Anxiety is treatable
Anxious feelings, worries, or fears are common among children and adolescents. Most children experience a normal amount of apprehension in certain situations, whether it is an upcoming test, change in schools, or a thunderstorm. Anxiety is a normal part of childhood, and every child goes through phases of apprehension and worry, but a phase is temporary and usually harmless. Children who suffer from an anxiety disorder experience fear, nervousness, and shyness, and start to avoid places and activities and may even skip school. These children tend to get "stuck" on their worried thoughts and have a hard time doing normal daily functions like going to school, playing, falling asleep, or trying new things. Getting "stuck", when it begins to interfere with daily functioning, is the key. This is what separates normal childhood worries from an anxiety disorder that requires professional intervention.
Anxiety is very treatable, but 80% of kids with a diagnosable anxiety disorder and 60% of kids with diagnosable depression are not getting treatment, according to the 2015 Child Mind Institute Children's Mental Health Report. Anxiety disorders affect one in eight children. Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse.
What are anxiety disorders?
There are many types of anxiety disorders including generalized anxiety, social anxiety, separation anxiety, panic disorder, selective mutism, specific phobias, obsessive compulsive disorder, and post traumatic stress disorder. However, these all share the symptom of excessive fear and cause significant distress interfering with ability to maintain daily functions for at least 6 months. Anxiety is the anticipation of real or perceived fear and is reduced by pervasive avoidance behaviors. The most common symptoms in children and teens are:
- Excessive worry and apprehension that is difficult to control
- Feeling restless or "on edge"
- Easily fatigues
- Difficulty with concentrating
- Muscle tension
- Sleep disturbances
Research has shown that they are caused by a combination of temperament, environmental factors and genetics. While this is true, only with a careful evaluation can you determine the underlying thought patterns that fuel the anxiety.
- Temperament: Children with a tendency towards behavioral inhibition, negative affect (neuroticism), and harm avoidance have been associated with anxiety disorder.
- Environmental: Although adverse childhood experiences and parental overprotection have been associated with anxiety disorder, no factors have been identified sufficient enough for making the diagnosis without additional criteria.
- Genetics: One third of the risk of experiencing anxiety is genetic, and these genetic factors overlap with the risk of neuroticism and shared with other mood disorders, specifically depressive disorder.
The first step to successful treatment is a comprehensive and thorough assessment of functioning. The assessment includes:
- Review of current symptoms, concerns, duration and intensity
- A thorough review of child development and past medical history
- Review of family systems
- Additional important family background information including history of mental health issues
- Play therapy to assist child in expressing what is troubling them when they do not have the verbal language to express thoughts and feelings.
- Family therapy including play to explore and/or challenge existing family dynamics
- Cognitive behavioral therapy to replace negative thought patterns
- Mindfulness training to learn grounding skills to cope with anxiety
- Psycho-education with family to learn causes, symptoms, and treatment of anxiety