What You Should Know About Anxiety Disorders in Children
Children and adolescents experience anxiety disorders just like any adult. In children, this disorder is usually the result of life-changing experiences and stressful events, such as moving to a new city, the loss of a loved one or it can be triggered by a simple incident like going to a new school. If anxiety disorder is ignored, it could affect a child’s self-esteem and change his relationship with his peers significantly. It can also cause adjustment problems, an inability to handle schoolwork and can even lead to drug and alcohol use. There is also a huge chance a child may continue experiencing anxiety disorder well into adulthood.
When it’s time to seek professional help
Certain behaviors in children may not constitute an anxiety disorder and symptoms associated with it usually disappear after a while. However, if a child or teen continues to develop or exhibit certain behaviors, it may be time to ask for treatment. These behaviors include: mood swings, loss of appetite, difficulty in sleeping, aggressive behavior, difficulty in language and speech development, decline in school and activity performances and regression.
As we discussed, there are different types of anxiety disorders, each one with different symptoms. Let’s review them in context with children. These include:
Generalized Anxiety Disorder or GAD
Separation Anxiety Disorder
Post-Traumatic Stress Disorder
Panic Disorder
Obsessive-Compulsive Disorder
Phobias
Generalized Anxiety Disorder usually occurs in middle childhood and during the adolescent period. This is characterized by extreme worries about normal day-to-day activities that border on the unrealistic. Children and adolescents suffering from GAD are also often tense and self-conscious, always asking for reassurance from parents and peers. Some physical manifestations can also occur, including headaches, stomachaches and the like.
A child who has Separation Anxiety Disorder often finds it extremely difficult to leave the company of his parents. This clingy behavior is also accompanied by insomnia, withdrawal, bouts of sadness and depression. This is a fairly common disorder and about 4% of children at one time or another experiences this.
Children and adolescents who experience a traumatic event, such as violence, physical abuse, sexual abuse, assault or a disaster, exhibit post-traumatic stress disorder. Children often develop troublesome flashback episodes and nightmares and over-react when surprised.
Panic Disorder occurs when children and teens experience bouts of panic attacks, seemingly without cause. Physical manifestations include sweating, increased heart rate, nausea or a feeling of dread.
Obsessive-Compulsive Disorder or OCD is characterized by repetitive patterns of thought or behavior, which appear not to have any sense. While very distressing to the child, he will find it difficult to control himself. This repeated behavior includes frequent washing of the hands, arranging objects, keeping specific linear arrangements of everyday things or compulsive counting.
Some fears in childhood are quite normal, such as fear of the dark or of imaginary creatures. But if a fear becomes excessive and unrealistic, it becomes a phobia. It can manifest in different ways and usually focuses on one subject such as heights, animals, water, enclosed spaces, etc.
Who usually develops anxiety disorder?
Research has shown that proneness to anxiety disorder is usually the result of basic temperament. Extremely shy, restrained or uncommunicative children are at a risk in developing the disorder. However, these patterns of behavior are not accurate indications of anxiety disorder because children change temperaments as they grow older and many of their childhood fears and worries disappear or take on a mild form in later years.
There is also a tendency for children and adolescents to develop an anxiety disorder if one of their parents has it. However, there is no proof as to whether anxiety disorder is genetically passed on or whether the environment or a combination of both factors causes it.
Most researchers suggest that parents should watch out for signs of anxiety disorder in children ages 6 to 8. This is usually the time when children’s priorities and life experiences begin to change as they start to extend their social life through school and peer relationships.
Treating anxiety disorder in children
Treatment is a process that both parents and child should be actively involved in. Parents are advised to seek only the help of a professional. Some treatment courses may involve CBT or Cognitive Behavioral Therapy, family therapy, relaxation techniques, biofeedback and medication.
One or a combination of two may be prescribed to help the child overcome his anxiety disorder and it may or may not include medication. Some drugs that are commonly prescribed are SSRIs or selective serotonin reuptake inhibitors, fluoxetine, paroxetine, sertraline, citalopram, and fluvoxamine. Some anti-depressants such as imipramine and lorazepam are not as commonly used.
When medications are prescribed, parents should discuss with the doctor the possible benefits and risks. For example, in 2004, the FDA warned that some medications like SSRIs and other anti-depressants increased suicidal behaviors in a few young subjects. Although the study was short-term, it involved more than 4,000 children and 9 different anti-depressant medications. Parents should find out what exactly they can expect from the medications and other forms of treatment and if there are other courses of action they may choose to take.
Anxiety disorder affects millions of children and adolescents worldwide but it is a disorder that can be treated. The successful treatment of anxiety disorder rests on the treatment/s of choice, the extent of the child’s disorder and the parents’ participation in the treatment.
Treatment involving medication may be continued on a regular basis for about one year, after which the child will be reassessed and the variety, type and dosage may be adjusted. It is very unlikely for a child to continue medication for the rest of his life. In fact, he may only undergo one medication course and will only need further treatment if symptoms of anxiety disorder persist. Otherwise, the doctor will only make follow-up assessments until the child’s disorder is managed or totally eliminated.
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