The Anxious Child
In the United States, more children are living with anxiety disorder than any other mental disorder. As many as nine out of every 100 children between the ages of three and 17 have been diagnosed with anxiety disorder.1
Having feelings of anxiety is normal — most of us experience some apprehension when it comes to public speaking, taking an exam or going to the dentist — but children with an anxiety disorder may experience so much fear around these events that they make every effort to avoid them. To children with anxiety, these stressful experiences border on the catastrophic.
What are the symptoms of Anxiety Disorder in children?
Some of the symptoms you might see in a child with anxiety disorder include:
Excessive worrying
Agitation and irritability
Restlessness
Fatigue
Difficulty concentrating
Stomachaches and headaches
Muscle tension
Difficulty falling asleep or staying asleep
What are the different types of Anxiety Disorder?
Not all children experience anxiety the same way. The most common types of anxiety diagnosed in children are:
Generalized anxiety disorder
Panic disorder
Separation anxiety disorder
Social anxiety disorder
Specific phobias
What is Generalized Anxiety Disorder?
Children with generalized anxiety disorder are nervous about many things. They frequently begin conversations with “What if …?” They may worry about burglars, relationships at home and school, current events, personal athletic and academic performance, finances, and disease. They often seek reassurance from others but are rarely comforted for long before being plagued with another worry.
What is Panic Disorder?
A child is diagnosed with panic disorder when they have experienced at least two panic attacks and subsequently develop a persistent fear of a future attack. Panic attacks are sudden episodes of intense anxiety accompanied by a feeling of doom or fear of death and physical symptoms such as chest pain, a racing heart, shortness of breath, dizziness, and numbness. Panic attacks may last minutes to hours and frequently develop without warning. Although not dangerous, the symptoms can be terrifying.
Fearing another panic attack, the child may try to avoid places or situations associated with prior attacks or where help may not be available.
What is Separation Anxiety Disorder?
Separation anxiety is the worry children experience when separated from their parents or caretakers. Separation anxiety is developmentally normal during the toddler years and when a young child begins daycare or preschool. Separation anxiety disorder may be present if the child:
Continues to experience separation anxiety after age three
Refuses to go to school
Refuses to sleep alone
Worries about parents’ safety
Worries about getting lost
Has frequent nightmares about being separated from parents
What is Social Anxiety Disorder?
Children with social anxiety disorder experience fear of everyday social situations. An encounter with another child may cause feelings of intense anxiety, embarrassment, and self-consciousness. When asked a question in front of the class, the child may struggle to answer out of fear of being judged critically and humiliated by the other students. These anxious feelings interfere with the child’s ability to make friends and perform well at school.
What are Specific Phobias?
Specific phobias are manifested as an intense fear of a particular object, place, or situation, such as a fear of dogs, heights, or flying. Adults who suffer from specific phobias generally recognize that their fear is irrational; this is not the case with children. When children encounter a feared object, place, or situation, they may resort to crying or experience physical symptoms such as headaches, dizziness, nausea, and stomach pain.
What happens if Anxiety Disorder is left untreated?
Anxiety disorder can affect a child’s self-esteem, learning ability, and social skills. Untreated anxiety disorder is associated with an increased risk for substance abuse and depression in adulthood.
What treatment options exist for Anxiety Disorder in children?
Anxiety disorder is treatable, yet as many as two in five children with diagnosed anxiety are not receiving treatment.2 Traditional treatment includes psychotherapy (talk therapy) and medication.
Talk Therapy
Cognitive-behavioral therapy is an effective form of talk therapy in the treatment of anxiety in children.3 During therapy sessions, children are taught the nature of anxiety, relaxation techniques, and methods for identifying and challenging anxiety-provoking thoughts.
Other variations of talk therapy include acceptance and commitment therapy and dialectical behavioral therapy. In acceptance and commitment therapy, children learn to let the feelings pass over them without judgment. In dialectical behavioral therapy, children learn how to regulate their negative emotions and deal with conflicting feelings.
Medication
The most common medications for children with anxiety disorders are the selective serotonin reuptake inhibitors. These medications increase the serotonin in the brain — a neurotransmitter that affects our mood, emotions, and sleep — and have been shown to be effective in treating children with anxiety.
The American Academy of Child and Adolescent Psychiatry recommends psychotherapy alone as the first-line treatment for children with mild anxiety and a combination of talk therapy and medication for children with moderate to severe anxiety. 4
Alternative Therapies
In the last decade, interest in alternative therapies to supplement medical and talk therapy has grown. Studies on the benefits of mindfulness meditation and yoga are ongoing. A review of experimental studies evaluating the effects of yoga on children and young adults found yoga to be beneficial in reducing anxiety and depression.5 In a similar review looking at adults, study participants with a history of panic attacks showed a particular benefit from the practice of yoga.6
Even though these results are encouraging, the National Center for Complementary and Integrative Health warns not to delay traditional treatment. The practice of meditation and yoga can be considered a supplement to conventional therapy.7
Summary
Anxiety disorder does not need to dictate the course of a child’s life. It is a treatable condition and with mental health support, children can develop the coping mechanisms necessary to live a life not ruled by worry.
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