When our children are upset, we are upset.  The pain of witnessing our child struggle is heart and soul breaking.  Managing a child or adolescent with anxiety can be excruciating, time consuming, and distressing.

If you are a parent of an anxious child, you are not alone.  Anxiety is a common mental health problem for children and adolescents, as well as adults.  Usually we see this upset in our child as worry or fear about something, or many things.

Some indicators that your child is suffering from anxiety can be:

• distress and agitation that seems excessive and not in proportion to a situation
• excessive worry and “what if” thinking and questioning
• constant seeking of reassurance marked by repetitive questions that when answered does not seem to help
• excessive time spent by you on reassuring, consoling, coaxing, and formulating plans and ideas to avoid upset and worry
• avoidance of places, situations, and things and /or refusal to go places or do things
• excessive worries about what others think and with pleasing others, worrying if others are angry
• excessive fear of a specific thing or situation
• repetitive checking, ordering, or doing things “just so”
• difficulty falling or staying asleep, difficulty with sleeping alone, nightmares
• excessive physical symptoms like headache, stomach ache, digestive issues
• panic, including rapid heartbeat, sweating, feeling of impending doom

All of these indicators can disrupt daily life and necessary activities like going to school, school performance, upholding commitments, and engaging socially.

According to The National Institute of Mental Health, the Child/Adolescent Anxiety Multimodal Study (CAMS), in addition to other studies on treating childhood anxiety disorders, found that high-quality cognitive behavioral therapy (CBT), given with or without medication, can effectively treat anxiety disorders in children and adolescents.

By learning to manage symptoms your child’s distress can be significantly reduced.  Parents often want to protect their children from worry; we can find ourselves reassuring our child or teen and helping to avoid the things or situations that trigger their anxiety.  Although we have the utmost best intentions, reassurance and avoidance actually gives the message to be afraid; avoidance and reassurance actually reinforces rather than reduces anxiety. 

In working with children and adolescents I help them see that the problem is not what they are worrying about but how their body and brain is responding to the trigger; the body goes into a fight or flight response and signals that there is danger when indeed there is not.  I teach children and adolescents how worry and anxiety works and how we can retrain our brains to respond in a different way that reduces symptoms and helps us feel power over our worry brains.  Kids learn how to manage and tolerate discomfort and uncertainty and re-evaluate danger messages so that when anxiety arises kids feel confident that they can manage their symptoms.   I also teach kids that they are not alone and that no matter how strange or unusual their worry might seem to them, many others have the same experience. 

As a part of child and adolescent treatment of anxiety I help parents become “coaches” encouraging their child to face their worries, to learn to live with uncertainty, use therapeutic tools to build resilience and manage their anxiety, so that symptoms significantly decrease. 

 More specifically, I specialize in using a CBT and Exposure and Response Prevention approach in treating the following:

• Obsessive Compulsive Disorder and OC Spectrum Disorder
• Generalized Anxiety
• Social Anxiety
• Specific Phobias
• Panic
• Adjustment and Stress related issues

The following are some main features of the different ways anxiety issues can be exhibited in children and adolescents.

Obsessive Compulsive Disorder

OCD is most often characterized by unwanted, intrusive, and very upsetting thoughts which escalate anxiety, usually accompanied by internal or behavioral rituals intended to reduce anxiety.  Kids with OCD can not stop worrying and they are drawn to certain behaviors, thoughts, and avoiding in order to reduce their anxiety.    

Some common obsessions in kids include:

Fear of contamination

Preoccupation with body wastes

Fear of illness or harm to self or others

Need for specific order or symmetry or hearing words or phrases from parents in a certain way or number of times (reassurance)

Some common compulsions as a way to cope are:

Grooming rituals, including hand washing, showering, and teeth brushing.

Repeating and re-doing behaviors, such as reentering a room, erasing and rereading and re-writing school work.

Checking and re-checking to make sure things are locked or off or finished.

Counting, tapping, or touching rituals

Ordering/arranging objects

Asking parents to perform rituals to reassure

Generalized Anxiety

In Generalized Anxiety there is persistent and constant worry on most days. Worries are typically focused on any day to day activity, task, or responsibility, as well as exaggerated and catastrophic type worries, focusing on issues like money, health, school, family etc.  Constant perseverating feels difficult to control and can make it hard to just get through a day.

Social Anxiety

Social Anxiety can present as a persistent fear of performance situations like speaking in front of others, playing a sport, or participating in an academic, or musical performance.  Social anxiety can also present in a more general way of feeling intense self-consciousness when preparing for and being in general social situations and even among groups of friends.  One then will typically try to reduce anxiety through avoidance. 

Specific Phobias

Common phobias that we often hear about include the fear of flying, fear of heights, fear of medical procedures, the fear of certain animals or insects, the fear of vomiting, as well as others.  Sometimes what looks like a phobia can be more about the fear of having a panic attack and “losing control”.

Panic

Panic attacks are frightening anxiety responses that can include heart palpitations and pounding, sweating, trembling, nausea, feeling faint, feelings of unreality, fears of dying, and feeling like one is going crazy or losing control.

Adjustment and Stress Related Issues

Symptoms of anxiety and depression may follow an upsetting life event.  For children and adolescents events such as separation/divorce, death of a loved one, chronic illness of self or a family member, and sometimes moving and starting a new school can cause distress that does not resolve.  Children who are struggling with adjustment have a difficult time coping.  It is also important to note that an adult may not think that the life event is significant enough to cause distress in a child, however a child may experience the event as very significant.  General stress as a result of perceived pressures, demands, and responsibilities also can challenge coping skills of children and adolescents.

If you have these concerns about your son or daughter, please feel free to call me and discuss your situation.  There can be relief in knowing there is effective help and support for you and your child.

All of these indicators can disrupt daily life and necessary activities like going to school, upholding commitments, and engaging socially.

According to The National Institute of Mental Health, the Child/Adolescent Anxiety Multimodal Study (CAMS), in addition to other studies on treating childhood anxiety disorders, found that high-quality cognitive behavioral therapy (CBT), given with or without medication, can effectively treat anxiety disorders in children and adolescents.

By learning to manage symptoms your child’s distress can be significantly reduced.

If your have these concerns about your son or daughter please feel free to call me and discuss your situation.  There can be relief in knowing there is effective help and support for you and your child.