Two Common Anxiety Disorders in Children

Do you recall what your very first day at school felt like? Or how about your first day of work on the job? These thoughts and fears may no longer reside in your memory since they were normal and temporary reactions. However, imagine how it would feel if you were to experience those same feelings constantly, even when they made no sense!

These feelings of anxiety can be overwhelming for a child. Maybe your child struggles with anxiety and you are wondering what is really going on in their head when they fear a social setting so much that they can’t participate.

It can be tough on the whole family when one of the children struggles with anxiety symptoms, and even more so when their best friend or their teacher just doesn’t get what is happening, or understand how to support them.

Some teachers are not equipped to know what is happening when a child experiences anxiety and they can underestimate the effects that it has on the student’s success and performance and social relationships. Teachers may confuse anxiety with other things, such as behavioral issues, and not know how best to work with parents for a successful outcome, as well as how to advocate for the child within the larger framework of the school system.

Perhaps you have wondered how to better understand your child’s needs when they face these types of challenges but are met with misunderstandings and/or lack of support from others.

The remainder of this article will cover 10 ways that anxiety affects a child’s life and education:

• A child’s feelings of worry about themselves, their parents, or family members
• Having nightmares or night terrors and lack of sleep
• Symptoms of panic attacks
• Decline in educational success
• Physical symptoms of headaches and stomachaches
• Extreme difficulty focusing or concentrating
• Heightened risk of developing depression or other anxiety disorders
• Lack of social skills or experience
• Low levels of communication while in social situations
• Being misunderstood by family, school teachers, and/or peers

There is a difference between anxiety and an anxiety disorder. There are anxiety disorders that occur only in children. The Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5) distinguishes between anxiety disorders and normative fear or anxiety, noting that anxiety disorders are extreme and persist beyond a time that is developmentally appropriate.

Anxiety disorders in children can cause them to read greater levels of danger into a situation or completely avoid it. Separation anxiety disorder and selective mutism typically begin in the early years and persist throughout adulthood when left untreated. Sometimes children with anxiety disorders may have the symptom of panic attacks in response to a fear.

Separation Anxiety

Although some separation from a caregiver is normal in children, separation anxiety is when a child is so anxious from the separation of a caregiver that it is developmentally inappropriate. The diagnostic criteria for separation anxiety disorder include:

• Nightmares
• Worry that their attachment figure might be hurt in some way and a reluctance to be separated from them.
• Physical symptoms related to distress.
• Extreme apprehension about possible events such as kidnapping, accidents, getting lost or getting sick – anything that might separate them from their attachment figure.
• Reluctance or refusal to leave the house and go to places like school, aversion to sleeping somewhere other than home, and physical symptoms such as head or stomach aches when separated from the attachment figure.

The most commonly diagnosed childhood anxiety disorder is separation anxiety. School disruption effects 75% of children struggling with separation anxiety because of their unwillingness to even attend school on a daily basis. Even children who end up going to school may still suffer because they cannot focus on what is being taught due to their anxiety over those at home.

Sleep disturbances are also common with symptoms consisting of nightmares as well as physical symptoms. This is a challenge for any parent who is unaware of the level of fear that their child experiences from sleeping in their room alone.

When a child does not get enough sleep, it is difficult for them to function at school. Their behavior may cause confusion in the classroom which can create tension in their relationship with teachers and peers. The behavior can become so disruptive that the teachers and peers may find it difficult to engage with them on a developmentally appropriate social level, resulting in the child being labeled as defiant.

A parent may develop their own response to their child’s anxiety symptoms. Some parental responses can end up reinforcing the child’s symptoms and behaviors. Negative behaviors may result in a parent removing them from the area in which the behavior occurred, which can increase their anxiety even more.

This can be increasingly frustrated for parents who struggle to understand what is going on with their child. Parents may continue to reinforce behaviors, for example, by allowing their child to sleep with them when they fear to sleep alone or to stay home from school when they do not want to go. This is detrimental to the family as a whole and may cause stress to the rest of the family.

Do you have a closer bond with one child more than the others? Perhaps this bond was formed with the child who most needs the sense of closeness and safety. This can cause rifts between you and your spouse or other family members before you are even aware of it.  While you spend much of your time attending to the child struggling with separation anxiety, others in the family may be feeling left out.

Not only does separation anxiety have an immediate effect, but it can prove detrimental long-term as well. The isolation a child experiences today can bring on social problems, later on, making it more likely they will remain unmarried. In addition, children who suffer from separation anxiety disorder are more likely to develop depression or other types of anxiety disorders as they grow up.

Selective Mutism

Anxiety can affect a child’s life and educational success in other, more subtle ways. Does your child never talk at school, but won’t stop talking as soon as you pick them up?

Does your child act shy in public when around people that you know, when only moments ago they were laughing and talking with their brothers or sisters in the car? Does this seem to be context-specific? Perhaps they suffer from selective mutism, another anxiety disorder that can strike children.

Selective mutism, though quite rare, typically affects children prior to the age of five. It often goes unnoticed until such time as the child enters school. Many times, children grow out of selective mutism, but understanding the effects, symptoms, and signs of it is still important because of the many ways that anxiety can affect a child’s life and education.

In order to deliver a diagnosis of Selective mutism, certain criteria have to be met, such as:

• Not speaking in settings or situations where it would normally be expected (i.e. – school).
• Not speaking when it isn’t merely a result of ignorance of the subject being spoken about.
• Symptoms that are unrelated to some other type of communication disorder or which happen simultaneously with some other disorder, like autism spectrum disorder.
• Behavior that lasts for more than a month and stretches beyond the first month of school, when children are normally hesitant to participate in their new surroundings.

Here are a few factors that are critical for understanding the kinds of symptoms that one should look for. Children with selective mutism will often have normal patterns of communication at home with their family. However, they will clam up in public settings (such as school) and may even fail to speak to their extended family members who do not live with them. Children may also be silent when in the company of peers.

A child with anxiety may have even more of a struggle in making friends at school than will a child who is anxiety free. It is even more challenging for a child that suffers from selective mutism. Other children may be hesitant to befriend a child that cannot talk to them.

Selective mutism may also produce other problems at school, especially if the teacher cannot interact with, and assess the educational levels of the child, or where the child cannot communicate their needs to the teacher.

Even though children with selective mutism can occasionally come up with nonverbal methods of communication, like pointing, the lack of communication may increase the possibility that they will be teased by peers, which will further aggravate their anxieties about being in social settings.

A child with anxiety, whether ongoing or only occasional, has feelings, emotions, and behaviors that may be initially confusing to those who care about them. Young children will likely not understand the anxiety symptoms in their body at first, but they pass into the adolescent years they become more aware and they may prioritize their need to feel better, even though they might not know exactly how to achieve this.

They may try things that may appear to relieve the anxieties that they experience and run the risk of developing unhealthy or risky habits that can lead to increased anxiety, shame, guilt, or confusion.

Parents, siblings, friends, and teachers can find it a significant challenge to interact with a child that experiences all the worry and fear brought on by separation anxiety or selective mutism. However, these challenges can be overcome – there is hope, because of the high success rate of managing both conditions.

Therapy can (and should) include both the child and family members to increase their understanding of the symptoms and to help develop more appropriate ways to manage anxiety and its causes. Children will be taught more appropriate ways of coping with their anxiety and develop skills to change their thought patterns when anxiety symptoms show up.

If you are unsure whether anxiety is the cause of your child’s distress, schedule an appointment with a Christian Counselor Newport Beach today. Becoming educated about your child’s anxiety can be the beginning of a new day for everyone.