Anxiety in Children

ANXIETY IN CHILDREN

SEPARATION ANXIETY/SCHOOL REFUSAL

My child complains of headaches, stomach upset, is tearful, and won’t go to school.  When we drop her off at school, she cries and if she makes it to class, she wants to visit the nurse.  She has missed many days from school and we are worried.  Her doctor says there are no medical problems.  What can we do?

Separation anxiety and school refusal may occur in children of all ages.  Fearfulness and physical symptoms without a known medical cause may occur and the child may request to go to the nurse’s office.  Behavioral strategies can include preplanned, brief phone contact with a parent during the school day.  At times, medical treatment for the anxiety is considered.

PANIC DISORDER

My teenage daughter has panic attacks and won’t leave her “safe zone.”  What can we do?

Panic Disorder includes “out of the blue” intense anxiety with the heart pounding, shortness of breath, and feeling out of control.  Even without the anxiety attack, kids anticipate them once they have taken place and may also avoid activities fearing to have another attack.  Treatment include cognitive behavioral therapy with relaxation, exercises and challenging negative thoughts.  Anxiety medication used briefly along with a serotonin reuptake inhibitor (example, Prozac, Zoloft, or Lexapro) is often helpful.  Caffeine use should be avoided and a medical evaluation to evaluate other causes of anxiety is helpful.

GENERALIZED ANXIETY DISORDER (GAD)

My child can’t stop worrying and it distracts him.  He seems so stressed by everything.  How can he relax?

Generalized anxiety presents with constant worry, frequent headache and feeling tense or on edge.  Relaxation strategies, challenging excessive worries, and considering a serotonin reuptake inhibitor (SSRI) may be very helpful.

OBSESSIVE COMPULSIVE DISORDER (OCD)

My son keeps tapping objects three times including tables, lockers, and doors.  He also has a fear of dirt and germs, often washing his hands.  If he can’t do his rituals, he becomes really stressed.

Obsessive Compulsive Disorder includes obsessive thoughts and/or repetitive behaviors.  These can be very distracting and interfere with the child’s functioning.  Behavioral strategies including “response prevention” along with an SSRI-type medication is often very helpful.

SOCIAL ANXIETY DISORDER

My daughter will not raise her hand in class or speak in front of the class.  She does not eat lunch with her friends either.  She won’t go to group activities and is mostly verbal at home with her family but not outside of home.  She said she is afraid of being embarrassed.  How can we help?

Social Anxiety Disorder is the most common form of anxiety.  Before it interferes with the child’s functioning, they may have a history of “selective mutism” during early elementary years.  Gradual exposure to feared situations and SSRI-type medication is often helpful.