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Anxiety Disorders in Youth

How can I tell whether my child or teen is anxious?
Children/teens with anxiety typically exhibit at least two of the following symptoms:

  • Physical symptoms (headaches, stomachaches, muscle tension, etc.)
  • Avoidance of a variety of situations
  • Perfectionism, self-consciousness, or lack of self-confidence
  • Difficulty in social/performance settings, attending school, or separating from a caregiver
  • Excessive worry or concern about future and past events, loved ones, or their own safety

Anxiety can start when children are very young and stay hidden for many years, causing children to suffer in silence. Anxiety can interfere with academic, social, and family functioning and worsens over time. Left untreated, anxiety disorders may lead to depression and other mental health problems. Fortunately, anxiety disorders are highly treatable and most individuals recover with appropriate treatment. There are several types (or diagnostic categories) of anxiety disorders in children. Below is some more information about each.

 

Separation Anxiety Disorder (SAD): A child or adolescent with separation anxiety fears something terrible may happen to cause a lasting separation from home or loved ones. As a result, the child has extreme difficulty being away from home or the parents and tries to avoid these situations.

Common difficulties:

• Sleeping alone
• Reluctance to go to school or friends’ homes
• Clinging to parents
• Refusing to stay with a sitter or relative
• Tantrums
• Physical complaints

Social Phobia: Children who are socially anxious experience extreme distress in social situations and may exhibit excessive shyness. They fear being rejected or judged by others.

Common difficulties:

• Avoidance of situations involving other people, such as school situations, play dates, sports events, parties, or taking tests
• Starting or joining a conversation
• Reading aloud
• Performing in sports or musical events
• Having pictures taken

For more information on social phobia and shyness, click here

Generalized Anxiety Disorder (GAD): These children and adolescents are worriers. They experience excessive and uncontrollable worry about a wide range of topics.

Common difficulties:

  • Excessive worries about school, the child’s own health and the health of family members, past events, and issues going on in the world or heard on the news
  • Physical complaints (may include difficulty falling asleep, trouble concentrating, restlessness, irritability, or muscle aches)

Specific Phobias: Phobias are irrational and excessive fears of specific objects or situations.

Common phobias experienced by children and teens:

  • Insects
  • Animals
  • Vomiting
  • Blood or injections
  • Thunderstorms
  • Darkness
  • Doctors/dentists

Panic Disorder with or without Agoraphobia: Typically not experienced until adolescence, panic disorder includes unexpected and recurrent panic attacks. These children often experience a fear of future panic attacks and may therefore attempt to avoid situations in which these attacks may occur, such as school, stores, movie theaters, or their friendsí homes.

Symptoms of a panic attack:

• Dizziness
• Racing heart
• Sweatiness
• Shortness of breath
• Fears of losing control
• Sweating
• Hot or cold flashes
• Tingling sensations
• nausea

Obsessive Compulsive Disorder (OCD): Children with OCD experience persistent, recurrent, and intrusive thoughts (obsessions) that are often accompanied by an overwhelming need to perform repetitive behaviors or rituals (compulsions) to prevent some dreaded event.

Common obsessions:

• Germs
• Illness
• Getting things “just right”
• Doubting themselves
• Having Scary images
• Hearing songs repeatedly
• Patterns
• symmetry

Examples of compulsions:

• Excessive amount of time washing
• Excessive amount of time checking things
• Excessive amount of time spent seeking reassurance from parents
• Rewriting homework several times
• Rereading words
• Saying words over again several times
• Bedtime rituals that take a long time and cause distress
• Untying shoes and retying shoes several times until it feel right
• Touching things a certain way or repeatedly

Post Traumatic Stress Disorder (PTSD): Children and adolescents experience this type of anxiety following a traumatic event, such as accidents, fires/floods/tornados, or physical/sexual abuse. These children often experience heightened levels of anxious arousal, as they may feel they are re-experiencing the traumatic event, and they may avoid situations that remind them of the traumatic event.

Trichotillomania (TTM) is an impulse disorder that causes people to pull out the hair from their scalp, eyelashes, eyebrows, or other parts of the body, leading to noticeable bald patches. Although it is considered an impulse-control disorder, it may resemble a habit, an addiction, tic disorder, or obsessive-compulsive disorder.

Mood Disorders

Major depressive disorder (MDD) and dysthymic disorder are two commonly diagnosed mood disorders in childhood. Children with depression may exhibit the following symptoms:

• Lack of interest in activities they used to enjoy
• Persistent sad or irritable mood
• Feeling or worthlessness or inappropriate guilt
• Loss of energy
• Being irritable more than usual
• Thoughts about death or dying, suicidal ideation
• Change in sleep
• Change in appetite
• Easily distracted and difficulty concentrating
• Psychomotor agitation or retardation

 
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