Anxiety disorders in children
An anxiety problem is a mental health problem that can affect people of all ages, including children. In fact, anxiety disorders are the most common type of mental health disorder in children, affecting as many as 10% of young people. Persistent and intense anxiety that disrupts daily routine is a mental health problem that requires intervention.
Symptoms of different anxiety disorders
Anxiety is a sense of worry, apprehension, fear and distress. Symptoms of anxiety typically fall into two groups: physical symptoms (headache, feeling sick) and the emotional symptoms of nervousness and fear.
Anxiety disorders, when severe, can affect a child's thinking, decision-making ability, perception of the environment, learning and concentration. It raises blood pressure and heart rate and can cause vomiting, stomach pain, ulcers, diarrhoea, tingling, weakness and shortness of breath among other things.
Causes of anxiety in children
There are many factors that contribute to the development of anxiety disorders in children. These may include genetic predisposition, psychological factors and environmental factors.
For more information in general about this condition, see the Anxiety disorders section.
All children experience some anxiety; this is normal and expected. For example, when left alone at school for the first time, many children with show distress; a young child in his or her own room may develop a fear of the dark. Such anxiety becomes a problem when it interrupts a child's normal activities like attending school and making friends or sleeping.
Treatment for children
Anxiety disorders are treatable. Children who show persistent symptoms of an anxiety disorder should be referred to a child psychologist. Effective treatment for anxiety disorders may include some form of psychotherapy, behavioural therapy or medications.
Forms of childhood anxiety disorders
Generalised anxiety disorder
Children with generalised anxiety disorder (GAD) have recurring fears and worries that they find difficult to control. They worry about almost everything - school, sports, being on time, even natural disasters. They may be restless, irritable tense or easily tired, and they may have trouble concentrating or sleeping. Children with GAD are usually eager to please others and may be "perfectionists", dissatisfied with their own less-than-perfect performance.
Separation anxiety disorder
Children with separation anxiety disorder have intense anxiety about being away from home or about their caregivers that affects their ability to function socially and in school. These children have a great need to stay at home or be close to their parents.
Children with this disorder may worry excessively about their parents when they are apart from them. When they are together, the child may cling to parents, refuse to go to school, or be afraid to sleep alone. Repeated nightmares about separation and physical symptoms such as stomach-aches and headaches are also common in children with separation anxiety disorder.
Social phobia
Social phobia usually emerges in the mid-teens. Young people with this disorder have a constant fear of social situations or when they have to perform such as speaking in class or eating in public. The fear is often accompanied by physical symptoms such as sweating, blushing, heart palpitations, shortness of breath, or muscle tenseness.
Young people with social phobia typically respond to these feelings by avoiding the feared situation. For example, they may stay home from school or avoid parties. Young people with social phobia are often overly sensitive to criticism, have trouble being assertive, and suffer from low self-esteem. Social phobia can be limited to specific situations, so the adolescent may fear dating and avoid recreational events but can still be confident in academic and work situations.
Obsessive-compulsive disorder
Obsessive-compulsive disorder (OCD) typically begins in early childhood or adolescence. It is estimated that at any given time, 1 to over 3% of adolescents are experiencing symptoms of OCD. Children as young as 5 or 6 can show symptoms and may have frequent and uncontrollable thoughts (called "obsessions") and may perform routines or rituals (called "compulsions") in an attempt to eliminate the thoughts. Those with the disorder often repeat behaviours to avoid some imagined consequence. For example, a compulsion common to people with OCD is excessive hand washing due to fear of germs.
Other common compulsions include counting, repeating works silently, and rechecking completed tasks. These obsessions and compulsions take up so much time that they interfere with daily living and cause a young person a great deal of anxiety.
Another type of OCD is Tourette's syndrome, which is more likely to be present in boys and in children who develop OCD at a younger age. Children and adolescents with OCD are also more likely to have Attention Deficit Hyperactivity Disorder (ADHD), learning disorders, opposititional behaviour, separation anxiety disorder and other anxiety disorders
Post-traumatic stress disorder
Children who experience a physical or emotional trauma such as witnessing a shooting or disaster, surviving physical, emotional or sexual abuse, or being in a car accident may develop post-traumatic stress disorder (PTSD). Children are more easily traumatised than adults. An event that may not be traumatic to an adult - such as a bumpy plane journey - might be traumatic to a child. A child may "re-experience" the trauma through nightmares, constant thoughts about what happened, or re-enacting the event while playing.
A child with PTSD will experience symptoms of general anxiety, including irritability or trouble sleeping and eating. Children may exhibit other symptoms such as being easily startled.
Panic disorder
Children and adolescents with panic disorder have unexpected and repeated periods of intense fear or discomfort along with other symptoms such as racing heartbeat or feeling short of breath. These "panic attacks" can last for minutes to hours. Panic disorder often begins during adolescence, although it may start during childhood. Panic attacks can interfere with a child's or adolescent’s relationships, schoolwork and, and normal development.
Children and adolescents with panic disorder may begin to feel anxious most of the time, even when they are not having a panic attack. Some children with panic disorder develop agoraphobia; others can develop severe depression and may be at risk of suicidal behaviour. As an attempt to decrease anxiety, some adolescents with panic disorder will use alcohol or drugs. Panic disorder in children can be difficult to diagnose but once diagnosed the child usually responds well to treatment.
