Diseases & Conditions


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Anxiety disorders


Mental health disorders characterized by persistent worry. Anxiety disorders are the most common type of mental health disorder in children, affecting as many as 10 percent of young people. Studies suggest that children or adolescents are more likely to have an anxiety disorder if their parents have the same condition. All children experience ANXIETY occasionally; for example, from about eight months of age through the preschool years, healthy youngsters may show intense anxiety when separated from their parents. Young children may have short-lived fears of the dark, storms, animals, or strangers. Anxiety becomes a problem when it interrupts a child’s normal activities, such as separating from parents, attending school, and making friends. Parents should consider seeking the evaluation and advice of a child and adolescent psychiatrist. Symptoms Anxious children are often overly tense. Some may seek a lot of reassurance, and their worries may interfere with activities. Because anxious children may also be quiet, compliant, and eager to please, their problems may be overlooked. Parents should be alert to the signs of severe anxiety so they can intervene early to prevent complications. There are several types of anxiety disorders that affect children, including generalized anxiety disorder, SEPARATION ANXIETY DISORDER, SOCIAL PHOBIA, OBSESSIVE-COMPULSIVE DISORDER, and POST-TRAUMATIC STRESS DISORDER. Generalized Anxiety Disorder Children with generalized anxiety disorder have recurring fears and worries that they find difficult to control. They worry unnecessarily about almost everything—school, sports, being on time, even natural disasters. They may be restless, irritable, tense, or easily tired, and they may have trouble concentrating or sleeping. Children with generalized anxiety disorder usually are very eager to please others and may be “perfectionists,” dissatisfied with their own less-than-perfect performance. Separation Anxiety Disorder Children with separation anxiety disorder have intense anxiety about being away from home or caregivers to the point where social or school functioning is affected. Such children have a great need to stay at home or close to their parents. When they are apart, these children may worry excessively about their parents, and when they are together, the children may cling to parents, refuse to go to school, or be afraid to go to sleep. Repeated nightmares about separation and physical symptoms such as stomachaches and headaches are also common. Social Phobia Social phobia usually emerges in the mid-teens and typically does not affect young children. Children and adolescents with this disorder have a constant fear of social or performance situations, like speaking in class or eating in public. They are always afraid of being embarrassed in these situations. This fear is often accompanied by physical symptoms, such as sweating, blushing, heart palpitations, shortness of breath, or muscle tenseness. Young people with this disorder typically respond to these feelings by avoiding the frightening situation, such as staying home from school or not going to parties. Young people with social phobia are often overly sensitive to criticism, have trouble being assertive, and have low self-esteem. Social phobia may be limited to certain situations so that the adolescent may experience a sense of dread in relation to dating or recreational events but may be confident in school and work situations. Obsessive-Compulsive Disorder Children with obsessive-compulsive disorder have frequent and uncontrollable thoughts (“obsessions”) and/or perform routines or rituals (“compulsions”), usually to get rid of the thoughts. This disorder often involves repeating behaviors to avoid some imagined consequence, so that a child might constantly wash hands because of a fear of germs. Other common compulsions include: counting, repeating words silently, and rechecking completed tasks. The obsessions and/or compulsions may take up a lot of time and cause a child much anxiety. Typically, this disorder begins in adolescence. Post-Traumatic Stress Disorder Children who experience a physical or emotional trauma, such as witnessing a shooting, surviving physical or sexual abuse, or being in a car accident, may develop post-traumatic stress disorder (PTSD). Children are more easily traumatized than adults: An event that may not be traumatic to an adult might be to a child, such as a turbulent plane ride. As a result of the trauma, a child may “reexperience” the event through nightmares, constant thoughts about what happened, or by reenacting the event while playing. A child with PTSD will experience symptoms of general anxiety, including trouble sleeping and eating or being irritable. Many children may exhibit other physical symptoms as well, such as being easily startled. Treatment Anxiety disorders are treatable, especially with early diagnosis. Effective treatment for anxiety disorders may include some form of psychotherapy, behavioral therapy, or medications. Children who exhibit persistent symptoms of an anxiety disorder should be referred to and evaluated by a mental health professional who specializes in treating children. The evaluation may include psychological testing and consultation with other specialists. A comprehensive treatment plan should be developed with the family, and whenever possible, the child should be involved in making treatment decisions.