What Parents Should Know About Childhood / Adolescent Anxiety

Generalized Anxiety Disorder (GAD)

Many things can trigger Anxiety in children and adolescents, including biological factors (things in their body), psychological factors (things they think and feel) and social factors (where they go to school and who their friends are).

Some children and adolescents feel intensified sensitivity to unfortunate information, circumstances and events. They have what is known as a “sensitive personality,” which means they are more likely to experience feelings of sadness, worry, frustration, fear or general upset more than others. This personality factor puts a child or adolescent at risk to experience these feelings more often and more intensely than others. It also can lead to heightened anxiousness, Anxiety Disorders and Depression.

Feeling a Loss of Control

The sensitive personality can be intensified through a variety of experiences in a child’s life. One of the most important influences appears to be related to a child’s sense of control over his or her life and what happens in it. Some researchers have found that children who feel they cannot control certain things are likely to have a more negative reaction to bad experiences.

The loss of control can be made worse through situations that limit a child’s opportunity to experience the world, to master challenges and to ask for help at the appropriate times. Most importantly, a child needs to develop a sense that he or she can make even truly bad things less bad by making them go away or learning how to cope or deal with them.

The Role of Bad Experiences in Childhood / Adolescent Anxiety

In addition to these important feelings about control, certain bad experiences can occur in life that can affect a child’s sensitive personality to express itself. For example, a child at risk in this way who is bitten by a dog may develop a phobia of dogs. If a child is excessively teased, a social phobia might develop. Or if a child has a bad experience with a stranger, Separation Anxiety may develop. And so it goes.

It is important for parents to understand that an Anxiety Disorder usually is the result of several factors that accumulate over time, including personality type, early feelings of being out of control and bad experiences. There can also be genetic and biological factors that influence the development of an Anxiety Disorder.

The Effects of Negative Thinking on Childhood / Adolescent Anxiety

Children with anxiety problems see the world in a slightly different way from other children. In particular, they are quicker to grasp onto negative ideas and assume how things can go wrong.

This tendency manifests itself in myriad ways, especially with their attention span, how they interpret events and their indulgence in negative “self-talk.” One research study found that anxious children were more likely to interpret ambiguous words and situations as dangerous. Their anxiety was evident when they were asked, “When you hear a noise in the middle of the night, what do you think it is?” Anxious children were more likely to answer “burglar” than calm children.

Another study showed that anxious children indulge in more negative self-talk – telling themselves, for example, “I won’t be able to handle this situation.”

The Effects of Anxiety on Feelings

It is crucial that parents recognize that some anxiety is normal and even healthy. After all, anxiety is fundamentally meant to protect us from danger – to trigger an alert in the brain and the body to self-protect.

In its first stage, such as when a threat is still somewhat distant, Anxiety shows up as worry, tension, increased attention to the possible danger and a reduction in normal activities. One researcher calls this first stage the “stop, look and listen” stage of Anxiety. For example, a child who hears a dog barking as she walks to school might stop, look and listen – and then contemplate a safer route to travel to school to avoid the dog.

It is only when children experience anxiety when there is no need to – in other words, when there is no real threat or danger – that anxiety becomes a problem. Sometimes this type of Anxiety is called a “false alarm.”

Anxiety Can Trigger a Chemical Reaction

If a threat gets closer or grows more intense, feelings in a child can escalate and other parts of the body are often marshaled to confront the danger. This is part of the body’s natural and purposeful response to survive a threatening experience.

But sometimes, Anxiety triggers a second stage – fear or panic, which is also known as the “fight or flight” response to danger. This stage is marked by a quickening heartbeat, faster breathing, a spike in blood pressure and a surge of chemicals throughout the body to bolster alertness, speed and strength. Some of these chemicals, such as adrenaline, can have negative side effects, including shakiness or nausea.

Children / Adolescents with Anxiety Disorders can experience these emotions when there is no real danger, such as when those who usually get good grades panic while taking a test at school. This is another example of a “false alarm,” and a negative one at that.

How Cognitive–Behavioral Therapy Works

The treatment approach that works best with Childhood / Adolescent Anxiety Disorders is called Cognitive-Behavioral Therapy. This approach is based on the idea that it is important to teach children the skills they need to identify a perceived danger as just that: perceived and not real. Instead, they have encountered a false alarm.

Empowering children with the ability to accurately identify when situations are safe helps reduce or eliminate their tension and worry as well as feelings of fear and panic. Much of this evolution occurs through practice exercises that use reasoning and experience to show children that their Anxiety is not necessary – and that they should, in fact, feel safe.

The challenge for the therapist is getting to that place: Anxious children (like adults) tend to avoid what they fear and so may resist these helpful practice exercises. The therapist’s role, then, is to act as an encouraging guide who supports the child so that he or she participates in these exercises and ultimately learns how to distinguish between truly dangerous situations and perfectly safe ones.