Anxiety Disorders

Anxiety disorders cause individuals to feel excessively frightened, distressed and uneasy during situations in which most others would not experience these symptoms. Left untreated, these disorders can dramatically reduce productivity and significantly diminish an individual’s quality of life. Anxiety disorders in children can lead to poor school attendance, low self-esteem, deficient interpersonal skills, alcohol abuse, and adjustment difficulty.
Anxiety disorders are the most common mental illnesses in America. They affect as many as one in 10 young people. Often these disorders are difficult to recognize. And, many individuals that suffer from them are either too ashamed to seek help, or they fail to realize that these disorders can be treated effectively.

The most common anxiety disorders include:

Panic Disorder

Characterized by panic attacks. This disorder results in sudden feelings of terror that strike repeatedly and without warning. Physical symptoms include chest pain, heart palpations, shortness of breath, dizziness, abdominal discomfort, feelings of unreality, and fear of dying. Children and adolescents with this disorder may experience unrealistic worry, self-consciousness, and tension.

Obsessive-Compulsive Disorder (OCD)

Characterized by repeated, intrusive and unwanted thoughts or obsessions and/or rituals that seem impossible to control. Adolescents may be aware that their symptoms don’t make sense and are excessive, but younger children may be distressed only when they are prevented from carrying out their compulsive habits. Compulsive behaviors often include counting, arranging and rearranging objects, and excessive hand washing.

Posttraumatic Stress Disorder (PTSD)

Persistent symptoms of this disorder occur after experiencing a trauma such as abuse, natural disasters orextreme violence. Symptoms include nightmares; flashbacks; the numbing of emotions; depression; feeling angry, irritable and distracted; and being easily startled.


Consist of a disabling and irrational fear of something that actually poses little or no danger. The fear leads to avoidance of objects or situations and can cause extreme feelings of terror, dread and panic, which can substantially restrict one’s life. “Specific” phobias center on particular objects (e.g. animals) or situations (e.g. heights or enclosed places). Common symptoms for children and adolescents with “social” phobias are hypersensitive to criticism, difficulty being assertive and low self-esteem.

Generalized Anxiety Disorder

Chronic, exaggerated worry about everyday, routine life events and activities that lasts at least six months

Children and adolescents with this disorder usually anticipate the worse and often complain of fatigue, tension, headaches, and nausea.

Separation Anxiety Disorder

Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached

This disorder is evidenced by three or more of the following:

  • Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated
  • Persistent and excessive worry about losing or about possible harm to major attachment figures
  • Persistent and excessive worry that an untoward event will lead to separation from major attachment figure (e.g. getting lost or kidnapped)
  • Persistently and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings
  • Persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home
  • Repeated nightmares involving the theme of separation
  • Repeated complaints of physical symptoms such as headaches, stomach aches, nausea, or vomiting when separation from major attachment figures occurs or is anticipated
  • The duration of the disturbance is at least four weeks
  • The onset is before the age of 18 years
  • The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning
  • The disturbance does not occur excessively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder with Agoraphobia

Although studies suggest that children and adolescents are more likely to have an anxiety disorder if their caregivers have anxiety disorders, it has not been shown whether biology or environment plays the greater role in the development of these disorders. High levels of anxiety or excessive shyness in children aged six to eight years may be indicators or a developing anxiety disorder.
Scientists at the National Institute of Mental Health (NIMH) and elsewhere have recently found that some cases of OCD occur following infection or exposure to streptococcus bacteria. More research is being done to pinpoint who is at greatest risk, but this is another reason to treat strep throats seriously and promptly.

Effective treatments for anxiety disorders include medication, specific forms of psychotherapy also known as behavioral therapy or cognitive-behavioral therapy, family therapy, or a combination of these. Cognitive-behavioral treatment involves the young person’s learning to deal with his or her fears by modifying the way he or she thinks and behaves by practicing new behaviors.

Ultimately, parents and caregivers should learn to be understanding and patient when dealing with children with anxiety disorders. Specific plans of care can often be developed and the child or adolescent should be involved in the decision-making process whenever possible.

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