General Information about Anxiety Disorders

Although some anxiety is normal among children of different ages, it may be problematic if your child's anxiety is causing distress and interfering with his or her ability to attend school, make and spend time with friends, sleep, or spend time away from you. There are several different anxiety disorders experienced by children and adolescents, and they are all characterized by pervasive feelings of excessive, irrational fear and distress. Each, however, has its own distinct features. Feel free to review a brief description of the symptoms specific to each anxiety disorder. You may also find the Anxiety Disorders Association of America website to be of help.

Generalized Anxiety Disorder

Chronic, excessive worry or anxiety for a minimum of six months characterizes generalized anxiety disorder. Your child may worry about a number of events or situations such as school, your health, friendships, and money, and will likely have a very difficult time trying to control the anxiety. Physical symptoms such as restlessness, fatigue, difficulty concentrating, sleep disturbances, and muscle tension occur during this time as well. Irritability is also a common complaint.

Social Anxiety & Shyness

Avoidance of social or performance situations, or endurance of these events with extreme discomfort characterizes social anxiety. Fear of being observed, judged, and scrutinized by others is predominant, and your child may be reluctant to talk with and meet new people, attend birthday parties, join sports teams, and participate in other group activities with his or her peers.

Obsessive-Compulsive Disorders

Recurring unwanted and intrusive thoughts (obsessions) and/or repetitive senseless behaviors or rituals (compulsions) characterize obsessive-compulsive disorder. Compulsions usually occur in response to the anxiety-provoking obsessions, and in an attempt to alleviate the anxiety, can themselves become extremely distressing and/or time-consuming. For example, fears of being contaminated by dirt and germs may lead to compulsive hand washing. Compulsions may also manifest as mental rituals. For instance, counting sequences in one's head may reduce anxiety produced by unwanted thoughts. The content of obsessive thoughts may vary depending upon the age of your child and may change over time. Please visit the Obsessive-Compulsive Disorder Foundation for further information.

Panic Disorder / Agoraphobia

Panic disorder is characterized by repeated, sudden episodes of intense fear and discomfort. Symptoms of a panic attack include heart palpitations, shortness of breath, dizziness, increased heart rate, chest pain, chills or hot flashes, and fear of going crazy or dying. Agoraphobia is when one avoids, or endures with extreme anxiety, places or situations for fear of having a panic attack and not being able to escape. For instance, your child may avoid leaving home alone, being in a crowd, or using public transportation because he or she is fearful that safety will not be within reach in the event of having a panic attack. It is possible to have panic disorder with or without agoraphobic avoidance or to have agoraphobia without ever actually having had experienced full-blown panic.

Posttraumatic Stress Disorder & Trauma

Posttraumatic stress disorder (PTSD) is characterized by an exaggerated stress response after exposure to an extremely traumatic event. Symptoms must persist for at least one month and include avoidance of stimuli associated with the trauma, emotional numbing, re-experiencing the trauma through recollections of the event in dreams or nightmares, and signs of heightened arousal such as difficulty sleeping, hypervigilance, irritability, and impaired concentration. PTSD often exists concurrently with depression and anxiety. Please visit the National Center for Post-traumatic Stress Disorder for further information.

Specific Phobias

Avoidance of a specific object or situation, or endurance of the feared stimuli with extreme discomfort, characterizes a specific phobia. Persistent fears of animals, elevators, heights, flying, needles, and thunder and lightning are common. Depending upon the phobic stimulus, the impairment caused by the phobia may vary. For example, a fear of elevators may cause more distress than a fear of flying if you have an elevator in your apartment building but your child only occasionally flies.

Separation Anxiety / School Refusal

Separation anxiety is characterized by excessive distress concerning separation from home or from one's parents or significant caretakers. Children with separation anxiety worry about their parents or themselves being harmed in some way and may have nightmares or difficulty sleeping due to these concerns. It is common for these children to complain of headaches or stomachaches when separation is anticipated, and some children will be reluctant or refuse to go to school or spend time with friends if a parent or other "safe" adult is not nearby. Separation concerns, especially if they impact your child's ability to attend school or be with friends, can cause significant distress for your entire family and may affect your child's academic and social development.

Hypochondriasis

Although not actually considered an anxiety disorder, we have included hypochondriasis in this section because it shares the pervasive feelings of excessive, irrational fear and distress that characterizes the different anxiety disorders. Hypochondriasis is when one is preoccupied with fears of having, or the belief that one already has, a serious disease. These concerns are based on a misunderstanding of normal bodily symptoms or of a minor physical problem, and the preoccupation persists even after comprehensive medical exams reveal that no medical condition exists.

Selective Mutism

A consistent failure to speak in specific social situations despite speaking in other situations characterizes selective mutism, and this lack of speech is not due to linguistic difficulties or lack of knowledge. For instance, a child may speak, laugh, and sing when at home but be completely silent when at school. This behavior is problematic if it continues for at least one month and is interfering with your child's educational or social functioning.

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