Dr. Tally Bodenstein-Kales
Child & Adolescent Psychologist
Taking a deeper look at anxiety
What is anxiety?
In the course of typical development, many children and teens go through stages in which they worry about different things. Young children may go through a stage of being worried about monsters or shadows, older children may worry about death or serious injury, teens worry about how they fit in socially or how they physically look. In most cases, these worries phase without interfering with the normal daily living of the child or family. Sometimes, however, children and teens continue to worry about things for a very long time and spend way too much time worrying about things. In such cases, the excessive worries and fears begin to affect normal living for the child and for the entire family. That is when it is time to seek professional help.
Is anxiety common in children and adolescents?
Anxiety or excessive worries that interfere with normal living occur in approximately 6% of children and adolescents. However, many more children and teens experience anxiety episodes throughout their development that can disrupt their daily living. Some signs of anxiety are frequent stomach aches, headaches, bedwetting, nightmares, worrying about separating from parents, difficulties falling asleep alone, worrying about tests or school presentations, refusing to go to school.
Anxiety is not an all or nothing phenomenon. There are degrees of anxiety: some children are only affected in some situations while others are affected in many situations.
What Causes Anxiety?
Excessive worrying and anxiety are traits that often run in families and have a genetic component to it. Often, children who are temperamentally very shy or tend to worry about simple things are at risk of developing anxiety disorders. Anxiety can also develop in response to a stressful or traumatic situation or stressful daily environment. Despite the various causes of anxiety, whether biological or environmental, anxiety disorders can be treated successfully.
Different Types of Anxiety
There are different types of anxiety that children and teens can experience in the course of their lives. The thing that they all have in common is that they affect the normal life of the child and teen as well as their family.
Some of these are:
Separation Anxiety Disorder
This happens when children become really afraid to leave their parent(s) or someone that they are really close to. They typically worry that something bad will happen to their parent(s) or the person that they really love. As a result of this anxiety, children may refuse to go to school, cling to their parents and cry when they have to separate, have difficulties falling asleep if the parents are not home, repeatedly call the parents if they are out, have nightmares about being kidnapped, stomach aches, headaches or even throw up.
Generalized Anxiety Disorder (GAD)
This happens when children and teens worry about many different things and feel afraid to go places and do things that are typical for their age. They frequently experience muscle tension, restlessness, fatigue, irritability, difficulties focusing, sleeping problems and seem impatient and on edge most of the time.
This is more likely to occur in adolescents than in children. Teens who suffer from social anxiety become very worried about social situations and how others will judge them. They are afraid of meeting new people, speaking in front of a group, saying stupid things, making mistakes, and being rejected by others. These teens often get very easily embarrassed, have low self-esteem, sweat easily and experience muscle tension in social situations. They often avoid parties and prefer to interact with other teens using computers and text messages.
This type of anxiety happens when children refuse to talk in situations that they feel uncomfortable. At home where they feel comfortable, they speak and behave perfectly normal but when they feel anxious they refuse to speak. At school, they may use gestures, eye signals or whisper. This type of anxiety usually start in kindergarten and affects children who tend to be extremely shy.
Obsessive-Compulsive Disorder (OCD)
This type of anxiety happens when children and teens develop frequent, repeated and uncontrollable thoughts (“obsessions”) that are driven by fear or excessive worries about certain things like germs. In order to get rid of these uncontrollable thoughts, they perform actions or rituals (“compulsions”) like washing their hands repeatedly to get rid of germs. Some other examples of compulsions include checking if doors are locked, counting backwards from 100, moving in a certain ritual way before bedtime. These rituals can take up so much of their time that they interfere with normal living.
This type of anxiety occurs when teens (and sometimes children) experience unpleasant physical symptoms as a result of their anxiety like rapid heart rate, difficulty breathing, dizziness, and shakiness that they actually think they are going to die or are going crazy. They then develop a fear of these symptoms and are afraid to go to places where they think they might have a panic attack.
Post-Traumatic Stress Disorder (PTSD)
This type of anxiety can develop when children and teens experience or witness a traumatic event in which they believe they or someone they love could have died or been seriously hurt (e.g., car accident, physical or sexual abuse) Typically, symptoms include having frequent and distressing flashbacks of the scary experience, nightmares, jumpiness, severe anxiety, nervousness, and avoidance of situations that remind them of the trauma.
How can a psychologist help your anxious child?
A psychologist can help your child face, cope, overcome and beat anxiety by teaching the connection between thoughts, feelings and actions. Through a method called cognitive-behavioural therapy (CBT), your child will learn how to recognize catastrophic and anxiety-provoking thoughts that cause bodily tension and physical aches and produce intense fear. Your child will also learn to challenge such thoughts, physically calm his or her body and reduce muscle tension, and gradually face fearful situations instead of avoiding them. This method has been proven to be highly effective in treating anxiety.