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. Please share, comment, and let us know what you want to
discuss…
