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Anxiety disorders are among the most common disorders in children. Anxiety is typified by unreasonable fear and is accompanied by physiological responses such has rapid heart rate, shortness of breath, and butterflies in the stomach.
It is estimated that nearly 300,000 children in the UK have an anxiety disorder, this is around 5 – 19% of all children and 2-5% of children under 12.
Kids Matter in Australia state that around one in seven school age children have a mental health problem including anxiety and depression, but only one in four get the help they need.
Most types of anxiety disorder can be experienced by both children and adults but there are two which have onset in childhood only. These are called separation anxiety disorder and reactive attachment disorder. A further disorder called sibling rivalry disorder is described in the ICD. In the DSM, sibling relationship problems are recorded under 'Other conditions which may be the focus of clinical attention'.
It should be noted though that anxiety is also quite normal in children. Normal anxiety typically evolves as the child develops. In early infancy, children are fearful of strangers and have a strong attachment to their mothers and caregivers. In early childhood, children are often fearful of animals, the dark, and monsters. In adolescence, children are often fearful about social situations and their self-adequacy. Anxiety disorders in childhood follow the same developmental courses as normal anxiety but symptoms are more exaggerated and they last longer. Age at onset can be variable, but onset for separation anxiety is ordinarily in early childhood and onset for social anxiety disorder is in adolescence.
Children may experience anxiety or be worried at times, that is perfectly normal, but if it starts to affect their wellbeing, they may need support to overcome and deal with their anxiety.
Children can feel anxious about many different things and this can be part of normal development.
From six months to three years approximately, children can experience separation anxiety. This is when the child worries when they are not with their parent or usual caregiver. They will be clingy and cry when they are separated from their parents or primary care giver. This is normal and the child will tend to grow out of this naturally around the age of three. However, in older children it can be a sign that they are feeling insecure about something.
Pre-school children may also experience phobias or have specific fears, such as there is someone under the bed, monsters in the cupboard, insects, dogs, cats, thunder, the dark and so on. These fears usually go away on their own.
Children may also experience other anxieties as they go through childhood, starting new schools, exams, tests, new social situations and so on.
However, in some cases, children (and adults) do not always recognise what causes their anxiety. They may not recognise the triggers to their anxiety, which can make it worse.
Anxiety can become a problem when it starts to affect the child’s daily life, when it becomes more regular and long term. It is perfectly normal for a child to feel nervous going to school on the day of an exam, but not to feel so anxious every day that they can’t go to school.
Other types of Anxiety
Children may experience social anxiety, when they do not want to see friends, go out in public or take part in activities. Being shy is normal for children, but it becomes a problem when they feel an intense overwhelming fear which affects their ability to interact with others socially. This tends to affect older children, but not always.
Children can be anxious about going to school, bullying, friendships, schoolwork or changing schools. They may share their worries with their parents or teachers, but sometimes they may complain about feeling ill, stomach aches, headaches or sickness. They may seem tired or cry in the mornings.
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