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How To Treat Anxiety In Children

What Are The Symptoms Of Gad

Recognizing and Treating Problematic Fear & Anxiety in Children | John Piacentini, PhD | UCLAMDChat

All of us are born with the instinctive fight or flight response that helped our ancestors escape predators and other threats. When we are afraid, concerned, or stressed, the part of our brain responsible for the fight or flight response will generate the nervous, fearful sensation we call anxiety. While everyone experiences anxiety at times, children with anxiety disorders contend with excessive worrying that does not subside the way normal anxiety does.

Children with generalized anxiety disorder experience excessive and uncontrollable worry about a number of events or activities. They feel anxious in multiple settings and are often unable to put their worries aside no matter how hard they try.

Examples of common worries experienced by children with GAD include:

  • past behaviors and incidents
  • social acceptance
  • personal abilities
  • perceived personal shortcomings
  • school performance

Children with GAD often worry about the same subjects as children who do not have an anxiety disorder. The difference is that for a child with GAD, there is no on-off switch for the worry: it is ever-present and so extreme that it interferes with the childs ability to relax, concentrate, and enjoy activities.

Symptoms of generalized anxiety disorder can vary. They may include:

Physical signs and symptoms may include:

  • muscle tension or muscle aches

When Should I Seek Help For My Child’s Anxiety

If anxiety is having a significant impact on your child’s everyday functioning and preventing them from participating in activities that their peers can comfortably do, this is a sign that you should seek help.

Tamariki may need some extra support when:

  • they feel anxious more than other children of a similar age
  • anxiety stops them participating in activities at school or socially
  • anxiety interferes with their ability to do things that other children their age can do
  • their fears and worries seem out of proportion to the issues in their life

It is important an assessment takes place by a professional who knows about anxiety in children and young people. Physical examinations are also recommended to ensure there is no underlying illness causing the symptoms.

Research has shown a form of psychological therapy is effective in learning ways to overcome or manage anxiety. Your doctor may recommend medicine if the anxiety is very severe or if there are multiple difficulties at the same time . If your doctor does prescribe medicine, then psychological therapy should also be part of the treatment.

Going to your family doctor is the best first step as they will be able to provide guidance about where to get more help. This may involve a referral to a counsellor in the community or to a local child and adolescent mental health service who can provide specialist assessment and interventions for anxiety.

In A Calmer Moment Talk With Your Child About Their Anxiety

Ask them what it feels like in their mind and body, and what things make them feel that way. It can be tempting to dismiss their worries because you want to reassure them, but its important to empathise with their experience and validate their feelings. You can find more tips on our guide to starting a conversation.

  • reflect on how youre feeling
  • talk to other people you trust
  • remind yourself youre not alone odds are someone in your friendship circle has anxiety or depression too

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What Is An Anxiety Disorder

To understand what an anxiety disorder is, we must first look at the mechanisms that control our fear response.

Every human being is born with a fight or flight response that is controlled by the brains limbic system.

This system is composed of structures such as the amygdala, and once our fight or flight response kicks into gear, we start to experience intense feelings of fear, nervousness, and threat.

This survival response is normal and part of our evolutionary history, and without it, we would be more susceptible to falling victim to predators, environmental hazards, and other kinds of external threats.

The feeling of dread that accompanies the fight or flight response should dissipate over time, but if the symptoms of anxiety are persistent and excessive, then the individual may be suffering from an anxiety disorder.

The most common type of anxiety disorder the Drake Institute treats is Generalized Anxiety Disorder , which is described by the DSM-V as excessive anxiety and worry , occurring more days than not for at least 6 months, about a number of events or activities .

If left untreated, an anxiety disorder can cause significant discomfort and impairment in ones day-to-day life, and in the case of children, it can disrupt their ability to concentrate on schoolwork, make friends, and feel comfortable being away from their parents.

Brighter Futures For Anxious Kids

Anxiety in Children

Psychologists are homing in on the best ways to treat and prevent the most common mental health disorder among children and adolescents

Print version: page 50

Monitor on Psychology48

Clinging to mom’s leg at preschool drop-off, fearing monsters under the bedworries are a common part of childhood. But for many children, worries are something more. Anxiety disorders are the most common mental health disorders among children and adolescents. Nearly 32 percent of adolescents in the United States have an anxiety disorder, according to national survey data reported by Kathleen Merikangas, PhD, at the National Institute of Mental Health, and colleagues .

Yet anxiety is woefully underdiagnosed, say multiple experts who treat children with the disorders. “The majority of children with anxiety never receive treatment,” says Golda Ginsburg, PhD, a psychologist and professor at the University of Connecticut Health.

One reason for that might be that anxiety symptoms are so variable. Kids with generalized anxiety often feel overwhelmed with worry, and some have physical symptoms such as headaches or stomachaches. Others have intense social phobias that prevent them from doing things like going to birthday parties or participating in extracurricular activities. Some have specific phobiasfear of the dark or of dogs, for instancewhile still others experience obsessive-compulsive disorder.

“Anxiety is often viewed as a gateway problem,” Silverman says.

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Types Of Childhood Anxiety

Like adults, children can also have other anxiety disorders, which range from separation anxiety and obsessive-compulsive disorder to panic attacks. Some signs of anxiety are easier to spot, but other anxiety disorders can be a little harder to detect.

Some of the different types of childhood anxiety include:

Reading The Signs: What Anxiety Looks Like In Children

Anxiety disorders reveal themselves in physical and psychological ways. How an anxiety disorder manifests depends on the age of the child and the type of anxiety disorder. Because anxiety can manifest through physical symptoms, its important to consult a pediatrician to make sure the behaviors and symptoms are anxiety-related and not due to an underlying medical condition.

Some general symptoms:

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Supporting Children With Anxiety

If you think your child has anxiety, you can support them by:

  • acknowledging your childs fears dont dismiss or ignore them
  • gently encouraging your child to do things theyre anxious about
  • waiting until your child actually gets anxious before you step in to help
  • praising your child for doing something theyre anxious about
  • avoiding labelling your child as shy or anxious

What Are The Different Types Of Anxiety Treatment

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While many different types of therapy are used to treat anxiety, the leading approaches are cognitive behavioral therapy and exposure therapy. Each anxiety therapy may be used alone, or combined with other types of therapy. Anxiety therapy may be conducted individually, or it may take place in a group of people with similar anxiety problems.

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Types Of Anxiety Disorders In Children

: Excessive worrying that something bad will happen if the child is not with their parents, caregiver, or anyone to whom they are attached. The child may be reluctant or refuse to stay at a relative or friends house, sleep alone or go to school. Many children experience separation anxiety between 18 months and three years old when it is normal to feel some anxiety when a parent leaves the room or goes out of sight. Usually, children can be distracted from these feelings. However, separation anxiety may surface or resurface when the child is older and especially between ages 7 and 9.

: Chronic anxiety and excessive worry about everything and everyday life. A child with GAD worries about the meaning of a canceled play date or a delayed response to a text. Children with GAD fret about bad things happening to people they love or that no one will come to the birthday party they didnt want in the first place. The worry is overblown in relation to the events that sparked the worry. GAD is exhausting as children worry chronically and constantly and cant control these thoughts. In addition, children with GAD often dont trust their instincts and seek constant approval or reassurance from others.

Panic Disorder: Imagine being ten years old and suddenly, without warning, experiencing a fear so intense that you feel like youre going to pass out. Your heart is pounding. You are terrified and feel out of control. You may experience shortness of breath and chest pain. Thats a .

Feeling Anxious For Most Of The Time For No Apparent Reason

While it’s normal for children to frequently have fears and worries, some anxious children may grow up to develop a long-term condition called generalised anxiety disorder when they become a teenager or young adult.

Generalised anxiety disorder causes you to feel anxious about a wide range of situations and issues, rather than one specific event.

People affected by it feel anxious most days and often struggle to remember the last time they felt relaxed.

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Treatments For Anxiety Disorders In Children

The type of treatment offered will depend on your child’s age and the cause of their anxiety.

Counselling can help your child understand what’s making them anxious and allow them to work through the situation.

Cognitive behavioural therapy is a talking therapy that can help your child manage their anxiety by changing the way they think and behave. Learn more about CBT.

Anxiety medicines may be offered to your child if their anxiety is severe or does not get better with talking therapies. They’re usually only prescribed by doctors who specialise in children and young people’s mental health.

What Makes Children Anxious

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For tamariki and rangatahi, there are common fears that are often associated with age. For example, infants may fear separating from their parents. Young children often fear insects and animals. Some children may also be scared of the dark or will imagine there are monsters under the bed.

Teenagers also have many anxieties including worrying about fitting in and being judged by other people. Performance anxiety is common amongst children and young people competing for high levels of sporting or academic excellence.

Some tamariki may feel anxious as they come across new experiences and situations. They think the fear or danger theyre worried about is much greater than it actually is. Thinking about the situation can make them more worried and tense.

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The Bully In The Brain

For children with anxiety disorders, the process begins by helping them, and their parents, get some distance from the anxiety and start thinking of it as a thing that is separate from who they are. One way I do this is by having them conceptualize it as a bully in the brain, and I encourage kids to give the bully a name and talk back to him. Kids Ive worked with have called him the Witch, Mr. Bossy, Chucky, the Joker, and, in the case of some teenagers, names I cannot repeat here.

We explain that we are going to teach skills to handle the bully, giving children the idea that they can control their anxiety rather than it controlling them.

Its also important to help kids really understand how their anxiety is affecting their lives. I may actually map out things a child cant do because of their fears like sleeping in their own bed, or going to a friends house, or sharing meals with their own family and how that makes them feel. Getting kids to understand how their anxiety works and gaining their trust is important because the next step facing down their fears depends on them trusting me.

Adopting Robert Frosts observation that the only way around is through, exposure therapy slowly and systematically helps a child face their fears, so they can learn to tolerate their anxiety until it subsides rather than reacting by seeking reassurance, escaping, avoidance or engaging in ritualistic behaviors such as hand washing.

Think Things Through With The Child

Sometimes it helps to talk through what would happen if a childs fear came truehow would they handle it? A child whos anxious about separating from their parents might worry about what would happen if a parent didnt come to pick them up. So we talk about that. If your mom doesnt come at the end of soccer practice, what would you do? Well I would tell the coach my moms not here. And what do you think the coach would do? Well he would call my mom. Or he would wait with me. A child whos afraid that a stranger might be sent to pick them up can have a code word from their parents that anyone they sent would know. For some kids, having a plan can reduce the uncertainty in a healthy, effective way.

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About The Expert: Golda Ginsburg Phd

Golda Ginsburg, PhD, is a professor of psychiatry at the University of Connecticut Health Center and has been developing treatments for anxious youth for more than 20 years. She led the largest national longitudinal study of anxious youth in the United States to examine the long-term outcomes of anxiety treatments. She is following up with a study of the long-term effect of family-based treatments for the children of anxious parents.Earlier in her career, Ginsburg was a professor of psychiatry at Johns Hopkins University School of Medicine. She received her BA from California State University in Northridge, and her MA and PhD from the University of Vermont.

How Is Gad Diagnosed

How to Treat Anxiety with Exposure and Response Prevention

Generalized anxiety disorder is diagnosed by a mental health clinician who can help determine whether the symptoms your child is experiencing is related to an anxiety disorder or another medical condition. The mental health clinician will make the diagnosis following a comprehensive assessment, which includes a diagnostic with you and your child. During the assessment, parents are asked to talk about their childs anxiety symptoms and related behavior. You will also be asked to give an overview of your childs family history, medical history, social history, and social interactions. Sometimes parent or child questionnaires are used to help clarify the diagnosis.

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How To Help A Child With Anxiety

Anxiety relief for kids traditionally encompasses two treatment strategies: anti-anxiety medications, and/or Cognitive Behavioral Therapy .

However, even though medications can have a positive impact on a childs wellbeing, they also carry the potential of a significant number of unwanted side effects.

What Makes Young People Anxious

A young person may feel anxious for a number of different reasons, depending on the individual. If your child is feeling unmanageable amounts of worry and fear, this is often a sign that something in their life isnt right and they need support to work out what the problem is.

The following kinds of things can make some children and young people feel more anxious:

  • experiencing lots of change in a short space of time, such as moving house or school
  • having responsibilities that are beyond their age and development, for example caring for other people in their family
  • being around someone who is very anxious, such as a parent
  • struggling at school, including feeling overwhelmed by work, exams or peer groups
  • experiencing family stress around things like housing, money and debt
  • going through distressing or traumatic experiences in which they do not feel safe, such as being bullied or witnessing or experiencing abuse.

This video by Braive is a useful way of understanding how stress and anxiety can build up in a person’s life.

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Signs Of Anxiety In Children

Because some children with anxiety can be quiet and eager to please, their symptoms may be overlooked. Parents and other authority figures should be alert to the numerous signs of anxiety so they can intervene as early as possible.

Although many of the signs overlap, symptoms in children depend on what type of anxiety theyâre presenting.

Symptoms of Separation Anxiety

  • Few friends outside the family

Screening for Anxiety

The United States Preventive Service Task Force recommends screening for anxiety in children and adolescents ages 8 to 18 years and screening for major depressive disorder in adolescents ages 12 to 18 years.

Causes Of Childhood Anxiety Disorder

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According to the National Institutes of Mental Health , both genetic and environmental factors contribute to the risk of developing an anxiety disorder. Research shows that biology, biochemistry, life situations, and learned behaviors all play a role. Many anxious kids have anxious family members, says Alvord. Children model behaviors on what they see, she adds.

And then theres the genetic component. Anxiety disorders do run in families but a family history doesnt mean a child is destined to develop a disorder. Parental behavior can exacerbate and worsen childrens problem but thats not the same as saying that parents are the cause of the child having the problem in the first place, Lebowitz says.

Much depends on the childs innate sensitivity, family dynamics, and life experiences. Some children have a natural predisposition or vulnerability to anxiety or have difficulty regulating their feelings of anxiety and fear. And thats not because their parents did this or didnt do that, stresses Lebowitz, That said, parents can and should play an important role in helping children learn to cope better with their anxiety.

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