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As with many other health problems, children and adolescents experience anxiety disorders differently from adults. The symptoms themselves are the same but they are displayed differently. Until recent years, family physicians tended to minimize the exceptional behaviour patterns of children whose parents came seeking advice. The diagnosis was often that the child was going through a phase which he or she would outgrow. Today, most have been re-educated to investigate the possibility that deeper problems may exist. Many anxiety disorders are now recognized as first appearing during childhood and adolescence and, as with adults, it is quite usual to have more than one of these disorders at the same time. Following is a list of the disorders and the probable way in which they will manifest themselves in children and adolescents.
Generalized Anxiety Disorder
Excessive, and often unrealistic anxiety, is the chief characteristic of GAD. Children with the disorder are usually perfectionists who will spend hours doing the same homework which other children are likely do very quickly. They are restlessness, find it difficult to concentrate, have trouble sleeping and may even refuse to go to school. Such symptoms exhibited over a six-month period are a signal that a child may be suffering from generalized anxiety disorder.
While less likely in young children, panic disorder is more common in adolescents. A panic attack is considered to have occurred when four or more of the following symptoms are experienced within 10 minutes:
palpitations sweating chills or hot flashes
trembling choking sensation chest pain dizziness
nausea stomach ache a feeling of being detached
from oneself fear of losing control fear of going crazy
fear of dying numbness tingling
Panic disorder often occurs with agoraphobia and the child may refuse to leave his or her home. In contrast to the general reaction of school personnel of a few years ago that punishment was in order, refusal to attend school is now considered a signal that the child needs help.
While, most children experience periods of shyness and feel uneasy around strangers, for some usually during the teen years avoiding strangers, including people their own age, becomes so extreme that it interferes with normal social development and leads to isolation and depression. In young children, a type of social phobia called selective mutism prevents the child from speaking when in the company of strangers and people he or she does not know well.
Separation Anxiety Disorder
Being anxious due to separation from familiar people and situations is a normal part of growing up. This natural anxiety diminishes as the child grows older. Children or adolescents, suffering from separation anxiety disorder, experience much longer term excessive anxiety when separated from parents, home or other familiar situations. Small children react with crying and panic on separation, and with clinging behaviour. In older children and adolescents, unrealistic worry about loved ones being harmed in some way, fear they will not return home, fear of sleeping alone, refusal to go to school are usually the signs of separation anxiety disorder. Stomach ache, headache and constipation are the most common physical symptoms.
Specific, simple or single phobia is intense fear of a specific object or circumstance which is not normally dangerous e.g. animals, insects, storms, heights. Some, such as the fear of dentists, needles and other medical procedures may impact on general health and wellbeing, while others cause only inconvenience. In young children, these phobias are usually not as debilitating as they can sometimes become in adults, and may disappear as the child grows older.
In OCD bsessions consuming the individual for more than one hour a day and usually involving unrealistic fear and anxiety are relieved by performing repetitive behaviours or compulsions. Compulsions such as washing, praying, checking, counting and arranging things are the most common in children and adolescents. It is estimated that as many as three percent of young people suffer from OCD, with boys being twice as likely as girls to have the disorder. Many also have tic disorders.
Post-Traumatic Stress Disorder
In children, post-traumatic stress disorder is generally exhibited in very agitated behaviour. They avoid things that remind them of the trauma and may have physical symptoms such as being easily frightened or scared. The traumatic event is sometimes relived, particularly by young children, in repetitive play that features some aspect of it, in frightening dreams or complete re-enactment.
Copyright Jean Jardine Miller.