In my previous post I focused on anxiety in general. In this post I am going to describe specific symptoms of childhood anxiety disorders and include some simple checklists to help parents narrow down what kind of anxiety their child may be experiencing.
Separation Anxiety Disorder (SAD)
Separation Anxiety is fear of being apart from a parent or important caregiver. This is perfectly normal for very young children but can become a big problem when school starts or if parents need to use childcare for work or other situations.
This anxiety disorder is generally the earliest occurring anxiety disorder. The focus for a child with this might be that something will happen to him or her or that something will happen to the adult caregiver. This, like many anxiety disorders, can result in a panic attack.
Some of the more difficult variations of this disorder are when it results in school refusal and when a child insists on sleeping with a parent. Another common variation is that a child insists on certain measures during the school day or at the end of the school day like being able to see a parent’s car as soon as they exit the building or having permission to contact a parent during the school day.
Separation Anxiety Disorder Symptom Checklist
- My child gets scared/upset when my mom, dad or other loved one leaves.
- My child will cling, cry, plead or have a tantrum when caregiver must separate
- My child fears that something bad might happen to an adult family member (like mom or dad)
- My child worries he or she might get lost or someone might take them and my parents can’t find me
- My child won’t go places like school if can’t be with my mom or dad or does so with extreme distress
- My child hates being alone without an adult
- My child doesn’t like to go asleep by him or herself.
- My child reports bad dreams about being apart from his or her parents
Social phobia (SP)
Social phobia, as you can tell by its name is about an audience. It is fear that takes place in the public, when there are others looking on. Sometimes this is called social anxiety disorder. Primarily there are a couple aspects of it. First, it is a fear of being embarrassed or shamed and second, it is fear of being judged or negatively critiqued. No one likes either of these but kids with this fear are terrified of this happening.
Like many other anxiety disorders, the physical symptoms make it worse. Kids with this have increased heart rate, get sweaty, flush red, hyperventilate (making it hard to speak smoothly) and their focus goes inward on these feelings causing them to lose their place in conversation. Kids with this tend to overestimate other’s expectations and underestimate their own ability. In an unusual twist there is the fear that positive feedback will increase expectations and is undesirable.
Common areas of fear for kids are situations requiring performing such as speaking or recitals. It can be overwhelming to start, join or even participate in conversations especially around new people. Unfortunately, this can lead to fewer friends and underperforming at school. The reaction can be clinginess, extra caution, emotional outbursts and avoidance.
Social Phobia Symptom Checklist
- My child gets very anxious when I have to be around kids I don’t know
- My child hates having to do something, especially while other kids are watching
- Being embarrassed is one of the worst things for my child
- My child thinks he or she come across badly to others. They say, “They don’t like me.”
- My child makes excuses to avoid being around others
- My child seems very self-conscious around other kids
- My child tries to not to speak or raise their hand in class
- My child doesn’t fit in or is worried they won’t fit in
- My child is quiet and doesn’t know what to say when others are talking
- My child worries others will notice when they are anxious and feel they “stick out”
- My child gets very upset when we try to make him or her do things with others
- My child has a very hard time making eye contact with people
- My child worries a lot about what people think about him or her
Generalized Anxiety Disorder (GAD)
Sometimes kids just have a problem with worry. The subject of the worry may change from time to time. They might not even know at any given point what exactly is bothering them. Sometimes it is hard to tell if it is depression or anxiety and maybe both. It is probably safe to say that everyone worries. The difference between everyday worries and a problem called generalized anxiety disorder (GAD) is that GAD is way out of proportion to the actual situation. It is also next to impossible for kids with GAD to control the worry. With regular worry usually you can put it out of mind enough to focus on the present. GAD worry tends to demand attention and get in the way of day-to-day functioning. Kids with this may worry about their ability to do something or how well they can do it. It might seem a lot like perfectionism. GAD also is very persistent. Regular worries come and go but this just keeps going. Worries tend to multiply with this as well. So if the worries are way out of proportion to the problem, they interfere with life, and they persist for weeks and months then it is quite possible regular worry has built enough steam to become a generalized anxiety disorder.
Generalized Anxiety Disorder Symptom Checklist
- My child gets lots of feedback to quit worrying so much
- My child is always worrying about something
- My child feels “fidgety, jittery or jumpy” on the inside a lot
- My child complains of being tired much more than you would expect
- My child’s worry causes concentration problems
- The worry seems to make my child irritable
- My child’s muscles hurt even without exercise
- My child has trouble falling asleep a lot of nights
- My child often thinks something is going to go wrong
- My child tries to not worry but can’t seem to stop
- My child gets lots of stomachaches
- If my child stops worrying about one thing they start to worry about something else
These checklists are not meant as actual diagnostic instruments, rather as educational information for parents. Sometimes kids have more than one kind of anxiety disorder. If you check a lot of these on more than one checklist that might be the reason. The purpose of these is to help you decide if it is time to get your child help. In the next entry, I will cover panic disorder, obsessive compulsive disorder and various phobias.