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As with many other health problems, children and adolescents experience anxiety disorders differently from adults. The symptoms themselves are the same but they are displayed differently. Until recent years, family physicians tended to minimize the exceptional behaviour patterns of children whose parents came seeking advice. The diagnosis was often that the child was going through a phase which he or she would outgrow. Today, most have been re-educated to investigate the possibility that deeper problems may exist. Many anxiety disorders are now recognized as first appearing during childhood and adolescence and, as with adults, it is quite usual to have more than one of these disorders at the same time. Following is a list of the disorders and the probable way in which they will manifest themselves in children and adolescents.
Generalized Anxiety Disorder
Excessive, and often unrealistic anxiety, is the chief characteristic
of GAD. Children with the disorder are usually perfectionists
who will spend hours doing the same homework which other children
are likely do very quickly. They are restlessness, find it difficult
to concentrate, have trouble sleeping and may even refuse to go
to school. Such symptoms exhibited over a six-month period are
a signal that a child may be suffering from generalized anxiety
disorder.
Panic Disorder
While less likely in young children, panic disorder is more common
in adolescents. A panic attack is considered to have occurred
when four or more of the following symptoms are experienced within
10 minutes:
palpitations sweating chills or hot flashes
trembling choking sensation chest pain dizziness
nausea stomach ache a feeling of being detached
from oneself fear of losing control fear of going
crazy
fear of dying numbness tingling
Panic disorder often occurs with agoraphobia and the child may
refuse to leave his or her home. In contrast to the general reaction
of school personnel of a few years ago that punishment
was in order, refusal to attend school is now considered a signal
that the child needs help.
Social Phobia
While, most children experience periods of shyness and feel uneasy
around strangers, for some usually during the teen years
avoiding strangers, including people their own age, becomes
so extreme that it interferes with normal social development and
leads to isolation and depression. In young children, a type of
social phobia called selective mutism prevents the child from
speaking when in the company of strangers and people he or she
does not know well.
Separation Anxiety Disorder
Being anxious due to separation from familiar people and situations
is a normal part of growing up. This natural anxiety diminishes
as the child grows older. Children or adolescents, suffering from
separation anxiety disorder, experience much longer term excessive
anxiety when separated from parents, home or other familiar situations.
Small children react with crying and panic on separation, and
with clinging behaviour. In older children and adolescents, unrealistic
worry about loved ones being harmed in some way, fear they will
not return home, fear of sleeping alone, refusal to go to school
are usually the signs of separation anxiety disorder. Stomach
ache, headache and constipation are the most common physical symptoms.
Specific Phobia
Specific, simple or single phobia is intense fear of a specific
object or circumstance which is not normally dangerous
e.g. animals, insects, storms, heights. Some, such as the fear
of dentists, needles and other medical procedures may impact on
general health and wellbeing, while others cause only inconvenience.
In young children, these phobias are usually not as debilitating
as they can sometimes become in adults, and may disappear as the
child grows older.
Obsessive-Compulsive Disorder
In OCD bsessions consuming the individual for more than one hour
a day and usually involving unrealistic fear and anxiety are relieved
by performing repetitive behaviours or compulsions. Compulsions
such as washing, praying, checking, counting and arranging things
are the most common in children and adolescents. It is estimated
that as many as three percent of young people suffer from OCD,
with boys being twice as likely as girls to have the disorder.
Many also have tic disorders.
Post-Traumatic Stress Disorder
In children, post-traumatic stress disorder is generally exhibited
in very agitated behaviour. They avoid things that remind them
of the trauma and may have physical symptoms such as being easily
frightened or scared. The traumatic event is sometimes relived,
particularly by young children, in repetitive play that features
some aspect of it, in frightening dreams or complete re-enactment.
Copyright Jean Jardine Miller.