Anxiety in Children and Adolescents

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Children and adolescents can suffer from anxiety, impacting their functioning at school or interactions with peers. Typically what characterizes anxiety in children and adolescents is constant worry or an intense fear (either real, perceived or imagined) that be extremely debilitating. Some children have heightened anxiety responses due to trauma, bullying, or experiencing some sort of stressor/adjustment. Below are other anxiety disorders and how they manifest in children and adolescents.

General Anxiety: Is your child a worry wart? Children who constantly worry may find it difficult to concentrate on school work, socializing, or engaging in activities. For some, anxiety may be difficult to detect due to children being high achieving and extremely well behaved. High-achieving children and adolescents with anxiety suffer in silence as they try to achieve perfection in every aspect of their lives.

OCD: Children with Obsessive Compulsive Disorder (OCD) show anxiety symptoms such as having obsessive thoughts related to contamination, harming others, or being bad. Different ways in which they may try to alleviate their anxiety is by engaging in compulsions such as being rigid, compulsive hand washing, showering, cleaning, or even counting different behaviors (knob turning). Signs of OCD in children include extreme rigidity and intense reactions (sometimes tantrums) when they can't engage in a compulsion or behavior that alleviates their anxiety.

Panic Attacks and Disorder: Some children experience panic attacks characterized by a combination of physical symptoms such as dread, pounding heart, shortness of breath, dizziness, tingling and numbness in the limbs. Typical panic attacks last between 5-10 minutes. Another key feature of panic disorder is fearing that a future panic attack may occur. Therefore, children may engage in avoidance behavior in an effort to prevent triggers or future panic attacks.

Post Traumatic Stress Disorder (PTSD) and Trauma-Related Symptoms: When children have been exposed to a traumatic event it is normal for them to react with upset and fear. While children can be very resilient, some are impaired by different symptoms that are directly related to experiencing the traumatic event. For children who are constantly in situations in which they are not safe, or don't feel safe, they can continue to experience anxiety. Some signs that your child may be experiencing symptoms of Post Traumatic Stress Disorder (PTSD) include, irritability, repetitive play reenacting trauma, poor sleep, nightmares, restlessness (that can be mistaken for hyperactivity), or socially disconnected. Most children will not meet full criteria for PTSD, but can have an anxiety disorder due to specified trauma. For more information about trauma and it's effects, click here.

Treatment: I use a wide range of interventions that focus on educating about anxiety symptoms, fear responses and ways in which the body tries to protect itself from real, perceived or imagined threat. I have experience in using Cognitive Behavior Therapy Exposure and Response Prevention (CBT ERP) for these anxiety disorders. CBT ERP has been shown to be extremely effective in treating each of these anxiety disorders by providing education regarding anxiety and our bodily responses to it, discussing, understanding and challenging anxiety-related thoughts, along with gradually exposing them to their fears by engaging in exposure exercises. Additionally, we will talk about different ways to incorporate fun deep breathing, relaxation, grounding and other ways of coping into your child's life.

For a complete list of the different anxiety disorders and what CBT entails see the Academy of Cognitive Therapy website here.

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