Anxiety/Stress

Anxiety

Anxiety is an excessive fear about real or imagined circumstances

There are several types of anxiety disorders which include:

• Generalized Anxiety Disorder
• Separation Anxiety
• Social Anxiety or Phobia
• Post-Traumatic Stress Disorder
• Obsessive Compulsive Disorder
• Panic Disorder

Generalized Anxiety Disorder: persistent, excessive, and unrealistic worry about everyday things and occurring in a variety of settings.

Children with GAD may tend to:

• be very hard on themselves/strive for perfection
• seek approval or frequent reassurance from others.
• worry excessively about grades, family issues, friendships, and performance in sports.

Separation anxiety: A child experiences excessive anxiety away from home or when separated from parents or caregivers.

Children with Separation Anxiety may:

• Refuse to go to school
• Not want to attend play dates, sleepovers, camp
• Need someone to stay with them at bedtime
• Worry that something bad will happen to their parent/caregiver when they are apart

Social Anxiety: the extreme fear of being scrutinized and judged by others in social situations

Children with Social Anxiety disorder may:

• refuse to play with peers
• exhibit clinging behavior, tantrums, or mutism
• come up with excuses to avoid social situations
• have difficulty forming friendships
• be fearful of being called on in class

Post-traumatic Stress Disorder: prolonged anxiety that develops after experiencing harm or the threat of harm

Children with PTSD may:

• have difficulty sleeping or concentrating
• be easily irritated or angered
• have recurrent dreams about the event
• avoid people or places that remind them of the event
• lose interest in other activities

Obsessive-Compulsive Disorder: a disorder where intrusive thoughts interfere with daily functioning which then often compels the individual to repeatedly perform ritualistic behaviors in an effort to ease their anxiety.

Children with OCD may:

• exhibit repeated (unrealistic) thoughts or behaviors
• demonstrate extreme obsessions and compulsions
• exhibit distress if their rituals are interrupted
• be resistant to stopping the compulsive behavior
• be socially isolated
• have difficulty concentrating in school

Panic Disorder: a condition where the individual experiences unpredictable panic attacks and has a persistent concern about future panic attacks. Symptoms of a panic attack could include heart palpitations, sweating, nausea, shortness of breath, feeling dizzy, fear of losing control

Children with Panic Disorder may:

• appear to be suddenly frightened or upset without a clear reason

What are some of the general symptoms of anxiety?

At home, parents may notice some of the following symptoms:

• Frequent stomachaches or headaches
• Difficulty sleeping
• Difficulty relaxing
• Not wanting to leave the parent's side
• Becoming upset when the parent is out of the room
• Worried about their safety
• Not wanting to go to play dates, birthday parties, etc
• Withdrawing from previously enjoyed activities
• Extreme fear of meeting new people (social anxiety)
• Avoiding social situations or performance situations (social anxiety)
• Anxiety/panic attacks- sweating, nausea, shaking, shortness of breath, chest discomfort

At school, staff may notice the following symptoms:

• Difficulty with changes in classroom routine
• Anxious about field trips or not wanting to attend
• Difficulty concentrating on tasks
• School refusal or school reluctance
• Excessive worry about tests
• Difficulty separating from parent in the morning
• Frequent visits to the nurse
• Complaints of frequent stomachaches and headaches
• Avoiding tasks/specials
• Asking to call the parent
• Avoiding interactions with peers (esp social anxiety)
• Inability to speak with certain individuals/in certain situations (social anxiety)

It is important to remember that…

Experiencing some amount of anxiety is part of typical development!

Examples of some common fears at different stages of development:

• Infants/Toddlers: fear of strangers, loud noises, separation anxiety.
• Preschool/Early Elementary: fear of the dark, ghosts/monsters, animals, older kids, injury, natural disasters
• Later Elementary: worries about school performance, transitions to new schools, peer issues, fear of death

Experiencing some amount of anxiety is actually beneficial as it encourages a person to be:

1. Careful when the situation warrants caution (ie. crossing a busy road, staying close to an adult in a large crowd, keeping distance from an unfamiliar dog)
2. Prepared or organized (ie. studying for a test, preparing for a presentation, creating a schedule for a long-term project)

How to support your child at home:

• Remember that anxiety is not willful misbehavior. Be patient and ready to listen.
• Make time to listen to your child’s concerns. But children also may need a time limit on conversations about anxiety.
• Avoid treating anxious emotions, questions or statements as unimportant or silly. Being overly critical or impatient may make the problem worse. —
• Have realistic, attainable goals and expectations for your child. Help them to understand that perfection is not expected.
• Make a plan. If your child is anxious about an upcoming event, talk through what might happen and any worries that your child has.
• Have consistent routines at home.
• Teach coping strategies such as staying organized, relaxation strategies, and using simple scripts for what to do or say
• Enlist your child’s help and suggestions for what might help to alleviate their anxiety. Children can be surprisingly insightful about what might be beneficial for them.

Books for kids: (Note: Parents should preview books before reading with their child to ensure that it is appropriate for their child’s developmental level)

You’ve Got Dragons, by Kathryn Cave

Don’t Pop Your Cork on Mondays!: The Children’s Anti-Stress Book, by Adolph Moser

Wemberly Worried, by Kevin Henkes

Wilma Jean the Worry Machine, by Julia Cook

A Boy and a Bear: The Children’s Relaxation Book, by Lori Lite

What to Do When You Worry Too Much: A Kid's Guide to Overcoming Anxiety (What to Do Guides for Kids), by Dawn Huebner and Bonnie Matthews

Testing Miss Malarky, by Judy Finchler and Kevin O'Malley

The Big Test, by Julie Danneberg

Separation Anxiety:

When I Miss You (The Way I Feel Books), by Cornelia Maude Spelman

The Invisible String, by Patrice Karst

OCD:

What to Do When Your Brain Gets Stuck: A Kid's Guide to Overcoming OCD (What-to-Do Guides for Kids), by Dawn Huebner

Books for caregivers:

Seven Steps to Help Your Child Worry Less: A Family Guide, by Robert Brooks

The Worried Child: Recognizing Anxiety in Children and Helping Them Heal, by Paul Foxman, Ph.D.

Anxiety-Free Kids: An Inter-active Guide for Parents and Children, by Bonnie Zucker, Psy.D.

Articles for caregivers:

http://www.childmind.org/en/posts/articles/2010-11-24-how-parent-anxious-kids

Websites for caregivers:

Anxiety and Depression Association of America: http://www.adaa.org/

Mass General : http://www.massgeneral.org/psychiatry/services/anxiety_disorders.aspx

Anxiety BC: http://www.anxietybc.com/

References:

Anxiety and Depression Association of America website: http://www.adaa.org/

Mass General website: http://www.massgeneral.org/psychiatry/services/anxiety_disorders.aspx

“Anxiety and Anxiety Disorders in Children: Information for Parents.” By Thomas J. Huberty, http://www.nasponline.org

Helping Students Overcome Anxiety and Depression: A Practical Guide, Kenneth W. Merrell, 2008.