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Anxiety Additional information on anxiety in children and adolescents is available from: National Institute of Mental Health American Academy of Child & Adolescent Psychiatry
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Anxiety disorders are among the most common childhood psychiatric illnesses. Children and adolescents who are afflicted with anxiety often experience considerable distress and impairment in their day to day functioning. They may avoid situations that are important for their optimal development, such as school, peer involvement and functioning independently from parents. Anxious children/teens are also more likely to experience problems with their mood, conduct and overall functioning with family and peers.
Generalized Anxiety Disorder (GAD)
GAD is excessive anxiety and worry about a number of events or activities. Children with GAD tend to worry about their school performance or the quality of their performance (e.g., sports), and have trouble controlling their worry. For instance, even if they got a good grade on an exam, these children may get upset about a few questions they missed. The anxiety and worry are accompanied by at least one of the following symptoms: restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and disturbed sleep.
Along with being approval-seeking, children with GAD tend to be perfectionist, and may redo tasks because of excessive dissatisfaction with less-than-perfect performance. GAD very frequently occurs with Mood Disorders (e.g., Major Depressive Disorder or Dysthymic Disorder). back to top
Separation Anxiety Disorder (SAD)
Children with SAD have excessive anxiety about being separated from home and the people they are closest to. These children end up having significant trouble at school (i.e., refuse to go), social situations, and in general functioning (e.g., sleeping alone). In fact, they may physically get sick on days when they have to go to school or know they will be separated from their parents. Children with SAD are described as "unusually conscientious, compliant, and eager to please." SAD occurs in approximately 4% of children and adolescents. back to top
Children with SOC have a marked and persistent fear of being embarrassed in social or performance situations. Often, children are afraid of being called "crazy" or "stupid," and usually, the social or performance situation is avoided, or else endured with dread. To have a diagnosis of SOC, this avoidance or fear must interfere significantly with the person's daily routine or functioning. back to top
Panic Disorder with or without Agoraphobia (PD)
Not as common in children and adolescents, Panic Disorder is the presence of recurrent, unexpected Panic Attacks (symptoms of Panic Attacks include shortness of breath, dizziness, pounding heart, tingling or numbing sensations, trembling or shaking, hot or cold flushes) followed by at least 1 month of persistent concern about having another Panic Attack, worry about the possible implications or consequences of the Panic Attacks, or a significant behavioral change related to the attacks. back to top
Although fears are common in the general population, they do not usually result in sufficient impairment or distress to warrant a diagnosis of Specific Phobia. A Specific Phobia is an intense and persistent fear of a particular object or situation. Intense, irrational fears of certain things or situations such as animals, snakes, insects, enclosed places, heights, storms, escalators, tunnels, highway driving, water, flying, and injuries involving blood are a few of the more common ones. Most adolescents and adults with phobias recognize that their fear is excessive or unreasonable.
Most often the object or situation is avoided, although at times it can be endured with extreme distress. Children may not recognize that their fear is excessive or unreasonable. They may express their fear through crying, tantrums, or clinging. The diagnosis is made only if the avoidance, fear, or anxious anticipation of encountering the object or situation interferes significantly with the person's daily routine or functioning.
Obsessive-Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, anxious or "strange" thoughts or rituals that the individual feels she/he cannot control. Obsessions are persistent, disturbing, intrusive thoughts or impulses that the person finds illogical but irresistible. The obsessions may appear as ideas, words, rhymes, or melodies that annoyingly interrupt normal thoughts and interfere with getting anything accomplished. These obsessions usually lead to compulsions. Compulsions are obsessive rituals or actions the person feels urgently compelled to engage in. For example, individuals with OCD may be obsessed with germs and may repeatedly wash their hands. They may be filled with doubt and feel the need to check things repeatedly (e.g., checking the door locks, household electronic appliances). They may spend long periods of time touching certain things or counting to certain numbers. A person with OCD may also be preoccupied by order or symmetry, such as needing to follow a precise ritual of washing one arm, then the other arm when taking a shower. If the ritual is interrupted in any way, the person must start over. This may cause interpersonal difficulty for the individual as they may be chronically late for school or activities. These rituals are performed to try to prevent or eliminate their obsessions. back to top
Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder (PTSD) is a type of anxiety disorder that may develop following exposure to an extreme traumatic event. Often, people with PTSD have persistent frightening thoughts and memories of the traumatic event. Examples of traumatic incidents include: kidnapping, serious accidents such as car, train, or plane wrecks, natural disasters such as floods, earthquakes or hurricanes, violent attacks such as mugging, rape, or torture or being abused. The person with PTSD may experience sleep problems, depression, feeling detached or numb, or being easily startled. They may lose interest in things that they usually enjoyed and have difficulty feeling affectionate. People may sometimes become extremely irritable or have violent outbursts. Going places or seeing things that remind them of the traumatic event may be very troubling, and so they may avoid those places or situations. Anniversaries of the traumatic event are often very difficult. Some individuals with PTSD repeatedly "relive" the trauma in the form of nightmares, disturbing memories, experience "flashbacks," or intrusive images of the traumatic event. Regular everyday events may trigger the flashback. The "flashback" may come in the form of images, sounds, smells, or feelings. The person experiencing a flashback may lose touch with reality for brief or longer periods of time (dissociation). The person may experience dissociation that lasts from a few seconds to several hours, or even days, during which the components of the event are relived and the person may believe the traumatic event is happening all over again. Not every individual who experiences a traumatic event will go on to develop full symptoms of Post-Traumatic Stress Disorder. Some individuals will have no symptoms at all. The likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increases. back to top
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