Anxiety in Children and Adolescents
Common symptoms:
Somatic: irritable bowel, stomachaches, vomiting, headaches, difficulty breathing, and panic attacks
Executive Functioning: remembering to complete tasks, staying on task, following directions, planning, coordination, misplacing items, making simple errors, perfectionistic behaviors, and struggling with fine motor skills, like handwriting
Emotional Regulation: difficulty controlling and managing fears/worries, tearfulness, overwhelmed “big feelings,” irritability and anger, depression and internalization or externalization
Developmental Considerations: difficulty accurately interpreting social cues (ex. “you’re ‘mad’ at me,” “I was wrong,” etc.), negative self-appraisal, performance anxiety, illness related anxiety, separation anxiety and social anxiety
Considerations:
Fear is a sign of intelligence, representing a natural physiological, cognitive and emotional response to a situation interpreted as threatening
Being around chronic worriers breads anxiety. When possible, attempt to notice your own anxiety, in response to an anxious child or teen, as not to reinforce the “snowball effect”
In American Culture, we have a tendency to reinforce internalizing behaviors (ex. “he’s sensitive with a big heart”) as opposed to externalizing behaviors (ex. “she’s an angry kid”). Anxiety fuels both behaviors, regardless of our appraisals
Aspects of anxiety are inherently temperamental, meaning “I was born this way.” The goal of therapy is not to get rid of anxiety forever
Treatment:
Diagnosis: as anxiety can look like many other mental health conditions (ex. ADHD, OCD, and even Autism), a psychological assessment involving cognitive, and psychological testing may be recommended when alternative diagnoses are considered
Interdisciplinary Care: it can be helpful to gather information from a variety of sources (medical, school, home, extracurricular) to gain insight into the function of your child’s anxiety, and how others may be responding to it
Referrals: common referrals include psychiatry, occupational and physical therapy, and an array of relevant strengths based extracurricular activities
Psychotherapy: cognitive behavioral therapy is an evidenced based treatment approach for childhood anxiety, involving education regarding the neurobiological function of anxiety, exploration of the individual’s unique anxieties and identification/practicing of relevant coping skills (ex. yoga, play, mantras, etc.). When relevant, family members may be involved in treatment. Parents must be involved in sessions with children under the age of 4, and likely will not be regularly involved in work with adolescents 14 years and older. There are always exceptions to these recommendations, depending on the needs of the child, adolescent and family.