Anxiety disorders in childhood

What is an anxiety disorder?

All humans experience some form of fear and worry as it acts as a form of protection and can enhance our performance. Along this vein, most children experience anxiety at some stage of their development and it is typically a normal part of growing up. However, approximately 8-22% of children experience anxiety to a greater degree than their peers, and to an extent where it interferes with their ability to complete day to day tasks. This persistent and excessive degree of fear and worry characterizes anxiety disorders.

What causes anxiety disorders?

Anxiety disorders arise from a combination of both genetic and environmental factors. Studies have shown that these conditions run in families, suggesting that there may be a genetic basis for their development. Other environmental factors such as traumatic experiences may also play a role.

Types of anxiety disorders

There is a variety types of anxiety disorders that can affect children. Listed below are the symptoms of a few of the most common types.

Social anxiety:

This is characterized by fears or worry about situations where your child will have to interact with others (e.g. school playground). Children with this type of anxiety disorder typically:

  • Worry that others will judge or think badly of them
  • Exhibit signs of shyness
  • Are reluctant participating in group activities
  • Have few friends
  • Avoid social situations.
Separation anxiety:

Separation anxiety:
This is characterized by fears and worries about being away from their parents. Children with this type of anxiety disorder typically:

  • Are very distressed when being separated from one or both parents
  • Worry about having an accident themselves or that their parents will be involved in
    an accident
  • Avoid situations where they are without their parents (e.g. daycare, school etc).
  • Report feeling ill when separated.
Generalized anxiety:

This is characterized by general worry about different areas of life. Children with this type of anxiety disorder typically:

  • Worry about a range of things (e.g. health, school, world events etc).
  • Have perfectionistic tendencies
  • Avoid new situations
  • Need constant reassurance

When should I seek help for my child?

Since most children experience anxiety as a typical part of their development, it can be difficult to judge when it is appropriate to seek professional help. Broadly there are three important things to consider when making this decision.

Firstly, compare your child’s fears with those his or her age. Children typically go through stages of specific phobias at different stages of their lives. For example, toddlers may be afraid of the dark or being on their own. Primary school age children may worry about things that will happen in the future such as social situations or failure. If your child’s fears and worries are excessively different from their peers, then it may be worthwhile to consider professional help.

Secondly, is your child’s anxiety interfering with his or her ability to do activities that he or she needs to do or enjoys? For example, children with social phobia may have difficulty forming friendships or avoid social situations such as school etc. If the answer is yes, then it may be appropriate to seek help from a mental health professional.

Thirdly, consider the intensity of your child’s reaction. If he or she is excessively hard to settle or extremely distressed, then professional help may be warranted.

What types of help are available?

Usually treatments for anxiety disorders focus on gradually exposing the child to the feared situation so that they become less fearful of it. Here at Sydney Cognitive Development Center we offer cognitive behavioral therapy (including Exposure Therapy) which is a scientifically validated treatment where children are taught to examine their thinking patterns in the presence of the feared situation. It is based on the principle that our thinking influences our feelings and behavior. Medications are also occasionally prescribed for children with severe cases of anxiety. However, this is rare and should only be considered in conjunction with a type of ‘talking therapy’ such as CBT.

Tips for parents

  • It is important to expose your child to their feared objects/events in graded steps. Start with a situation that causes your child the least anxiety and expose them to it a number of times until they are comfortable in it. For example, if your child has a phobia of dogs. You might start off standing a distance from the dog, and gradually move closer as your child becomes more accustomed to it.
  • Offer plenty of encouragement and reassurance when your child approaches things that they are anxious about. Also reward appropriate behaviour rather than reprimanding the child for being afraid etc.
  • Children can be taught to alter their thinking patterns to help them cope with the feared situation. Younger children can rehearse phrases such as “I can be brave” or “Mummy and daddy will come back” in order to self-soothe. Older children can be taught to think more realistically through asking themselves questions such as “what happened last time?” or “is it likely that I will get hurt etc”.
  • Children often learn their fears from other people. In this respect, it is important that you are a role model in the feared situation. Be careful that you don’t inadvertently model anxiety through your words and actions.