"Reports that say that something hasn't happened are always interesting to me, because as we know, there are known knowns;there are things we know we know.We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns-the ones we don't know we don't know."
Monday, August 4, 2014
Symptoms of anxiety in children and information about child anxiety disorders
Just like adult anxiety, children can also suffer from anxiety. In fact, anxiety in children should be expected at specific times during development and is in those cases regarded as normal (for example, the first day of school). Some children may also suffer fromexcessive shyness and may struggle to adjust to new situations.
They may not yet have the ability to vocalize their feelings, nor the coping skills needed to manage them - making their fears and anxiety even more difficult for them to cope with.
Most children have short-lived fears, and quickly grow out of them as they learn through experience that there is no real danger in the things they fear. For example, a child will learn that there are no monsters under the bed or that when mom leaves for work, she will come back at the end of the day. This is regarded as a routine part of development.
Some children are more anxious than others and may need additional reassurance or help from a professional, especially if an Anxiety disorder is suspected. Anxiety becomes a problem if it begins to affect your child’s daily routine and functioning or if it is causing your child significant distress.
When is Child Anxiety Normal?
It is normal for all children to experience certain anxieties at specific developmental stages.
Between 7 and 11 months, healthy youngsters will often feel anxious around unfamiliar faces.
Between 7 months and the 3 years, most children experience anxiety when separated from
Young children may have short-lived fears, such as fear of the dark, storms, animals, or ‘monsters’,
and they often develop temporary ‘phobias’ after particular bad experiences. A child may fear
dogs after being bitten by a dog.
When they start going to school, they are subject to school concerns such as ‘fitting in’, academic and social pressures, and other anxieties that arise as a result of developing an independent sense of self.Anxieties such as these are normal and should resolve over time
and through reassurance.
Diagnosing Child Anxiety
Recognizing child anxiety disorders can be tricky since the symptoms of anxiety in children are often different to those we observe in adults. Moreover, children of different ages and temperaments may display different symptoms. Here are some tell-tale signs and symptoms of child anxiety:
Nightmares or night terrors
Avoidance of certain activities (such as school or social events)
Being overly clingy and crying easily
Frequent feelings of panic and fear that disrupt activities
Constant worrying about future events
Difficulty making friends and being overly shy
Low self-esteem and lack of confidence
Fears of embarrassment
Fears of making mistakes
Compulsive behaviors (such as checking under the bed or in the closet before bedtime)
Extreme resistance to any change
Recurrent physical symptoms, such as stomach ache or headache, without an apparent cause
What Causes Child Anxiety?
Separation anxiety is very normal in young children and usually subsides with age. Faced with separation from familiar people, your child may throw tantrums, refuse to go to school or become insistently clingy, tearful or manipulative. If an older child or teenager persists with this behavior, they may have separation anxiety disorder and professional help may be required.
Change and fear of the unknown. Like adults, children often fear the unknown and are cautious in new and unfamiliar situations. The first day of school, meeting new people or moving neighborhoods can be an anxious time for your child.
Traumatic events. Unpleasant or bad experiences can lead a child to believe that certain things are ‘dangerous’ or threatening. This could include an embarrassing social situation, or one that caused physical harm or fright (such as a dog bite or a near accident). In particularly distressing situations there is the risk of post-traumatic stress disorder (PTSD) and your child may need professional counseling.
School related problems. Your child may be anxious about something going on at school such as bullying, trouble making friends, or a strict teacher. In some cases the anxiety may stem from difficulties coping with school work and a Learning Disorder may be the root cause.
Family problems. A disturbance in the home environment may cause your child to feel anxious. Hearing or seeing parents continually fight can be particularly distressing for your child and make them feel insecure. Other family issues that may lead to an anxious child are separations and divorce, death or illness in the family, and inconsistent or harsh discipline.
Learned behavior. Children can often ‘pick up’ or adopt anxious behavior from parents. This is especially true for children with over-protective or overly anxious parents (who themselves may suffer from an anxiety disorder).
Help for Child Anxiety
Anxiety in children may be managed in a variety of ways. Recognizing child anxiety disorders is the first step. Methods used in treating child anxiety may be conventional (allopathic) or involve a more holistic approach.
Conventional Medical Treatments for Childhood Anxiety
When treating child anxiety it is important that your doctor do a full medical examination in
order to exclude physical causes unrelated to anxiety. This will involve a medical consultation
as well as certain tests – for example blood tests.
The conventional or allopathic approach to treating child anxiety is to treat it with prescription
medication to relieve the symptoms of anxiety as well as tricyclic or SSRI antidepressants to treat the
condition from more long term point of view.
In severe cases, especially when there are high levels of restlessness, doctors will prescribe medication
which has been intended to treat psychosis. A combination of these drugs may also be prescribed.
Doctors may also refer your child to a psychologist for assessment and therapy. Be sure to research
the options thoroughly before deciding what is best for your child.
Unfortunately it is not uncommon for doctors to prescribe high schedule psychiatric drugs as a first option afterrecognizing child anxiety disorders. Before agreeing to this course of action, make sure
that you read up on the side effects and potential for addiction of the drugs your doctor is
recommending and seek a second opinion if you are not happy with the advice you are getting.
Many children end up taking a cocktail of high schedule drugs in order to deal with the side effects of
the medication that was first prescribed. Considering the fact that there are safer and equally viable
alternatives, it is not necessary for children to be subjected to this (see below for more information).
Research has shown that a combination of treatment interventions has the best chance of success in the
treatment of anxiety conditions. Here are some more alternatives to investigate:
There are a number of books available for parents with anxious children. These can be especially
helpful in teaching parents strategies to assist their anxious child while promoting positive parenting
techniques that help build confidence and good self image.
Play therapy with a qualified psychologist can be very beneficial to a child struggling with anxiety.
Through the power of play, children often re-enact their fears and anxieties and are able to come to
solutions and happy endings for their own problems. Play therapy is also a useful tool in communicating
with young children to determine the root cause of the anxiety as they play out specific themes.
More Information on Child Anxiety
Anxiety as a Symptom
If you do feel that your child’s anxiety is not age-appropriate or out of the normal range, seek a
professional opinion as one of the following disorders or medical conditions may be the underlying cause:
Generalized Anxiety Disorder (GAD)
Post-Traumatic Stress Disorder (PTSD)
Separation Anxiety Disorder
Social Anxiety Disorder
Obsessive Compulsive Disorder (OCD)
Hyperthyroidism or hyperparathyroidism
Vestibular or inner-ear disorders
Tips for Parents
Encourage your child to discuss his/her fears with you. Children who are encouraged to talk
about their concerns and feelings, will feel comforted and less alone. By listening to your child, you
may also discover what the underlying problem is and therefore find ways to help. Suggest that
your child write a story or draw a picture of scary things, and look for clues to help you understand
his fears better.
Reassure and comfort your child. Children need lots of hugs and assurance that they are
safe and understood. It is important to acknowledge their fears as being real to them and
not trivialize their
feelings. What children fear may seem silly to you, but that doesn’t make the emotion any less real.
Watch out for your own anxieties and worries. In some cases, anxiety is a learnt response and
children may be picking up on your tensions. You are your child’s best model for behavior!
Teach your child relaxation techniques like deep breathing during anxious moments,
counting to 10 or self-soothing statements. These methods can help to empower your child and
will provide the inner confidence needed to overcome the fears.
Routines and plenty of warning before change can go a long way to making your child feel
more secure and less anxious. Explain new situations in advance in a simple, friendly manner.
(Try role playing to prepare for upcoming situations)
Remind your child of old fears that they overcame. This will provide the courage and
confidence to face current fears. Always praise children’s efforts and successes when they do
confront these anxieties.
Do not accommodate your child’s fears. If your child fears something, don’t purposefully
avoid it as this will reinforce the need for escape and confirm the ‘reality’ of the danger. However,
DO reassure your child and try to help him or her through the situation successfully.