are they getting enough sleep? Are they drinking enough water? Are they eating enough food? How are their relationships? What is their timetable? How are they getting to school? What’s their socioeconomic status? All of these stresses – we look at them, we nourish the sensory systems and then we wait and we watch and we start to unpack. And if this child is able to adapt better when we nourish their sensory systems and adapt to the environment, then we know that fundamentally what’s going on here is not anxiety but the sensory stresses are so great that they’re causing an anxiety response. But if after adapting and treating for sensory anxiety is still very prevalent than we refer – we find a really good mental health provider who understands sensory but we refer to them and we get them involved and we start unpacking the rest of the picture and what’s going on and that’s really important. So that’s been a a little introduction to sensory processing disorder and anxiety and the interactions between the two. It’s sensory awareness month. I’m Virginia Spielmann the associate director of STAR Institute here and we are trying to raise awareness, educate and research more into sensory processing disorders so there will be a link that we’d love you to click on to show your support. 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