Anxiety Disorders

Anxiety disorders also called Generalized Anxiety Disorder (GAD) are the most common psychiatric illnesses affecting both children and adults. Anxiety disorder is characterized by excessive, extreme unrealistic worry abut everyday life activities that lasts six months or more; in adults, the anxiety may focus on issues such as health, money, or career. In addition to chronic worry, GAD symptoms include trembling, muscular aches, insomnia, stomachaches, dizziness, and irritability Cold, clammy hands; Difficulty swallowing, Jumpiness that do not appear to have any physical cause. In general children with GAD are very self-conscious, feel tense, and have a strong need for reassurance.

The focus of GAD worry can shift, usually focusing on issues like job, finances, health of both self and family; but it can also include more ordinary issues such as, chores, car repairs and being late for appointments. The intensity, duration and frequency of the worry are disproportionate to the issue and interfere with the sufferer's performance of tasks and ability to concentrate.
GAD may associate with other anxiety disorders such as:

• Separation Anxiety Disorder: Children with separation anxiety disorder often have difficulty leaving their parents to attend school or camp, stay at a friend's house, or be alone. Often, they "cling" to parents and have trouble falling asleep. Separation anxiety disorder may be accompanied by depression, sadness, withdrawal, or fear that a family member might die. About one in every 25 children experiences separation anxiety disorder.

• Phobias: Children and adolescents with phobias have unrealistic and excessive fears of certain situations or objects. Many phobias have specific names, and the disorder usually centers on animals, storms, water, heights, or situations, such as being in an enclosed space. Children and adolescents with social phobias are terrified of being criticized or judged harshly by others. Young people with phobias will try to avoid the objects and situations they fear, so the disorder can greatly restrict their lives.

• Panic Disorder: Repeated "panic attacks" in children and adolescents without an apparent cause are signs of a panic disorder. Panic attacks are periods of intense fear accompanied by a pounding heartbeat, sweating, dizziness, nausea, or a feeling of imminent death. The experience is so scary that young people live in dread of another attack. Children and adolescents with the disorder may go to great lengths to avoid situations that may bring on a panic attack. They also may not want to go to school or to be separated from their parents.

• Obsessive-Compulsive Disorder: Children and adolescents with obsessive-compulsive disorder, sometimes called OCD, become trapped in a pattern of repetitive thoughts and behaviors. Even though they may recognize that the thoughts or behaviors appear senseless and distressing, the pattern is very hard to stop. Compulsive behaviors may include repeated hand washing, counting, or arranging and rearranging objects. About two in every 100 adolescents experience obsessive-compulsive disorder (U.S. Department of Health and Human Services, 1999).

• Post-traumatic Stress Disorder: Children and adolescents can develop post-traumatic stress disorder after they experience a very stressful event. Such events may include experiencing physical or sexual abuse; being a victim of or witnessing violence; or living through a disaster, such as a bombing or hurricane. Young people with post-traumatic stress disorder experience the event over and over through strong memories, flashbacks, or other kinds of troublesome thoughts. As a result, they may try to avoid anything associated with the trauma. They also may overreact when startled or have difficulty sleeping.

Who is at risk?

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Researchers have found that the basic temperament of young people may play a role in some childhood and adolescent anxiety disorders. For example, some children tend to be very shy and restrained in unfamiliar situations, a possible sign that they are at risk for developing an anxiety disorder. Research in this area is very complex, because children's fears often change as they age.

Researchers also suggest watching for signs of anxiety disorders when children are between the ages of 6 and 8. During this time, children generally grow less afraid of the dark and imaginary creatures and become more anxious about school performance and social relationships. An excessive amount of anxiety in children this age may be a warning sign for the development of anxiety disorders later in life.

Studies suggest that children or adolescents are more likely to have an anxiety disorder if they have a parent with anxiety disorders. However, the studies do not prove whether the disorders are caused by biology, environment, or both. More data are needed to clarify whether anxiety disorders can be inherited.

Treatment Guide:

Children and adolescents with anxiety disorders can benefit from a variety of treatments and services. Following an accurate diagnosis, possible treatments include:

• Cognitive-behavioral treatment, in which young people learn to deal with fears by modifying the ways they think and behave;
• Relaxation techniques;
• Biofeedback (to control stress and muscle tension);
• Family therapy;
• Parent training; and Medication.

While cognitive-behavioral approaches are effective in treating some anxiety disorders, medications work well with others. Some people with anxiety disorders benefit from a combination of these treatments. More research is needed to determine what treatments work best for the various types of anxiety disorders.

Repeated symptoms of an anxiety disorder in children or adolescent should be treated by specialist.