More Than the Monster Under the Bed
“Childhood fears” are called that for a reason—they’re common for kids to have. However, some types of fearfulness and anxiety—especially those that are excessive or don’t go away—might be indicative of a need for help.
“Mom, my stomach hurts—I don’t want to go to school today,” your 7-year-old son whines. When you express your doubts that he’s really sick and tell him to grab his backpack, he continues, “I really don’t feel good, and the other kids don’t like me. Don’t make me go, please, Mommy, please!” This scenario, or something like it, has played itself out in virtually every household with school-aged children. Sometimes the child in question really is sick, and other times he might be trying to avoid some specific event that’s going to happen at school. But what if this behavior repeats itself every day? What if it escalates into tears and genuine terror? For an increasing number of children, that “what if”—or something just as serious—is a reality.
Yes, some fear and anxiety are normal for kids. (Monsters, ghosts, or being afraid of the dark, anyone?) However, other types of anxiety do indicate a problem that parents should address. So, how can concerned parents distinguish between what’s normal and what’s not, and how can they know when to seek help for their kids?
“Realize that the vast majority of kids do feel anxious at various times to one degree or another,” write Dr. Charles Elliott and Dr. Laura Smith, coauthors of Overcoming Anxiety For Dummies, 2nd Edition (Wiley Publishing Inc.). “After all, one of the primary tasks of childhood is to figure out how to overcome the fears that life creates for everyone.
“However, it has been shown that childhood anxiety has grown to epidemic proportions during the past 40 to 50 years,” they continue. “In addition to the things that have always triggered childhood anxiety, today’s kids are exposed to increased violence, the threat of terrorism, an increasingly hectic world, and more—if not directly, then through the worries of their concerned parents.”
If your child’s fears seem especially serious and/or interfere with his life or schoolwork in a major way, they may be problematic and warrant attention.
The authors offer the following insight into the more common types of problematic anxiety in kids:
Leaving parents: separation anxiety disorder. It’s normal for kids to worry about being apart from their parents, so the occasional “Dad, don’t go!” shouldn’t bother you too much. However, if your child is older than age four and exhibits one or more of the following symptoms, intervention might be warranted: becomes extremely distressed when you leave, worries about something happening to you while you’re gone, stubbornly refuses to go to school or other activities, worries about going to bed alone, experiences nightmares, and/or suffers from frequent physical complaints when you’re not there.
Separation anxiety disorder is one of the most common anxiety disorders that kids experience, and can be a precursor for problems later in life—especially depression. If your child’s symptoms persist longer than a month or two and interfere with normal life, seek further professional help. For children who are anxious about going to school, most school counselors will be an excellent resource.
Sleep terror. No child has ever grown to adulthood without occasional bedwetting, frequent awakenings, and problems going to sleep. But what if, an hour and a half after going to bed, your child suddenly sat up and screamed for up to half an hour—while asleep? That’s what sleep terrors look like, and they occur in 1 to 6 percent of all kids.
Sleep terrors are especially strange and frightening to parents; however, because the child in question is asleep, he or she doesn’t remember it upon awakening and usually won’t experience daytime distress as a result. Too little sleep may increase the likelihood of sleep terrors, so parents should make sure their children get enough sleep. And stress may also contribute to sleep terrors, so parents should attempt to alleviate stress and other anxieties in their children.
Worrying all the time: generalized anxiety disorder. Based on what we know today, generalized anxiety disorder is fairly common among kids, and more common among older kids than younger ones. It most often develops at the onset of puberty or shortly thereafter.
Generalized anxiety disorder is characterized by excessive worry about school, friendships, or family problems. It can manifest itself in physical symptoms such as stomachaches, headaches, or loss of appetite, and it can cause children to have difficulty concentrating, to be irritable, or to be restless, agitated, or have trouble sleeping.
Connecting with others: social phobia. Some kids are just plain shy. They’re born that way, and relatives often make comments like, “He’s just like his dad was at that age.” Sometimes, shyness decreases with age, but when it swells and causes a child to fearfully avoid social encounters in everyday life, your little one may have a problem.
Social phobia usually doesn’t manage to get diagnosed until around 10 years of age because it’s often difficult to distinguish from more general shyness. If your child’s fears of unfamiliar peers or adults show no improvement by the time he or she turns three or so, you may want to check with a professional to see if the problem is serious.
Anxious repetition: obsessive-compulsive disorder. Popular culture tends to use the term “OCD” in a cavalier or teasing manner, but it is a very real disorder that affects both kids and adults. Obsessive-compulsive disorder is a less common type of anxiety; nevertheless, almost one in fifty teens suffers from it. OCD often begins in childhood, and while it usually doesn’t develop until age ten, it can manifest itself as early as age four or five. Any child who exhibits signs of OCD should be evaluated, because the disorder tends not to improve without treatment. The good news is that treatment really works!
“Obsessions” are recurring, unwanted thoughts your child can’t stop. They may include: excessive fear of intruders, fear of germs, fear of illness, or fixation on certain numbers. In contrast, “compulsions” involve rituals or behaviors that your child feels compelled to repeat over and over. They can include: arranging objects in a precise manner, excessive hand-washing, hoarding items of little value, and repeatedly counting stairs, ceiling tiles, and steps taken while walking.
Yes, it is alarming that childhood anxiety is escalating—both intrinsically, and because of the fact that anxiety disorders often precede the development of depression later on. For the moment, though, say Elliott and Smith, what parents need to know is how to recognize whether your child’s fears represent normal development or a more sinister frame of mind that requires help.
“Remember,” they conclude, “if you have any doubts about the seriousness of your children’s anxiety, you should consider a professional consultation. A mental health counselor or your pediatrician should be well-equipped to handle your questions.”
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Drs. Elliott and Smith are clinical psychologists and coauthors of: Overcoming Anxiety For Dummies (2nd Edition), Borderline Personality Disorder For Dummies, Obsessive Compulsive Disorder For Dummies, Seasonal Affective Disorder For Dummies, Anxiety and Depression Workbook For Dummies, Depression For Dummies, Hollow Kids: Recapturing the Soul of a Generation Lost to the Self-Esteem Myth, and Why Can’t I Be the Parent I Want to Be? For more information, visit their website at www.psychology4people.com.
