Written by: Andrea Potthoff, PhD, LP
Anxiety can look different in children for a number of reasons. Children have a harder time labeling anxiety and may describe it as physical complaints like a stomach ache. Recognizing and treating anxiety in childhood can help prevent it from becoming a more debilitating problem later in life. Below are some of the most common types of anxiety seen in children.
Generalized anxiety disorder (GAD) is described as excessive worry about a number of topics. The worries are difficult to control and are often accompanied by distressing physical symptoms, such as difficulty sleeping or muscle tension. Unlike adults, children are more likely to worry about natural disasters, school events, and athletic performance. Children with GAD may also be overly concerned with rules and demonstrate perfectionistic behavior.
Separation anxiety is also common in children. While this is a normal developmental stage for children, it can become problematic if it persists. Children with separation anxiety often worry about the safety of their parents. They may struggle with school refusal and have difficulty making friends when away from caregivers. They may complain of nightmares about separation and physical symptoms when left alone.
Anxiety in social situations occurs in children and needs to be distinguished from ordinary levels of shyness. Seventy-five percent of individuals diagnosed with social anxiety disorder report an onset between 8 and 15 years of age. Typically, social anxiety gets worse as children enter adolescence because their parents are less involved in their social life and they have the opportunity to avoid social situations if they want to. Avoidance tends to maintain anxiety and should be dealt with as soon as it appears.
Specific phobias are not uncommon in childhood. A phobia is an intense, irrational fear that results in distress or impairment. A child who cannot be around dogs due to a fear of being bitten is an example. Phobias can be more unusual as well, such as intense fear about a specific character, activity, or bodily function, such as vomiting. Fears are normal and expected in childhood, but when a fear get in the way of a child’s daily activities, it has become a problem. Specific phobias are most likely to develop prior to age 10.
Fortunately, there are treatments for childhood anxiety that have been proven to be effective. Research shows that exposure therapy is the most effective treatment for most forms of anxiety. Exposure therapy is a brief, behavioral treatment aimed at reducing anxiety quickly. In exposure therapy, children are gradually introduced to a feared stimulus until they can learn to manage, tolerate, and cope with the feeling anxiety and its accompanying physical sensations. Exposure therapy is best when done in vivo (meaning in life), as opposed to imaginal exposure. A child can usually be exposed to the source of the anxiety (e.g., separation from parents, being close to a phobic object) in the office and the psychologist will assist the child in managing his or her anxiety.
If you are interested in speaking with a psychologist about anxiety in children, please call us at 612-470-4099.