Skipper L Harvey, PsyD
December 19, 2013
www.drskipper.com
drskipper@drskipper.com

Anxiety Disorders and Children

We can all remember a time in our childhood when we were anxious about something (first day of school, move to a new neighborhood, divorce). For most of us, the feelings of anxiety were typically short lived and we were free to go about with the demands of being a kid. Unfortunately, this is not always the case. Children who suffer from a diagnosable anxiety disorder often find themselves consumed with symptoms to the point that they cope by avoiding places and activities. Research has shown that children afflicted with an untreated anxiety disorder are at a higher risk for poor school performance, do not engage in social experiences with peers, and are at an increased risk for substance abuse.

What Is a Diagnosable Anxiety Disorder According to the DSM-V?

• Generalized Anxiety Disorder – Excessive worry about a variety of things such as academic performance, family related matters, peer relationships, and performance in an activity (e.g. sports).

• Obsessive-Compulsive Disorder (OCD) – OCD is characterized by unwanted and intrusive thoughts which are the obsessions and feeling compelled to repeatedly perform rituals and routines which are the compulsions. Obsessions and compulsions are an attempt to relieve anxiety.

• Panic Disorder – This type of anxiety disorder is diagnosed when a child has at least two anxiety or panic attacks that present suddenly and for no known reason. At least one of these attacks must be followed by at least a one month period of concern over having another attack or the consequences of the attack and/or a significant maladaptive change in behavior related to the attacks.

• Posttraumatic Stress Disorder (PTSD) – This type of anxiety disorder involves a child having intense fear and anxiety, becoming emotionally numb or easily irritable, or avoiding people, places, or activities after experiencing or witnessing a traumatic or life-threatening event. Keep in mind that these emotions and reactions are much more intense than what would be considered a normal reaction to such an event. Children who are at the highest risk for developing PTSD are those who directly witnessed a traumatic event, suffered directly from a traumatic event, suffered from mental health problems before the event, and who lack a strong support network. Violence within the home can also increase a child’s risk.

• Selective Mutism - This is diagnosed when children refuse to speak in situations where talking is expected or necessary. Refusal is to the extent that it impairs a child’s ability to successfully perform in school or make friends. Children who suffer this disorder may often stand motionless and expressionless, turn their heads, chew or twirl their hair, avoid eye contact, or withdraw into a corner or other space to avoid talking. It’s important to understand that these children can be very talkative and display normal behaviors at home or in another place where they feel comfortable. The average age of diagnosis is between four and eight years old, or around the time a child enters school.

• Separation Anxiety Disorder Separation anxiety experienced between the ages of 18 months and three years old is pretty characteristic. Feelings of anxiety when a parent/caregiver leaves the room or is out of a child’s sight are pretty normal for this age and stage of development. Children can typically be distracted from these feelings which lessen their anxiety. It is also common for a child to cry when he/she experiences their first day of daycare or pre-school and usually subsides when the parent leaves and the child engages in a stimulating activity. If your child is continually crying or overly anxious upon separating from a parent or being away from home when they are older, between the ages of seven to nine, then Separation Anxiety Disorder needs to be considered. Other symptoms of this disorder include refusing to go to school, camp, or a sleep over and demanding that someone stay with them at bedtime. Children with this disorder also often worry that something bad is going to happen to a parent/caregiver, in particular when they are apart.

• Social Anxiety Disorder (Social Phobia) - This type of anxiety disorder is characterized by an intense fear of performance and social situations and activities such as being called on in class or initiating a conversation with a peer. Needless to say, this can significantly impair your child’s performance in school, including attendance, and can hinder their ability to socialize with peers and develop and maintain healthy peer relationships.

What Should I Do If I Think My Child May Have an Anxiety Disorder?

If you feel your child may be suffering from anxiety to the point that his/her social, academic, emotional, and/or behavior functioning is being negatively impacted it is important to seek professional help immediately. An anxiety disorder will most likely continue, rather than subside on its own, unless properly treated. The two treatment options that have been proven to provide the most benefit are cognitive-behavioral therapy and medication. A psychologist who uses the cognitive-behavioral approach will teach skills and techniques to your child that he/she can use in their real world to reduce symptoms of anxiety. Depending on severity, it is possible that medication can be a short-term treatment option while new coping skills are learned and implemented to improve overall functioning. Because of this, it is important that the treating psychologist and prescribing physician work together for the benefit of your child’s treatment.

Websites for Additional Information on Anxiety Disorders

http://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/Anxiety_Disorder_Resource_Center/FAQ.aspx

http://www.additudemag.com/adhd/article/5231.html

http://kidshealth.org/parent/emotions/feelings/anxiety_disorders.html

http://www.webmd.com/anxiety-panic/guide/recognizing-childhood-depression-anxiety

http://www.childmind.org/en/posts/articles/2013-3-26-anxiety-and-disruptive-behavior

About Dr. Skipper
Dr. Skipper is a Florida Licensed Clinical Psychologist who works extensively with children, adolescents, and families to provide therapy and psychoeducational assessment services.

She received her doctorate degree from the Florida School of Professional Psychology.  Dr. Skipper has worked with children, adolescents, and families in a variety of settings which include mental health clinics, residential settings, drug treatment facilities, and schools.

Through the integration of a variety of empirically-based treatment approaches, Dr. Skipper assists her clients by providing new skills and empowering strategies to build distress tolerance, enhance awareness and communication, facilitate insight, and challenge maladaptive relationship and thinking patterns. She employs an active therapeutic stance to facilitate long-lasting, positive change. 

Dr. Skipper’s background also includes a B.A. in Elementary Education with 11 years of experience in primary education. 

Disclaimer: The above information is not intended to provide professional advice or diagnostic service. If you have any concerns about Anxiety Disorders or other health issues, please consult a qualified health care professional in your community.