Center for Children with Special Needs Tufts-New England Medical Center
What Are Anxiety Disorders?
Anxiety is a normal response to stress, whether real danger or a perceived loss of self-esteem or control. It helps one deal with a tense situation, study harder for an exam, or keep focused on an important project. In general, it helps one cope. But when anxiety causes an excessive, irrational dread of everyday situations, it becomes a disabling disorder.
Unlike the relatively mild, brief anxiety caused by a stressful event (such as starting kindergarten, a big test, or a first date), anxiety disorders last at least 6 months and can get worse if they are not treated. Many physical and emotional signs suggest a possible anxiety problem. If your child seems out of step with his or her friends or exhibits changes or problems in eating, sleeping, school work, activity level, mood, relationships, or irritability, it is worth having an assessment done.
Each anxiety disorder has different symptoms, but all the symptoms cluster around excessive, irrational fear and dread. Anxiety disorders we see in children and adolescents include:
These disorders tend to occur at certain ages. As with adults, depression has a high rate of co-existing conditions in children, especially among teenagers.
How Do We Diagnose Anxiety Disorders?
It can be hard to diagnosis in children and adolescents because: 1) children may not display anxiety symptoms like adults do;2) it’s difficult to know what is a developmental stage versus a disorder, and 3) anxiety can co-occur with speech and language problems, developmental delay, learning disabilities, and other mental health disorders like ADHD, depression, and autism spectrum disorders. A good evaluation is important.
How Are Anxiety Disorders Treated?
While there are some differences in treatment by the type of anxiety disorder, in general, the following treatments are effective.
Cognitive behavioral therapy, stress management techniques, and meditation can help people with anxiety disorders calm themselves and may enhance the effects of therapy. There is a possibility that aerobic exercise may have a calming effect. Since caffeine (in coffee, tea, and many soda pops), certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, these substances should be avoided. Medications, especially the Selective Serotonin Reuptake Inhibitors (SSRIs) have also been shown to help children and adolescents with anxiety symptoms. This group of medications includes fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).
In addition, if the anxiety co-occurs with another learning, developmental, or mental health disorder, treating that other disorder may help the anxiety. In some cases, these other problems may need to be treated before a child will respond to treatment for the anxiety disorder. Related Information
The American Association of Anxiety Disorders has a great site with general information on anxiety as well as a specific section on childhood and teen anxiety. See:
Developed for the Learning, Education, and Attention in Pediatrics (LEAP) Clinic by the Center for Children with Special Needs (CCSN)
and the Center on Child and Family Outcomes (CCFO) at Tufts-New England Medical Center. 2007.
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