Recent studies have indicated that 10 to 20 percent of U.S. preschoolers suffer from one of several anxiety disorders.
Signs of anxiety in young children are easy to mistake for trivial childhood growing pains and developmental hiccups. However, when true anxiety manifests in early childhood, it often continues to develop into the adolescent years and even into adulthood. In fact, children with clinical anxiety early have double the risk of anxiety and substance abuse in their teen years, compared with children who don’t have an anxiety disorder. Anxiety in adolescents has been linked to missed school, drug abuse, depression and even suicide.
The first step in preventing this type of future for a potentially anxious child is to be vigilant about thoughtfully observing their behavior and taking the proper steps to intervene. Anxious behavior can manifest and show through physical, emotional and behavioral signs. The following checklist from Understood.org is a great tool to keep on hand.
Researchers have been studying anxiety in young children for decades, tracking the biological roots of anxious minds with the hopes of developing intervention plans to ease anxieties before they become debilitating and life-altering. It’s wildly understood that childhood anxiety is deeply linked to abnormalities in the way the brain processes fear.
If a child is struggling to succeed in typical, age-appropriate activities, some psychiatrists are quick to prescribe antidepressants. However, we don’t have a lot of data to back up the effect of medications like antidepressants in early childhood, and researchers know that antidepressants can cause hyperactivity in young children such as uncontrolled outbursts, restlessness and disrupted sleep. Studies of antidepressants in children tend to be small and shorter than a year in duration, with sparse studies researching the effects of medicating children under age 5.
While there are cases when medication is necessary to help a child cope after exhausting other options, it is never ideal. As an alternative, specialized therapy has proved to help the brain develop anxiety-alternative paths and anxiety coping skills. You will see that cognitive behavioral therapy, a hands-on approach to changing patterns of thinking or behavior, is the most common, and the current gold standard for treating anxiety in adults. Parent-Child Interaction Therapy, or PCIT, is another promising therapy geared at strengthening the parent-child relationship where parents can learn with the child how to manage the fears that trigger anxiety.
Below are the most common anxiety disorders in early childhood and first-steps toward providing an anxious child with the best resources to help ease their anxious mind:
1. Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) causes excessive worry about a variety of subjects like family relationships, relationships with peers and performance in school and sports. Children with GAD tend to be perfectionists who are very hard on themselves when perfection is not attainable. They may also seek constant approval or reassurance from others.
How to help: GAD is often treated with cognitive behavioral therapy. Other techniques involve coaching the child through recognizing their symptoms and understanding what type of thinking triggers their anxiety. This is referred to in some circles as “decatastrophizing.”
2. Panic Disorder
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Panic disorders are diagnosed in children when they have suffered at least two unexpected panic or anxiety attacks followed by at least one month of concern over having another attack, losing control or feeling like they are “going crazy.” By definition, panic attacks come on suddenly and for no apparent reason. Physical descriptions of symptoms are similar to those of a heart attack.
How to help: Through cognitive behavioral therapy, a therapist will begin by reducing negative, avoidance-based behavior patterns. In addition, exposure therapy can counteract anticipatory anxiety through gradual exposure to situations that are associated with attacks.
3. Separation Anxiety Disorder
Many children experience normal levels of separation anxiety between 18 months and three years old when they are first exposed to a parent leaving them at school, daycare or simply being out of sight in another room. Usually, children can be distracted from these feelings and begin to grow out of them naturally as they are exposed to new situations and gain confidence. However, if the behavior continues as the child ages and they are still unable to leave their parent or family member, then the child may be showing signs of separation anxiety disorder, which affects 4 percent of children.
Symptoms include refusing to go to school, playdates or a sleepover, and only feeling comfortable if someone stays with them at bedtime. Children with separation anxiety commonly worry about bad things happening to their parents or caregivers while they are apart.
How to help: Relaxation training is vital for children struggling with Separation Anxiety Disorder. Deep breathing, guided relaxation and progressive muscle relaxation can help children learn to self-soothe during an anxious moment. Play therapy, family therapy and cognitive behavioral therapy are all important in helping a child work through this disorder.
4. Social Anxiety Disorder
Social anxiety disorder, or social phobia, manifest in an intense fear of social and performance situations and activities. This could be as simple as starting a conversation with a peer or being called on in class.
How to help: A therapist will work on improving the child’s social and coping skills during anxiety-provoking situations through cognitive behavioral therapy. Relaxation strategies such as progressive muscle relaxation, guided imagery and breathing techniques are great first steps for children with social anxiety disorders, in addition to working on further developing social skills to boost confidence in social situations.
5. Selective Mutism
Children suffering from selective mutism often refuse to speak in situations where talking is expected or necessary, sometimes to the extent that their condition interferes with making friends and participating in school. Despite sometimes being talkative and seemingly “normal” at home, in public, a child suffering from selective mutism may stand motionless and expressionless, turn their heads, avoid eye contact or remove themselves from people by retreating to a corner or hiding place.
How to help: Even pediatricians and other specialists often misdiagnose selective mutism. It’s commonly mistaken for autism, a communication disorder or that a child isn’t talking because h/she is being willful or oppositional. In reality, children with SM want to talk, but are paralyzed from anxiety—they are not refusing. Be thoughtful observative of your child at home and in public and seek professional help if you feel that your child may be suffering from this painful disorder.
www.childmind.org provides a thorough overview of selective mutism therapy techniques.
6. Specific Phobia
A specific phobia is the intense, irrational fear of a specific object (like a dog) or a situation (like swimming). Common childhood phobias include animals, storms, heights, water, blood, the dark and the hospital. This can manifest in behaviors like crying, tantrums, clinging, avoidance, headaches, and stomachaches. They are unable to recognize that their fear is irrational.
How to help: Specific phobia in childhood is highly treatable through behavior therapy where gradual, repeated exposure to the feared object, event or situation can ease the phobia and give the child control over their anxiety.
Parenting an anxious child can be all-consuming, stressful and overwhelming. It’s important to remember that by educating yourself on anxiety disorder symptoms and being vigilant in identifying the symptoms in your child if they arise, you have the ability to intervene before those anxieties become debilitating. You are their first and most important advocate in their journey towards finding peace and confidence as they grow.