Anxiety disorders are characterized by fear, worry, or apprehension that greatly affects the ability to evolve and is disproportionate to the circumstances. There are many types of anxiety disorders that are characterized by a focus on fear or worry. Children most often refuse to go to school, frequently citing physical symptoms, such as stomach aches. Child anxiety therapists usually diagnose symptoms, but sometimes do tests to rule out disorders that may be causing the physical symptoms that anxiety often brings. Behavioural therapy is often sufficient, but if the anxiety is severe, medication may be needed.
All children sometimes feel anxious. For example, children between the ages of 3 and 4 are often afraid of the dark or of monsters. Older children and teens often become anxious when giving a presentation to their classmates. These fears and anxieties are not signs of a disorder. However, if children become so anxious that they fail to progress or are overcome with great pain, they may be suffering from an anxiety disorder. Studies show that about 3% of 6-year-olds, 5% of adolescent males and 10% of adolescent girls have anxiety disorders. Children with anxiety disorder are at increased risk for depression, suicidal behaviour, alcoholism, substance use disorders and academic difficulties later in life.
People can have an inherited predisposition to anxiety. Anxious parents tend to have anxious children.
Anxiety disorders include:
- Generalized anxiety disorder
- Panic disorder
- Separation anxiety disorder
- Social anxiety disorder
Many children with anxiety disorders refuse to go to school. They may suffer from separation anxiety, social anxiety, panic disorder, or a combination of these disorders. Some children talk about their anxiety in specific ways. For example, they may say “I’m worried that I’ll never see you again” (separation anxiety) or “I’m afraid the children will laugh at me” (social anxiety disorder). However, most children complain of physical symptoms, such as an upset stomach. These children are often telling the truth, because anxiety frequently causes stomach upset, nausea, headache and trouble sleeping.
Many children with an anxiety disorder struggle with anxiety until adulthood. However, with early treatment, many children learn to control their anxiety.
Child anxiety therapists usually diagnose anxiety disorder when the child or parents describe typical symptoms. However, child anxiety therapists can be misled by the physical symptoms that anxiety causes and perform tests for physical disorders before the anxiety disorder is raised.
If the anxiety is mild, behaviour therapy is usually the only action required. Therapists expose children to the situation that triggers the anxiety and help them cope with the situation. Children therefore gradually desensitize and feel less anxiety. When appropriate, concurrent treatment of anxiety in parents is often helpful.
If the anxiety is severe, medication may be used. If long-term treatment is needed, the first choice is usually a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI), such as fluoxetine or sertraline. Most children can take SSRIs without any problems. However, some may have stomach upset, diarrhoea, insomnia, or weight gain. More rarely, they may become restless or more impulsive. Concerns have arisen that antidepressants may slightly increase the risk of suicidal thoughts in children and adolescents if drug treatment is only needed in the short term (for example, if a child is particularly anxious before a procedure), benzodiazepines (a type of sedative) are usually used.
Overall, in combination with a form of cognitive therapy called cognitive behavioural therapy, it often improves symptoms. is a structured, short-term form of talk therapy designed to help people identify and challenge negative thought patterns so they can handle difficult situations more effectively.