August 30, 2022

Anxiety and its Many Manifestations

Sofia Ferguson

When it comes to stress and anxiety, it often manifests itself very different in children compared to adults and adolescents. It is important to be able to identify normal, age-appropriate worries and fears in your child, and whether those worries and fears may begin to escalate pathologically.

First, it's important to understand exactly what fears and worries are. Fears refer to anxieties elicited in the presence of a specific stimulus, while worries are usually anxieties about possible future events. For every child, there are age-appropriate and specific fears and worries. For example, it's common to observe toddler-age children having a fear of the dark. For children in elementary school, it is often observed that their fears revolve around injuries. But when do these fears cross the line between normal and "abnormal"?

Second, the key here is intensity, duration, and persuasiveness. When anxiety becomes pathological, it means that these three factors increase to a point where certain characterizations can be observed. With anxiety disorders, you'll often observe inhibition and withdrawal, exaggerated and unrealistic fears or worries, overcontrolled behavior, as well as somatic symptoms. With regards to children, there are certain anxiety disorders that are more common, including generalized anxiety disorder, separation anxiety disorder, and phobic disorders.

Generalized anxiety disorder, or GAD, refers to excessive anxiety and worry about a variety of stimuli and situations. For example, a child may have excessive anxiety about a natural disaster occurring and harming their family, while the actual threat of a natural disaster harming their family is very low. In this way, GAD surpasses reason by convincing the child that this fear is rational and appropriate. The child may spend excessive time ruminating on this fear, making it grow out of proportion to the actual reality of the event occurring.

Separation anxiety disorder, or SAD, refers to developmentally inappropriate and excessive anxiety concerning separation from those the child is attached to. For example, a child may have excessive fear of sleeping alone, or sleeping over at a friend's house. This escalates when a child can't fall asleep without those the child is attached to, or when the fear creates dysfunction in social, emotional, and somatic regulation.

Last, we have phobic disorders, which manifest themselves indifferent ways. Phobic disorders refer to excessive and exaggerated fears of particular objects or situations, intense anxiety in their presence, and avoidant behaviors. One common specific phobia is agoraphobia, which refers to intense anxiety in places where someone feels insecure, trapped, or not in control (think of fear of small spaces). Another specific phobia is social phobia, which is a fear of scrutiny or evaluation of others (think performance anxiety).

Remember, the key is intensity, duration, and persuasiveness. Fears and worries are normal, as long as they are age appropriate. Remember to always talk to a doctor before making any medical decisions, but now you have a bit more information on anxiety and how it manifests in children.

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