This article will focus on the issue of anxiety in children. And, I will try to answer the questions: what is it? And what can you do about it? But first, let me share an observation from my own family. My 15-month old daughter is working her way through her fear of “belue.” That’s baby-talk for a half-filled white balloon that has been floating around my house for a while. It’s apparently the squishy-ness that bothers her. So, she skirts around it exhibiting intense curiosity mixed in with fear. Last week, she poked it with her finger and ran away. A few days later she kicked it and watched it roll. As a child psychiatrist, I’ve watched with fascination how her fear and her ability to overcome it is such an integral part of her normal development. What is the difference between fear and anxiety? So, how is anxiety different from fear? Fear is usually an immediate intense emotional reaction to a more imminent real or perceived danger (like “belue”). Anxiety, on the other hand, is more about anticipating a threat that might be lurking around sometime in the future. Fear and anxiety overlap and may result in children having misguided cognitive/thinking patterns (“There are monsters under my bed”), leading to caution (“I need the lights on”) and potentially evolving to avoidant behaviors (“I do not want to sleep alone”). Do fear and anxiety have any benefits? Anxiety and fear are not always bad. At least not in the traditional way we think about it. Both serve an essential evolutionary purpose. For example, it probably saved the cave people from being eaten away. Also, developmentally appropriate stranger anxiety protects infants and toddlers from venturing too far away from their primary caregivers, thus keeping them safe. Anxiety about disappointment or failure helps children practice their baseball skills to perfection and perform flawlessly as the turkey in the annual school play. Functionally, anxiety serves to protect children day-to-day while they learn how to interact socially with others or master skills effectively. How do you distinguish routine anxiety from an anxiety disorder? Everyone falls on a spectrum of how much anxiety we create when presented with the same anxiety-provoking stimuli. Sometimes children develop a fear/anxiety response that is large enough to actually prevent them from doing these activities. They may manifest physical or emotional symptoms, including the following: feeling overwhelmed crying freezing sweating throwing tantrums blanking out getting dizzy These uncomfortable symptoms automatically generate a desire to get away from the anxiety-provoking stimuli by a variety of avoidance behaviors. You may hear your child complain: “My stomach hurts, so I can’t go to school today” or “I’m not reading my homework in front of the class, so I’ll just not do it.” A diagnosis of an anxiety disorder should be considered (AmericanPsychiatricAssociation, 2013) when anxiety responses are beyond what is expected given a child’s developmental age and, interfere significantly with their ability to perform persist longer than what is reasonably expected, and is not attributable to the child’s cultural contextAdverse Childhood Events and are linked to a number of poor health outcomes both physical, as well as mentalAnxiety Disorders: Everything You Need to Know Is Cyberschool a Solution for Children with Anxiety What is Non-Verbal Learning Disorder? However, when combined with appropriate relaxation skills, the child can learn to change to a more effective way of thinking such as: “I may stumble over some words, but so does everyone else. It’s no big deal!” Children can learn to cope with anxiety Children can learn how to use coping skills to “calm” their anxiety down using strategies like deep breathing or chicken-fingers. Other skills-based trainings like social skills training or assertiveness training can complement the child’s progress and help build their confidence. Most therapies for anxiety involve an appropriate and graduated dose of exposure to the anxiety-provoking stimuli, which allows for the practice of the skills and techniques learned. Medications may also play a role, especially if the level of anxiety is moderate to severe. The largest evidence-base exists for the use of serotonergic medications like fluoxetine, escitalopram, or sertraline which helps normalize the low serotonin neurotransmitter levels that occur in brains of children with anxiety disorders. It is important to discuss the benefits and risks of each of these options, or a combination, with your health-care provider before embarking on a particular course of therapy. The bottom line for anxiety in children The bottom line is that some degree of anxiety is an essential part of your child’s normal development. Recognize that and let them work through it while you hang around for safety and support. Maybe your child will have the ability to work through the fear on their own (e.g., the “belue” example). However, if it feels like their anxiety is excessive and is interfering with their quality of life, reach out for support and assistance from health professionals. Source
