Anxiety and phobias in children and teenagers

It is common for children and teenagers to feel worry and fear. It is not dangerous to feel strong emotions, and it goes over. But if the fear does not go over and affect how the child or teen works in everyday life it can be an anxiety disorder. Then they may need treatment.

This article is aimed at you who are the parent or guardian of a child who has anxiety. You can read more about anxiety here . If you are a teenager can read more about  anxiety UMO.se .

The word child in this text refers to both children and teenagers.

How do you notice children having anxiety?

These are common expressions of anxiety in children:

  • She begins to cry easily.
  • They often get outbreaks.
  • They are restless.
  • She’s having trouble falling asleep.
  • They have trouble concentrating.
  • She is irritated, pulls away or is difficult to contact.

They can also suddenly become afraid of something, or have difficulty doing something that they have previously managed. For example, it can be sleeping away or staying in a foreign environment. 

The symptoms can be experienced differently

Symptoms of anxiety can be experienced differently for different children, and manifest in different ways depending on the child’s age. It can also feel different at different times.

For example, a child might describe anxiety like this:

  • It feels like butterflies in the stomach.
  • It hurts the stomach or you feel unwell.
  • The heart beats hard and / or fast.
  • It feels like a pressure over the chest.
  • It is difficult to breathe.
  • The muscles are tense, the body shakes or trembles.
  • It swings and spins in your head.
  • It feels like there’s a lump in your throat or stomach.

They can suddenly become pissed or loose in the stomach, and have to go to the toilet frequently.

Anxiety can be felt in the body in many different ways. The symptoms are because the brain’s nervous system releases stress hormones, the fold affects several organs in the body.

Anxiety syndrome in children and teens

Anxiety syndrome is a collective name for several different diagnoses. The difficulty the child may have depends on the type of anxiety disorder it is about. These diagnoses include anxiety disorders:

Sometimes the child may have problems that correspond to more than one syndrome. The problems can go away over time, but treatment is often needed.

Specific phobias

It is called specific phobia when anxiety is linked to a specific situation, place or thing. It is often one of the following that you are afraid of:

  • animals such as spiders, snakes or dogs
  • thunderstorms, high altitudes or darkness
  • blood and syringes
  • confined spaces such as aircraft or elevators
  • to throat, vomit or get a disease.

Upon contact with what is frightening, the child may react with escaping, having an outbreak or crying. Other reactions may be fainting or becoming completely silent and apathetic.

Phobias do not always need to be treated and they can sometimes go away on their own. But seek help in the care if the problems are difficult and affect everyday life.

Panic disorder

Strong anxiety that comes suddenly and feels strongly in the body is called a panic attack. You can have heart palpitations, difficulty breathing, nausea, shaky, dizzy or vomiting. You may feel that you are fainting, going crazy or even dying.

Recurrent panic attacks are sometimes called panic syndrome. Then you avoid certain situations, places or environments for fear of a new panic attack.

Agoraphobia – fear of the squares

Agoraphobia is the fear of falling into places or situations that are difficult to escape. Sometimes it is called squares, but the fear is not just about open places like squares. Often, the fear is about spaces that can be perceived as confined, such as buses, cinemas or shopping malls.

Agoraphobia can sometimes come after something serious has happened, when one has felt a strong helplessness. Sometimes you have agoraphobia at the same time as panic syndrome.

Separation Anxiety

Most children are sometimes worried and afraid of being abandoned or abandoned by their parents or relatives, for example when leaving a preschool or school. But in separation anxiety the whole existence is affected.

This can be shown, for example, by the child not wanting to be alone in his room or sleeping in his own bed. Often the child expresses a fear that the parent will die or disappear.

Generalized anxiety disorder, GAD

To constantly feel anxiety and worry about a variety of things, is called generalized anxiety or GAD. GAD is an abbreviation of the English general anxiety disorder. Concerns can be anything from managing school, for example, and getting good grades to fear of illness, accidents, family finances, wars or natural disasters. 

It is common for those who have GAD repeatedly accuse themselves of their mistakes. Because the turmoil takes a lot of energy and energy, they can also show signs of depression. In addition to anxiety and negative thoughts, it is common to have stomach aches, tension headaches, shoulder and neck pain, difficulty sleeping and feeling tired or restless.

Social anxiety

Most children are more or less shy at times. But feeling strong anxiety before getting the attention of others can develop into what is called social anxiety.

Fear is about being scrutinized, revealed and done away with other people and that others should perceive one as ugly, clumsy, unsuccessful or strange. It will then be difficult to hang out with several people at the same time, talk on the phone, raise your hand in the classroom or participate in social contexts.

Selective mutism

Selective mutism, or involuntary silence as it is also called, means that a child only speaks in certain safe environments but is completely silent in others. The most common thing is that a child with selective mutism talks at home with the family but not in school.

Children who start school can often be quiet at first, but it usually goes away after about a month. Selective mutism is when silence continues to be a problem. The inability to talk is completely involuntary, and cannot be controlled with will. Sometimes the child can communicate by nodding, using gestures or writing notes.

Often selective mutism occurs in connection with a stressful event such as a relocation, change of group in preschool or school start.

What Is Anxiety Syndrome?

It is common to feel worry and fear. It is emotions and reactions that go over. For it to be considered an anxiety disorder, the symptoms must have been present for at least six months.

It is unclear why some children and teens develop anxiety syndrome. But there is an innate fear in everyone for some threatening things or situations, which is a healthy and important reaction. This applies, for example, to things that have been around the world for a long time, such as thunderstorms, confined spaces and dangerous animals. When this reaction happens without endangering life, the fear has turned to a state of anxiety.

Everyone has different sensitivity when it comes to anxiety and fear, both because of innate characteristics and experiences of life.

It is common to have anxiety when something difficult happens, or when major changes occur. Moving and starting in a new school or having a relative become seriously ill or die are things that can lead to anxiety.

When and where should I seek care?

Contact your child if your child has such a problem that anxiety affects everyday life, and you find that the situation is difficult to manage. The same applies if you are concerned that the problems affect the child’s development.

Depending on the child’s age, you can contact one of the following places: 

  • childcare center, bvc  – for children up to six years
  • medical center or pediatric clinic
  • child and adolescent psychiatry, bup
  • student health – for children who attend school .

In most regions there are receptions that have a specific mission to take responsibility for the mental health of children and young people. It’s called first-line psychiatry. It can be at a health center or pediatrician and is often called a call center.

Treatment of anxiety

The treatment is adapted to the child’s age and personal maturity. Assessment and treatment are usually better if parents or close relatives are involved in the care.

Everyone should be able to participate and decide on their treatment of anxiety. This also applies to children under 18.

Treatment of anxiety disorders consists of three parts:

  • knowledge of anxiety
  • cognitive behavioral therapy, KBT
  • medicines if needed

Knowledge of anxiety

Treatment begins with a basic education about anxiety and how it manifests itself. It is sometimes called psychoeducation. Then you and the child will learn about anxiety and how the body can react when you become afraid of something.

It can often help those who are anxious to understand that the brain cannot discern a real threat, and for example a frightening thought.

What you learn during the training is both a part of the treatment, and a preparation for the KBT treatment. It is important that both the child and you as an adult participate in the treatment as much as possible.

Cognitive Behavioral Therapy, KBT

The method of treatment recommended for anxiety disorders in children is  Cognitive Behavioral Therapy (KBT) . 

In therapy, the child is allowed to talk about the thoughts, feelings and behaviors they have taken to avoid what is causing anxiety. They may also train themselves to pay attention to the body’s various signals, which may be signs of increased anxiety and anxiety.

In therapy, the child receives help and support to approach the unpleasant feelings, which reduces them. This is done step by step in a method called exposure. The treatment also includes learning methods of relaxation.

It is important to practice often. It is important that both you and the child are involved in the treatment as much as possible. Treatment is planned individually for each child, but can sometimes take place in groups.

Treatment of anxiety with drugs

Sometimes medication may be needed as part of the treatment. For example, there may be antidepressants belonging to the drug group SSRI.

It is important to know that it may take several weeks for these drugs to produce the desired effect. During these weeks you can even feel worse.

It is more common for teens to get drugs, but there are also some SSRIs that can be given to children from the age of six.

Advice and support for healthy habits

Sometimes the treatment can also include advice and support for getting healthy, regular habits. In order to feel good, it is important to take care of basic needs such as eating well , moving around and getting enough sleep and rest.

If there is a suspicion that the child or teen uses alcohol, drugs or tobacco, it is important to tell your doctor.

Being a parent or close relative of a child with anxiety

Anxiety in children can awaken strong feelings in you as an adult. You may experience powerlessness, shame or worry. Anxiety in children is very rarely due to poor parenting.

The first thing you can do to help your child or teen is to gain knowledge, for example, by reading books and articles on anxiety syndrome. You can be a better support if you have knowledge of the child’s specific problems.

Encourage the child to be brave

Continuing to avoid what is associated with anxiety reinforces the syndrome. Therefore, encourage the child to still do what they are afraid or worried about.

You may want to help the child prepare for what is difficult, but try to set just high demands on what they are trying to do.

Practicing doing things despite having anxiety can also increase  self-esteem .

Strengthen the child’s own motivation

It is important that you take your child’s problems seriously from the start and do not hesitate to seek professional help when needed. Seek care in consultation with the child. 

If the child does not want help, it is difficult to get the treatment to work. Then you may have to start by trying to motivate and try to understand what the child himself experiences as the biggest problem. 

It is common to get frustrated and maybe even angry when the child does not dare to do certain things, especially if it impedes everyday life. It’s no wonder getting angry, but it can be good to know that it doesn’t help barking at a child who already feels fear.  

Seek help for your own part

It can be good to talk to someone if you find it difficult to handle your everyday life. If you and your child have contact with a child psychiatric clinic, you can contact the clinic for your own benefit. You can also contact the health center and ask for call support.

Talk to others

It is often enough to talk to someone who is listening to get a new perspective on the problem. For example, you can contact a  chat or phone call .

There are also  affiliates and non-profit associations  where you can gain knowledge and an opportunity for valuable contacts.

In addition, you can learn from others’ experiences as you share your own. Here are two places you can visit: 

  • The Anxiety Association, ÅSS
  • National Association for Social and Mental Health

Being close to someone who does not want help

It means a lot that you as a relative or a parent are there for the person who is feeling ill. But if the child himself does not want to receive treatment, you probably cannot get them to do it at once. This also applies to persons under the age of 18.

Try to respect the child’s wishes. What you can do is keep talking about how they are doing. Bring up the issue of seeking help on several occasions, but without requiring them to do as you say.

Try to formulate what you feel yourself: “I get worried when I see you pull away and not spend time with your friends. Is there any way I can help you? “

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