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Wha=
t is Anxiety? Anxiety
is an emotional state similar to fear.
Fear can be defined as a normal (adaptive) emotional and physiolog=
ical
response to perception of an external threat.
Anxiety is the pathological or irrational anticipation or
persistence of fear in the absence of threat. When symptoms associated with anxiet=
y are
frequent, intense, numerous, and durable (FIND) enough to cause significa=
nt
distress or impairment of functioning, an Anxiety Disorder can be diagnos=
ed.
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How=
common are
Anxiety Disorders? According=
to
Massachusetts General Hospital (MGH) “Anxiety disorders are one of the mo=
st
common mental health conditions in children and adolescents.”
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Wha=
t are the
consequences of Anxiety Disorders:
Research has shown that if left untreated, children with anxiety
disorders are at higher risk to perform poorly in school, to have less
developed social skills and to be more vulnerable to substance abuse. Anxiety disorders are often associate=
d with
avoidance, a coping mechanism that temporarily lowers distress, but also
shrinks the size of the individual’s zone of comfort. The anxious person’s world tends to b=
ecome
smaller and smaller. Anxiety dis=
orders
can become chronic and debilitating.
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How=
do Anxiety
Disorders present in childhood?
Physiological and behavioral responses to fear are primitive survi=
val
mechanisms carefully selected for by evolution. Immature human animals tend to act on=
their
feelings rather than talk about them.
Because youngsters are still developing skills for self-observation
and have may have a limited vocabulary for feelings, behavior does the
talking for them. Behavioral res=
ponses
to fear and anxiety can be overt/intuitive or covert and counterintuitive=
.
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Chi=
ldren's Mental
Health Facts
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Chi=
ldren and
Adolescents with Anxiety Disorders
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Wha=
t are anxiety
disorders?
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Childr=
en and
adolescents with anxiety disorders typically experience intense fear, wor=
ry,
or uneasiness
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that c=
an last for
long periods of time and significantly affect their lives. If not treated
early, anxiety
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disord=
ers can lead
to:
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• Repe=
ated school
absences or an inability to finish school;
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• Impa=
ired relations
with peers;
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• Low =
self-esteem;
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• Alco=
hol or other
drug use;
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• Prob=
lems adjusting
to work situations; and
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• Anxi=
ety disorder
in adulthood.
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|
Wha=
t are the
types and signs of anxiety disorders?
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Many d=
ifferent
anxiety disorders affect children and adolescents. Several disorders and
their signs are
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descri=
bed below:
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Gen=
eralized
Anxiety Disorder: Children and adolescents with generalized anxiety disor=
der
engage in
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extrem=
e, unrealistic
worry about everyday life activities. They worry unduly about their acade=
mic
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perfor=
mance,
sporting activities, or even about being on time. Typically, these young
people are very
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self-c=
onscious, feel
tense, and have a strong need for reassurance. They may complain about
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stomac=
haches or
other discomforts that do not appear to have any physical cause.
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Sep=
aration
Anxiety Disorder: Children with separation anxiety disorder often have
difficulty leaving
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their =
parents to
attend school or camp, stay at a friend's house, or be alone. Often, they
"cling" to parents
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and ha=
ve trouble
falling asleep. Separation anxiety disorder may be accompanied by depress=
ion,
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sadnes=
s, withdrawal,
or fear that a family member might die. About one in every 25 children
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experi=
ences
separation anxiety disorder.
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Pho=
bias: Children
and adolescents with phobias have unrealistic and excessive fears of cert=
ain
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situat=
ions or
objects. Many phobias have specific names, and the disorder usually center=
s
on animals,
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storms=
, water,
heights, or situations, such as being in an enclosed space. Children and
adolescents with
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social=
phobias are
terrified of being criticized or judged harshly by others. Young people w=
ith
phobias
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will t=
ry to avoid
the objects and situations they fear, so the disorder can greatly restrict
their lives.
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Pan=
ic Disorder:
Repeated "panic attacks" in children and adolescents without an
apparent cause are
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signs =
of a panic
disorder. Panic attacks are periods of intense fear accompanied by a poun=
ding
heartbeat,
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sweati=
ng, dizziness,
nausea, or a feeling of imminent death. The experience is so scary that y=
oung
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people=
live in dread
of another attack. Children and adolescents with the disorder may go to g=
reat
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length=
s to avoid
situations that may bring on a panic attack. They also may not want to go=
to
school or to
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be sep=
arated from
their parents.
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9
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Obs=
essive-Compulsive
Disorder: Children and adolescents with obsessive-compulsive disorder,
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someti=
mes called
OCD, become trapped in a pattern of repetitive thoughts and behaviors. Ev=
en
though
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they m=
ay recognize
that the thoughts or behaviors appear senseless and distressing, the patt=
ern
is very
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hard t=
o stop.
Compulsive behaviors may include repeated hand washing, counting, or
arranging and
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rearra=
nging objects.
About two in every 100 adolescents experience obsessive-compulsive disord=
er
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(U.S. =
Department of
Health and Human Services, 1999).
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Pos=
t-traumatic
Stress Disorder: Children and adolescents can develop post-traumatic stre=
ss
disorder
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after =
they
experience a very stressful event. Such events may include experiencing
physical or sexual
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abuse;=
being a
victim of or witnessing violence; or living through a disaster, such as a
bombing or
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hurric=
ane. Young
people with post-traumatic stress disorder experience the event over and =
over
through
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strong=
memories,
flashbacks, or other kinds of troublesome thoughts. As a result, they may=
try
to avoid
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anythi=
ng associated
with the trauma. They also may overreact when startled or have difficulty
sleeping.
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|
How=
common are
anxiety disorders?
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|
Anxiet=
y disorders
are among the most common mental, emotional, and behavioral problems to o=
ccur
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during=
childhood and
adolescence. About 13 of every 100 children and adolescents ages 9 to 17<=
/font>
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experi=
ence some kind
of anxiety disorder; girls are affected more than boys.1 About half of
children and
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adoles=
cents with
anxiety disorders have a second anxiety disorder or other mental or
behavioral
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disord=
er, such as
depression. In addition, anxiety disorders may coexist with physical heal=
th
conditions
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requir=
ing treatment.
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Who=
is at risk?
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Resear=
chers have
found that the basic temperament of young people may play a role in some
childhood
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and ad=
olescent
anxiety disorders. For example, some children tend to be very shy and
restrained in
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unfami=
liar
situations, a possible sign that they are at risk for developing an anxie=
ty
disorder. Research in
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this a=
rea is very
complex, because children's fears often change as they age.
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Resear=
chers also
suggest watching for signs of anxiety disorders when children are between=
the
ages of
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6 and =
8. During this
time, children generally grow less afraid of the dark and imaginary creat=
ures
and
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become=
more anxious
about school performance and social relationships. An excessive amount of=
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anxiet=
y in children
this age may be a warning sign for the development of anxiety disorders l=
ater
in life.
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Studie=
s suggest that
children or adolescents are more likely to have an anxiety disorder if th=
ey
have a
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parent=
with anxiety
disorders. However, the studies do not prove whether the disorders are ca=
used
by
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biolog=
y,
environment, or both. More data are needed to clarify whether anxiety
disorders can be
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inheri=
ted.
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|
Wha=
t help is
available for young people with anxiety disorders?
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Childr=
en and
adolescents with anxiety disorders can benefit from a variety of treatmen=
ts
and services.
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Follow=
ing an
accurate diagnosis, possible treatments include:
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•
Cognitive-behavioral treatment, in which young people learn to deal with
fears by modifying
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the wa=
ys they think
and behave;
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• Rela=
xation
techniques;
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• Biof=
eedback (to
control stress and muscle tension);
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• Fami=
ly therapy;
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10
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Sys=
tems of Care
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Indivi=
dual help is
available for children diagnosed with severe anxiety through
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commun=
ity-based
systems of care. Systems of care help children with serious
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emotio=
nal
disturbances and their families overcome obstacles associated with=
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diffic=
ult mental
health, emotional, and behavioral problems. To learn more about
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system=
s of care,
call 301-443-1333, or to request a free fact sheet on systems of
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care, =
call
1-800-789-2647.
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• Pare=
nt training;
and
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• Medi=
cation.
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While
cognitive-behavioral approaches are effective in treating some anxiety
disorders, medications
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work w=
ell with
others. Some people with anxiety disorders benefit from a combination of
these
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treatm=
ents. More
research is needed to determine what treatments work best for the various
types of
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anxiet=
y disorders.
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|
Wha=
t can parents
do?
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|
If par=
ents or other
caregivers notice repeated symptoms of an anxiety disorder in their child=
or
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adoles=
cent, they
should:
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|
• Talk=
with the
child's health care provider. He or she can help to determine whether the=
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sympto=
ms are caused
by an anxiety disorder or by some other condition and can also provide
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a refe=
rral to a
mental health professional.
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|
• Look=
for a mental
health professional trained in working with children and adolescents, who=
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|
has us=
ed
cognitive-behavioral or behavior therapy and has prescribed medications f=
or
this
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|
disord=
er, or has
cooperated with a physician who does.
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• Get =
accurate
information from libraries, hotlines, or other sources.
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• Ask =
questions
about treatments and services.
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|
• Talk=
with other
families in their communities.
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• Find=
family
network organizations.
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|
People=
who are not
satisfied with the mental health care they receive should discuss their
concerns with
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|
the pr=
ovider, ask
for information, and/or seek help from other sources.
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This i=
s one of many
fact sheets in a series on children's mental health disorders. All the fa=
ct
sheets listed
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below =
are written in
an easy-to-read style. Families, caretakers, and media professionals may =
find
them
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helpfu=
l when
researching particular mental health disorders. To obtain free copies, ca=
ll
1-800-789-2647
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|
or vis=
it
http://www.mentalhealth.samhsa.gov/child.
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Imp=
ortant
Messages About Children's and Adolescents' Mental Health
|
|
• Ever=
y child's
mental health is important.
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|
• Many=
children have
mental health problems.
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• Thes=
e problems are
real and painful and can be severe.
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• Ment=
al health
problems can be recognized and treated.
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|
• Cari=
ng families
and communities working together can help.
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