Further Reading

Chronic Anxiety Disorders in Children

by Tariq M. Khan, MD, FAAP

Chronic anxiety is not limited to adults and is quite common in children. It usually occurs in response to different stresses such as illness, loss of a loved one, a traumatic experience, or dealing with a bully at school. Most of the time it is mild, brief, and self-limiting. This type usually does not need anything else except support and comfort from family.

What can become problematic and cause a lot of distress is if this anxiety becomes chronic in nature. Children of all ages can experience this, and it results in different emotions and reactions. This may be anything from worrying about every little thing to not being able to enjoy activities one usually likes due to over worrying about something being wrong. It can have different manifestations and presentations. Some commonly encountered forms of chronic anxiety in children are the same as seen in adults such as: Generalized Anxiety, Social Anxiety, Post Traumatic Stress Disorder, Obsessive Compulsive Disorder, and Phobias.

Experts do not know the exact cause of anxiety disorders, but some factors such as family history and stressors in life can play a role. As mentioned earlier, all children can experience anxiety at different times in their life, but when its persists for a long time and when it starts to affect their day to day functioning, it needs proper evaluation.

Some signs that parents or care givers may see are persistent difficulty sleeping at night, irritability along with lack of interest, withdrawal from activities that the child used to enjoy, and/or a child worried about trivial items daily to a point that it’s affecting their education or interaction with peers. These examples are just a glimpse of what children with anxiety may be experiencing. These children and adolescents avoid talking about these feelings in fear of being judged by family and peers.

Usually the first step is the parents setting up an appointment to discuss these concerns with their child’s primary care doctor. Once the child and family decide to seek help, there is a lot available that can be done to help these children. It starts with an evaluation and then counseling by a trained therapist who is experienced in working with children and adolescents. Once the diagnosis is made, then the therapist can devise a plan to teach that individual age appropriate skills to overcome and cope with their anxiety over time. Cognitive Behavior Therapy (CBT), or talk therapy, is quite commonly used in these situations to teach skills and age appropriate relaxation techniques to be able to deal better with symptoms. This form of therapy has been shown to be highly effective. Medical treatment may be needed, but it is usually not the first step in management unless symptoms are quite severe and debilitating.