Anxiety in children can be a very common problem. It can be a stand-alone issue, or it can tag along with other disorders such as ADHD or learning differences. Although it occurs frequently, it often goes unrecognized and untreated. Get the basic facts on anxiety disorders in children, and find out whether your family should follow up.
1. Anxiety In Children: What Is It?
Basic anxiety or worries and concerns about things that might happen is a very natural and necessary human emotion. Think of the basic “fight or flight” response that we all know so well. At normal levels, basic anxiety can keep us safe, healthy and whole.
Anxiety itself is not bad. But sometimes anxiety can become excessive. And, it becomes disproportionate to the danger or risk at hand. It can be debilitating and significantly interfere with one’s ability to conduct or enjoy day to day affairs. Being a little anxious or fearful is entirely rational. However, if a child is excessively anxious, having difficulty at school, home, in social life, it may indicate an anxiety disorder.
Experts believe that 10% to 15% or more of children experience an anxiety disorder before the age of 18. But, up to 80% of kids with some type of diagnosable anxiety disorder fail to receive treatment. Treatment that could greatly improve their quality of life, and the quality of life of their families. And, treatment that could otherwise greatly enhance their ability to function successfully as adults.
Sometimes anxieties disorders may be overlooked or ignored. Adults may brush off or misattribute otherwise troubling behavior because they think kids shouldn’t have any major worries. They don’t have the stressors commonly seen in adulthood – like money, relationships, career, health etc.
Or, other issues could be overshadowing excessive anxiety. Kids who experience ADHD or other learning disabilities may often also experience intense anxiety. Particularly, if they are experiencing undiagnosed conditions that create frustrations and problems in everyday life. The lack of meaningful explanation or a plan to address the underlying conditions may yield to intense anxiety.
Some of the more commonly occurring anxiety disorders include:
* Generalized Anxiety Disorder
Children with Generalized Anxiety Disorder will worry excessively about a wide range of everyday things or commonly occurring events. You may see this as intense anxiety about his or her own performance at school. Or, excessive performance anxiety around outside activities or sports. Sometimes these worries may seem like extreme perfectionism.
Kids with this disorder may have anxieties about others and not just themselves. For instance, intense worries about something happening to family members and friends. Or, excessive concerns about natural disasters or emergencies.
* Social Anxiety Disorder
Social anxiety disorders basically revolve around worries about how others perceive you. Kids may have an intense fear of being judged by others. Or, experience worries about being the center of attention. It may show up as extreme self-consciousness. Or, unusually intense concerns about being embarrassed or humiliated. Social anxiety disorders arise most often in adolescents. But they occur in younger children as well.
* Obsessive Compulsive Disorder
Kids experiencing an obsessive-compulsive disorder are beset with negative thoughts, fears or emotions that are repetitive in nature. And, their obsessive thoughts trigger some ritualistic attempt to control or repel those unwanted thoughts, fears or emotions.
This is the anxiety disorder that you will more frequently see portrayed in the movies. It may be most famously displayed in the movie “As Good As It Gets” with the locking of the doors and avoidance of cracks in the sidewalk.
Other common compulsions include repetitive hand-washing, repetitive rechecking of information, seeking repetitive assurances about the same situation, hoarding or “collecting” items of no apparent value.
Posttraumatic Stress Disorder afflicts more than just veterans. And it can be a very real condition for some children. PTSD consists of the unhealthy expression of anxieties after witnessing or experiencing a traumatic or life-threatening event. For example, a catastrophic accident, natural disaster, or physical or emotional abuse. A child may essentially re-experience the trauma through nightmares or flashbacks.
* Other Anxiety Disorders
- Panic Disorders. This involves multiple intense anxiety attacks or panic attacks, along with an intense fear of experiencing similar attacks in the future.
- Separation Anxiety Disorders. This consists of a fear or avoidance of seperating from family members or caregivers long past the typical age for such concerns.
- Phobias. Intense, irrational fears of a specific thing like dogs, water, or heights.
2. Anxiety In Children: Signs and Symptoms
How can you distinguish your child’s atypical and problematic anxiety from common level anxiety? Some signs to look for:
- her thoughts, fears and worries prevent her from doing activities she enjoys
- her worries have no tether to reality
- prolonged excessive worry – meaning intense worries almost every day for weeks or months.
- inability to concentrate
- sleeplessness – either can’t fall asleep or can’t stay asleep – which can be followed by excess sleeping during the day because of sleep deficits
- frequent headaches, stomaches or similar complaints without any apparent or identifiable cause
- frequently clenches or tenses muscles
- excessive crying
- extreme perfectionism – this can also manifest as needing to always assess blame and point fingers at others
- frequent nightmares and sleep disturbances
- avoids social situations
- avoiding situations that he used to enjoy
As Dr. Liz Matheis explains Identifying Signs Of Anxiety In Children: “ Essentially, anxiety in children tends to manifest as negative behaviors that you may have glimpsed briefly in the past, but that are becoming consistent and intense.“
For some great, vivid examples of how severe anxiety meaningfully varies from normal anxiety, check out When to Worry About an Anxious Child. This article provides several striking and easily relatable examples. For instance, the contrast between a high school student who is extremely stressed about his S.A.T. exam vs. a third grade student who is equally stressed about the same exam that’s years away.
3. Diagnosing Anxiety Disorders in Children
Anxiety disorders can be diagnosed by a physician or other healthcare professional. Although a physical exam will not reveal an anxiety disorder, your physician may take some tests to rule out other potential causes of the complaints. An actual diagnosis for an anxiety disorder requires a trained professional using screening tools and the diagnostic criteria found in the DSM-V.
If you are concerned about whether your child has an anxiety disorder, try this online tool screening tool. You can use it as a starting point for an evaluation. Print out the results and discuss them with a healthcare professional.
4. Anxiety In Children: Treatment & Intervention
Evidenced-based treatment options that have been shown to be effective in treating anxiety in children include cognitive-behavior therapy (CBT), certain medication options, or a combination of both.
CBT teaches children specific coping mechanisms and strategies to reduce anxiety. CBT teaches a child how to identify his own negative thoughts and replace them with positive ones. And, it helps him to seperate rational thoughts from unrealistic ones. By transforming negative thoughts into positive ones, a child can replace negative behaviors with ones that are positive.
Typically, CBT works on specific goals. It’s not open ended therapy. It usually lasts about 12 weeks.
Prescription medications can also be effective for treating anxiety in children. But, research has shown that medication combined with therapy can be more effective than medication alone.
5. Anxiety In Children: Long Term Prospects
With proper treatment, children will usually start to see some results within a few weeks. Although behavioral therapy for anxiety typically occurs over a defined time period, the coping skills learned will continue to benefit a child into adulthood.
As for prescription medication used for anxiety in children, doctors typically recommend that such treatment continue for about a year.
Left untreated, anxiety disorders in childhood can lead to poor outcomes. These can include impaired academic performance, stunted social skills, and increased propensity for substance abuse. In severe cases, it can also lead to major depression, suicidal behavior, and other more severe mental problems in adulthood.
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- For more about the unique challenges that kids with learning differences can experience with anxiety and tips on how parents can help, read
- Books for anxious kids: