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Childhood Anxiety Disorders

hiding-1209131_640Children experience anxiety as a normal part of their lives, in the same way that adults do. Anxiety disorders involve more than temporary worry or fear. When children do not outgrow the fears and worries that are typical in young children, or when there are so many fears and worries that they interfere with school, home, or play activities, the child may be diagnosed with an anxiety disorder.

Anxiety disorders affect 25.1% of children between 13 and 18 years old. Examples of different types of anxiety disorders include:

  • Being very afraid when away from parents (separation anxiety)
  • Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)
  • Being very afraid of school and other places where there are people (social anxiety)
  • Being very worried about the future and about bad things happening (general anxiety)
  • Having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic disorder)

Anxiety may present as fear or worry, but can also make children irritable and angry. Anxiety symptoms can also include trouble sleeping, as well as physical symptoms like fatigue, headaches, or stomachaches. Some anxious children keep their worries to themselves and, thus, the symptoms can be missed.

Anxiety disorders most common in children and teens

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is characterized by excessive worry about a variety of everyday problems for at least 6 months. Children with generalized anxiety disorder display excessive anxiety or worry for months and face several anxiety-related symptoms.

Symptoms include:

  • Restlessness or feeling wound-up or on edge
  • Being easily fatigued
  • Difficulty concentrating or having their minds go blank
  • Irritability
  • Muscle tension
  • Difficulty controlling the worry
  • Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep)

Panic Disorder

Panic disorder causes panic attacks, which are sudden feelings of terror when there is no real danger. It usually starts when people are young adults. Children with panic disorder have recurrent unexpected panic attacks.

Symptoms include:

  • Sudden and repeated attacks of intense fear
  • Feelings of being out of control during a panic attack
  • Intense worries about when the next attack will happen
  • Fear or avoidance of places where panic attacks have occurred in the past

Separation Anxiety Disorder

Children with separation anxiety disorder experience excessive anxiety and a lot of distress upon separation from parents or from other familiar people. They might refuse to be alone or go to school, or be reluctant to sleep alone.

Symptoms include:

  • constant thoughts and intense fears about the safety of parents and caretakers
  • refusing to go to school
  • frequent stomachaches and other physical complaints
  • extreme worries about sleeping away from home
  • being overly clingy
  • panic or tantrums at times of separation from parents
  • trouble sleeping or nightmares

Social Anxiety Disorder

Social anxiety disorder is characterized by an intense fear of social and performance situations and activities such as being called on in class or starting a conversation with a peer. It is equally common among males and females and typically begins around age 13.

Symptoms include:

  • fears of meeting or talking to people
  • avoidance of social situations
  • few friends outside the family

Specific Phobias

Specific phobia involves marked and persistent fear and avoidance of a specific object or situation. This type of phobia includes, but is not limited to, the fear of heights, spiders, and flying. Symptoms typically begin in childhood; the average age-of-onset is 7 years old.  Unlike adults, children often do not recognize that their fear is irrational.

Symptoms include:

  • extreme fear about a specific thing or situation (ex. dogs, insects, or needles)
  • the fears cause significant distress and interfere with usual activities

Close related to anxiety disorders

Obsessive-Compulsive Disorder (OCD)

An individual with OCD has frequent, upsetting thoughts called obsessions and an overwhelming urge to repeat certain rituals or behaviors to try to control those thoughts. These are called compulsions. The average age of onset is 19, with 25 percent of cases occurring by age 14. One-third of affected adults first experienced symptoms in childhood.

Posttraumatic Stress Disorder (PTSD)

PTSD starts at different times for different people. Signs of PTSD may start soon after a frightening event and then continue. Other people develop new or more severe signs months or even years later. Childhood sexual abuse is a strong predictor of lifetime likelihood for developing PTSD.

Sources: https://adaa.org/, https://www.cdc.gov/, and https://www.nimh.nih.gov/

If you have concerns about your child, you can arrange a free 30-minute Care Consultation to explore options with an expert. We invite you to call or email our Care Managers at 650.688.3625 or caremanager@chconline.org to set up an initial Parent Consultation appointment.

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