General Questions

1) What is the best treatment option for children with anxiety?

Cognitive behavioural therapy (CBT) is effective in treating anxiety in children. Different children with the same diagnosis respond differently to a particular treatment and therefore it is important to discuss your doctor about what treatment is most suitable for your child.

Cognitive behavioural therapy has been shown to be effective in treating children anxiety disorders. It consists of learning skills and techniques that your child can use to reduce their anxiety, identifying negative thought patterns and replacing them with positive ones and separating unrealistic thoughts from realistic thoughts.

Other forms of therapy for children with anxiety is using a strategy of acceptance and mindfulness, which in other words mean living in the moment and experiencing things without judgement, as a way to cope with negative or unwanted thoughts and feelings. This is called Acceptance and commitment therapy. Another therapy is called dialectical behavioural therapy. It teaches your child to take responsibility for their problems and how to examine how they deal with negative thoughts and conflict situations.

Medication is also a treatment option for children with anxiety and it is usually used together with cognitive behavioural therapy. Research shows that this combination works best out of all the options especially for children ages 7-17. Depending on the severity of your children`s anxiety, medication can be used long term or short term. Your doctor also needs to know what other medication has your child already tried in past.

Selective serotonin reuptake inhibitors are the most commonly used for childhood anxiety and also adult anxiety. Less commonly used medications are benzodiazepines and tricyclic antidepressants.

Side effects of the selective serotonin reuptake inhibitors (SSRI) can be headaches, nausea and sleeping difficulties. Also watch for signs of depression and consult your doctor if you notice any new symptoms in your child`s behaviour. A very small number of children with anxiety treated with SSRI may develop suicidal thoughts.

2) Does my child have an everyday anxiety or is it already an anxiety disorder?

Anxiety is a normal reaction of our body telling us about a danger. It helps us to prepare for important events and helps us to act quickly when facing a dangerous situation or keeps us away from danger.

But your child may experience a persistent and overwhelming anxiety that is out of their control. They experience an excessive irrational fear and worry about everyday situations. When it interferes with daily activities, it might be an anxiety disorder.

The term anxiety disorder includes the following disorders: Generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, social anxiety disorder.

Research shows that anxiety disorders run in families like allergies or diabetes. Anxiety disorders in children may develop from several risk factors such as personality, life experience, genetics and brain chemistry.

The following table explains the difference between an everyday anxiety and an anxiety disorder:

3) Is general anxiety the same as generalized anxiety disorder?

No, general anxiety is a normal human reaction to stressful and dangerous situations. It is your body telling you to stay alert and be prepared for action.

Generalized anxiety disorder however is explained as persistent, excessive and unrealistic worry about everyday things. Children and adults with this disorder may be aware that their worry is unrealistic, but feel unable to control their worry and expect the worst. Sometimes just the thought about performing everyday activities causes anxiety.

4) Does my child need treatment or will my child`s anxiety fade away with time?

It may surprise you how often this question is asked by parents. Many fears in childhood are part of normal development of your child. Different type of fears rise at different ages, for example fear of the dark is typical at age 4 to 6. Also it is normal for children to be afraid of loud noises in a very young age. But regardless of your child`s age, if you notice your child is experiencing an unremitting and irrational fear or a worry that interferes with their life and everyday social or personal activities, then they may need treatment. Just like other medical problems, anxiety disorders need to be treated in order to prevent them becoming chronic. Children with anxiety need professional guidance to manage and overcome their anxiety successfully. Family support also plays an important role. Research shows that if anxiety is not treated, children are at higher risk of poor school performance, slower social skills development and vulnerability to substance abuse. That is why it is important to get help for your child as soon as possible. Your child deserves an anxiety free future. If you are not sure if your child`s anxiety is normal or it excessive, you may consider to seek advice form a psychologist.

5) I also suffer with and anxiety disorder. Did I give it to my child?

Although research has shown that genetics play some role in anxiety disorders, there are other and probably more important factors to consider. For example your child may be more temperamental and that may make them more prone to anxiety. Secondly fears are often acquired through the media, experience and observed behaviour. Your child might have experienced trauma. For these reasons it is unlikely that you simply “gave” an anxiety disorder to your child. You may interact with your child in a way that increases their anxiety though and it is important to identify these possible triggers, preferably by a consultation with a psychologist.

6) Why does one of my children exhibit anxiety when my other child is not anxious at all?

It is normal to see this. Different children have different temperaments; some children can cope with difficult situations more easily than others. Some children don`t worry about feeling anxious and some seem to be always anxious. But it is possible for children to learn to manage their anxiety so that they can take part in all activities and not be “held back” by their anxiety.

7) How effective is treatment of anxiety in children and how long does it take?

Most children with anxiety disorders benefit from professional care, success of treatment varies. Benefits of cognitive behavioural therapy are usually noticeable in 12 to 16 weeks. The use of medication is long or short term, depending on your therapist decision and on severity of your child’s anxiety symptoms. It can take some time to find the drug that works best for your anxious child.

Also if your child has more than one anxiety disorder, which is possible, treatment may be complicated. Where there are other co-existing conditions, substance abuse or depression, treatment can take longer. That is why treatment options must be discussed with a professional and must be tailored specifically for each child.

8) What if my child suffers with side effects of medication?

If your child experiences side effects, contact your physician, even if you are unsure a symptom is caused by a medication. Medication should not be stopped by you without consulting the prescribing physician as this may cause other health risks or bring your children’s anxiety back. Medications are only effective if they are taken as prescribed. They may not fully resolve all of your children’s anxiety symptoms.

The most common side effects are headache, stomach ache, nausea and sometimes sleeping difficulties. Your doctor should know about all medications your child is taking including antibiotics and allergy medicine.

9) How do I choose the right health professional for my child?

Anxiety disorder in children can be treated by psychologists, psychiatrists, psychiatric nurses, clinical social workers. Primary care physicians are more and more aware of anxiety disorder in children and can prescribe medication and refer to a mental health provider.

10) My child has started on medication for anxiety, will they have to take it for the rest of their life?

The short answer is no. Taking an antidepressant – selective serotonin re-uptake inhibitors (SSRI) does not mean it has to be taken for life. Physicians and prescribing psychologists and psychiatrists usually recommend the initial treatment of anxiety in children with an antidepressant should last for about one year. Your doctor needs to regularly reassess the treatment and change it accordingly if necessary. There is no evidence that SSRI cause an addiction, however always consult your doctor how long your child needs to take the medication and what changes should you see in your children` anxiety symptoms and when.

11) How can I tell if I am having a panic attack or a heart attack? The symptoms are so similar

Panic attacks symptoms are quite similar to heart attack symptoms. In both cases you can experience shortness of breath, palpitations, dizziness, numbness of hands and feet, trembling, sweating and chest pains. Some patients described this experience as feeling as if they are going to die.

A panic attack usually occur spontaneously and out of the blue and poses no immediate danger, although it can be a frightening experience. A heart attack is dangerous medical emergency and requires immediate medical attention. If someone experiences panic attacks and also had a heart attack in past, it is important to consult the doctor to identify the symptoms that should trigger a trip to emergency hospital. And when these symptoms occur, the person should treat them as symptoms of a heart attack and attend an emergency room without delay. All the other symptoms should be treated as symptoms of anxiety.

Those who never had a heart attack, but had a panic attack and worry about a heart attack, should get a thorough physical examination and evaluation. If they are not at risk of heart attack, then a psychological treatment for panic attack should begin.