ANXIETY
DISORDERS

Social Anxiety Disorder

Social anxiety often comes on as children move into adolescence, i.e. the preteen years. The amount of upheaval, both from puberty and from the transition between schools that most children experience at this age, cause anxiety that may have been manageable before to become overwhelming. It's important to not simply write off this anxiety as “normal” if it seems to be significantly affecting a child's quality of life.

This is another disorder than can be difficult to differentiate from a child's natural tendencies; shyness around strangers is quite normal in very young children, and some children simply remain rather introverted, reluctant to leap into group activities and so on. Social anxiety may therefore be more easily detected if one looks not only at a child's reticence about meeting strangers or joining in with peers, but at how the child feels after a social experience: Does the child worry excessively about the kind of impression he or she made? Does the child get convinced he or she will never be invited out again? Etc. Likewise, where introverts do not desire much social interaction, socially anxious children often do wish to interact, but feel they are prevented from doing so by their anxiety.

Selective Mutism, a rare form of social anxiety where a child will not speak to people outside his or her family, or will only speak to friends but not adults (or some other variation of this selective silence), is generally diagnosed once a child goes to school and people notice he or she isn’t speaking up.

Generalized Anxiety Disorder

Children with generalized anxiety demonstrate excessive worry about a wide variety of situations. Indeed, the anxiety often adapts to each new situation that comes up.

These children may even worry about events that did not happen, or that have not happened yet. Indeed, they may seem to be actively seeking things to worry about, trying to explain to themselves why they feel so anxious much of the time. You might find yourself censoring what information you give these children so as not to set off another round of “what ifs”.

If you have to reassure your child very frequently and find it often has little effect, then he or she may be struggling with generalized anxiety. Generalized anxiety is a pervasive, ongoing condition which seldom responds for very long to logical assurances that everything is in fact all right.

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder has suffered from a great deal of misrepresentation in popular culture, and many people think of it as a sort of stringent perfectionism, but true OCD is magical thinking run amok. People with OCD quite literally believe that their repetitive actions prevent very real calamities. This reliance on magical thinking goes far beyond the “standard” magical thinking of childhood, which can be seen in the common superstitions of children (in sayings like “don’t step on a crack or you’ll break your mother’s back”). It becomes instead a source of compulsion, of rituals the child “must” do to “prevent”, for example, his or her parent dying in a car crash.

These compulsions tend to become more complex over time, unlike the small rituals associated with normal childhood superstitions, which diminish and quiet with age.

Another difference between OCD and normal childhood magical thinking is that normal children can easily leave their rituals behind—if you tell them to hurry along and cease skipping on tiles, they can do so. A child with OCD will be unable to cease their rituals, no matter how dire the consequences, and will become visibly upset if pulled away from his or her compulsive activity.

Many children are not terribly tidy or orderly, so children with OCD often stand out for the way they are obsessed with organizing, cleaning, doing things in a certain order, etc.

It's important to note that OCD does not always manifest in stereotypical ways, such as counting or hand washing. The rituals associated with OCD can be quite diverse; in addition to repetitive actions, children may exhibit hoarding behaviour. Parents must be mindful to not get sucked into affirming these rituals; it's easy to get sucked into repeating things in certain ways or adhering to specific schedules in order to soothe your child, but this may mask a deeper problem.

OCD seems to set in around age ten in many children; for reasons that are as yet unknown, it's more commonly seen in boys before puberty, and in girls after puberty.

Panic Disorder/Somatic Symptoms

Panic Disorder is more often diagnosed in older children, but younger children (who are not yet able to understand and vocalize the complexity of their symptoms) may express their panic by complaining of somatic symptoms like stomach aches and headaches. Older children tend to experience the more typical symptoms of a racing heart and a fear of passing out or dying. It's important not to dismiss children who frequently complain of such physical symptoms as “faking it” to get out of chores or going to school, as this may be the only way these children can think of to express their underlying sensations of fear.

As a parent, it's important to remember not to panic yourself if your child is displaying some of the above symptoms; simply remain observant and try to ascertain, as objectively as you can, whether or not these symptoms are interfering with your child's day to day life to a great extent.

Regardless of whether or not your child has a full-blown anxiety disorder, learning to manage anxiety early in life is always beneficial, so do not hesitate to teach your child methods of dealing with his or her anxiety.

Separation Anxiety Disorder

It's important to understand that separation anxiety is perfectly normal in toddlers and preschoolers, but if by about age seven, your child still has a very hard time being apart from you, a deeper problem is likely present and the child should be evaluated by a professional.

Separation anxiety usually stems from a fear of something befalling the child's loved ones (or even their pets) while the child is absent, hence the need to “cling” to everyone and everything important. This type of anxiety may also arise from a difficult event, such as having a parent who was ill, a threat in the neighborhood, etc.

Naturally, many children with this type of anxiety disorder refuse to go to school.

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