Intervention is Key to Treating Significant Anxiety
“Untreated anxiety can lead to depression for some children,” says Loren P. Conaway, PhD, licensed clinical psychologist with Children’s Hospital & Medical Center Behavioral Health. “If their anxiety is significant, they are not going to grow out of it. They need tools to manage it.”
According to Dr. Conaway, for children ages 3 to 6, fears tend to be imagination-based. “Ghosts, monsters and things that go bump in the dark,” she says. “They worry about the scary things that hide under the bed or in the closet.”
For school-age children, the fears become more reality-based. “They have worries about physical injuries, school performance, world events or illness, and not just worry for themselves but also for their parents or siblings,” she says. “At this age, they also become socially aware and begin to fear rejection or embarrassment.”
Dr. Conaway says the difference between age-appropriate anxiety and anxiety disorders requiring therapy is the significance of the anxiety and whether or not it disrupts the child’s daily functioning.
Primary care physicians and parents should watch for changes in behavior or adjustment, such as problems with friendships, changes in grades, eating changes, withdrawal from activities, sleep difficulties or increased clinginess or dependence on parents.
Primary care physicians may also see physical symptoms rooted in anxiety. “Chronic stomach aches, headaches, nausea or difficulty eating, or panic symptoms (sudden onset crying, sweating, shakiness or dizziness), these could be a result of anxiety,” Dr. Conaway explains. “Lots of trips to the nurse’s office at school for these same symptoms are also an indication.”
If primary care physicians suspect an anxiety disorder or depression, Dr. Conaway says they have the option of educating parents on strategies, referring to a behavioral health specialist or both. She says a decision to refer may depend on how stressed the child is, how stressed the child’s parents are and how seriously the anxiety is interfering with the child’s life.
Typically, the behavioral health specialists at Children’s will attempt therapy before employing medication. “We have many evidence-based treatments, therapies and strategies that work,” Dr. Conaway says. “Although pediatric anxiety is on the rise, our knowledge is on the rise, as well.”