Anxiety disorders are among the most common mental health conditions affecting children in Australia, as well as the most common conditions we see walk through our doors. Needless to say, these disorders tend to have a significant impact on a child's emotional well-being, social functioning, academic performance, and overall quality of life.
Types of Anxiety Disorders in Children
There is no limit to the type of anxiety disorder a child can experience, with some of the most common disorders being;
Generalised Anxiety Disorder: Children with GAD experience excessive worry about a wide range of everyday situations, as well as the physiological symptoms of anxiety such as a racing heart, muscle tension, shaking, and a sore tummy. Children with GAD are often easily fatigued, restless, irritable and have difficulty concentrating.
Separation Anxiety Disorder: Separation Anxiety Disorder is characterised by excessive distress at the idea of being separated from loved ones. This can result in severe anxiety when anticipating separation and may lead to clinging, difficulty attending school/sleepovers, plus physical symptoms such as headaches and tummy aches.
Social Anxiety Disorder: children with Social Anxiety Disorder have marked fear or anxiety about social situations in which they may be scrutinised, e.g., having a conversation, meeting unfamiliar people or performing in front of others. They may avoid social interactions, cry or freeze and endure social situations with intense fear and anxiety.
Specific Phobias: Specific Phobias involve marked fear or anxiety about a specific object or situation e.g., flying, thunderstorms, animals, needles. The fear results in children going to great lengths to avoid the object or situation, and may result in panic, crying, freezing or clinging.
Causes and risk factors:
Genetics: Children with a family history of anxiety disorders, are at increased risk of experiencing anxiety disorders themselves.
Neurobiological factors: It’s thought that imbalances in neurotransmitters like serotonin and dopamine, as well as abnormalities in brain regions controlling fear, may contribute to anxiety disorders.
Temperamental factors: Each child is born with a certain temperament, and some temperamental traits such as a high sensitivity to stress and behavioural inhibition may predispose children to anxiety disorders.
Life stressors: Adverse childhood experiences such as abuse or trauma as well as familial stressors such as divorce or separation, lead a child to being more vulnerable to an anxiety disorder
Signs and symptoms: Early intervention is key to successfully treating anxiety disorders in children, so being on alert for the following signs and symptoms can help with early identification:
Excessive worry or fear about specific situations or events.
Physical symptoms such as headaches, stomach aches, or muscle tension.
Avoidance of anxiety-provoking situations or activities.
Difficulty sleeping or nightmares.
Irritability, restlessness, or difficulty concentrating.
Changes in eating habits or weight loss.
School refusal or academic decline.
Excessive reassurance-seeking or clinginess.
Frequent somatic complaints without medical explanation.
Assessment and diagnosis: Diagnosing an anxiety disorder requires assessment by one of our Clinical Psychologists and includes the following;
A thorough clinical interview with parents to gather information about development, symptoms, psychosocial factors and family history.
Formalised and standardised assessment tools/scales to measure the severity of anxiety symptoms and impairment in functioning.
Medical evaluation to rule out any underlying medical conditions that could be contributing to your child’s anxiety such as low iron or thyroid dysfunction.
Treatment and intervention: Anxiety disorders are highly treatable and a number of evidence-based treatments exist, some of these include:
Cognitive Behavioural Therapy (CBT): CBT is the most commonly used intervention for childhood anxiety disorders and targets the behaviours and cognitions that perpetuate anxiety.
Exposure therapy: exposure therapy is used to gradually expose children in a safe way to their feared object/stimulus to habituate the anxiety response. This is particularly useful for Specific Phobias and OCD.
Medication: In some cases, the symptoms of anxiety may be so severe or debilitating that medication is prescribed under the supervision of a child Psychiatrist or Paediatrician. These usually include selective serotonin reuptake inhibitors (SSRI’s) such as Fluoxetine.
Tips to helping your child with anxiety:
Help children recognise and understand their anxiety by educating them about anxiety. Ensure the child anxiety is a normal human emotion and that they are not weird or going crazy. It helps to sometimes name the ‘anxiety creature’, to help with externalising the anxiety.
Teach your child relaxation strategies such as belly breathing, progressive muscle relaxation and visualisation.
Put together a ‘fighting anxiety’ toolkit or box with activities and suggestions that help your child beat their anxiety. This might include worry dolls, fidget toys, other sensory soothing objects, a bubble blower for slow breathing, and positive affirmation cards.
Talk to your child about their thinking. One way of doing this is to introduce your child to the concept of red thoughts and green thoughts. Red thoughts make us feel bad, green thoughts help us feel positive. Teach your child how to challenge their catastrophic red thoughts and turn them around into green thoughts.
Help your child to very slowly and gradually face their feared stimuli. For example, if your child has a phobia of dogs start by talking about dogs, then looking at pictures of dogs, then videos, etc. When done correctly this helps extinguish the fear response.
See a Clinical Psychologist with your child to help them take control of the anxiety creature.
Buy your child books on anxiety. Such as:
Excellent advice thank you 😊