Childhood Anxiety & Related Disorders
Does My Child Have An Anxiety Disorder?
As discussed throughout this website, anxiety is useful in certain situations, some of the time. But how do you, the parent or caregiver, know when the signs of anxiety you are seeing in your child might be significant enough to qualify for an anxiety disorder? An appointment with your family physician or a trained mental health professional is a good first step. However, in preparation for that visit, or to decide whether a visit is needed, it can help to understand what professionals look for in diagnosing an anxiety disorder.
To begin with, there are eleven different "types" of anxiety disorders, and each anxiety disorder has a list of commonly occurring symptoms clustered into 4 areas:
- Physical responses
Next, anxiety specialists have identified that when a child experiences anxiety more often (e.g. most days, and for months at a time), and more intensely than other children of the same age, it is more likely that the child has an anxiety disorder. Finally, those children who experience a specific list of anxious symptoms, more frequently and intensely than peers, are more likely to also experience significant disruption in their lives. This disruption can interrupt or even stop him or her from participating in a variety of typical childhood experiences such as:
- Attending school
- Joining social, athletic or recreational clubs
- Meeting age expected demands such as sleeping through the night, doing homework, and making friends.
It is common for children and teens to experience anxiety symptoms of more than one anxiety disorder. This means as you read the definitions below, it would be fairly common to say, "Yes! This sounds like my child, but so does this other description!" Fortunately, the helpful approaches outlined throughout this website can be used for various anxiety problems, so that even if your child has 2, 3, or more disorders, many of the same tools can be used for all the disorders.
Be sure to watch our video below for more information...
Does your child have mild to moderate anxiety? If your child has mild to moderate anxiety, or has yet to be diagnosed with a disorder, click here to learn about a variety of general anxiety topics that can benefit you and your child or teen.
Does your child have a diagnosed (or suspected) anxiety disorder? Below is a list of nine anxiety disorders. Click on the links for a more detailed description, (including a video and stories), as well as home management strategies that are specific to that disorder.
Body Focused Repetitive Behaviours. Body-Focused Repetitive Behaviours, or BFRBs, are a cluster of habitual behaviours that include hair pulling (called Trichotillomania), skin picking (called Skin Excoriation), nail biting, nose picking, and lip or cheek biting. In both Trichotillomania and Skin Excoriation, the individual experiences ongoing and repetitive engagement in either pulling out of one’s hair or skin picking (dependent on the disorder), resulting in noticeable hair loss, or skin abrasions or lesions. This occurs despite extensive efforts to stop these behaviours. In both disorders there is significant impairment or disruption in routine life functioning for the individual.
Generalized Anxiety Disorder. Children and teens with this disorder worry excessively and uncontrollably about daily life events and are often nicknamed “worry warts”. Their worries include fear of bad things happening in the future such as global warming or parents divorcing, being on time or making mistakes, a loved one becoming ill or dying, personal health, academic performance, world events, and natural disasters.
Health Anxiety. Although health anxiety is not a disorder, there are several disorders defined by excessive anxiety related to somatic or physical symptoms, or having an illness or condition. In children, these health worries are excessive, ongoing, and uncontrollable, and often result in frequent visits to medical professionals and reassurance seeking from loved ones all due to exaggerated fears of being ill.
Hoarding Disorder (HD). Individuals with this disorder experience ongoing and significant difficulty getting rid of possessions regardless of their value; and strong urges to save and/or acquire, often non-essential, items, that if prevented leads to extreme distress. As a result, living space becomes severely compromised with extreme clutter. In addition, the individual experiences significant impairment in social, occupational, and other important areas of functioning.
Obsessive Compulsive Disorder. Children and teens with this disorder have obsessions, or unwanted thoughts, images, or urges that make them anxious or uncomfortable, and/or they engage in compulsions (repetitive physical or mental behaviors) in an attempt to reduce their anxiety or discomfort. Some compulsions may include repeated hand washing, checking, tapping, or mental routines (such as counting backwards from 100 and selecting “good” images to think about). An example of an obsession is "I might get sick and die from touching a bathroom door,” followed by the compulsion of washing hands for 5 minutes to reduce the anxiety and perceived likelihood of becoming sick.
Panic Disorder & Agoraphobia. Panic disorder is characterized by the sudden onset of intense fear, called an anxiety or panic attack, followed by at least one month of worry about having additional attacks and/or fear of something bad happening as a result of the panic attack. Symptoms include: difficulty breathing, racing heart, sweating, needing to escape, sense of danger or doom, and chest pain, among others. Agoraphobia occurs when the youth has a significant fear of being in at least two locations where escape appears difficult or s/he might be unable to get help, and therefore will avoid these situations as much as possible.
Post Traumatic Stress Disorder. This is an anxiety disorder that can develop after being directly involved, witnessing, or learning about a frightening, traumatic event. This disorder can be extremely debilitating for the child and is far more than simply being upset for a few days after a scary event. Symptoms include ongoing upsetting vivid memories, nightmares, flashbacks of the event, increased arousal such as being jumpy or irritable, and avoiding reminders of the incident. One of the most common situations for a child to develop PTSD is from being in a significant automobile accident.
Social Anxiety Disorder. These children and teens have an intense fear of social and/or performance situations because they worry about doing something embarrassing or being negatively judged by others. They may avoid social activities such as going to parties, performing in recitals, speaking to peers or adults, or even going to school. On the extreme end of this disorder is the rare condition Selective Mutism (children have the ability to speak but refuse to speak in social situations such as school).
Selective Mutism. Selective mutism is a childhood anxiety disorder that is diagnosed when a child consistently does not speak in some situations, but speaks comfortably in other situations. These children are capable of speaking yet are unable to speak in certain social situations where there is a demand to speak, such as at school, at dance class, at soccer practice, or at the corner store. In other situations, these same children may speak openly with others and may even be considered a “chatterbox”.
Separation Anxiety Disorder. These children have excessive anxiety about being separated from parents and/or primary caregivers, such as a grandparent or a nanny, or the home. For example, they may cling or cry when a parent leaves the home, or refuse to go to school, on play dates, or to sleep alone in their own bed. They may not be able to be alone in a different room from the parent or caregiver even in their own home.
Specific Phobias. Phobias are characterized by persistent, excessive and unreasonable fears of an object or situation, which significantly interferes with life, and the child or teen is unable to control his/her fear. Some common phobias for children and teens include fear of dogs and insects, swimming, heights, loud noises, and injections (needles).