Anxiety – When Fear is Overwhelming
Mental health issues in children and teens have become a huge issue in our country. Not only are the rates of disorders such as anxiety and depression rising in this population, it is increasingly difficult to get patients the help they need from mental health professionals. The focus of today’s article is anxiety – causes, symptoms to look for in your child, what you can do to help, seeking professional care, and treatment options.
Anxiety is a natural response to stress – it increases awareness and focus in order to deal with a stressful situation. However, sometimes anxiety becomes overwhelming and is an excessive worry or apprehension, usually about future events or situations that are uncertain. Anxiety is the most common mental health problem among all age groups. Rates of anxiety in teens has been rising rapidly over the past several years. In fact, studies from the National Institutes of Health show that nearly a third of all teens suffer from an anxiety disorder at some point during adolescence. Chronic anxiety leads to further mental health disorders, including depression and substance abuse. It causes disruption in school performance, and causes outward signs of physical pain, including headaches and non-specific abdominal pain.
What does anxiety look like?
Children and even teenagers often have a difficult time expressing anxiety. Rarely will they simply say, “I am anxious” or “I am worried.” Rather, their symptoms show in other, more vague ways that it is important for parents to be aware of. Common signs of anxiety in this age include:
- Trouble sleeping.
- Decreased concentration
- School issues – decreased concentration, grades dropping, cutting classes
- Avoiding activities, such as school, sports, or other extracurriculars.
- Irritability or anger that is out of the ordinary
- Fear and concern about issues that do not normally cause concern.
- Substance abuse
- Risky behaviors
- Chronic complaints of pain or fatigue.
Keep in mind that each individual responds to and shows signs of anxiety differently. Your child may be exhibiting a few or many of these characteristics and have something entirely different going on – sleep disturbances can lead to poor concentration and decreased school performance but actually have nothing to do with anxiety. The most important thing you can do is be aware of new behaviors in your child and respond to them quickly.
What causes anxiety?
It is thought that a combination of genetic predisposition and social/environmental factors contribute to the development of anxiety in children and teens. Parents who are anxious will often have children who are also anxious – again, through a combination of genetics passed on to the child as well as a transfer of anxious behavior modeled during the child’s development.
Of course, outside of genetics there are several factors that clearly affect the anxiety levels of today’s children. Abnormalities in the chemicals naturally occurring in the brain that regulate mood and responses have an impact on anxiety. Social and cultural pressures to “do more” and “be more” and higher demands to succeed lead to increased levels of fear and worry about not measuring up.
Social media use is closely tied to teen behavior and self esteem, and increased use and dependency on social media has been tied to increased anxiety levels in teens. Access to news programs with negative headlines, and increasingly volatile social environments also adversely affects behavior and mental processing.
What can you do to help your child with anxiety?
- Keep communication open. Talk to your child about his or her concerns. Let them know that you are there for reassurance and guidance. Help your child to find new ways of looking at issues.
- Create a safe space. Allow your child to verbally express thoughts, fears, concerns, and frustrations without judgments or punishments. Protect young children from difficult family conversations involving finances, divorce/custody issues, and illness.
- Social media. Ensure that your teen is taking breaks from social media, and talk about the very real effects it has on the lives of many teens. Social media platforms are often used for bullying, unfair comparisons, and promoting the fear of falling behind or not fitting in with peers. Encourage in-person, real life interactions with friends over online encounters.
How do doctors treat anxiety?
Starting at age 11, it is recommended to screen for mental health issues of anxiety and depression. If your child is found to have an elevated score on an anxiety screen, the Pediatrician will discuss options for treatment of anxiety with you and your child. An important thing to realize is that anxiety, like any mental health problem, is not an easy fix. It is a long-term effort on the part of the patient, parent, and physician.
One of the most important treatment methods for anxiety is counseling with a mental health professional. Behavior therapy, including play therapy, family therapy, and cognitive behavioral therapy, works to change the way a child approaches and deals with anxious feelings. They learn to change negative thoughts into positive ones, learn coping skills for episodes of anxiety, and learn to handle fearful situations.
Lifestyle changes can also make an impact on children and teens with anxiety, including balanced and nutritious meals, physical activity, proper sleep hygiene, and social supports from friends and family.
Sometimes older children and teens will need medication to help manage severe anxiety symptoms. It is my opinion that anti-anxiety medications should not be used as a sole method of treatment, and should not be used long-term. Rather, they should be used as an additive to traditional counseling measures, in order to bridge the gap to wellness. If you feel your child may have anxiety severe enough to require medication, please reach out to your Pediatrician to discuss in more detail.
Final thoughts
Over the past year, my colleagues and I have seen a significant increase in visits for anxiety in our pediatric population. Undoubtedly, some of this is due to the COVID pandemic – social isolation and emotional upheaval, changes in school and home environments, concerns for personal illness and the health of beloved family members. The pandemic environment has certainly impacted our children in a negative way. However, I do not think we can fully blame the current mental health crisis on the pandemic alone. We must take a closer look at our family environments, school conditions, social situations, sports and academic pressures, and exposures to violence and graphic situations in the media, in order to fully understand why our children are becoming more anxious every year. It is our responsibility to surround our children with love, support, and understanding, and to guide them through childhood and adolescence, and to get them professional help when it is needed.
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