Anxiety Disorders in Children and Adolescents

Anxiety Disorders in Children and Adolescents

Children and Adolescents very commonly experience anxiety. It is a normal emotion, and we all experience it at various times in our lives. It is one of the most common presentations to mental health services and can be disabling for young persons and their families. It can manifest in several ways such as physical, psychological, behavioural or a mix of all.

Common physical symptoms of anxiety

  • Dizziness
  • Feeling of light headedness
  • Hot and cold flushes
  • Nausea, vomiting, stomach-ache
  • Headaches
  • Easy fatiguability
  • Sleeping difficulties
  • Loss of appetite

Common psychological symptoms anxiety

  • Fear of things going wrong
  • Excessive worrying about illness or death of self or family members
  • Need to be perfect
  • Socially shy
  • Feelings of embarrassment in social situations
  • Feeling tense and on the edge most of the time

Behavioural symptoms of anxiety

  • Hair pulling, skin picking
  • Clinginess with family member or care giver
  • Concentration difficulties
  • Irritability and outbursts
  • Compulsive behaviours
  • School avoidance
  • Poor engagement in school activities
  • Social withdrawal
The common types of anxiety disorders in children and adolescents are
  • Generalised anxiety disorder
  • Social anxiety
  • Separation anxiety
  • Panic attacks
  • Depression and anxiety
  • Obsessive Compulsive Disorder
  • Phobias
  • PTSD (Post Traumatic Stress Disorder)
There are various types of anxieties such as
  • Generalized Anxiety Disorder
  • Social Anxiety Disorder
  • Panic Disorder
  • Separation Anxiety Disorder
  • Phobias
  • Obsessive Compulsive Disorder
  • PTSD
What can cause anxiety in Children and Adolescents?

In children and adolescents there could be several reasons that may cause anxiety. Such as 

  • Genetic factors – children whose parents suffer from anxiety are more likely to experience anxiety themselves,
  • Stressful and or traumatic life events – this could result in poor coping skills and increased vulnerability
  • Environmental factors – loss of family members, divorces, bullying, school pressures, social difficulties.
  • Not all children will become anxiety when exposed to those triggers.
How are they assessed?

If you think your child may have anxiety, you should contact your GP first. Your GP would be able to identify anxiety and point you in the right direction. You could see a Child and Adolescent Psychiatrist for further assessment and diagnosis. The diagnosis is based on the information from the child/adolescent in a psychiatric interview, using relevant questionnaires (when needed), getting collateral information from family/carers, and carrying out a complete mental state examination.

How is it treated?

There is a lot of evidence based on research that accessing the treatment early not only improves the mental health of the child but also reduces the chances of recurrence in adulthood. The treatment of anxiety is multimodal and includes the use of pharmacology, psychological interventions and, social interventions.

In milder cases of anxiety self-help interventions and Mindfulness-based interventions may be helpful. 
Some mild to moderate cases of anxiety may best respond with the psychosocial interventions such as use of Cognitive Behavioural Therapy (CBT), lifestyle changes, exercising, and using coping strategies.

In some cases of moderate anxiety and in severe anxiety, use of pharmacological interventions such as antidepressants or anxiolytics can be very helpful. SSRIs (Selective Serotonin Reuptake Inhibitors) are considered as the first line of medication option.  There are other medications available as well which you could discuss with your psychiatrist during the consultation. A combination of medication and psychotherapy has the strongest evidence for moderate to severe cases and has shown to produce the best outcomes. 

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