Anxiety Disorders

Impacting 6-10% of children and adolescents, anxiety is a response to a threat of well-being, safety or security. Though a small amount of fear is normal, when this fear is persistent and stops a young person from being able to function as they normally would (e.g., not going to school, not attending swimming lessons, not able to hand in assignments on time etc.) this may be classed as an anxiety disorder.

Fears in different ages

Due to the developing brain and the young persons understanding of their world and how they function in it, typical fears commonly occur at certain ages.

Toddler years (2-4 years)

  • the dark
  • imaginary creatures
  • potential burglars

Early childhood (5-7 years)

  • natural disasters
  • injury
  • animals
  • media-biased fears

Middle childhood (8-11 years)

  • poor academic and athletic performance

Adolescence (12-18 years)

  • peer rejection

Main types of Anxiety Disorders

Separation Anxiety Disorder

Fear occurs when the young person is separated from a significant person to the child (e.g., a parent or caregiver).

Selective Mutism

This occurs when the child speaks at home or with friends but is mute at school or to familiar adults.

Specific phobia

Fears associated with animals, injury, the natural environment and certain situation (e.g., fear of flying).

Social Anxiety Disorder (Social phobia)

Fear of being evaluated by others and behaving in an embarrassing way.

Panic disorder

Recurrent and unexpected panic attacks occur where they experience acute periods of intense anxiety that is extremely distressing.

Agoraphobia

Persistent worry about being in situations or places where escape might be difficult.

Generalized Anxiety Disorder

Ongoing worry that various misfortunes will occur. The worry is not focused on one particular object or situation.

Treatments

Education: understanding about the anxiety, what has triggered it, what has maintained it and any underlying factors that may provide additional vulnerability  (e.g., genetic factors such as a parent with anxiety). Education also includes helping the young person and their families understand the fight/flight/freeze response.

Monitoring: Allows progress to be tracked. It also allows unhelpful patterns that may be contributing to the anxiety to be identified.

Exposure: A central underlying feature of all anxiety treatments is that to overcome anxiety, the young person must be exposed to the thing they fear until that fear subsides. Exposure is usually gradual and based on a hierarchy or stepladder approach starting with moderately distressing situations and working up to highly distressing ones.

Relaxation training: To help manage the distress associated with the exposure tasks, it is helpful to train the young person in a variety of strategies to help lower their arousal levels. A common relaxation technique is focused breathing.

Cognitive restructuring: Involves reinterpreting situations as less threatening. This may include identifying unhelpful thinking patterns and then looking for evidence against these unhelpful thoughts or thinking of a more realistic explanation of the situation.