A parentís guide to anxiety disorders in children

2013-05-31 09:29:59 by Public Relations staff, as posted on the inside.akronchildrens.org blog.

young-child-hidingWhile it’s  normal for a child to be anxious about giving a presentation in front of the class or for a baby to have separation anxiety when left with a sitter, sometimes children experience anxiety that interferes with their daily lives.

“Anxiety disorders are among the most common mental health disorders we see in children and teens,” said Dr. Sumru Bilge-Johnson, a pediatric psychiatrist and trauma therapist at Akron Children’s Hospital. “As children grow and develop, they experience different phases of fear, such as separation anxiety or being afraid of the dark that are part of normal childhood development.”

These fears or anxieties can become a problem if they persist.

“All anxiety disorders are treatable and we can help children overcome these fears by looking at what else is going on and how to support their normal mental health development,” Dr. Bilge-Johnson said.

Types of anxiety disorders

sad-teen-boySuccessfully treating anxiety disorders starts with early identification. The types of anxiety disorders that typically affect children and teens include:



  • Generalized anxiety disorder – Kids who worry excessively about things they can’t control or meeting the expectations of others may suffer from generalized anxiety disorder. Symptoms usually manifest as headaches, stomachaches, irritability or difficulty sleeping.

  • Social phobia – Children who are extremely worried about being judged by others or embarrassing themselves may suffer from social phobia or social anxiety disorder. They're often considered shy. Their struggles become more apparent as teens. They may be embarrassed to eat or talk in front of others, which can affect their self-esteem. Symptoms may include a racing heart, trembling, dizziness, sweating or gastrointestinal distress.

  • Selective mutism – With selective mutism, children are unable to talk in certain settings, such as school or in front of others, but can talk freely at home and in other comfortable settings. In public, they may use gestures to communicate, but otherwise appear unable to speak.

  • Obsessive Compulsive Disorder (OCD) – Although not as common as other anxiety disorders, OCD is characterized by irrational and uncomfortable thoughts and repetitive behaviors to stop those thoughts. Often the child is driven to perform the repetitive behavior to prevent something bad from happening to her or her family. Compulsive behaviors may include excessive hand washing, checking and rechecking locks or stove burners, rewriting homework, performing tasks in a specific sequence or counting.

  • Post-traumatic stress disorder – Children who’ve experienced a traumatic event may become anxious and have feelings of hopelessness or horror. According to Dr. Bilge-Johnson, it doesn’t have to be a major event like abuse or a school shooting. Even everyday things like fireworks, thunderstorms or dogs can cause acute stress in some children. These excessive fears can cause nightmares, sleep problems, withdrawing from activities, temper tantrums and other behavior problems.

  • Panic attacks – Teens who experience excessive anxiety may suffer from a sudden panic attack. When this occurs, overwhelming anxiety makes it difficult to take a breath. They may become dizzy, have a racing heart and experience other symptoms of intense fear. The fear response is usually out of proportion to the situation that provoked it.


Treatment for anxiety disorders

Dr. Sumru Bilge-Johnson Dr. Sumru Bilge-Johnson

The stress and low self-esteem associated with anxiety disorders can lead to depression, so treatment is important.

“Anxiety disorders that prevent a child from participating in normal activities can be like living in a cage. The goal with treatment is to help the child be free and enjoy life,” Dr. Bilge-Johnson said.

Anxiety disorders are often successfully treated with cognitive behavioral therapy that helps the child recognize how irrational his thoughts or fears may be, or gradually expose him to the source of his fear. Relaxation techniques may help the child learn to cope in anxiety-producing situations.

In severe cases, such as OCD or certain phobias, the child may need a combination of therapy and medication to overcome the disorder.

When to seek help

Some degree of anxiety is healthy and normal for children and adults alike. Anxiety can help motivate us to prepare for an exam or keep us on guard in potentially dangerous situations.

It becomes a problem when the fears are unrealistic or irrational and cause a high level of distress that interferes with daily life. When this happens, it’s time to seek professional help.

Talk to your pediatrician or family doctor for a referral to a mental health professional who specializes in treating children.

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