There are several types of anxiety disorders, and children and adolescents often have more than one at a time. If your child is experiencing symptoms of anxiety—such as worrying excessively, having trouble concentrating, or becoming easily distressed or agitated—the specialists at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone, diagnose the condition and recommend treatment to ease his or her symptoms.
Children and adolescents with generalized anxiety disorder have persistent, excessive, and unrealistic worries that are not focused on a specific object or situation. A child may worry excessively about his or her performance at school or in activities such as sports, about personal safety and that of family members, or about natural disasters.
Children with generalized anxiety have a hard time “turning off” their worrying, which leads to difficulty concentrating, learning, and participating in social situations. Some children may be insecure and frequently seek reassurance, while others may be self-conscious, self-doubting, or overly concerned about meeting other people’s expectations. Generalized anxiety disorder typically affects school-aged children and adolescents.
Children with obsessive-compulsive disorder (OCD) have obsessions—intrusive, unwanted thoughts. To relieve the anxiety associated with those thoughts, they perform compulsions, or repetitive actions, rituals, or routines. Compulsions may involve washing, counting, organizing objects, or reading a passage of text over and over.
For children with OCD, these thoughts and behaviors significantly interfere with their daily functioning and can cause distress and embarrassment. OCD can develop at any age, but it’s most likely to occur between the ages of 8 and 12, in late adolescence, or early adulthood.
Some children or adolescents may experience extreme discomfort or fear when in certain situations or places, resulting in a panic attack. Symptoms may include shortness of breath, a pounding heart, or tingling sensations throughout the body.
Although severe anxiety may result in a panic attack, a child with panic disorder often has symptoms of panic without any apparent trigger. Unlike the occasional, mild worries children often experience, a panic attack may dramatically affect a child’s life by interrupting his or her normal activities. Often, a child becomes preoccupied with worry about possible future attacks. Panic disorder tends to begin during adolescence, although it may start during childhood, and sometimes runs in families.
Fears are common in childhood and are usually outgrown as a child matures. For some children and teens, however, fears can become severe. If a fear is excessive and persistent it may be a phobia, or an intense, irrational fear of a specific object or situation.
Phobias differ from usual fears in that they don’t decrease with reassurance, and they interfere with a child’s life. Children may develop phobias as early as age five. Specific phobias commonly involve animals, insects, heights, thunder, driving, dental or medical procedures, and elevators.
Social phobia, also known as social anxiety disorder, is an excessive fear of being rejected, humiliated, or embarrassed in front of others. Children and adolescents with social phobia worry about a wide range of situations, such as speaking in front of a group, participating in class, talking to adults or peers, starting or joining in conversations, or eating in public. They may fear unfamiliar people and have difficulty making friends. Social phobia can also be limited to specific situations. Some adolescents may fear dating and recreational events, for instance, but they may be confident in academic and work settings.
Children and teenagers with social phobia typically avoid the situations they fear—by staying home from school or shunning parties, for instance. Although the condition can occur in children as young as age four, it is more common among adolescents. The average age of onset is 13.
Children with separation anxiety disorder experience significant fear and distress about being away from home or their caregivers. This fear affects a child’s ability to function socially and academically. For example, a child may have a hard time making friends or maintaining relationships because he or she refuses to go on playdates without a parent, or sleep without being near a parent or caregiver.
Children with selective mutism speak freely in familiar situations but become mute in specific situations or around certain people. Some children with selective mutism may avoid eye contact and refuse to communicate with others. Others may enjoy the company of others but remain silent or have a close friend speak for them. Selective mutism typically affects preschool-aged children and those in elementary school, usually before age 10.
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