What is Obsessive-Compulsive Disorder? With 3 Paths to Recovery
If you’re noticing signs of Obsessive-Compulsive Disorder (OCD) in your child or if they’ve recently been diagnosed with OCD, it can be difficult to know what to do.
This mental illness is often misunderstood because of its representation in the media. It’s often described as simply liking a clean room or keeping things a certain way. Clinical OCD is much more intense than this. It often needs professional intervention for the person to be able to live a normal life.
So, what are the signs and symptoms of OCD in children? How can you help after a diagnosis of childhood OCD? It’s all outlined here.
If you’re noticing signs of Obsessive-Compulsive Disorder (OCD) in your child or if they’ve recently been diagnosed with OCD, it can be difficult to know what to do.
This mental illness is often misunderstood because of its representation in the media. It’s often described as simply liking a clean room or keeping things a certain way. Clinical OCD is much more intense than this. It often needs professional intervention for the person to be able to live a normal life.
So, what are the signs and symptoms of OCD in children? How can you help after a diagnosis of childhood OCD? It’s all outlined here.
Signs and Symptoms
The hallmark symptom of OCD is ritualistic behaviors. These ritualistic behaviors are done repeatedly and excessively. Some ritualistic behaviors include washing hands, rechecking items like ovens or door locks, putting things in a particular order, counting the same set of objects, repeating certain words or phrases, or separating food on a dinner plate.
OCD behaviors are different for every individual. This list of behaviors is not exhaustive. Any behavior that is done over and over excessively may be a sign of OCD.
Other emotional symptoms of OCD include:
Intense worry or fear about having things in a particular order
Extreme fear of germs, dirt, or bodily waste
Constant doubts about something being done, like the door being locked or the oven being turned off
Strong need to have tasks done perfectly
Compulsion to touch or count objects
Destructive thoughts
Lack of self-esteem or self-confidence
Difficulty concentrating at school or home
A sense of panic if they aren’t able to perform their rituals exactly as they’d like to
A sufferer of OCD may also experience physical symptoms from their mental state. These include:
Racing heart
Headaches or stomachaches
Shaking and trembling
Difficulty breathing
Feelings of weakness
Intense fatigue
Sweating
Difficulty sleeping
When these symptoms begin to interfere with a child’s ability to function normally is when they need professional help.
Risk Factors
Many of the risk factors of OCD are very similar to other anxiety disorders. The four risk factors are predisposition, genes, environment, and biological processes.
Predisposition refers to the fact that some children are less capable of handling stress well and are more prone to anxiety. Genes, or a family history of OCD, make a child more likely to develop the disorder.
Certain environments may be a factor in the development of OCD. Some of these situations include parental divorce, a death in the family, the birth of a sibling, moving, attending a new school, or experiencing trauma.
Specific biological processes have been suspected to be linked to OCD. These processes are an imbalance of serotonin or a strep infection.
Ways to Help Your Child
So, what if you’ve already seen the signs and received a diagnosis of OCD for your child? Here are some steps you can take to help them.
Learn More
It’s very difficult to help someone with an issue that you do not understand. So, learning more is the first step.
OCD Awareness Week is fast approaching. In 2022, it will be celebrated from October 9th to the 15th. The International OCD Foundation hosts the event, providing videos to watch and events to participate in.
The theme this year is The Road to Reclaiming Your Life. This theme encompasses the idea that with the right treatment and support from those around a person, full recovery from OCD is possible.
Learning more about OCD is beneficial for everyone–not just those suffering from the disease. Understanding better the experiences of those with OCD gives us compassion and ways to help them succeed.
All events are free, and you can click here to check it out.
Speak to a Mental Health Professional
The first line of treatment for OCD is most often therapy. Cognitive-Behavioral Therapy (CBT) in particular is very effective in treating OCD.
CBT helps a child recognize what their thought patterns are and how those thought patterns may be affecting their behavior. By changing their thoughts, they are able to change their actions.
When treating compulsive behaviors, CBT often employs Exposure Response Prevention. This technique supports children while they face their fear of not giving in to compulsive urges. Children slowly work through more and more difficult and scary scenarios. Eventually, they can resist engaging in all of their previous compulsive behaviors.
This approach, while effective, takes a lot of work. It can help if children can see that the hard work is worth it. My upcoming book, Khloe Kitten Is Afraid of Germs!, does just that.
Khloe Kitten experiences compulsive urges around germs, like many of those who suffer from OCD do. She wants to go down the slide like all her other friends do, but she has too much fear. She employs Graded Exposure to slowly expose herself to germs and overcome her fear and behavior.
As your child works through a stepladder approach in therapy, they will be able to see themselves in Khloe Kitten. They may be working on different compulsive behaviors, but they will recognize her feelings and fear.
A child will know that if Khloe Kitten can do it, they can do it too. They also may better understand what their therapist is asking them to do.
Also, each book comes with an About Anxiety page, a Coping Strategies page, and a Stepladder page for parents. Each page will equip you with more information to help your child.
A therapist may also employ other strategies of CBT to help your child. These could include role-playing exercises, teaching positive self-talk, introducing relaxation techniques, and talking through how their thoughts or fears are irrational. Your therapist will create a unique treatment plan for your child.
Medication
If various types of therapy don’t bring enough relief for your children, medication may be a helpful option. Anti-anxiety medications should only be used under the supervision of a pediatrician and psychologist.
Obsessive-Compulsive Disorder can be frustrating and confusing for children and parents alike. However, with the right treatment and support, it’s possible for most children with OCD to lead a productive life.
To learn more information about various mental health illnesses in childhood, be sure to subscribe to my newsletter or check out my podcast, Genius Little Minds.
References
https://adaa.org/sites/default/files/How-to-Help-Your-Child-A-Parents-Guide-to-OCD.pdf
https://childadolescentpsych.cumc.columbia.edu/professionals/research-programs/y-team/ocd-treatment
https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-disorder
Navigating Social Anxiety with Selective Mutism: Using a CBT Approach
A diagnosis of social anxiety with selective mutism (SM) can be hard to navigate.
Especially if you’re an extrovert or you just enjoy social interactions, it can be hard to put yourself in the shoes of a child that feels intense anxiety in those same circumstances. Or your child may not be able to articulate their feelings and tell you exactly what’s wrong when you go out in public.
This article will not only give you a better idea of how to spot this disorder but also the best methods for treating it.
Let’s dive into it.
A diagnosis of social anxiety with selective mutism (SM) can be hard to navigate.
Especially if you’re an extrovert or you just enjoy social interactions, it can be hard to put yourself in the shoes of a child that feels intense anxiety in those same circumstances. Or your child may not be able to articulate their feelings and tell you exactly what’s wrong when you go out in public.
This article will not only give you a better idea of how to spot this disorder but also the best methods for treating it.
Let’s dive into it.
Signs and Symptoms
So, how can you spot a child that may be struggling with social anxiety with selective mutism? The symptoms are quite similar to many anxiety disorders with the differentiator being that the anxiety is brought on or worsened by social situations.
The ‘selective’ in selective mutism means that it only happens in certain situations. The child is physically capable of speaking and forming words, but they feel such intense anxiety in certain situations that they are unable to speak.
This disorder can also involve intense fear even when just thinking about or anticipating social situations. So, parents may notice that their child stops speaking while at home when they know that they will be leaving soon for some social event.
This can seem confusing at first since their home also seems to be their safe place. Sometimes it is necessary to take a step back and examine the full situation to understand how a child may be feeling.
Other emotional symptoms of this disorder include:
Intense anxiety or panic in or about social situations
Refusal to participate in social situations
Temper tantrums
Fear of embarrassment or judgment
Expecting the worst possible consequences during social situations
Inability to interact with strangers
Lack of self-confidence
Difficulty concentrating in various settings
n addition to these emotional symptoms, a child may also experience various physical symptoms independently or as a result of their anxiety. These include:
Heart palpitations or a racing heart
Trembling
Difficulty breathing
Feelings of weakness
Excessive sweating
Fatigue
Headaches
Stomachaches
Difficulty sleeping
When any of these symptoms begin to interfere with a child’s ability to function normally, help from a professional is needed.
Causes and Risk Factors
The causes and risk actors of SM are similar to those of many other anxiety disorders. The three main risk factors are a predisposition, genetic influences, and a child’s environment.
Predisposition is the fact that some children, because of their personality or other factors, are more likely to develop SM and are less capable of handling stress in a healthy way. It may take less severe events to trigger the onset of anxiety episodes or the disorder as a whole.
Our genetic makeup also influences mental health. If a child’s parents or other people in their family tree have mental illnesses, specifically anxiety disorders, then a child is more likely to develop SM.
Certain environmental factors can also bring on a mental health crisis. These factors could include embarrassing social situations, overly controlling parents, others in their home having a mental illness, attending a new school, or being bullied. Any event that brings trauma can also bring on an anxiety disorder.
None of these factors mean that a child will for sure develop social anxiety with selective mutism, but they do make it more likely to happen.
Treatment Options
If your child is struggling with symptoms of social anxiety or has been diagnosed with social anxiety with selective mutism, there are multiple treatment options that you can consider.
Cognitive-Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is the most recommended and evidence-backed form of treatment for anxiety disorders. CBT helps children identify their thought patterns and recognize how those thoughts may be helping or hurting them.
CBT can guide a child to see how what’s happening inside their heads translates into their behavior. A mental health professional will help a child use relaxation techniques, role-playing, and positive self-talk to help them face and conquer their fears.
One of my upcoming children’s books addresses social anxiety with selective mutism in specific. Darcy Deer Is Afraid to Talk, Sometimes! follows Darcy Deer as he wants to perform in the school play but is very worried that he won’t be able to say his lines. Darcy uses a science-proven, stepladder approach to face his fears.
A stepladder approach, or Graded Exposure, slowly and systematically helps a child face their fears and learn to manage the symptoms of their anxiety. It involves gradually taking on tasks that cause increasingly more anxiety. Throughout the process, a child would use the coping skills that they learned in therapy.
A child that is receiving CBT for a diagnosis of social anxiety with selective mutism will relate to Darcy Deer. They will see the hard work that he is putting into managing his symptoms. This might help them feel less alone and more confident in their ability to overcome their own anxiety.
Darcy Deer Is Afraid to Talk, Sometimes! can also be a great resource for parents. Each book contains an About Anxiety page, a Coping Strategies page, and a Stepladder page. This information will you better understand your child and give you concrete ways to help them
Darcy Deer Is Afraid to Talk, Sometimes! will be available late 2023.
Anti-Anxiety Medication
In some cases, a child may not respond as well as hoped to CBT. If therapy options have been exhausted, your child may be prescribed anti-anxiety medication. Medication can be very helpful for some children, but the benefits and risks should be weighed carefully by the parents and a child psychiatrist before medication is given.
Social anxiety with selective anxiety can be tricky to navigate and understand. Oftentimes, figuring out exactly what’s wrong is the biggest obstacle. With the right support and therapy, almost all children are able to cope with this disorder and even push beyond it and thrive.
For more tips and insight on child mental health, be sure to subscribe to my newsletter or check out my podcast Genius Little Minds.
References
What Is Panic Disorder with Agoraphobia? Recognizing the Causes, Symptoms, and Treatments
Most of us really enjoy being at home. It's a place with all our favorite things. It contains familiar faces and special memories. It houses our family members and pets that we love. It’s a safe and comfortable place to be.
This love of familiarity is often felt by our children as well. They like having their own space, a reprieve from an often demanding outside world.
Sometimes, however, it's more than that. What if your child never wants to leave? What if leaving their home or safe space causes them to spiral out of control, having panic attacks or uncontrollable irrational fears? It may seem like something more than average anxiety. It may be panic disorder with agoraphobia.(1)
Most of us really enjoy being at home. It's a place with all our favorite things. It contains familiar faces and special memories. It houses our family members and pets that we love. It’s a safe and comfortable place to be.
This love of familiarity is often felt by our children as well. They like having their own space, a reprieve from an often demanding outside world.
Sometimes, however, it's more than that. What if your child never wants to leave? What if leaving their home or safe space causes them to spiral out of control, having panic attacks or uncontrollable irrational fears? It may seem like something more than average anxiety. It may be panic disorder with agoraphobia.(1)
Panic Disorder
Panic disorder is part of the family of anxiety disorders. It is characterized by sudden, unexpected episodes of intense fear. These episodes are often called panic attacks, and they cause extreme physical and emotional discomfort. Panic attacks can feel so intense that the person may mistake them for a heart attack or other physical issue.(2)
The symptoms and duration of panic attacks vary from person to person. Some people only experience one panic attack that lasts a few minutes, while other people may experience multiple panic attacks in a row with the whole episode lasting hours.
Sometimes it’s easy to pinpoint what triggers the panic attack, but other times they can pop up with little warning or explanation. With therapy and self-reflection, a person experiencing panic attacks may be able to anticipate the attacks and take steps to prevent them or decrease their severity.
Agoraphobia
Agoraphobia is an anxiety disorder that involves an intense fear of being trapped.(1) What exactly ‘trapped’ means can vary from person to person. Some people with agoraphobia feel trapped by small or crowded spaces. This could include places like elevators, the movies, or large events.
Conversely, others feel trapped by wide-open spaces, such as a bridge or park. Being in these situations can cause panic attacks. In some cases, the person does not even have to be in the situation for a panic attack to be triggered. They may simply be thinking about the anxiety-inducing place or be on their way to such places. Because of this, those with agoraphobia tend to avoid these situations if at all possible.
Symptoms
When a child experiences panic attacks along with their fear of being trapped, they may be diagnosed with panic disorder with agoraphobia.
Physical symptoms of panic disorder with agoraphobia include:(2)
Panic attacks
Rapid heartbeat
Difficulty breathing
Pressure or pain in the chest
Headaches
Stomachaches
Shakiness and/or tingling in hands and limbs
Feelings of weakness
Excessive sweating
Fatigue
Insomnia
Children may also experience emotional symptoms such as:
Feeling trapped with no escape
Sensing that something bad is about to happen to them
Fear of open spaces or enclosed spaces
Fear of long lines or crowds
Feeling like they are losing control or dying
Difficulty concentrating
Intense fear of separating from parents
Refusal to go to school or leave home
Feeling anxiety in anticipation of a feared situation
Expecting the worst possible consequences if in open or enclosed spaces
Avoidance of situations that may lead to the feeling of being trapped
These symptoms will often begin to interfere with a child’s day-to-day life. School may become more difficult. They may not get enough sleep at night. Concentrating on academic and fun tasks alike may be harder. This is the point at which a mental health professional is needed.
Causes
Panic disorder with agoraphobia is caused by three main factors: predisposition, genetics, and environment.(3)
Children’s personality or tolerance for stress can make them predisposed to developing anxiety disorders. Children with a family history of mental health illness are more likely to develop a mental illness themselves.
Certain experiences or events that invoke intense fear in a child can also bring on panic disorder with agoraphobia. A child may have a traumatic experience in a crowded or enclosed space. Or they may experience a traumatic event in some other part of their life, like a car accident, abuse, or parental divorce, and that event manifests into panic disorder as agoraphobia.
Treatment
Like with many other anxiety-related disorders, cognitive-behavioral therapy is the most widely-recognized and evidence-based treatment for panic disorder with agoraphobia.(4)
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy (CBT) is a type of talk therapy that helps children recognize what their thought patterns are and how they may be affecting their emotions and behaviors.
CBT will walk a child through how the outcome that they are imagining is not realistic. It is easier to recognize that these outcomes are not realistic when a child is not in the midst of a panic attack, but they also need to be able to recognize this when they are in the moment. So, CBT gives tools, such as self-talk or relaxation techniques, to use when the fear and panic are starting to build.
A mental health professional will likely also use Graded Exposure. In this CBT technique, a child will slowly face their fear, employing the techniques CBT has given them to keep them calm. They will start with a situation that only makes them slightly uncomfortable and then work closer and closer to the feared situation.
An example of this would be starting off by being in a small space with one person, then with two or three people. Then, perhaps the child would be in a space with four or more people that is also noisy. Slowly they would go to places with more and more people until they can manage their anxiety effectively.
Implementing CBT Techniques
Children learn by seeing. They learn by watching someone walk through a situation and then mimicking what they saw.
If your child is suffering from panic disorder with agoraphobia, you may be struggling with how to help them, particularly if you don’t struggle with the disorder yourself. You don’t fully understand what they are experiencing or what their anxiety feels like.
Books like, Pablo Parrot Is Afraid of Being Trapped!, provide a great solution to both of these issues. Part of Dr. Madeleine Vieira’s anxiety disorder series, I’M AFRAID, this book specifically focuses on panic disorder with agoraphobia. Pablo Parrot experiences all the feelings and emotions that your child is about being trapped in certain situations. Your child will see themself in Pablo.
Pablo Parrot can help your child practice the CBT techniques, like Graded Exposure, that they are learning with their mental health professional. You will also get to play a vital role in your child’s treatment as you work through the exercises with your child. You will have actionable steps to help your child work through their anxiety and fear.
On the days when facing their fears feels extra tough, books like Pablo Parrot Is Afraid of Being Trapped!, can provide a reprieve. Your child will know they are not alone and they are strong enough to face their fear.
To learn more about the I’M AFRAID series, click here.
Medication
If the symptoms of panic disorder with agoraphobia persist even with therapy, medication such as SSRI may be recommended.(1) Medication should only be used under the direct guidance of a mental health professional and a doctor.
Panic disorder with agoraphobia can feel like a beast that needs to be tamed. It can rearrange your whole schedule if your child struggles intensely with leaving the house.
However, with the proper treatment, and enough time, returning to normal life is possible.
Would you like more information on childhood mental health? Check out my podcast, Genius Little Minds, for new episodes every two weeks.
Don’t forget to subscribe to my newsletter to hear about new blogs and podcast episodes!
References
PTSD Awareness: How to Help a Child Through Trauma
We often think of Post-Traumatic Stress Disorder (PTSD) as a mental illness that only soldiers suffer from. In fact, it has been referred to in the past as Shell Shock or Combat Fatigue.(1)
While PTSD is common in those individuals who have seen and experienced war, unfortunately, any person who has experienced trauma can develop PTSD.
This even includes children.
So what should you be looking for if you suspect that your child or another child in your life has PTSD? And how can you help them? Let’s talk about it.
We often think of Post-Traumatic Stress Disorder (PTSD) as a mental illness that only soldiers suffer from. In fact, it has been referred to in the past as Shell Shock or Combat Fatigue.(1)
While PTSD is common in those individuals who have seen and experienced war, unfortunately, any person who has experienced trauma can develop PTSD.
This even includes children.
So what should you be looking for if you suspect that your child or another child in your life has PTSD? And how can you help them? Let’s talk about it.
Symptoms
Common symptoms of PTSD specifically relating to the trauma include:
Flashbacks to the traumatic event
Intense distress when memories of the traumatic event are triggered
Avoidance of people or places associated with the event
Denial that the trauma happened
Reenacting the event
Those struggling with PTSD also tend to experience other symptoms such as:
Nightmares and sleep disturbances
Ongoing sadness, fear, and anxiety
Increased aggression or violent outbursts
Lack of positive emotions
Inability to show affection
Being hypersensitive to possible threats
Feelings of helplessness or hopelessness
Loss of interest in hobbies and activities previously enjoyed
Symptoms must continue for at least one month before a diagnosis of PTSD will be given. PTSD symptoms often appear around 3 months after the traumatic event but can appear months or even years after the event.
It’s essential to understand PTSD across the lifespan and how it can look different in children than it does in adults. Many professionals have worked tirelessly to develop diagnostic criteria for PTSD in children that are developmentally appropriate.(2)(3)
Children with PTSD may have unique symptoms such as having problems at school or regressing to behaviors like thumb-sucking or bedwetting. They also may be overly worried about dying at a young age.(5)
Causes
A variety of traumatic events can cause PTSD. These include:
Sexual, emotional, or physical abuse or neglect
Being a witness to or a victim of a crime
Watching serious illness or death in a loved one
Natural disasters, such as a hurricane or tornado
Serious car accidents
Invasive medical procedures
This list is not exhaustive. Any event that is traumatic can trigger symptoms of PTSD in a person.
It’s important to remember that not every person experiences and processes events in the same way. Two people can experience the exact same event and only one person may emerge with PTSD. This is totally normal and does not mean that there is anything wrong with that person. They simply need more support to work through their trauma.
Risk Factors
Some children are more likely to experience PTSD than others. Genetics play a role, along with a child’s temperament. A more anxious or nervous child may be more likely to develop symptoms of PTSD.
A history of personal mental illness or having many family members with mental illness can also make a child predisposed to developing PTSD
Treatments
Psychotherapy
Many types of psychotherapy may be beneficial to treat PTSD. Using the variety of psychotherapy methods available, a therapist or psychologist will encourage a child to speak, draw, play, or write about the traumatic event.(8) As the mental health professional and patient converse, they examine the patient’s thoughts and feelings to determine the best way to change them for the better.
Many people are hesitant to try psychotherapy but having a non-judgmental, objective person listen to the sufferer can be incredibly healing. Plus, they will also help a person navigate the best way to cope with their symptoms.
Cognitive-Behavioral Therapy
Cognitive-Behavioral Therapy (CBT) is most often the first line of treatment after a diagnosis of PTSD. This type of therapy helps children recognize their thought processes and feelings around the traumatic event. CBT helps a person identify distortions, or inaccuracies, in their thinking that are causing them harm.
Then, a mental health professional will help the child learn how to reframe their thoughts and change their behavior. They learn problem-solving skills and coping techniques to better handle their symptoms when they strike.
If there are other mental health illnesses at play, CBT is a great option.(7) CBT has been proven effective in treating many mental health disorders including anxiety disorders, depression, eating disorders, and more.
Dialectical Behavior Therapy is another technique used in CBT that gives sufferers more tools to manage their stress.(9) This method may be useful for children with PTSD to understand what emotions they’re feeling, how their reactions affect their relationships with others, and what behavioral skills can help change those emotions and reactions.
Acceptance and Commitment Therapy
Acceptance and commitment therapy is another type of psychotherapy that may be useful in treating PTSD. (9) This technique helps a child become more aware of their thoughts and feelings and works towards acceptance of them. Then, the mental health professional will encourage the child to commit to specific changes that will increase their ability to cope with their feelings and adjust better in stressful situations.
Supportive Psychotherapy
Supportive psychotherapy focuses on improving both a sufferer’s symptoms and their self-esteem.(10) The mental health professional is a source of comfort, support, and empathy to the child as they examine their emotional responses and behaviors. Praise, reassurance, and encouragement are used to help the child feel more comfortable with their emotions.
Medication
If a child is not experiencing improvements in their symptoms with therapy, medications may be prescribed as the next option. The use of medications in children should be used sparingly and under the careful supervision of mental health and medical professionals.
PTSD Awareness Month in the US
June marks PTSD Awareness Month in the United States. The goals of this event include raising awareness, understanding PTSD, and getting support. There’s an activity you can complete every day in June or you can join the Virtual Walk, walking 30 minutes every day to raise awareness for PTSD.
To check out more of the resources and events available, visit: https://www.ptsd.va.gov/understand/awareness/index.asp
PTSD affects about 4% of people worldwide.(6) It is dark and scary, but it does not have to be tackled alone.
Children experiencing PTSD need us to come alongside them and support them through this difficult illness. With the right treatment, full recovery is possible.
Check out my podcast, Genius Little Minds, for more information on topics such as Oppositional Defiant Disorder and Autism Spectrum Disorder. You can even submit questions you have about your own children at the bottom of this page!
Don’t forget to subscribe to my newsletter to stay up to date on all my latest blogs and podcast episodes.
References
https://www.talkspace.com/mental-health/conditions/articles/history-of-ptsd/
De Young, A.C., Landolt, M.A. PTSD in Children Below the Age of 6 Years. Curr Psychiatry Rep 20, 97 (2018). https://doi.org/10.1007/s11920-018-0966-z
Pate, Kailey Marie, "A Comprehensive Review of Post-Traumatic Stress Disorder (PTSD) in Children" (2020). USF St. Petersburg campus Honors Program Theses (Undergraduate) https://digitalcommons.usf.edu/honorstheses/263
https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
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.
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.
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
https://www.mayoclinic.org/diseases-conditions/specific-phobias/symptoms-causes/syc-20355156
https://adaa.org/understanding-anxiety/additional-disorders/phobias
https://adaa.org/understanding-anxiety/specific-phobias/symptoms
https://www.mayoclinic.org/diseases-conditions/specific-phobias/diagnosis-treatment/drc-20355162
https://www.nhs.uk/mental-health/conditions/phobias/treatment/
Why Is My Child Acting Out? Oppositional Defiant Disorder Explained
Some kids are just “bad kids.” You know the ones. They run down the aisle screaming at church. They have meltdowns in the supermarket. They don’t listen, they talk back, and they laugh in the face of authority. They can’t be controlled by their parents or teachers.
In short, they’re a menace with a capital M.
Except… there’s no such thing as a “bad kid,” is there? There are good kids who need help… Kids who start to believe the worst about themselves because they’ve come to expect negative reinforcement from their parents, other adults, or their peers…
Believe it or not, that kid yelling obscenities at his mother in the school parking lot probably doesn’t want to be doing that. But children with oppositional defiant disorder, or ODD for short, have difficulty controlling their impulses and making healthy, developmentally appropriate choices.
Some kids are just “bad kids.” You know the ones. They run down the aisle screaming at church. They have meltdowns in the supermarket. They don’t listen, they talk back, and they laugh in the face of authority. They can’t be controlled by their parents or teachers.
In short, they’re a menace with a capital M.
Except… there’s no such thing as a “bad kid,” is there? There are good kids who need help… Kids who start to believe the worst about themselves because they’ve come to expect negative reinforcement from their parents, other adults, or their peers…
Believe it or not, that kid yelling obscenities at his mother in the school parking lot probably doesn’t want to be doing that. But children with oppositional defiant disorder, or ODD for short, have difficulty controlling their impulses and making healthy, developmentally appropriate choices.
What is Oppositional Defiant Disorder?
Oppositional defiant disorder (ODD) is a behavior disorder that’s typically diagnosed in childhood between the ages of 6 and 8 (3). Children with ODD can be defiant, hostile, exceptionally uncooperative, and argumentative.(1)
ODD Symptoms(2)
If your child has ODD, you may notice they frequently have an angry and irritable mood and are:
Easily annoyed by other people
Resentful
Often losing their temper
If your child has ODD, you may notice defiant, argumentative behavior where they:
Argue with authority figures frequently
Defy adults and refuse to follow rules
Deliberately annoy and upset other people
Blame others for their own mistakes, misbehaviors, or wrongdoings
If your child as ODD, you may notice vindictive behavior where they:
Behave spitefully
Try to “get back at” someone they feel has wronged them
But children with ODD aren’t having your typical toddler tantrum or teenage rebellion. Just because your toddler learned the word “no” and loves saying it to everyone and everything, for example, does not mean they have oppositional defiant disorder.(2) For a parent of a child with ODD, things like screaming matches, angry or aggressive behavior, expulsions from school, or daily rule breaking are the norm.(4) And it can be really hard on families.
In children with ODD, the oppositional and defiant behavior is persistent, extreme, and significantly interferes with their ability to function in school or have relationships with others.(1) It also has to be going on for at least 6 months in order to be diagnosed as ODD.(2)
Is ODD Genetic?
Biological, genetic, and environmental factors may all play a role in a child developing oppositional defiant disorder.(5) Unbalanced neurotransmitters may play a role too, as many children with ODD also have other mental health disorders, such as ADHD or mood disorders.(5)
Risk Factors for ODD:
Lack of supervision(11)
Poverty(11)
An unstable or dysfunctional home life(11)
Exposure to violence or aggressive behavior(8)
A family history of substance abuse(8)
Abuse or neglect(8)
Inconsistent parenting and disciplining(7)
A parent or close relative with mental illness(7)
You may be thinking, “Now, wait a minute. I’ve given my child everything! Nothing you’ve described sounds like our family. There’s no violence, no drugs. The rules are clear, easy to follow, and my child still has these out-of-control outburst and anger issues.”
A chaotic, stressful home life can contribute to mental health problems, there’s just no way around that. But even in a stable home, some children will develop oppositional defiant disorder.
Genetics may also be a factor. If a child has a close relative with mental illness, they are more likely to develop ODD.(7) Oppositional defiant disorder occurs more commonly among children whose family members have a history of ADHD, mood disorders like depression or bipolar disorder, and substance use disorders.(8)
Comorbidity
Children with ODD may struggle with one or more of the following:(9)
ADHD
Conduct disorder
Mood disorders (anxiety and depression)
ODD Diagnosis
You love your child desperately… You’d do anything for them. You’d die for them! But at this rate, you’re finding it very difficult to like them.
You know the angry outbursts, temper tantrums, spiteful behavior and arguments are, well… not exactly normal. So what’s a parent to do?
A medical doctor or mental health professional like a child psychologist or psychiatrist can diagnose oppositional defiant disorder. It’s likely they’ll want to talk to you, the parent or caregiver, and your child to conduct an assessment. They may also want to speak to your child’s teachers and conduct an assessment at school, depending on where your child exhibits their ODD symptoms.
What’s the Outlook for Kids with ODD?
About two thirds of children diagnosed with ODD overcome the disorder and don’t show behavioral symptoms anymore by the time they’re 18. (7) Amazing news, right?
It’s so important that your child get help if you think they do have ODD. Left untreated, severe oppositional defiant disorder can become conduct disorder, which is a more serious, delinquency version of ODD. But when treated early, prognosis is much better. Studies have shown that ODD symptoms resolve within 3 years in about 67% of children with the diagnosis.(14)
Treatment
There are many treatment options for children with ODD, and they will likely involve the whole family!
Family Therapy
ODD can be very taxing for parents and difficult on siblings. Family therapy can help improve communication skills, suggest systemic changes that need to be made within the family unit, and provide support for the entire family.(1) Being involved in your child’s treatment plan is important. Share your concerns, goals, and hopes with your child’s care team.
Parent-Management Training
Want to learn how to manage your child’s behavior? There’s a class for that! In parent-management training, you’ll be taught positive reinforcement techniques and how to discipline effectively.(14) Ask your child’s therapist or doctor for information on where to sign up.
Cognitive Behavioral Therapy
Often, children with ODD don’t understand that their defiant and aggressive behavior is wrong or unjustified. When asked why they behave the way they do, they might say, “because my parents are always on case.” In therapy, your child will master social skills and learn that he’s capable of making different, healthier choices.
Cognitive Behavioral Therapy (CBT) helps tackle unhelpful patterns of thinking and replaces them with healthier patterns.(10) In therapy, your child may role play scenarios he might encounter with family or friends and practice more adaptive, appropriate behaviors.
Peer Group Therapy
This can be a great resource if your child struggles to interact and socialize with peers. ODD can be hard on friendships. Peer group therapy provides a safe space for children with ODD to practice getting their social interactions right so they feel safe to try things out in the real world.
Medication
Typically, medication is not recommended to treat ODD unless another underlying condition like ADHD needs to be addressed.
Interested in Learning More?
Check out this podcast episode on ODD. You’ll learn five surprising questions you should ask yourself if you think your child has oppositional defiant disorder… and you’ll learn more about the parent-child relationship and how it can impact your child’s mental health. This is an episode you won’t want to miss!
Equip yourself with knowledge and tools to help your child thrive. Subscribe here to the Genius Little Minds podcast so you never miss an episode!
References
https://www.hopkinsmedicine.org/health/conditions-and-diseases/oppositional-defiant-disorder
https://www.healthline.com/health/childrens-health/odd-in-children
https://my.clevelandclinic.org/health/diseases/9905-oppositional-defiant-disorder
https://www.additudemag.com/what-is-oppositional-defiant-disorder/
https://www.sonorabehavioral.com/behavioral/odd/symptoms-causes/
https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
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?
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 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
Anxiety and Depression Association of America. Facts & Statistics. 2014. http://www.adaa.org/about-adaa/press-room/facts-statistics.
(2020, September). Anxiety Disorders in Children. NHS Inform. https://www.nhsinform.scot/illnesses-and-conditions/mental-health/anxiety-disorders-in-children
Generalized Anxiety Disorder. Boston Children’s Hospital. https://www.childrenshospital.org/conditions-and-treatments/conditions/g/generalized-anxiety-disorder-gad
(2017, July). What is Cognitive Behavioral Therapy. American Psychological Association https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
(2019, June). Is Anxiety Genetic? Healthline. https://www.healthline.com/health/mental-health/is-anxiety-genetic#symptoms
Personality Traits Associated With Anxiety. Brainsway. https://www.brainsway.com/knowledge-center/personality-traits-associated-with-anxiety/
The Relationship Between Anxiety and Depression. Hartgrove Behavioral Health System. https://www.hartgrovehospital.com/relationship-anxiety-depression/
(2020, August). Does Anxiety Run in Families? UNC Healthtalk. https://healthtalk.unchealthcare.org/does-anxiety-run-in-families/