Many children exhibit behavioral and/or attentional problems. Some of these symptoms are age appropriate and disappear as the child matures, while others require further attention from professionals. However, when it comes to childhood mental health, school personnel, pediatricians, therapists, and other professionals are often quick to label a child simply from pure observation, rather than understanding the symptoms from the child’s experience. Unlike popular belief, anxiety, rather than ADHD or autism, is the most prevalent mental health disorder in children. Studies indicate that 13 out of every 100 children ages 9 through 17 experiences some kind of anxiety disorder. Furthermore, according to the National Institute of Mental Health (NIMH), 25% of 13-18 year olds will experience an anxiety disorder during their adolescence. Since parents are often left with confusion from all of the various childhood anxiety disorders, it’s crucial for parents to be well informed in order to advocate for appropriate services for their child.
What is Anxiety?
Anxiety is the result when a person perceives danger. Anxiety, in and of itself, is not unhealthy or abnormal. This is an adaptive, innate response that keeps you surviving when faced with real threats. The problem occurs when a person misinterprets innocent situations, objects, or people as harmful. Whenever you perceive a threat, the brain’s alarm system responds and floods your body with hormonal chemicals to help you quickly react via fighting or fleeing. However, this natural “fight-or-flight” response cannot filter the difference between a real danger or a false alarm. It simply reacts to whatever threat you perceive. Anxiety becomes a disorder when a person consistently misinterprets these false alarms as real dangers. As a result, the anxiety sufferer perpetually avoids the falsely perceived threats and/or overreacts with fearful responses.
As you can imagine, “anxiety” is a very broad term, and there are many different conditions under this umbrella. Want to learn more about the differences amongst the various anxiety disorders common to children? Follow these links for specific details of each condition:
Medical – Dental – Specific Phobias
Social – Performance – Sports Anxiety
Generalized Anxiety Disorder (GAD)
Obsessive-Compulsive Disorder (OCD)
Signs of Anxiety in Children
Now that you have a basic understanding of the differences amongst the various anxiety disorders, here are some red flags that may signal excessive anxiety in your child. If these signs are present, it’s a good idea to have your child checked by an anxiety expert to determine the true nature of these symptoms and whether treatment is needed.
- Constant tantrums, pleading, emotional meltdowns, anger outbursts, and irritability.
- Obvious signs of worries and fears.
- Refusal to go to school.
- Fears of being alone.
- Repetitive, ritualistic, or extreme avoidance behaviors.
- A continual fear that something terrible will happen to themselves, loved ones, or random strangers.
- An exceptionally long time spent getting ready for bed, leaving for school, or using the bathroom.
- Constant nightmares and/or bedwetting.
- Requests for family members to repeat specific phrases, behaviors, or keep answering the same questions.
- Sudden drop in academic performance or avoiding peers.
- Refusal to sleep alone or sleep away from home.
- Excessive, unproductive hours spent doing homework.
- Raw, chapped hands from constant washing.
- Difficulty concentrating.
- Being easily startled.
- Holes erased through test papers and homework.
- A persistent fear of illness and diseases, or constant checks of the health of family members.
- Physical complaints, such as headaches, fatigue, and stomachaches.
- Difficulty falling or staying asleep.
Effective Treatment for Anxiety Disorders
Cognitive-Behavioral Therapy (CBT) is the evidence-based treatment for anxiety disorders. When combined with Family Systems Therapy, it is highly effective for treating childhood anxiety. This type of treatment is usually short-term and has long lasting effects. CBT is not simply the traditional talk therapy or play therapy. It provides the child with tools that need to be practiced in order for him/her to develop the necessary skills to defeat anxiety.
In CBT, children learn to identify negative thinking patterns that aren’t serving them. This allows them to change their perspectives about themselves and the world, so they can engage with the environment in healthier ways. Exposure therapy is a specific type of CBT that helps children confront fears in a stepwise manner in order to learn that the fears actually are not that threatening. CBT is essentially exercise for the brain. The more you flex those brain muscles, the stronger you become.
For childhood anxiety, CBT is the first route to take, especially when the young brain is still developing and growing, and there are so many negative side effects to medications. Only when a child’s symptoms are very severe are medications used as an adjunct. However, once symptoms lesson as the child is able to apply the CBT tools, the medication regimen is slowly reduced and eliminated. The ultimate goal is for sufferers to rely on their own skills, rather than depending on medications for the rest of their lives.
In Family Systems Therapy, the goal is to teach family members about anxiety and how to be supportive of the child without enabling the condition. Many symptoms of anxiety cause havoc on the whole family by interfering with healthy family dynamics and boundaries. When symptoms are chronic, family members wind up inadvertently expressing emotions in negative ways harmful to the relationship with the child. As such, Family Systems Therapy helps to reduce family conflict, re-establish healthy boundaries, and improve effective communication.
Most importantly, even if symptoms are currently minimal, it doesn’t hurt to see an expert early on and begin learning the tools to defeat anxiety before it becomes overwhelming and uncontrollable. Without treatment, anxiety tends to persist into adulthood, and generally becomes more severe and difficult to manage in the long run.