When you have a child that has anxiety, it is important to identify what type of anxiety is present. Doing so will help guide his/her treatment. Because not all anxiety is the same, treatments may vary depending on the symptoms and presentation of the worry or worries. A brief description and symptoms of the various kinds of anxiety disorders is listed below.
Generalized Anxiety Disorder (GAD)
Children with GAD are best described as “worry warts” because they experience uncontrollable worry about a number of things. Their brain holds a laundry list of worries. Main symptoms of GAD include excessive worry about ordinary situations (e.g., grades, tests, friends, etc.), worry is uncontrollable, physical symptoms of anxiety (e.g., irritability, sleep disturbance, etc.), and worry present most of the time for at least 6 months.
Separation Anxiety Disorder (SAD)
Children with SAD have difficulty separating from caregivers or home. While uneasiness about separating may occasionally occur in all children, those with SAD have this problem for at least 4 weeks and it interferes significantly with daily life (e.g., going to friends’ houses, bed, or school). Parents too often have limited mobility as a result of the child’s worries. Other symptoms of SAD include excessive worry about harm befalling the parent or caregiver, nightmares involving separation themes, reluctance to go to sleep or engage in activities in fear of being separated from caregiver, and crying/clinging behavior upon separation that is not developmentally appropriate.
Panic Disorder consists of recurrent, unexpected Panic Attacks. These attacks are characterized by a number of symptoms (e.g., racing heart, shaking, nausea, trembling, etc.) that are abrupt and reach a peak in 10 minutes. The child also has feelings of losing control, going crazy, or dying, and begins to avoid situations for fear of having a panic attack. When children experience panic they seek their safety zone, which is usually home.
A phobia is an intense fear of a specific situation/object that poses no real danger. The child avoids the feared situation. When faced with the feared situation, the child displays extreme distress such as crying, freezing, clinging, tantrum etc. Children with phobias are typically worry-free when they avoid the situation. A phobia typically forms when a child overestimates the danger of a situation/object while underestimating the ability to cope with it. Common childhood phobias include airplanes, bees, bugs, dogs, and injections. While most children may not like bees etc., the child with a phobia restricts their activities in an effort to avoid encountering the feared situation. Social phobia is a subtype included in this category. This describes a condition where a child is consistently and extremely shy or uncomfortable around people or situations where performance is the focus (e.g., raising hand in class) and feels significant discomfort about being embarrassed.
Obsessive-Compulsive Disorder (OCD)
Children who suffer from OCD display recurrent obsessions or compulsions that are severe enough to be time consuming and interfere with their daily living. An obsession is an intrusive, unwanted thought or image that is involuntary, irrational, and occurs whether the child wants to think about it or not. A compulsion is a repetitive action (e.g., ordering, checking, counting etc.) performed to suppress or reduce the obsession (intrusive thoughts) the child is having. A child with OCD is in a sense trapped in a vicious cycle of unwanted thoughts and/or behaviors that causes significant anxiety and suffering. A child with OCD believes that unless he/she does something in a certain way, something bad will happen.
There are highly effective treatments for childhood anxiety. Early intervention is important in helping your child get better. If you feel that your child fits a description of one of these anxiety disorders, seek the professional opinion of a child psychologist.
Maria Kanakos, Psy.D.
Licensed Clinical Psychologist