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Anxious feelings, worries or fears are common among children and
adolescents. Many children experience a normal amount of apprehension in certain
situations, whether it's an upcoming test at school or a thunderstorm.
Some children, however, experience these types of situations with an overwhelming
sense of fear and dread. Others can't seem to stop thinking about these situations and
their accompanying fears. No amount of reassurance seems to help.
All anxiety-related problems share four common features:
- The anxiety is often an inexplicable fear or preoccupation that interferes with the
child's or adolescent's ability to enjoy life
- The anxiety is often as puzzling to the child as it is to his or her parents
- The anxiety does not respond to or diminish after logical explanations, since anxiety
symptoms often defy logic
- The anxiety problem can be helped
What are anxiety disorders?
There are many different types of anxiety disorders, including generalized
anxiety disorder, phobias, and panic disorder. All of these disorders cause significant
distress and a reduced level of functioning and competency for children and adolescents.
Some common symptoms of anxiety include:
- Feeling nervous or "on edge"
- Unfounded or unrealistic fears
- Trouble separating from parents
- Sleep disturbance
- Obsessive thoughts and/or compulsive behaviors
- Trembling, sweating, shortness of breath, and other physical symptoms associated with
anxious feelings
Often, the child or adolescent feels these symptoms are not under his/her control, which only
adds to their concerns.
Types of Anxiety Disorders
Generalized anxiety disorder is an excessive worry and/or apprehension about a
number of events or activities. These feelings occur almost all the time.
Some examples include: fear of failure or poor performance, worries about what others
will think of them, and apprehension about new situations or meeting new people.
Phobias are highly specific and exclusive fears. The child or adolescent
functions normally until confronted by the dreaded object, event, or situation.
Some examples include fears of bugs or flying in an airplane.
Separation anxiety disorder is the child's or adolescent's excessive worry and
apprehension about being away from their parents. Children with separation anxiety
disorder often fear that their parents will be harmed in some way. Separation anxiety
disorder is often seen in preschoolers, but it is also seen in older children and
adolescents in response to stressful life events.
Some examples include preschoolers who won't allow their mothers to be out of their
sight or school-aged children who are fearful about attending school and refuse to do so.
Obsessive-compulsive disorder - obsessions are recurrent thoughts, impulses, or
images that are difficult to control and cause significant distress. Some examples of
obsessions are excessive concerns about germs or lucky/unlucky numbers.
Compulsions are recurrent behaviors that are difficult to control and cause significant
distress. Some examples of compulsions include excessive hand washing or needs for
cleanliness and orderliness.
Panic disorder is characterized by discrete and intense periods of anxiety that
occur unexpectedly, without warning, and are not always linked to a specific place or
situation. With panic disorder, there is often no warning, and therefore it is harder to
predict when it may occur.
Post-traumatic stress disorder is an intense re-experiencing of a traumatic
event by distressing recollections, dreams, and/or associations (such as things or
situations that remind the child or adolescent of the traumatic event).
Some examples include witnessing or experiencing a natural disaster, being in a serious
automobile accident, or witnessing a violent crime.
What causes anxiety disorders?
Anxiety disorders are caused by a combination of life events, heredity, inborn
vulnerability, and biochemical disturbance. And, while many children and adolescents are
able to manage day-to-day anxiety in their lives, others become more easily overwhelmed
and distressed.
In some ways, anxiety disorders are like allergies: we can identify the problem easily
enough, but only through a careful evaluation can the causes and circumstances that cause
anxiety disorders be identified and effectively treated.
Can anxiety disorders be helped?
Yes. Anxiety disorders can be helped by a combined treatment approach using
medication, behavioral treatment, and/or family intervention based on the individual needs
of the child or adolescent.
Often, children and adolescents do not initiate the help-seeking process and need the
support and direction of their families.
What are the risks if I don't seek help for my child?
Not obtaining treatment can have serious negative consequences on your child's
development and self esteem. Untreated anxiety disorders can strain family relationships
and friendships, interfere with normal functioning, and lead to more serious mental and
physical health problems for the child.
What is the typical approach to treatment?
Assessment: The first step to successful treatment begins with a comprehensive
psychiatric evaluation of your child. A psychiatric evaluation includes:
- A review of current problems and concerns
- A thorough review of your child's development and background
- Past medical and psychiatric history
- Important family background
- A mental status exam
Parents and guardians are included in the evaluation process to obtain
background information and history as well as to participate in treatment planning.
Treatment: as part of the evaluation, the psychiatrist will discuss an
individualized treatment plan for your child. The treatment plan may include:
- Cognitive behavioral therapy for your child
- Medication
- Family therapy
- Parent education and support
The role of parents and guardians in their child's treatment is essential.
Obtaining help for your child
Please consult with a health care provider about your child's situation. If
you're uncertain about whether or not an assessment is appropriate, a health care
professional can talk to you about your concerns and help you decide what to do.
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