Recognizing Anxiety Disorders In Children
It’s not uncommon for a child to experience anxiety or fear. Certain situations in any child’s life are bound to evoke such feelings—the first day of school, a public recital, a big test. But some children have fears that go far beyond such rational and limited causes, and escalate into the true essence of anxiety disorders in children.
This can be hard to recognize in a young child, partly because we expect them to be innocent and untouched, and also because children may not be able or willing to let you know what is happening in their minds and bodies at these times. You need to be able to spot and interpret unusual or extreme behaviors—does your child worry excessively about school assignments? Is she too much of a perfectionist, doing the same assignment over and over because it’s just not right? Does he cling and whine, constantly needing your attention and support?
One clue can be the development of obsessive-compulsive behaviors. These behaviors can arise in children as early as age two or three, though they more commonly emerge at 10 or older. For children as for adults, OCD involves an inability to shut off unwanted thought and behavior patterns. The child repeats certain actions compulsively—washing hands, checking under the bed, counting and recounting.
Children also can develop panic disorder, which tends most often to be diagnosed in adolescence. Again, in for adults, a formal diagnosis of panic disorder diagnosis is based on a person having experienced at least two full-blown attacks and continuing to experience anxiety about a possible recurrence over an extended period—a month at minimum.
Persistent phobias are another external sign that can be evidence of anxiety in children. It may be a little difficult to tell the difference between more normal though equally unfounded fears in children—many children are afraid of the dark, of loud storms, of large animals. But if the fear takes over their lives, interfering with school or play, or lasts for many months, it may need further investigation to determine whether it is an actual phobia and a sign of a deeper anxiety that would benefit from treatment.
Children are particularly susceptible to the emotional effects of powerfully stressful events—the death of a close relative or friend, a serious accident or household disaster, for instance. Such events can induce post-traumatic stress syndrome even in children, resulting in nightmares or other sleep disturbances, reduced appetite, emotional dissociation, and constant fear of recurrence.
Children have far fewer resources available to them to understand what is happening to them and reach out for help. The younger they are, the more vulnerable they are. It is vital that the adults in their lives be sensitive to and aware of the external behaviors that are a sign of internal anxieties and fears. Tears, tantrums, and periods of increased dependence are normal phases of most children’s development, but when taken to extremes and continued for long periods, these may also be signs that the child needs professional help. If you have any concern that your child is experiencing some form of anxiety disorder—whether panic attacks, OCD, or post-traumatic stress—a visit to your pediatrician is the place to start.
