Anxiety in Children
All children experience some anxiety in the form of fear, worry, apprehension, dread, fear or distress. Anxiety serves as an important protection or signal for caution in certain situations. As children grow, there are situations that are expected to create a sense of anxiety, where the child may temporarily retreat, depend on parents for reassurance, be reluctance to take a chance, and demonstrate wavering confidence. Typically these concerns will resolve as the child learns how to master the situation or the situation changes. But, for some children, the worry gets stuck and can impact functioning. The content may be “normal” but help is needed when a child is experiencing too much worry, when worry and avoidance become a child’s automatic response, when they feel constantly keyed up, or when reassurance is ineffective in moving them through. For these children anxiety is not protecting them, but rather preventing them from fully participating in typical activities of daily life-school, friendships, academic performance.
The following are some signs of childhood/adolescent anxiety:
- worrying that something bad will happen to them or someone they love.
- worrying about situations/events before they occur (when this happens your child may ask frequent “what if” questions) Anxiety is considered a disorder not based on what a child is worrying about, but rather how that worry is impacting a child’s functioning. The content may be “normal” but help is needed when a child is experiencing too much worry or suffering immensely over what may appear to be insignificant situations, when worry and avoidance become a child’s automatic response in many situations, when they feel constantly keyed up, or when coaxing or reassurance are ineffective in moving them through. For these children anxiety is not protecting them, but rather preventing them from fully participating in typical activities of daily life-school, friendships, academic performance.
- trouble separating
- becoming easily upset in unfamiliar situations
- frequent headaches or stomachaches, too sick to go to school
- anticipatory anxiety, worrying hours, days, weeks ahead
- disruptions of sleep with difficulty falling asleep, frequent nightmares, difficulty sleeping alone
- perfectionism, self-critical, very high standards that make nothing good enough
- overly-responsible, people pleasing, excessive concern that others are upset with him or her, unnecessary apologizing
- demonstrating excessive avoidance, refuses to participate in expected activities, refusal to attend school
- excessive time spent consoling child about distress with ordinary situations, excessive time coaxing child to do normal activities- homework, hygiene, meals
When worry/fears begin to interfere with a child’s usual activities (such as separating from parents, attending school and making friends) parents should consider seeking an evaluation. Early treatment can serve to prevent anxiety from causing secondary problems, such as loss of friendships, academic difficulties, and feelings of low self-esteem.
Though some parents may be advised that their child’s fear is normal, or that their child will outgrow it, whatever the age or type of fear, if your child’s anxiety is interfering with his or her ability to function, it is prudent to seek professional consultation. Anxiety disorders are the most treatable mental health condition in children, and early intervention can prevent a lifetime of suffering. Highly effective, short-term treatments are available. A child anxiety specialist can help you determine whether your child needs treatment, or can guide you on how to better address the situation at home.
The following are treatment approaches that are recommended for childhood/adolescent anxiety.
- Education about anxiety
- Use of behavioral and cognitive behavioral therapy (CBT)
- Family therapy which includes teaching parents how to help their child work through the anxiety (rather than avoid it or situations that cause it)
- School collaboration
- Medication management