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It is normal for young people to feel fearful, anxious and worried at times.
- Fear is our emotional response to an actual or perceived threat. We may have thoughts of immediate danger and behave in ways that help us escape. With fear we often feel the physical symptoms of ‘fight or flight’ (e.g., increased heart rate, increased breathing rate etc.).
- Anxiety is what we feel when we anticipate a future threat. We may be more cautious and behave in ways that help us to avoid the perceived threat. With anxiety, we often experience physical symptoms of feeling on edge or feeling muscle tension.
- Worry is feeling concerned that a negative or unpleasant outcome will arise because of something that has happened or is going to happen.
In most cases these feelings are brief, occasional and manageable. When these feelings are persistent, intense, excessive, and unmanageable, and impact children’s daily lives they are considered anxiety disorders.
Anxiety disorders are very common; approximately 10 to 15% of children have an anxiety disorder. Anxiety disorders are twice as common in girls. There are many causes of anxiety disorders, including temperament, genetics and environmental factors. Some children are more likely to develop an anxiety disorder because they are perfectionists, have low self esteem, are unable to regulate their emotions, tend to have a negative outlook on the world or think that anxiety symptoms are harmful. Some children are more likely to develop an anxiety disorder because they inherit the genetic likelihood from their parents. Finally, some children may develop an anxiety disorder after having experienced a major change, a stressful event or a traumatic event (e.g., a disaster, a death, a major change, abuse, etc.).
Many anxiety disorders develop in childhood and will persist into adulthood if they are untreated. With appropriate intervention most children with anxiety disorders can develop skills that challenge their thinking so that they see the world differently and thrive in their daily lives.
Find more information below about the different types of anxiety, how we determine if your child has anxiety and how we treat your anxious child. If you believe your child might be anxious and you would like us to help, please contact us to schedule an appointment.
Types of anxiety disorders
Generalised anxiety disorder
It is typical for children to feel anxious and to feel worried at times. However, children with generalized anxiety disorder have excessive, distressing, unmanageable anxiety and worry that significantly interferes with their daily functioning. They also have at least one of the following symptoms: restlessness/feeling on edge, easily tired, difficulty concentrating, irritability, muscle tension (as well as trembling, twitching, feeling shaky and feeling sore) or sleep disturbances (difficulty falling asleep, staying asleep and feeling rested from sleep). Children with generalized anxiety disorder may be perfectionistic, overly conforming and lack confidence. They tend to worry about their abilities and skills and the quality of their school, sporting or other activity performances. They may also worry about being punctual or about the possible occurrence of traumatic events. To be diagnosed with generalised anxiety disorder, their anxiety and worry must interfere with their normal routine, schooling or other activities.
It is part of ordinary early development, and of the existence of a secure attachment for children, to experience periods of feeling anxious about being separated from their parents. However, children with separation anxiety have fear or feel anxious about separating from their parents/primary caregivers to a degree that is developmentally inappropriate. They often worry that their parents will be hurt. They often worry that they or their parents will suffer from an unfortunate event that will result in the child being separated from or losing their parents. Children with separation anxiety often find it difficult to be left alone (to play or to fall asleep), to leave their home (with or without their parents), to be cared for by someone else, to go to sleepovers, or to attend day care, preschool or school. They may also experience physical symptoms of fear/anxiety, such as headaches, upset stomachs, nausea and/or vomiting, when they are separated from their parents.
Children with social anxiety almost always have intense fear or anxiety in relation to social situations with their peers. Their primary fear is that they will be scrutinized and negatively judged by their peers; this fear is usually out of proportion to the actual risk of it occurring. They may also fear they will display symptoms of their anxiety that will be negatively judged by their peers, that they could offend others or that others could reject them. Children with social anxiety tend to express their fear or anxiety by crying, having tantrums, clinging, shrinking or failing to speak in social situations. Adolescents with social anxiety tend to express their fear or anxiety by withdrawing or avoiding situations that cause or trigger the anxiety. To be diagnosed with social anxiety, their fear, anxiety and avoidance must interfere with their normal routine, schooling or social activities/relationships.
Children with selective mutism speak in certain situations, but consistently fail to speak in other social situations. They have the knowledge and skills required to speak in the social situations and their lack of speaking is not the result of a communication disorder or other developmental disorder (e.g., autism spectrum disorder). They are negatively affected by their lack of speech in social situations; for example, they may experience social impairments because they won’t socially interact with other children or they may experience educational impairments because they don't communicate their personal needs or demonstrate their academic knowledge and skills to teachers. Children with selective mutism often have another anxiety disorder, such as social anxiety, separation anxiety or specific phobia.
Children with a specific phobia have intense fear or anxiety about particular situations or objects. It is very common for children to have a number of specific phobias. Some common feared situations and objects are: animals (e.g., insects, spiders or dogs), the natural environment (e.g., water, storms or heights), situational (e.g., elevators, aeroplanes or enclosed spaces), blood, injections or injury. Their fears almost always occur in the presence of the situation or object and are usually severe. Their fears are out of proportion to the actual danger posed by the situations or objects. They often experience physical symptoms of ‘fight or flight’ (e.g., increased heart rate, increased breathing rate, etc.) in anticipating or being in the presence of their feared situation or object. Children with specific phobias tend to express their fear or anxiety by crying, having tantrums, freezing or clinging. Adolescents with specific phobia tend to express their fear or anxiety by actively avoiding their feared situations or objects. To be diagnosed with a specific phobia, the children’s fear, anxiety and avoidance must interfere with their normal routine, schooling or social activities.
Panic attacks commonly start to occur in young adulthood (early 20s). Sometimes adolescents experience panic attacks and children very rarely experience them. A panic attack occurs when a person suddenly feels intense fear or discomfort that peaks within minutes. During a panic attack people feel a number of the following symptoms: pounding heart, sweating, trembling/shaking, feeling short of breath, feeling as if they are choking, nausea or stomach discomfort, dizzy/light-headed, chills/heat sensations, numbness/tingling, feeling as if they are detached from themselves or as if things aren’t real, fear of losing control or fear of dying. The length of the panic attack and how often they occur varies. Sometimes people know and sometimes they do not know why the panic attack happened. People often feel worried and scared after experiencing a panic attack. To be diagnosed with a panic disorder people must worry about having future panic attacks and/or change their behaviours to try to avoid future panic attacks in addition to experiencing panic attacks.
Assessment of anxiety
During your first session we meet with you and your child to conduct a clinical interview to identify your child’s underlying emotional concerns. Depending on your child’s emotional concerns and age, we may have you, your child, and/or your child’s teacher complete a questionnaire to identify your child’s level of fear, anxiety and worry before commencing treatment. Finally, we develop a personalised, evidence-based treatment plan to help your child and your family.
Treatment of anxiety
The aim of our treatment is to reduce your child’s level of fear, anxiety and worry and to overcome the negative impact those thoughts and feelings are having on your child’s daily functioning. We accomplish this by helping you to understand your child’s thoughts, feelings, and needs, and by providing your child and family with strategies and skills that challenge your child’s heightened levels of fear, anxiety and worry.
We use evidence-based, cognitive behavioural therapy to treat fear, anxiety and worry. We tailor your child’s treatment plan to meet his/her individual needs. We often use a range of cognitive behavioural therapy techniques, including:
- Emotion regulation
- Problem skills training
- Anxiety group programs
We may also use the following evidence-based therapy techniques:
- Resilience group programs
For more detailed information on what to expect in your sessions with us, please visit our Appointments page.
Please contact us if you would like to schedule an appointment for an assessment of behavioural, educational, emotional, and/or social concerns for your child.