By Amy Heiman*, M.S., LCPC
All children experience anxiety. But in 1997, it was estimated that between 3 to 8% of children and adolescents experienced an actual anxiety disorder. Since it can be difficult to distinguish between fear and anxiety, how is a parent to differentiate "normal" anxiety from a more debilitating condition that may require outside assistance? Generally, fear is associated with an external threat, while anxiety is typically related to a perceived threat. Consider the following when deciding whether or not to seek help.
Are the signs of anxiety atypical for the child's age? How are the feelings affecting the child's personal, social and academic performance? Is the intensity of the feeling higher than it seems it should be for a given situation? Anxiety and fears are partially inherited. Is there a family history of anxiety disorders? Certain external negative events contribute to anxiety disorders. Does your child seem to be under stress environmentally?
There are many potential environmental causes of anxiety in children. The following are some typical stressors that we see as contributing factors: family problems (pending divorce or competition between siblings;) excessive or unusual disciplinary practices; inconsitency in how children are handled or treated by adults; expectations and standards set up by the child or others that are perceived as unattainable; peer pressure to conform or "fit in"; rejection by peers; high need for achievement; concerns about success or failure; physical appearance; and ability level.
Counselors and psychologists look for certain symptoms that typically manifest themselves in over-anxious individuals. These symptoms are divided into 5 categories, resulting in different diagnoses.
Separation Anxiety Disorder. Constant thoughts and fears about safety or self or parents; refusing to go to school; frequent stomach aches or other physical complaints; extreme worries about sleeping away from home; overly clingly; panic or tantrums at times of separation from parents; trouble sleeping or nightmares.
Specific Phobia. Fear of a specific thing, such as dogs, insects, or needles; and these fears cause significant distress.
Social Anxiety Disorder. Children are afraid to meet or talk to new people; may have few friends outside the family.
Generalized Anxiety Disorder Many worries about things before they happen; constant worries or concerns about school performance, friends or sports; fears of embarrassment or making mistakes; low self-esteem.
Obsessive-Compulsive Disorder. Recurrent obsessions that are intense enough to cause severe discomfort. (Obsessions are persistent thoughts, impulses or images that are unwanted. They are frequently unrealistic or irrational; for example, believing someone will die if you have a bad thought about them); Recurrent compulsions that are intense enough to cause severe discomfort. (Compulsions are repetitive behaviors or rituals—like handwashing, hoarding or organizing, or repetitive mental acts—such as counting, repeating words silently); The obsessions or compulsions cause significant anxiety or distress, and interfere with normal academic, social, and relational functioning.
Bring your child or adolescent for a professional evaluation if you are concerned about any of the above conditions. Treatment may include individual therapy, family therapy, medications and/or consultation with the school. Early treatment can help prevent future difficulties such as loss of friendship, failure to reach social and academic potential, and feelings of low self-esteem.