When to WORRY about WORRY

March 4, 2013

Kids worry…and we parents worry about our kids worrying.   It’s normal for a preschooler to fear separation from his/her mother or to worry that monsters are under the bed.  A school-age child might be nervous starting a new school or before a test.  But when a child of eight or nine is afraid to sleep alone or if test anxiety becomes a panic attack, this could signal a problem.

The difference between normal worry and an anxiety disorder is the severity and duration of the anxiety.  While feeling nervous is a natural and, even healthy, reaction to stressful situations, these nerves grow into a disorder when they interfere with a child’s ability to handle everyday situations, or prompt the child to avoid things that most children his/her age enjoy.   Nearly 15 percent of children ages 7 to 18 meet the criteria for some form of anxiety disorder.  Anxiety tends to go unrecognized longer in children than in adults because children are unlikely to understand the problem and ask for help.   Anxious children are often quiet, compliant and eager to please – flying under the radar of caring family and school personnel.
Heredity plays a role.  A child with an anxious parent is seven times more likely to develop an anxiety disorder, though the type may differ.  While adults with anxiety typically experience feelings of restlessness, irritability and trouble concentrating, anxiety in children tends to show up in avoidance behaviors or in somatic complaints.  Refusal to go to school or the homes of family or friends, chronic headaches, difficulty falling asleep or staying asleep, stomach problems and unusual tantrums and clinginess may all be symptoms of anxiety in the child lacking in the language skills necessary to express their feelings.
Cognitive-behavioral therapy (CBT) and medication are typical treatments. CBT is a skill-based approach that teaches new ways to think and act. CBT can help children examine how their thoughts, feelings and actions are interwoven and how shifting thoughts can help to balance feelings and actions. Parents should stay abreast of the strategies used in therapy so that the child can be encouraged and supported in practicing new skills. Medication options should be explored with an experienced child Psychiatrist. Children with untreated anxiety are prone to depression, substance abuse, and other mental-health problems.
Here are some ways to distinguish every day worries from several types of anxiety:

·   Severe anxiety is out of proportion. A second grader might be nervous about taking a spelling test. A boy with generalized anxiety disorder (GAD) might be so worried that he starts studying for the test a week early and loses sleep for days.

·   Severe anxiety is being overly self-conscious. A girl might be nervous before performing in her first recital. Someone with social anxiety disorder might have a panic attack prior to ordering in a restaurant.
·   Severe anxiety is often unwanted and uncontrollable. A typical kindergartner might cry at school because he misses his mother. An older boy with separation anxiety disorder might cry at school because he can’t stop thinking that his mother will die if he is away from her.
·   Severe anxiety is unrealistic. A girl might be afraid of burglars robbing the house. Someone with obsessive-compulsive disorder (OCD) might think burglars will come unless she touches everything in her room twice.
·   Severe anxiety doesn’t go away. While anxiety symptoms are common and even expected after a disturbing experience such as a car accident or a flood, over time most children bounce back. Six months later a boy with post-traumatic stress disorder (PTSD) will still be having nightmares.
·   Severe anxiety leads to avoidance. A girl might be nervous about going to a birthday party. A girl with a specific phobia of clowns might refuse to go to birthday parties at all because she’s afraid that a clown may be there.
Examples courtesy of Child-Mind Institute, Jerome Bubrick, PhD
If you suspect that anxiety is interfering with your child’s ability to function, talk to someone – Pediatrician, Psychologist, School Personnel – and get a referral for help. Contact WISE Mind Solutions and we will brainstorm with you next steps for your family!   Be WISE!


Little boy image used with permission:  By Tina Phillips, published on 18 May 2010 Stock photo – image ID: 10016803
Little girl image used with permission:  By marin, published on 12 November 2012Stock photo – image ID: 100112499