
disorder. Anxiety may be as simple as shyness around strangers, a fear of the dark, an abnormal attachment to objects or people, or even a phobia. An overly anxious child may be described as a worrier. A child with chronic anxiety may have trouble concentrating, problems in the school environment and difficulty making friends. Anxiety has two components: the emotional one and the physical one. The physical aspects of anxiety include nausea, headaches, sweating, wetting, and hiding, crying, and going limp — refusing to stand or sit. Emotional aspects of anxiety include ruminative thoughts, fear, and depression. Children with severe anxiety may suffer from diarrhea, vomiting and shortness of breath. Everyone, including children, experiences occasional anxiety. Children, who have never been yelled at, may think their kindergarten teacher is a scary monster. A child, who has been knocked down by a dog, may be fearful of pets and a child with no siblings may get nervous in groups. Twin studies suggest that the strongest causes of anxiety are environmental, but brain-imaging studies support minor physiological factors. When does simple anxiety become a disorder? A diagnosis of generalized anxiety disorder can occur when symptoms like sleep difficulties, irritability, difficulty concentrating last longer than six months. Anxious children may need constant reassurance and appear overly eager to please. Panic attacks or anxiety attacks are considered a panic disorder when anxiety attacks are reoccurring and accompanied by the fear of having another attack. Clinical symptoms of anxiety attacks include: increased heart rate, chills, hot flashes, numbness, dizziness, detachment, trembling, shaking, sweating, fainting, hyperventilation and fears of going crazy, dying and losing control. Anxiety attacks must lead to behavioral changes to be considered a disorder—like avoidance, crying or thumb sucking. Separation anxiety usually occurs when parents and caretakers leave the child with someone else—like a sitter. The child may “melt down”, cry or throw a tantrum, and cling to the primary caregiver. They may frequently ask when their parent or guardian will return. Children that suffer from separation anxiety are reluctant to go to school, and may complain of stomachaches or other physical ailments. These children are often unable to go on “sleepovers.” They may also experience sleep difficulties. A child with social anxiety will be reluctant to make friends outside of their family. They may be described as shy and tend to hang back in social situations unable to speak. A child who suffers from a phobia will have a fear of a particular object or situation and experience anxiety and behavioral changes. Common phobias in children include needles, spiders, clowns, and dogs. Children, like adults, will adopt behaviors to relieve anxiety. Once the anxiety subsides, a child may maintain the behavior or rely on it again whenever a situation threatens to cause anxiety. We have all seen the five-year-old with a pacifier or the tween who sleeps with a blankey. Coping behaviors may be adaptive like sleeping with a night light on, or maladaptive like sleeping with a baby bottle in their mouth. Early attention to anxiety can ward off future self-esteem problems. As anxious children get older, they are more prone to cope with anxiety by avoidance, anger, and depression. These children are considered to be more at risk for drugs, alcohol, gangs and dropping out of school. Treatments for anxiety may include psychotherapy, behavioral therapy, and medication. Individual “talk therapy” may be used in the initial stages of therapy, but group therapy is recommended more often. Behavioral therapy should focus on confidence building and independence in the child’s environment. Because many prescription drugs used to treat anxiety are addictive, alternative therapies should be exhausted first. Several non-addictive prescription medications are available, but the side effects are not easily tolerated by children.
to talk about their concerns and feelings, will feel comforted and less alone. By listening to your child, you may also discover what the underlying problem is and therefore find ways to help. Suggest that your child write a story or draw a picture of scary things, and look for clues to help you understand his fears better. * Reassure and comfort your child. Children need lots of hugs and assurance that they are safe and understood. It is important to acknowledge their fears as being real to them and not trivialize their feelings. What children fear may seem silly to you, but that doesn’t make the emotion any less real. * Watch out for your own anxieties and worries. In some cases, anxiety is a learnt response and children may be picking up on your tensions. You are your child’s best model for behavior! * Teach your child relaxation techniques like deep breathing during anxious moments, counting to 10 or self-soothing statements. These methods can help to empower your child and will provide the inner confidence needed to overcome the fears. * Routines and plenty of warning before change can go a long way to making your child feel more secure and less anxious. Explain new situations in advance in a simple, friendly manner. (Try role playing to prepare for upcoming situations) * Remind your child of old fears that they overcame. This will provide the courage and confidence to face current fears. Always praise children’s efforts and successes when they do confront these anxieties. * Do not accommodate your child’s fears. If your child fears something, don’t purposefully avoid it as this will reinforce the need for escape and confirm the ‘reality’ of the danger. However, DO reassure your child and try to help him or her through the situation successfully.
researcher Sheli Ellsworth
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