How to Determine If Your Child Has an Anxiety Disorder
- In This Quick Guide:
- Childhood Anxiety Disorders
- Are the Red Flags Waving?
Many kids are more anxious these days, but how much anxiety is too much? When is a fear “normal,” and when is it a cry for help? In this guide, we take a look at what amount of anxiety is typical of childhood and what is not. No matter how large or small our child’s problem is, though, keep this in mind: help is available.
Childhood Anxiety Disorders
Although all children are afraid some of the time, no child should be afraid all of the time. Some children don’t outgrow their fears; instead, they get worse and begin to interfere with their daily lives. Although we don’t know how many children develop clinical levels of anxiety, we do know two alarming facts. They are often overlooked or misjudged, and many adult diagnoses likely have their first manifestations in childhood.
Given that the lifetime prevalence for anxiety disorders in adults is about 25 percent, we can make an educated guess that there are a lot of children with a treatable mental condition who are suffering needlessly.
For example, separation anxiety disorder, an intense worry and fear about being apart from family members or individuals to whom the individual is most attached, affects approximately 4 percent to 5 percent of U.S. children between ages 7 and 11. Social anxiety disorder typically surfaces during adolescence, although it can be preceded by a period of shyness in childhood. In addition to separation anxiety disorder and social phobia, children can—and do—develop generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder, and specific phobias.
Symptoms of Separation Anxiety
- Constant thoughts and intense fears about the safety of parents and caretakers
- Refusing to go to school
- Frequent stomachaches and other physical complaints
- Extreme worries about sleeping away from home
- Being overly clingy
- Panic or tantrums at times of separation from parents
- Trouble sleeping or nightmares
Symptoms of Phobia
- Extreme fear about a specific thing or situation (for example, dogs, insects, or needles)
- The fears cause significant distress and interfere with usual activities
Symptoms of Social Anxiety
- Fears of meeting or talking to people
- Avoidance of social situations
- Few friends outside the family
Other Symptoms of Anxious Children
- Many worries about things before they happen
- Sleep deprivation due to worry, fear, or attempts to control these concerns
- Constant worries or concerns about family, school, friends, or activities
- Repetitive, unwanted thoughts (worries or obsessions) or actions (compulsions or avoidance of certain situations)
- Fears of embarrassment or making mistakes
- Low self esteem and lack of self-confidence
- Family conflict over seemingly mundane issues (such as going to school, a minor change in routine)
In evaluating whether or not a child has an anxiety disorder, professionals often consider four factors:
- How intensely does the child experience the anxiety symptoms; do they make her physically ill? Do her worries take up much of the day?
- How long have they lasted; anxiety that lasts longer than a month is one benchmark in looking at professional treatment.
- How age appropriate are the child’s fears? Separation anxiety at 1 year is not a matter of concern; it might be if the child is 9.
- How much do the anxiety symptoms prevent the child from engaging in, and enjoying, regular activities? Is the child missing sleepovers or getting ready in the morning?
For us parents, though, our primary questions are how much emotional pain our child is experiencing and how we can help lessen it.
Are the Red Flags Waving?
Because anxious children may be quiet, compliant, and eager to please, their difficulties may be missed. We parents may be the first, or the best, ones to recognize when our child’s problems are too much for him or her to manage. In looking at this checklist, the focus is on the perspective of the child—not on clinical diagnosis; what matters to parents is the amount of distress and pain our child is experiencing.
- Has your child’s anxiety lasted more than one month?
- Does your child worry a lot about the future?
- Does your child often ask unnecessary questions and repeatedly ask for reassurance?
- Does your child worry excessively about a number of events and activities?
- Does your child get frequent stomachaches and headaches at school?
- Does your child have nightmares about being separated from you or excessive fears about something bad happening to you?
- Does your child seem exceedingly anxious or uncomfortable with peers, to the point that s/he avoids them?
- Does your child feel extremely nervous when she has to do something (play a sport, speak up in class) while others watch her?
- Have you noticed your child’s school work or social activities declining?
- Does your child seem to make up a lot of excuses to avoid school whenever possible? (“Illnesses” that magically improve as soon as he or she is allowed to stay home.)
- Does your child throw temper tantrums to avoid certain activities or objects?
- Does your child constantly worry about things that have already happened?
- Does your child have certain rituals or routines that are extremely distressing when disrupted?
- Does your child worry to the point that she feels physical symptoms (like throwing up, dizziness, shakiness, or sweatiness)?
- Does your child redo tasks because he’s never satisfied with his performance?
- Does your child constantly worry about how well she is doing at school or other competitive activities?
- Is your child consistently afraid to meet or talk to new people?
The more items you recognized in your child, the better the odds that you can benefit from the advice of a professional.
Recognizing your child has an anxiety disorder is the first step in dealing with the issue. Congratulations on taking that first step, and good luck!
From The Complete Idiot’s Guide to Controlling Anxiety by Joni E. Johnston, Psy.D.
