While most people think anxiety disorders are only prevalent in adults, this is not the case. Anxiety disorders in children and teens are occurring more often nowadays, and this can leave a searing imprint on their childhood, adolescent and/or teenage years.
Types of Childhood and Adolescent Anxiety Disorders
• Generalized Anxiety Disorder (GAD): Kids with this disorder worry excessively about aspects of their life such as their studies, sports, punctuality at school and even natural disasters. These kids tend to be restless, irritable, tense and easily tired. They also often wish to be people-pleasers and "perfectionists," and don't settle for anything that is less than perfect, lest they become very disappointed. They also have trouble concentrating or sleeping, lack confidence and may need to be reassured at times.
These indicators of GAD are said to appear once a child reaches school age, but some pre-school children may already have anxiety. 3 Certain factors that increase a child's risk of GAD include shyness or cautiousness, seeing the glass as "half-empty," having overprotective parents and a dislike for risks. Girls are twice as likely to have the disorder compared to boys.
• Separation Anxiety Disorder: As the name implies, this disorder is characterized by intense anxiety in kids when they realize they might be separated from home, family members or caregivers. These children often have a great need to just stay at home or be close to their parents. This can affect their capabilities socially and academically.
Actually, fear of separation is actually "developmentally appropriate" in children, but only until they are 2 years old. This fear should actually lessen as the child grows older. Typical symptoms of this disorder in children include excessive worrying about their parents once they are apart, clinginess to parents, refusal to go to school and fear of sleeping alone.
The child can also experience repeated nightmares about separation, as well as stomachaches and headaches. Separation anxiety disorder in children can occur at different points of their school life, especially during kindergarten, middle or high school. Children who are in their elementary years (typically at 7 to 9 years old) may show signs too.4
• Obsessive-Compulsive Disorder (OCD): Children who have OCD exhibit obsessions (frequent and uncontrollable thoughts) and compulsions (routines or rituals to eliminate the said thoughts and avoid imagined consequences). These two components of OCD can take up much of the child's time, disturbing daily routines and increasing anxiety levels.
Some indicators of OCD in children include a constant fear of illness, raw and chapped hands from constant washing, unproductive hours spent accomplishing homework and constant health checks on family members.5 The first symptoms of OCD typically appear in early childhood or adolescence, with most kids being diagnosed at 10 years old. Boys are more likely to have OCD before they reach puberty, while girls become affected during their adolescent years.6
• Post-Traumatic Stress Disorder (PTSD): This affects children who have experienced physical trauma because of incidents like car accidents or physical or sexual abuse, or emotional trauma because of witnessing a shooting or natural disaster. Children are more easily traumatized compared to adults, and this is why some events that may not be traumatic to adults may be emotionally harrowing for the child.
The first signs of PTSD actually may not appear until several months or even years after the event. As parents or guardians, it's crucial that you look out for the first few hallmarks of PTSD such as withdrawal from friends or family, mental flashbacks, irritability, concentration problems, eating troubles and nervousness toward surroundings.7
The onset of PTSD knows no age, since these events can unfortunately happen at any point of the child's life. However, not every child who experiences traumatic events will develop PTSD. Fearfulness, sadness or apprehension may still be present in some children after the event, although they can recover from these feelings.8
• Social Phobia: This refers to an excessive and persistent fear of social and/or performance situations that could lead to embarrassment and/or negative judgment about their personality.
Unlike the first four anxiety disorders that are often seen in children, social phobia does not typically affect young kids, but is obvious in adolescents or children in their mid-teens.9 Adolescents with social phobia often experience low self-esteem, trouble with assertiveness and oversensitivity to criticism. They also avoid going to school or parties and avoid talking to new people, public speaking and/or performing.
However, this fear can be limited to specific instances, since a child can fear situations such as recreational events and dating, but may be confident in academic and work conditions. Physical symptoms that come with social phobia include sweating, blushing, heart palpitations, shortness of breath and muscle tenseness.
How to Address Anxiety Disorders If You're a Parent or Guardian
If you're a parent or guardian, it's vital that you spot signs of anxiety disorders in children right away and consult a psychiatrist or mental health professional. Leaving these disorders untreated can be destructive, as Dr. Stan Kutcher of Dalhousie University points out in a 2008 article in The Medscape Journal of Medicine:10
"If left untreated, mental disorders can impede all aspects of health, including emotional well-being and social development, leaving young people feeling socially isolated, stigmatized and unable to optimize their social, vocational and interpersonal contributions to society.
Addressing mental health problems early in life can lead to decreases in emotional and behavioral problems, functional impairment, and contact with all forms of law enforcement. It can also lead to improvements in social and behavioral adjustment, learning outcomes and school performance."
According to NHS Choices, talking to your child first about their anxiety or worries, as well as reassuring and showing them that you understand their feelings is important. If they're old enough, you can even explain what anxiety disorders are and their effects on the body.11
However, for young children, you can help them develop skills and strategies first that can make them less stressed out, but make sure to provide ample room for them to learn their own. Other ways that the NHS suggests can help resolve feelings of anxiety in children include:12
- "Teach your child to recognize signs of anxiety in themselves and to ask for help when it strikes.
- Children of all ages find regular routines reassuring so, if your child is feeling anxious, try to stick to regular daily routines where possible.
- If your child is anxious because of distressing events, such as a bereavement or separation, see if you can find books or films that will help them understand their feelings.
- If you know a change, such as a house move is coming up, prepare your child by talking to them about what is going to happen and why.
- Try not to become anxious yourself or overprotective — rather than doing things for your child or helping them to avoid anxiety provoking situations, encourage your child to find ways to manage them.
- Practice simple relaxation techniques with your child, such as taking three deep, slow breaths, breathing in for a count of three and out for three.
- Distraction can be helpful for young children. For example, if they are anxious about going to [daycare], play games on the way there, such as seeing who can spot the most red cars.
- Turn an old tissue box into a 'worry' box. Get your child to write down or draw their worries and post them into the box. Then you can sort through the box together at the end of the day or week."
It's understandable for parents or guardians to always want all the best for their kids, so they exert much effort in making sure the child's physical well-being is in optimal condition. However, please do not forget that mental health is also an important aspect of life. Most, if not all, of the decisions that can be potentially made every day by a child or adolescent, whether at an academic, emotional or social level, rely on good mental health.