Anxiety in Children and Adolescents (page 2)
Alex, 15, describes what anxiety feels like:
I grew up in New York, the son of two loving parents. I played little league, I took piano lessons, and I was a good student. In the sixth grade I started feeling different. I began to believe that I would not be liked by anybody. I also began to be very nervous and panicky around people. Fear became a major part of my life. Fear I would say the wrong thing in front of friends and teachers or that I might somehow embarrass and humiliate myself. My desire to not let anyone see my nervousness became so dramatic that everything was pre-meditated. I gave great thought to things that others would find routine - how I moved from place to place, how I held a book or what I did with my hands.
I began to avoid anything that involved risk. If I wasn't doing anything, I couldn't screw up. If I was alone in my room, there was no risk involved and no fear of failure and embarrassment. I never dated, I never spoke with anyone on the phone if it wasn't about homework, and Saturday nights might be spent at a movie with a friend. That was the extent of my social life.
"Why are you so quiet? Why don't you like to go to parties? Why don't you have a girlfriend?" I would hear people say these things and I would become so angry that people had discovered I wasn't normal.
I found myself making excuses. The fact is, I really wanted to not be so quiet, to go to parties and to have a girlfriend, but I was too scared to risk failure. I began to believe that I was simply not meant to be a socially confident person and that everyone else was.
Some common signs:
- Difficulty going to, or staying in, school
- Afraid of being separated from parents
- Excessive worrying
- Trouble concentrating
- Extreme shyness of self-consciousness
- Frequent physical complaints-headaches or stomachaches
- Avoids specific places or situations
- Cries easily
- Lacks energy or interest in age-appropriate activities
Anxiety is a basic emotion experienced by all human beings. Everyone experiences anxiety at times in response to stress or to fear-provoking events. An anxiety reaction as a response to danger is actually helpful because it warns people to avoid or escape potentially dangerous situations. An anxiety reaction can be adaptive in certain situations, such as test-taking. Sometimes, however, anxiety becomes excessive and causes significant distress. When anxiety results in fear or apprehension that is out of proportion to an individual's life situation or developmental stage and impairs an individual's ability to function, it is a mental health disorder.
For example, some children have unusually strong or overwhelming feelings of anxiety. While many children are scared of things like the dark, taking tests, and meeting other kids, most eventually learn that there is nothing to fear about the dark, that studying helps pass tests, and that other kids are usually pretty friendly. Some children, however, have difficulty managing their anxiety and, instead of taking charge of their fears, they feel worse about themselves and their inability to control their anxiety. Anxious feelings might take the form of headaches, stomachaches, cold and clammy hands, rapid heartbeat, feelings of faintness, and a general feeling of tension. To avoid feeling anxious, these children may avoid the situations that are anxiety-provoking for them.
Anxiety results from a combination of factors - genetic, biological, and environmental. Anxiety disorders have a genetic component, with anxious parents being more likely to have anxious children (although the specific anxiety disorder often differs between parent and child).
It has also been found that people with anxiety disorders anticipate and experience threat even when no threat is present, and are more likely to interpret ambiguous situations as threatening than other people. The overestimation of threat may be due not only to a genetic predisposition but also to a chemical imbalance or biological differences in the hardwiring of the brain.
In addition to the genetic and biological factors, environment also plays a role in the development and perpetuation of anxiety. For example, parents who express excessive amounts of fear in a given situation teach their children that such a situation requires a strong fear response. In fact, parents might inadvertently teach their children to be unnecessarily fearful of a neutral situation.
Example: Julia's mother is afraid of meeting new people and confronting new situations. Julia, who is 5 years old, is beginning to learn that new people and new places must be scary, because her mom is so afraid of them.
Parents who are themselves fearful of a situation and avoid the situation at all costs in order to prevent feelings of anxiety teach their children that avoiding the anxiety-provoking situation is an acceptable way to reduce anxiety.
Example: Victor's dad is afraid of dogs and won't leave the house if there is a dog anywhere in the vicinity. Victor has learned that avoiding the situation is an acceptable way to prevent anxiety, and that not going to play at his friend's house is an acceptable way to deal with being afraid of new places.
Reprinted with the permission of the NYU Child Study Center. © NYU Child Study Center.
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