More Than Childhood Fear: How to Identify and Address a Specific Phobia

Many children hang on their mother’s leg with apprehension on the first day of kindergarten.  Other children struggle to sleep some nights because of the monsters they think are under the bed. Or maybe the trip to the dentist each year is a source of anxiety for your child.

These are all normal childhood fears. They are specific to one experience, and they can be worked through, and the child quickly moves on from them.

When a child’s fears become disproportionate to the actual situation and are long-standing, bleeding into many areas of the child’s life, there may be more going on, such as a Specific Phobia.(1)

A Specific Phobia centers on one particular activity, object, animal, or situation. The fear that the child feels drives them to avoid that trigger at all costs. An inability to avoid the trigger causes intense distress.

Some types of specific phobias include:(2)

• Fear of water (Aquaphobia)

• Fear of the dark (Nyctophobia)

• Fear of thunder and lightning (Astraphobia)

• Fear of insects (Entomophobia)

• Fear of dogs (Cynophobia)

• Fear of places or situations that might cause panic (Agoraphobia)

• Fear of social situations (Social Phobia)

 
This isn’t an exhaustive list. There are many other things that children may develop a Specific Phobia around. Looking for the tell-tale symptoms and speaking to a mental health professional are the best ways to determine if your child is suffering from a Specific Phobia.

Symptoms

Children with Specific Phobia can experience both emotional and physiological symptoms. The emotional symptoms of intense, unrealistic fear and panic around a specific situation or thing are what most people think of when they think of a Specific Phobia.(2) However, children can also feel a compelling need to avoid the object of their anxiety. This need for avoidance shapes their behavior and influences how they make decisions. 

Physical symptoms that are experienced with Specific Phobia can include headaches, stomachaches, a racing heart, trembling, difficulty breathing, sweating, and feelings of weakness.(5) Children can experience any combination of these physical symptoms in addition to the emotional symptoms they experience.

Specific Phobia can interfere with many aspects of a child’s life by disrupting their sleep patterns or ability to have fun.(4) It can also cause concentration problems that often result in behavior issues in the classroom. If the symptoms of Specific Phobia have progressed to this point, the child needs help from a mental health professional.

Causes

The three main causes of Specific Phobia are predisposition, genes, and environment. Predisposition speaks to a child’s personality. Some children are more prone to be anxious and are less capable of handling stressors in their lives.

Mental illnesses can be hereditary or related to genetics.(3) A child with more anxious people in their family history is more likely to be diagnosed with a Specific Phobia. Finally, if a child’s environment is stressful, that can also be a cause of Specific Phobia. These environments could include living in a volatile home, feeling stressed at school, having parents going through a divorce, or a loss of a family member.

Very rarely is just one of these factors at play with a diagnosis of Specific Phobia. More often two or three factors are involved to varying degrees.

Treatments

Cognitive Behavioral Therapy (CBT) is often the most effective type of therapy to treat a Specific Phobia.(7) CBT works to help a child identify their thought patterns and how those thoughts may be helping or hurting them. As they begin to recognize what their thought patterns are and the power that they hold, children can work to change those thoughts and, in turn, change their behavior.

One technique of CBT, known as Graded Exposure, helps children systemically face their fears and more effectively manage their symptoms.(6) Through repeated practice of Graded Exposure, a child can gain mastery over their fear.

The mental health professional may help your child understand how the outcome that they imagine when they are anxious is not realistic. They might teach your child how to use self-talk to combat fear. Therapy sessions may also consist of your child learning various relaxation techniques, like breathing exercises.(6) The exercises are great for you as the parent to learn as well so that you can help coach your child through them when they are anxious.

For a child suffering from a Specific Phobia and their parents, an effective technique like Graded Exposure can be an amazing tool. So let me tell you a bit more about implementing Graded Exposure with your child.

Graded Exposure

While treatment of a Specific Phobia should always be overseen by a mental health professional, there are strategies that can be practiced at home to help your child.

My anxiety disorder series, I’M AFRAID, has a book focused on Specific Phobia. Sophia Swan Is Afraid of Water! follows Sophia as she faces her intense fear of water. She uses Graded Exposure to slowly expose herself to water and address her fear step-by-step.

This book can be a wonderful tool to see the practical application of Graded Exposure. Your child may see themselves in Sophia. They can watch as a character that feels the same fear that they do is able to succeed in facing her fears.

The book also has a page outlining this stepladder approach and other coping strategies that may be useful.

Other Therapy Strategies

The mental health professional you partner with may also try other techniques to help your child address their fear.

Role-playing techniques can be a great tool to work through a worst-case scenario that a child is picturing. Through role-playing, the child can most often see how that scenario is not likely or even not possible.

A mental health professional can help a child find the combination of different strategies that work best specifically for them. They can also provide the space and encouragement to continue to practice these techniques until the child is able to use them successfully.

Remember, some childhood fears are normal. The many new and unusual things that a child experiences are bound to bring out some feelings of trepidation. However, if any anxiety is beginning to seem prolonged and unrealistic, reach out for help.(2) Even if there is no diagnosis, it never hurts to have someone come alongside you and your child and give you strategies to cope with anxiety.

Pre-order Sophia Swan Is Afraid of Water! HERE. To check out other books in the I’M AFRAID anxiety disorder series, visit: www.DrMadeleineVieira.com/books/imafraid

Would you like more information on childhood anxiety? Listen to my Genius Little Minds two-part podcast series on childhood anxiety disorders now! Click here for part 1 and Click here for part 2.

And don’t forget to subscribe to my monthly newsletter to stay up-to-date on the latest blogs and podcasts on infant and childhood mental health!

References

1. https://www.nimh.nih.gov/health/statistics/specific-phobia#:~:text=Specific%20Phobia-,Definition,brings%20on%20severe%20anxiety%20symptoms.

2. https://www.mayoclinic.org/diseases-conditions/specific-phobias/symptoms-causes/syc-20355156

3. https://www.med.upenn.edu/ctsa/phobias_symptoms.html

4. https://adaa.org/understanding-anxiety/additional-disorders/phobias

5. https://adaa.org/understanding-anxiety/specific-phobias/symptoms

6. https://www.mayoclinic.org/diseases-conditions/specific-phobias/diagnosis-treatment/drc-20355162

7. https://www.nhs.uk/mental-health/conditions/phobias/treatment/
   

Understanding Generalized Anxiety Disorder: What It Is, Why It Happens, and How to Help Your Child

“What if everyone stands up and leaves when it’s my turn to sing on stage?”

“What if I trip on the playground and no one ever wants to be my friend again?”

“What if all the walls of my bedroom fall in on me?”

These may sound like normal childhood fears; every child experiences fears at some point. However, it is important to be able to spot when normal childhood fear has become overwhelming anxiety. 

Generalized anxiety disorder sounds like a scary term, but breaking it down and understanding it will give you insight into how to cope with your child’s fears. So what is generalized anxiety disorder, what triggers it, and how is it treated? Let’s dive in.

What is Generalized Anxiety Disorder?

Generalized anxiety disorder (GAD) is exactly what the name suggests. A person suffering from this disease doesn’t feel anxiety about one particular thing or situation in their life but instead feels excessive anxiety throughout their daily activities.

They are always worried about what could go wrong, but their fears seem irrational or out of proportion to the situation. The intense worry that they feel about everything often makes it difficult for them to go about their daily life in a normal way.  

Other symptoms can include:

• Difficulty making decisions

• Restlessness or trouble concentrating

• Fatigue or trouble sleeping

• Crankiness or irritability

• Muscle tensions and aches

• Stomach upset, including nausea and diarrhoea

• Headaches

 
About 2% of American adults suffer from generalized anxiety disorder; most of these individuals begin experiencing symptoms in childhood or adolescence.(2) The prevalence of GAD in children is estimated to be similar to adults at 2-4%.(4)

Worry and nervousness are a part of life. Every child will feel these emotions at some point. When the anxiety seems out of control or disproportionate to the situation is when there may be something more going on. You have the power to get them the help they need to manage their anxiety and fears.

What Triggers Child Anxiety?

Oftentimes, anxiety disorders are not caused for reason alone. The risk factors can include environmental factors, genetic influences, and biological factors. Someone with GAD may experience any number or combination of these risk factors.

Environmental factors that may trigger episodes of anxiety include:

• Parental divorce or separation

• Loss of a family member or friend

• Living with an ill or disabled family member

• Living with someone with an anxiety disorder

• Living in a volatile home

• Moving

• Changing schools

• Experiencing a traumatic event

Genes often play a role in the likelihood of a child developing an anxiety disorder. Many mental health professionals will assess the parents’ mental health when diagnosing a child, but family members beyond the parents could also be considered. Children can be predisposed to anxiety disorders if there is a history of anxiety disorders in their family.  

Biological factors can also influence childhood anxiety. Imbalances of certain chemicals in the brain, such as serotonin and dopamine, can lead to feelings of anxiety and depression.(4)

How Can I Help My Child with Generalized Anxiety Disorder?

When your child is suffering from generalized anxiety disorder, it’s easy to feel helpless. Luckily there are many things that you can do to help your child.

Use Cognitive Behavioral Therapy Strategies

Cognitive Behavioral therapy (CBT) is often the first strategy employed by mental health professionals when treating children with generalized anxiety disorder.

CBT works on helping children identify what their thought patterns are and how those thought patterns help or hurt them. They learn to recognize that how they think influences how they feel. CBT can be a useful tool to give children the power back over their anxiety.

Check Out My Upcoming Book

 
Priscillia Puppy Is Afraid of Everything! uses a specific technique in CBT, called Graded Exposure, to help your child manage their anxiety.  

Graded Exposure helps children slowly and systematically face their fears and anxieties. The end goal is to help children learn to manage their anxiety and experience reduced symptoms.

As you read this story with your child, you will see Priscilla Puppy recognize her anxiety, use Graded Exposure, and be successful in managing her fears. Your child will learn how Graded Exposure could be applied to their fears and help them manage their anxiety.

Other Treatment Options

Treatment of generalized anxiety disorder should always be overseen by a mental health professional. Mental health treatment is not one size fits all. Having a professional on your child’s side is invaluable.  

Cognitive Behavioral Therapy is the gold standard for treatment of generalized anxiety disorder. Especially, Graded Exposure Therapy, part of CBT, is a very effective treatment to reduce anxiety symptoms. CBT includes some of the following techniques and strategies: 

• Psychoeducation – Learning about their symptoms and the pattern they follow.(8)

• Somatic management skills – Progressive muscle relaxation or diaphragmatic breathing to control the physical symptoms of anxiety.(5)

• Cognitive restructuring – Learning to reshape maladaptive thoughts or cognitive distortions.(8)

 
The mental health professional will continue to use tools and methods to help your child until they find the ones that work best. Alternative treatment options for your child are Mindfulness-Based Psychotherapy or Psychodynamic Psychotherapy.(6)

Your child’s mental health professional may suggest anti-anxiety medications if all other routes have not improved their symptoms as much as is needed. SSRIs and SSNRIs can be an effective form of treatment for generalized anxiety disorder but should only be used as a last resort and under the careful watch of a psychiatrist or psychologist.(7) Oftentimes, medication will be used in tandem with therapy to give a child all the tools they need to overcome their anxiety.(6)

Generalized anxiety disorder can feel difficult to overcome as it permeates every part of a sufferer's day-to-day life. However, there are many effective treatments. Your child can learn to cope with their anxiety and live a normal life.

Pre-order Priscillia Puppy Is Afraid of Everything! here. To check out other books in the I’M AFRAID anxiety disorder series, visit: www.DrMadeleineVieira.com/books/imafraid

Would you like more information on childhood anxiety? Listen to my Genius Little Minds two-part podcast series on childhood anxiety disorders now! Click here for part 1 and click here for part 2.

And don’t forget to sign up for my monthly newsletter to stay up-to-date on the latest blogs and podcasts!

Resources

1. https://www.drmadeleinevieira.com/books/imafraid/generalizedanxietydisorder

2. https://www.webmd.com/anxiety-panic/guide/generalized-anxiety-disorder#:~:text=Generalized%20anxiety%20disorder%20

3. https://www.med.upenn.edu/ctsa/general_anxiety_symptoms.html

4. https://www.childrenshospital.org/conditions/generalized-anxiety-disorder-gad

5. https://www.heretohelp.bc.ca/infosheet/strategies-for-children-with-generalized-anxiety-disorder

6. Wehry, A. M., Beesdo-Baum, K., Hennelly, M. M., Connolly, S. D., & Strawn, J. R. (2015). Assessment and treatment of anxiety disorders in children and adolescents. Current psychiatry reports, 17(7), 52. https://doi.org/10.1007/s11920-015-0591-z

7. Kodish, I., Rockhill, C., & Varley, C. (2011). Pharmacotherapy for anxiety disorders in children and adolescents. Dialogues in clinical neuroscience, 13(4), 439–452. https://doi.org/10.31887/DCNS.2011.13.4/ikodish

8. https://www.uptodate.com/contents/psychotherapy-for-anxiety-disorders-in-children-and-adolescents

3 Things to Do if You're Raising an Anxious Child

The past couple of years have been hard on all of us. But if you’re a parent, you’re a real hero. Working and parenting from home—all while tackling crippling pandemic anxiety—has become the new norm for many people.

And your children are likely feeling anxious too. They may not use the exact phrase “I’m anxious,” but the pandemic hasn’t been easy on anyone.  And they probably don’t even have the words to describe exactly what they’re feeling.

So it’s up to you to notice and tackle the issue head on.

Is the question, “Mom, what if…?” followed by the disaster of the day on repeat in your household?

No matter how many ways you assure them they’re safe—does their brain still get on an anxiety loop of worst-case scenarios?

And are you struggling to soothe them when their fear or worry becomes overwhelming?

Navigating a childhood anxiety disorder can be really taxing.

There are only so many ways you can assure your child they’re okay. When their brain gets on an anxiety loop of “what if… what if… what if…” it can feel impossible to flip the switch.

So how do you help them cope when you’re hanging on by a thread yourself?

You start with learning the signs and symptoms.

Signs of Anxiety in Children

Anxiety in children can look and sound different than anxiety in adults.

So What Does Childhood Anxiety Actually Look Like?

• Crying spells

• Frequent stomachaches and/or headaches

• Being unwilling to go to school or attend social events with peers

• Being afraid that something bad will happen to you or other loved ones

• Changes in mood, sleeping and eating habits or behavior

 
Symptoms vary from disorder to disorder. That’s why seeking professional evaluation and treatment is so necessary and important.

Should I Be Worried About My Child’s Anxiety?

It’s completely normal for children to be anxious or worried sometimes. They are human, after all! Just like you and me, sometimes they get scared or nervous when facing a new challenge, meeting new people, or being in an unfamiliar environment.

But when a child has an anxiety disorder, they feel extreme fear and worry. And the anxiety they feel is disproportionate to the situation at hand. It might feel impossible for them to relax because their worry is so pervasive. Their “fight or flight” response is activated even when there isn’t any real danger present. And they might have symptoms that show they aren’t coping with their fear and stress very well.

Your child may try to hide their anxiety from you due to shame, fear, or just not knowing what’s going on inside their own body and brain. Try to cultivate a sense of safety so they share their feelings and experiences with you.

If your child’s anxiety is so severe they feel physically ill, don’t want to go to school, have trouble focusing on schoolwork, and you’re unable to soothe them, then you may want to seek professional help.

Anxiety disorders in children and teens are actually quite common. It’s estimated that 1 in 8 children in the US (1) and between 5 and 19% of children and adolescents in the UK have an anxiety disorder. (2)

If you suspect your child has an anxiety disorder, try not to stress yourself out. “Disorder” is not a dirty word! And even if your child has a diagnosable anxiety disorder, it doesn’t mean they’re doomed.

What Causes Childhood Anxiety?

There are a number of factors that contribute to children developing anxiety disorders.

Genetics

This may be hard to hear, but just like your child might have inherited your hair and eye color, they might have also inherited your anxiety. Children of parents with an anxiety disorder can be as much as seven times more likely to develop an anxiety disorder themselves. (8)

Not all children with anxious family members will develop anxiety.

But a 2016 literature review found that panic disorder, generalized anxiety disorder and social anxiety disorder are linked to specific genes. (5)

And predispositions to neuroticism, shyness, conscientiousness and low extraversion also tend to be associated with anxiety. (6)

Most researchers will tell you that genes play a part in a child developing clinical anxiety. But remember, you’re also a hero and role model! When your child sees you coping and using healthy strategies to deal with your anxiety, they learn that anxiety is manageable. Together, you can reduce worries, implement self-care routines, and make healthy choices.

Biology and Brain Chemistry

Biology can also play a role—sometimes children’s dopamine and serotonin neurotransmitters can get out of whack. Consulting with your child’s healthcare provider can help rule out or hone in on any imbalances that need to be addressed.

Anxiety and depression often present simultaneously, so be sure to keep an eye out for depressive symptoms in your child as well. In children and teens, depression may present as irritability. (7) Stay tuned for the upcoming podcast episode with more information on childhood depression and how you can help your child overcome it.

Environmental Factors

A child’s environment also plays a role in how anxious they are. Stressful living situations, major life changes, the death of a loved one, or family problems can make a child’s anxiety skyrocket.

Life can be stressful—that’s just a reality we all have to face. But do your best to come up with a plan with your child before a stressful event so they know what to expect.

And the more you can cope with your own stress and show support as your child learns age-appropriate ways to manage their anxiety, the better.

How Can I Help My Anxious Child?

Calming an anxious child is no easy feat.

Finding a therapist who specializes in anxiety disorders can be extremely helpful. Early detection and intervention can help reduce the severity of symptoms and improve your child’s quality of life. (3)

The best thing you can do is seek out professional help sooner rather than later. Licensed mental health professionals specializing in Cognitive Behavioral Therapy (CBT) and Graded Exposure Therapy are a great place to start. They can also provide training on what you as a parent or caretaker can do to help your child take small steps toward conquering their fears.

Here are 3 steps you can take to help your anxious child today.

1.    Seek Out Professional Help

Therapy is safe and non-invasive. But it does require a medium to long-term commitment of weekly sessions. And those can range from a few months to over a year of treatment, depending on the severity of symptoms.

Cognitive Behavioral Therapy (CBT) is usually the first line of treatment for anxiety disorders, though in some cases medication is also useful. CBT is a form of talk therapy based on the idea that unhelpful thought patterns and behaviors can be changed into more realistic thoughts—which in turn has a positive effect on feelings and behavior. (4)  

Under the CBT umbrella there are two therapeutic interventions that are particularly useful for treating anxiety:

• Graded Exposure Therapy: With a stepladder approach, children are slowly and systematically exposed to the thing they fear, reducing their anxiety symptoms.

• Exposure Response Prevention Therapy: This is the CBT-based therapy of choice for Obsessive-Compulsive Disorder (OCD). It helps children with OCD face their fears while refraining from engaging in compulsive behaviors.

2.    Read Therapeutic Books Together

In addition to therapy, reading therapeutic books together can help your child understand their anxiety. Through storytelling and beautiful illustrations, your child will learn to overcome their fear-based behaviors.

The book series I’m Afraid, which is based on Graded Exposure Therapy, demonstrates that it is possible for children to manage their anxiety.

They’ll find themselves identifying with Sophia Swan Who’s Afraid of Water, Charlie Cub Who’s Afraid to Leave His Mother, or Khloe Kitten Who’s Afraid of Germs. These beautiful stories bring your child’s lived experience to the page. At the end of each story, they’ll see fears are conquerable. Pre-order my therapeutic book series about childhood anxiety disorders today!

3.    Learn More About Childhood Anxiety Disorders

By learning about what your child is going through, you’ll be better equipped to help them cope. Children often have a hard time finding the words to express their anxiety. So being cognizant of the physical signs and behaviors is so important.

Listen to my two-part Childhood Anxiety Disorders series on my podcast, Genius Little Minds, where I unpack 8 anxiety disorders and how they present in children.

Listen here:

Childhood Anxiety Disorders: Part One – My Child Cries When I Go to Work! And Other Anxious Tendencies

Childhood Anxiety Disorders: Part Two – My Child is Afraid of Messes! And Other Anxious Tendencies

And don’t forget to subscribe to stay up to date with the latest in children’s mental health!

References

1. Anxiety and Depression Association of America. Facts & Statistics. 2014. http://www​.adaa.org/about-adaa​/press-room/facts-statistics.

2. (2020, September). Anxiety Disorders in Children. NHS Inform. https://www.nhsinform.scot/illnesses-and-conditions/mental-health/anxiety-disorders-in-children

3. Generalized Anxiety Disorder. Boston Children’s Hospital. https://www.childrenshospital.org/conditions-and-treatments/conditions/g/generalized-anxiety-disorder-gad

4. (2017, July). What is Cognitive Behavioral Therapy. American Psychological Association https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

5. (2019, June). Is Anxiety Genetic? Healthline. https://www.healthline.com/health/mental-health/is-anxiety-genetic#symptoms

6. Personality Traits Associated With Anxiety. Brainsway. https://www.brainsway.com/knowledge-center/personality-traits-associated-with-anxiety/

7. The Relationship Between Anxiety and Depression. Hartgrove Behavioral Health System. https://www.hartgrovehospital.com/relationship-anxiety-depression/

8. (2020, August). Does Anxiety Run in Families? UNC Healthtalk. https://healthtalk.unchealthcare.org/does-anxiety-run-in-families/

Childhood Anxiety vs. Adult Anxiety: How Anxiety in Children Looks Different

Anxiety disorders are some of the most common mental health conditions today. 

7.1% of children aged 3-17 years have an anxiety diagnosis.(1) And it's estimated that 30% of children and adolescents will have an anxiety disorder at some point in their lives.(2)

Anxiety disorders can develop at any age, though we know that half of mental health disorders begin in childhood. While both children and adults can struggle with an anxiety disorder, there are some key differences in how these disorders present themselves.

Read on for the distinctions. 

What Are The Similarities Between Anxiety Disorders in Children and Adults?

First, let’s look at the similarities between childhood and adult anxiety.
Both children and adults with an anxiety disorder often experience: (3)

·       Excessive worrying
·       Feeling restless, irritable, or uneasy
·       Physical symptoms like a racing heart, headaches, or stomach aches
·       Trouble sleeping
·       Difficulty focusing

Each individual will have different symptoms, and some people may experience only a few of these symptoms while others may experience many. Anxiety symptoms also differ across the various types of anxiety disorders.

What Are The Different Types of Anxiety Disorders?

Anxiety disorders are generally characterized by excessive fear or worry. Here are some of the most common disorders: (4)

·       Generalized Anxiety Disorder
·       Phobias
·       Panic Disorder
·       Social Anxiety Disorder
·       Separation Anxiety Disorder
·       Obsessive-Compulsive Disorder
·       Post-Traumatic Stress Disorder

Adults and children can both develop these types of anxiety disorders. So how does anxiety manifest itself in children?

What Does Childhood Anxiety Look Like? 

There are a few key distinctions between adults and children when it comes to anxiety disorders.
Childhood anxiety vs. adult anxiety involves differences in:

·       How children process their anxiety
·       Diagnostic criteria
·       The symptoms children exhibit
·       The prevalence of certain disorders at specific ages

What Are The Developmental Differences?

Perhaps the biggest difference between adults and children is that children have not finished developing. Unlike adult brains, children's brains are still growing and thus, children are still learning how to process the world around them.

Because children's cognitive functioning has not completely developed, children may not be able to identify or understand the source of their anxiety. They just know that they feel scared or uncomfortable. They can also have a difficult time communicating how they feel to others.

How Does Diagnosis of Anxiety Differ in Children?

The DSM-5 includes diagnostic criteria for the different anxiety disorders. Children must meet different diagnostic criteria than adults to be diagnosed with an anxiety disorder. 

For example, to be diagnosed with generalized anxiety disorder, children only need to meet one of the six symptoms listed below, whereas adults need three of the six: (5)

·       Restlessness
·       Easily fatigued
·       Difficulty concentrating
·       Irritability
·       Muscle aches
·       Trouble sleeping

What Are The Signs of Anxiety in Children?

Some signs of an anxiety disorder in children include: (6)

·       Frequent crying
·       Emotional outbursts and tantrums
·       Having difficulty concentrating in school
·       Nightmares

Some of these symptoms may also be present in adults, but are more often seen among children. Because children have a harder time communicating and managing their emotions, they can become overwhelmed, angry, and emotionally dysregulated more easily than adults.

You know how children can get when you tell them, "no?" It's like someone swapped your sweet, well-behaved child for a pint-sized crocodile. 

When it comes to anxiety, the same thing can happen. One second, they're fine, the next they're melting down because they can't find their favorite toy.

They may lack the skills to identify how they feel, the words to express their anxiety, and the coping strategies to deal with these uncomfortable feelings. Thus, they may act out in anger or defiance. A child who seems to be exhibiting disruptive behavior in school may actually be struggling with an undiagnosed anxiety disorder.

A child with obsessive-compulsive disorder, who has to complete certain rituals to alleviate their intense anxiety, may have their behavior misconstrued as being disobedient or oppositional.

Anxiety in children can manifest in a multitude of ways, which is why an evaluation by a mental health professional is the best way to determine an accurate diagnosis and appropriate treatment.

Are There Differences Among Disorders?

Some anxiety disorders are also more common among children than adults.

For instance, while some adults may be diagnosed with separation anxiety disorder, it is more often seen in young children. Separation anxiety is actually a normal part of development until about the age of three. (7) After three years old, if a child continues to struggle with separating from caregivers, they may have separation anxiety disorder.

A child with separation anxiety can have a lot of trouble being away from their parents, even at school. They may cry and cling to their parents when it's time to go, have nightmares about being separated from them, or repeatedly ask if they are going to be okay. 

What Does Adult Anxiety Look Like? 

Unlike children, adults are more likely to be able to identify the source of their anxiety. Adults are generally aware of their anxious thoughts and feelings and can put them into words.

Additionally, because adult brains have fully developed, adults are better able to recognize cognitive distortions and regulate their emotions. 

Well, at least most of the time. Adults can get emotionally dysregulated too—otherwise road rage wouldn't exist.

But in general, adults are better at understanding and managing their emotions.

Summarizing Key Differences Between Anxiety in Adults and Anxiety in Children

While anxiety often looks similar across adults and children, it’s important to know when it can be different. 
The major differences in anxiety disorders between children and adults are:

·       Children are still learning how to process the world around them, while adults have a more developed cognitive functioning
·       Children may not be able to identify the source of their anxiety, while adults are generally more aware of their anxious thoughts and feelings
·       Children's symptoms may include behavior that doesn’t immediately look like anxiety, such as emotional outbursts, anger, and tantrums
·       The DSM has different criteria for diagnosing anxiety disorders in children and adults.
·       Some disorders are more prevalent at certain developmental stages

What Should You Do When You Think Your Child Needs Anxiety Treatment?

If you think your child is struggling with anxiety, seeking professional help is recommended. As a chronic condition, anxiety is not likely to go away on its own. 

But support is available. If you’re not sure where to start, your pediatrician can provide a referral to a therapist or psychologist who specializes in anxiety disorders.

The type of treatment depends on the specific anxiety disorder, but the first line of treatment is often cognitive-behavioral therapy (CBT). CBT helps children learn how to identify and manage their anxious thoughts and feelings. In structured sessions, children are given the tools to recognize their cognitive distortions and learn how to respond to them in a healthy way.

How I Help Children with Anxiety

As a clinical child psychologist who is an anxiety disorder specialist, I've worked with children with anxiety for years. I understand how anxious children think. And I encourage parents to seek expert guidance from a child psychologist first, before turning to medication for anxiety treatment.

My goal is to help children understand their thoughts and feelings and develop healthy coping skills that will serve them for a lifetime. 

Are you looking for more information on how to support your child with anxiety? Be sure to sign up for my newsletter to get regular tips and resources, directly to your inbox.
 

References

1. https://www.jpeds.com/article/S0022-3476(18)31292-7/fulltext

2. https://childmind.org/awareness-campaigns/childrens-mental-health-report/2018-childrens-mental-health-report/

3. https://www.nimh.nih.gov/health/topics/anxiety-disorders

4. https://www.medicalnewstoday.com/articles/types-of-anxiety

5. https://www.ncbi.nlm.nih.gov/books/NBK519712/

6. https://www.nhs.uk/mental-health/children-and-young-adults/advice-for-parents/anxiety-disorders-in-children/

7. https://www.mayoclinic.org/diseases-conditions/separation-anxiety-disorder/symptoms-causes/syc-20377455