Almost all children experience some kind of anxiety in their lives. Most children will be able to overcome their fears as they grow and develop. However, if the fears and worries become so intense that it disrupts everyday life, the child might be suffering from an anxiety disorder. Read on to find out the types of anxiety disorder that present in children.
General Anxiety Disorder (GAD)
GAD is when children have worries about everything everyday. These worries are excessive and uncontrollable and include matters such as health and safety of themselves and their families, about school and activities as well as about their future.
While many children worry about these matters, the worry is much more frequent and intense with children who have GAD. The fears that they face are very real and it is very difficult to ease their fears no matter what we do.
Not only do children with GAD find it almost impossible to stop worrying, they also often have physical symptoms such as inability to focus, feeling tired and irritable, muscle tension as well as having trouble sleeping.
Children with GAD will try to avoid school and activities because they worry about the whole event. They worry about attending a friend’s birthday party and may fear that something bad will happen to a loved one if they leave the house. They also worry about homework, exams and report cards. The anxiety caused by GAD is often physically draining and will have a negative impact on the child and family if not dealt in a proper manner.
GAD in young children is often quite straightforward, with worries generally about immediate matters. The anxiety that they feel often manifests in a physical symptom. For example, your child might complain of having a headache or a stomach ache because of an upcoming exam and refuse to go to school to avoid it.
However, as children grow, their worries will most likely become more complex. For example, “How will I be able to take care of my parents when I am older when I can’t cope with my own problems?”
Older children with GAD usually look tired and tense, redraw from friends and refuse to participate in many activities. GAD may extend into depression as the child becomes more anxious and more isolated. Besides this, older children may try other ways to cope with their anxiety, such as alcohol or drugs
Separation Anxiety Disorder
Separation anxiety is a normal developmental stage between 8 months to 3 years old. Babies learn that their parents still exist even when they are not around and feel distressed because parents (and primary caregivers) represent safety. This anxiety usually resolves on its own as the child learns that mom and dad will come back.
However, when the child continues to be very fearful and seems to be unable to move past this stage, then the problem could be separation anxiety disorder.
Children with separation anxiety disorder feel worried and afraid when they are apart from their parents. They are often anxious even when in familiar places such as school or daycare. Children with separation anxiety disorder often worry that something bad might happen to their parents when they are apart from them. They remain anxious until they are once again with their parents.
Separation anxiety disorder may result in the child missing many everyday activities, such as school and sports. Bedtime is likely to be an issue as the child will have issues sleeping on their own. If there is no proper intervention for the child, this disorder will be a disruption to the child and his or her family.
A child with Panic Disorder goes through repeated panic attacks in which they experience sudden and intense fear and anxiety. These panic attacks are often unexpected and are followed by worry about something bad happening because of the panic attack. Children who experience panic attacks will also likely be worried that it will occur again. They may be so worried that they change their behavior in hopes to avoid future attacks.
A panic attack occurs when there are four or more of the following symptoms:
- Shortness of breath / feeling smothered
- Increased heart rate / heart palpitation
- Chest pain
- Feeling choked
- Chills / hot flashes
- Feeling dizzy
- Feeling nauseous
- Abdominal pain / stomach upset
- Afraid of losing control
- Fear of ‘going crazy’
- Fear of dying
- Paresthesias – Numbness / tingling
- Derealization – Feeling of unreality
- Depersonalization – Being detached from oneself
Young children may not know how to articulate what is happening to them and are more likely to describe their physical symptoms such as their stomach ache and their chest hurting. A young child who is experiencing a panic attack may be suddenly very upset for seemingly no reason at all. They may also have tantrums, insist that something is wrong and refuse to go for their usual activities.
Older children will be able to express their emotions and anxiety far better. However, they might not feel comfortable describing their experience. Do not dismiss their fears and allow your child to work through what they are feeling and encourage them by being as supportive as you can.
Note that a child with other anxiety disorders may also experience panic attacks. The main difference is that children which panic disorder often have panic attacks that are unexpected. There might not seem to be any reason for the occurrence of the attack.
Selective mutism is when a child refuses to talk when in situations where they are uncomfortable but talks when they are at home.
A child with selective mutism will speak when they are comfortable (at home) and stop talking when in a new situation or when there are other people around. He may use gestures to communicate. When a stranger asks questions, the child might become ‘frozen’.
Children who are slow to warm up and have a tendency to withdraw from new situations are more likely to develop selective mutism. Genetics also play a role, with children who have a family member with an anxiety disorder more likely to develop selective mutism.
If you suspect that your child has selective mutism, refer to your doctor. Your doctor will first rule out other developmental issues such as speech delays). He will then refer you to a psychiatrist or psychologist who will be able to properly assess your child.
Early intervention is required for this disorder not only because it becomes harder to treat when the child is older, but also because selective mutism will have a significant impact on a child’s life. Behavior therapy is usually used to treat selective mutism.
Some children have an intense specific fear of an object or situation. This extreme fear results in intense anxiety and can become very severe over time. For example, the child may have a phobia of an animal, of needles (taking blood) or have a phobia of being in a small confined space.
Both genetics and environmental factors can contribute to a child developing a specific phobia. A traumatic event can cause a child to be extremely afraid of a certain object. For example, a child might develop an extreme fear of dogs after being bitten by a dog.
Children can also develop an irrational fear by watching how others react to a certain object or situation. For example, a young child might become afraid of a dog if she sees an older sibling scream when a dog approaches.
The life of the child with specific phobia as well as family members will definitely be affected. The child might refuse to go to school if what she fears exists in school. Trips to the park might become an ordeal if the child is afraid of dogs. If the child has an extreme fear of doctors, she might refuse to go to doctors appointments or hospitals.
You child might have a specific phobia if he/she exhibits the following behaviors:
- Avoiding the feared stimuli at all costs (even avoiding locations where the stimuli might be found).
- Making an older sibling or parent check to make sure the stimuli is not present.
- Wanting a parent to be with them at all times.
- Running away
- Throwing tantrums
A young child will most probably look to an adult to protect them from the perceived threat. Older children usually try to deal with their anxiety by choosing to avoid certain situations. Older children are also more likely to try to escape the
Obsessive Compulsive Disorder (OCD)
OCD seems to be a term that is used quite loosely these days. However, a child who really suffers from OCD has intrusive obsessions (thoughts, images or urges) that cause tremendous discomfort and anxiety. The child then engages in compulsions (repetitive behaviors / mental acts) in their attempt to reduce the obsession and anxiety.
Obsessions can include the following:
- Symmetry and exactness – Items have to be in order in a certain way, such as according to color. A child with this obsession may feel that ‘something is not right’ or that something bad will happen if things are not in the correct order.
- Perfection – Some children have a need for everything to be perfect or ‘just right’ before they are able to move on to the next task. For example, your child needs to have everything in her room kept perfectly before she is able to go to bed.
- Contamination – Children with this obsession feel very distressed about germs, and being dirty. They avoid going to ‘germy’ places, and sick people at all costs and definitely do not touch ‘contaminated’ surfaces.
- Accidental harm – This is a worry about causing harm to themselves or others by not being thorough enough. For example, ‘my family will get sick if I do not clean the doorknob because there are germs on it’.
- Forbidden thoughts – Teens who have OCD might find themselves overwhelmed with unwanted sexual thoughts and images even though it might be upsetting to them.
Compulsions include the following:
- Washing and cleaning – A child with OCD might have the compulsion to wash their hands excessively. Besides this, he/she might also have toilet rituals, grooming rituals, showering rituals and rules about how to wash the kitchen and specific steps to do laundry.
- Counting, Touching, Tapping, Rubbing – Children who have this compulsion will count, tap, touch or rub things in a certain way before feeling that it is ok to move on to the next task. For example, turning the light on and off 5 times before leaving the house.
- Checking – This compulsion causes the child to check doors, locks, windows to make sure that everyone and everything is safe. They are not able to put their worries to rest until they are sure that everything is ok.
- Ordering and arranging – Children with this compulsion have the need to arrange things in a specific manner. Having something out of place results in anxiety.
- Mental rituals – Some children have compulsions that are performed mentally. For example, having to repeat a certain prayer x number of times before being able to sleep.
OCD can be quite a debilitating disorder and children who struggle with it are often unable to focus. Their grades and school performance is affected. They may often be late to school because of all the rituals that have to be completed before they head to school. Friendships can be hard to maintain and they might have trouble going to sleep because things do not ‘feel right’.
If you feel that your child is suffering from OCD, seek help from a professional. Getting the right help will help you and your child to manage the disorder before it turns life upside down.
perceived danger, even when they know in their heads that the fear is actually irrational.
Post Traumatic Stress Disorder (PTSD)
Children may develop intense anxiety after experiencing a traumatic event. This is referred to as Post Traumatic Stress Disorder (PTSD). Witnessing a traumatic event happening to a friend or a loved one can also result in PTSD.
Traumatic events include (but are not limited to) experiencing natural disasters, being involved or witnessing a car accident, going through surgery, experiencing violence, or abuse.
A child who has PTSD may have repetitive and upsetting memories that are intrusive. They may also experience nightmares and flashbacks, where the child feels as if he is really going through the event once again. He or she may feel extreme anxiety and distress when something triggers the memory of the event.
PTSD can also result in negative emotions such as shame, confusion, sadness and guilt. This in turn may cause behavioral changes. A child who is suffering from PTSD may be irritable, have trouble focusing and have trouble sleeping. He or she might also seem to be always ‘on edge’.
Children with PTSD may recreate the traumatic event when they are playing and seem preoccupied with the trauma that they experienced. Older children might try to cope with their anxiety by engaging in high risk and reckless behaviors. There is also a chance of increased aggression and impulsive behaviors in teens with PTSD.
Social Anxiety Disorder
Children who have social anxiety disorder feel fear and distress when it comes to social situations such as going to school or sports. They also fear situations in which they have to perform, such as a public speaking.
These children are constantly worried about what others will think about them. They are very afraid that they might accidentally do something embarrassing. School refusal is common in children with this anxiety disorder. They avoid participating in activities or going to social events.
Additionally, they might also find it very stressful to use public washrooms and eating with other people. They find it hard to talk to adults and to express their opinions. They may be very self conscious and have very low self esteem.
Many children with social anxiety disorder go through their childhood without an adult noticing the disorder. They may just seem like an introverted child who is very quiet. However, being shy and naturally quiet is not the same as having social anxiety disorder.
How to Help Your Child?
If you have a child who is struggling with anxiety, talk to your child about what is happening to them and why it is happening. Your child might not understand what is going on and this can add to the distress that they feel. You can also help your child to calm themselves down through breathing methods and changing their focus. Do not hesitate to get help from a professional, as early intervention will save you a lot of future heartache.
Anxiety disorders may be very frightening to a child. As parents, the first thing we can do is to find out all we can about what they are facing. Do remember that many children have anxieties, and being anxious about certain things and certain times does not mean that your child has an anxiety disorder. Always refer to a medical professional that you trust if you need help in supporting your child through anxiety.