Anxiety Disorders

What is it?

Children and adolescents with anxiety disorders typically experience intense fear, worry, or uneasiness that can last for long periods of time and significantly affect their lives. Anxiety disorders are among the most common mental, emotional, and behavioral problems to occur during childhood and adolescence. About half of children and adolescents with anxiety disorders have a second anxiety disorder or other mental or behavioral disorder, such as depression. In addition, anxiety disorders may coexist with physical health conditions requiring treatment.

• Repeated school absences or an inability to finish school
• Impaired relations with peers
• Low self-esteem
• Alcohol or other drug use
• Problems adjusting to work situations
• Anxiety disorder in adulthood

What does it look like?

Generalized Anxiety Disorder: Children and adolescents with generalized anxiety disorder engage in extreme, unrealistic worry about everyday life activities. They worry unduly about their academic performance, sporting activities, or even about being on time. Typically, these young people are very self-conscious, feel tense, and have a strong need for reassurance.

Separation Anxiety Disorder: Children with separation anxiety disorder often have difficulty leaving their parents to attend school or camp, stay at a friend’s house, or be alone. Often, they “cling” to parents and have trouble falling asleep. Separation anxiety disorder may be accompanied by depression, sadness, withdrawal, or fear that a family member might die.

Phobias: Children and adolescents with phobias have unrealistic and excessive fears of certain situations or objects. Many phobias have specific names, and the disorder usually centers on animals, storms, water, heights, or situations, such as being in an enclosed space.  Social phobia is extreme anxiety about being judged by others or behaving in a way that causes embarrassment.

Panic Disorder: Repeated “panic attacks” in children and adolescents without an apparent cause are signs of a panic disorder. Panic attacks are periods of intense fear accompanied by a pounding heartbeat, sweating, dizziness, nausea, or a feeling of imminent death. The experience is so scary that young people live in dread of another attack.

Obsessive-Compulsive Disorder (OCD): Children and adolescents with obsessive-compulsive disorder become trapped in a pattern of repetitive thoughts and behaviors. The pattern is very hard to stop, even though they may recognize that the thoughts or behaviors appear senseless and distressing. Some examples of compulsive behaviors may include repeated hand washing, counting, or arranging and rearranging objects.  Typical obsessions may include worrying about contamination or fears of acting violently.

Post-Traumatic Stress Disorder (PTSD): Can affect individuals who have witnessed or have been involved in a traumatic event that involved intense fear, helplessness, or horror. Signs of PTSD last more than a month after the event and can include persistent frightening thoughts and memories that may be reenacted through traumatic play or nightmares. Reminders of the even cause emotional distress and often physical reactions including headache, stomachache, or dizziness. Children and adolescents can also become more impulsive, lose interest in things they used to enjoy, appear depressed, have difficulty sleeping, have bursts of anger and irritability, increased difficulty concentrating, and are more easily startled.

How is it treated?

Following an accurate diagnosis, possible treatments include:

• Cognitive-behavioral treatment, in which young people learn to deal with fears by modifying the ways they think and behave
• Relaxation techniques
• Biofeedback to control stress and muscle tension
• Family therapy
• Parent training
• Medication

For more information

Centers for Disease Control and Prevention
www.cdc.gov

Clinical Trials, National Institutes of Health
http://clinicaltrials.gov/

Substance Abuse and Mental Health Services Administration
http://mentalhealth.samhsa.gov

National Institute of Mental Health
www.nimh.nih.gov

Anxiety Disorders Association of America
www.adaa.org

Obsessive Compulsive Foundation
www.ocfoundation.org

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