Anxiety

child_+_adolescent

Anxiety

1 in 5 kids and teens meet criteria for an anxiety disorder, but far too few receive the right help. Unlike behavioural difficulties which are much more obvious, anxiety is difficult to detect and many parents are unaware that their child’s symptoms are anxiety related. It’s also not uncommon for kids and teens to feel anxious – like before a big test or a classroom speech – so it can be hard to know when anxiety crosses the line from normal anxiety to problem anxiety.

Identifying anxiety in young children can be particularly challenging because kids younger than 8 usually can’t put their worries into words. They will typically show physical and behavioural symptoms of anxiety though – signs to look out for include:

  • Frequent stomach aches, headaches, or other physical complaints
  • Irritability
  • Sleep problems
  • Difficulty concentrating
  • Clinginess, or school refusal


Regardless of whether your child meets full criteria for an anxiety disorder, if there are indicators that suggest that your child struggles with worry or anxiety it might be worth seeking the advice of a child clinical psychologist.

Click here for more information and tips on how to help your child cope with their anxiety.

Generalised Anxiety and Worry

Generalised Anxiety Disorder is an anxiety disorder that causes kids and teens to worry excessively and persistently about anything and everything. Kids and teens with this anxiety disorder might worry about their performance on school tests, the possibility of catastrophes like earthquakes or tidal waves, or the health and safety of loved ones.

What Are The Symptoms Of Generalised Anxiety Disorder?

Uncontrollable worry is the main symptom of Generalised Anxiety Disorder, but other symptoms include:

  • Stomach aches and headaches
  • Reassurance seeking
  • Concentration problems and distractability
  • Muscle tension
  • Restlessness
  • Sleep problems
  • Fatigue
  • Irritability
  • Disturbed appetite


Though not always, kids and teens who struggle with general anxiety and worry are also often highly perfectionistic.

Separation Anxiety

It’s normal for children to develop mild separation anxiety early in their development, but some children experience high distress in anticipation of or upon separation from a primary caregiver (usually parents, and most often mothers) over and above what would be considered normal for their age and developmental level.

What Are The Symptoms Of Separation Anxiety?

Children with Separation Anxiety fear that something bad will happen if they’re separated from their parents – ‘what if mum’s in a car accident?’, ‘what if I get lost and no-one can find me?’ Other common signs of Separation Anxiety are:

  • High levels of distress or tantrums when separation has to occur
  • Strong reluctance (or refusal) to sleep alone or away from home
  • Needing a parent in the room to fall asleep
  • Seeking parents out at home (asking for help when it isn’t really needed, or calling out for water or another hug at bedtime)
  • Following parents around the house to avoid being in a different room
  • Clinginess
  • Making frequent phone calls to parents when they’re out (and becoming extremely distressed if they don’t answer)
  • Choosing to run errands with parents over playing at home if it means avoiding separation


Symptoms of Separation Anxiety can wax and wane though tend to be worse after extended periods without separation (e.g. school holidays), during periods of change, or during stressful times.

Social Anxiety

Social Anxiety is an anxiety disorder that makes people worry about doing something embarrassing and being negatively judged by others. While most kids feel nervous before a classroom speech or before meeting a new group of people, kids with social anxiety experience intense anxiety and fear prior and may also experience strong physical symptoms of anxiety like a racing heart beat, sweaty palms, a tight chest, or nausea.

What Are The Symptoms Of Social Anxiety?

The main feature of Social Anxiety is a fear of social situations. More specific symptoms are:

  • Excessive shyness in social situations
  • Worry about what other people will think
  • Worry about doing something embarrassing in social situations
  • Worry and anxiety in the days, weeks, or months leading up to a feared social situation
  • Reassurance seeking about past or upcoming social situations
  • Self-criticism and negativity when reflecting on past social interactions
  • Making excuses to avoid or delay social situations
  • Refusing to participate in social activities
  • Tantrums or tears before anxiety provoking social situation


Because of their anxiety, kids and teens with social anxiety may have difficulty making friends, they might find it hard to be assertive in social situations, they may under-perform at school (because their test anxiety interferes with their ability to concentrate), and they might be at higher risk for low self-esteem.

My Child Doesn’t Speak At School – Do They Have Social Anxiety?

Some children become so anxious that they’re unable to speak in specific social situations.  Children who are able to speak in some situations (usually at home) but not others may have what’s called Selective Mutism (a more severe form of social anxiety).

Panic Disorder

A panic attack is a brief episode of intense anxiety that is accompanied by strong physical symptoms of anxiety:

  • Increased heart rate
  • Sweating
  • Trembling or shaking
  • Shortness of breath
  • Chest pain
  • Dizziness
  • Nausea
  • Chills or hot flushes


Panic attacks can be a symptom of any anxiety disorder.

Panic Attack vs. Panic Disorder – What’s The Difference?

Kids who experience panic attacks don’t necessarily have Panic Disorder. Symptoms of Panic Disorder are:

  • Recurrent panic attacks
  • Worry about having more panic attacks
  • Worry that the panic attacks are a symptom of a serious illness
  • Avoidance of places linked to past panic attacks
  • Avoidance of activities that trigger physical symptoms that mimic a panic attack (e.g. exercise)
  • Reassurance seeking (e.g. repeated medical tests, needing to have someone close by ‘just in case’)


Unfortunately many of the coping strategies kids develop for coping with their worry about panic attacks – like seeking reassurance – help them to feel better in the short-term, but in the longer-term they make the worry worse.

Specific Phobia

A phobia is an intense (usually irrational) fear of a specific object, situation, or person. Common phobias in kids include:

  • Animal phobias
  • Fears relating to specific situations (e.g. flying, bridges, elevators)
  • Natural environmental phobias (e.g. fear of storms, heights, water)
  • Phobia’s related to being injured or seeing blood
  • A fear of loud noises
  • Fear of costumed characters


How Can I Tell If My Child’s Fears Are Normal?

Most children are afraid of the dark, scared of thunderstorms, or fearful of needles at some point, but overtime these fears fade.  Phobias only receive a formal diagnosis if they:

  • Continue for more than 6 months
  • Cause significant anxiety (which may include physical symptoms)
  • Interfere with a child’s normal routines


How Can I Tell If My Child Has A Specific Phobia?

When kids with a Specific Phobia are exposed to a feared object or situation, they experience intense anxiety including strong physical symptoms or anxiety:

  • Increased heart rate
  • Sweating
  • Trembling or shaking
  • Shortness of breath
  • Chest pain
  • Dizziness
  • Nausea
  • Chills or hot flushes


Children and adolescents with specific phobias go out of their way to avoid the object or situation they fear, or endure the feared object or situation with extreme distress.  Younger children may express their anxiety through tantrums, clinginess, or tearfulness.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (or OCD) is an anxiety disorder associated with unwanted and intrusive thoughts or mental images (obsessions) and repetitive rituals (compulsions).

What Are Obsessions?

Obsessions are intrusive, unwanted thoughts or images usually about negative or catastrophic events. Common obsessions are:

  • Worries about germs and getting sick
  • Mental pictures about hurting others
  • Doubt (e.g. are the doors and windows locked?)
  • A strong need to have things done in a particular way or to have things in a specific oder


What Are Compulsions?

Compulsions are performed to relieve the anxiety and worry that accompanies obsessions, or to prevent a feared outcome like illness. Compulsions are distressing, they can take up a considerable amount of time, and they can be disruptive to family routines. OCD can manifest in a variety of different ways, but some of the most common compulsions are:

  • Cleaning and washing compulsions
  • Checking compulsions
  • Repeating and counting compulsions
  • Ordering compulsions
  • Mental rituals to neutralise thoughts
  • Compulsive praying