Anxious feelings, worries or fears are common among children and adolescents. Many children experience a normal amount of apprehension in certain situations, whether it's an upcoming test at school or a thunderstorm.
Some children, however, experience these types of situations with an overwhelming sense of fear and dread. Others can't seem to stop thinking about these situations and their accompanying fears. No amount of reassurance seems to help. Anxiety is a very real problem for many children and adolescents. Although there are different types, all anxiety problems have four things in common:
- The anxiety is often an inexplicable fear or preoccupation that interferes with the child’s or adolescent’s ability to enjoy life
- The anxiety is often as puzzling to the child as it is to his or her parents
- The anxiety does not respond to or diminish after logical explanations, since anxiety symptoms often defy logic
- The anxiety problem can be helped
In the Cleveland Clinic’s Section of Child and Adolescent Psychiatry, our multidisciplinary team of specialists can provide the relief needed.
What are anxiety disorders?
There are many different types of anxiety disorders, including generalized anxiety disorder, phobias and panic disorder. All of these disorders cause significant distress and a reduced level of functioning and competency for children and adolescents. Some common symptoms of anxiety include:
- Feeling nervous or “on edge”
- Unfounded or unrealistic fears
- Trouble separating from parents
- Sleep disturbance
- Obsessive thoughts and/or compulsive behaviors
- Trembling, sweating, shortness of breath and other physical symptoms associated with anxious feelings
Often, these symptoms do not feel under the child’s or adolescent’s control, which only adds to their concerns.
Types of anxiety disorders
Generalized anxiety disorder
Generalized anxiety disorder is the excessive worry and apprehension about a number of events or activities. These feelings occur almost all the time. Some examples include: fear of failure or poor performance, worries about what others will think of them, and apprehension about new situations or meeting new people.
Phobias are highly specific and exclusive fears. The child or adolescent functions normally until confronted by the dreaded object, event or situation. Some examples include fears of bugs or flying in an air plane.
Separation anxiety disorder
Separation anxiety disorder is the child's or adolescent's excessive worry and apprehension about being away from their parents. Children with separation anxiety disorder often fear that their parents will be harmed in some way. Separation anxiety disorder is often seen in preschoolers, but it is also seen in older children and adolescents in response to stressful life events. Some examples include preschoolers who won't allow their mothers to be out of their sight or school-aged children who are fearful about attending school and refuse to do so.
Obsessive-compulsive disorder is characterized by anxiety provoking, repetitive intrusive thoughts and/or behaviors. Obsessions are recurrent thoughts, impulses or images that are difficult to control and cause significant distress. Some examples of obsessions are excessive concerns about germs or lucky/unlucky numbers. Compulsions are recurrent behaviors that are difficult to control and cause significant distress. Some examples of compulsions include excessive hand washing or needs for cleanliness and orderliness.
Panic disorder is characterized by discrete and intense periods of anxiety that occur unexpectedly, without warning, and are not always linked to a specific place or situation. With panic disorder there is often no warning, and therefore it is harder to predict when it may occur.
Post-traumatic stress disorder
Post-traumatic stress disorder is an intense re-experiencing of a traumatic event by distressing recollections, dreams and/or associations (such as things or situations that remind the child or adolescent of the traumatic event). Some examples include witnessing or experiencing a natural disaster, being in a serious automobile accident or witnessing a violent crime.
What causes anxiety disorders?
Anxiety disorders are caused by a combination of life events, heredity, inborn vulnerability and biochemical disturbance. And, while many children and adolescents are able to manage day-to-day anxiety in their lives, others become more easily overwhelmed and distressed. In some ways, anxiety disorders are like allergies: we can identify the problem easily enough, but only through a careful evaluation can the causes and circumstances that cause anxiety disorders be identified and effectively treated.
Can anxiety disorders be helped?
Yes. Anxiety disorders can be helped by a combined treatment approach using medication, behavioral treatment and/or family intervention based on the individual needs of the child or adolescent. Often, children and adolescents do not initiate the help-seeking process and need the support and direction of their families.
What are the risks if I don’t seek help for my child?
Not obtaining treatment can have serious negative consequences on your child’s development and self esteem. Untreated anxiety disorders can strain family relationships and friendships, interfere with normal functioning and lead to more serious mental and physical health problems for the child.
How we can help
The first step to successful treatment begins with a comprehensive psychiatric evaluation of your child. A psychiatric evaluation includes:
- A review of current problems and concerns
- A thorough review of your child’s development and background
- Past medical and psychiatric history
- Important family background
- A mental status exam
Parents and guardians are included in the evaluation process in order to obtain background information and history as well as to participate in the treatment planning.
As part of the evaluation, the psychiatrist will discuss an individualized treatment plan for your child. The treatment plan may include:
- Individual behavioral therapy for your child
- Family therapy
- Parent education and support
The role of parents and guardians in their child’s treatment is essential.
Obtaining help for your child
To schedule an appointment with the Department of Psychiatry and Psychology, please call 216.636.5860 or 866.588.2264.
This information is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.