Anxiety
A condition of persistent nervousness, stress, and worry that is triggered by anticipation of future events, memories of past events, or ruminations about the self
Stimulated by real or imagined dangers, anxiety affects people of all ages and social backgrounds. When it occurs in unrealistic situations or with unusual intensity, it can disrupt everyday life. Some researchers believe anxiety is synonymous with fear, occurring in varying degrees and in situations in which people feel threatened by some danger. Others describe anxiety as an unpleasant emotion caused by unidentifiable dangers or dangers that, in reality, pose no threat. Unlike fear, which is caused by realistic, known dangers, anxiety can be more difficult to identify and alleviate.
A small amount of anxiety is normal in the developing child, especially in adolescents and teens. Anxiety is often a realistic response to new roles and responsibilities, as well as to sexual and identity development. When symptoms become extreme, disabling, and/or when a child or adolescent experiences several symptoms over a period of a month or more, they may be a sign of an anxiety disorder and professional intervention may be necessary. The two forms of childhood anxiety are overanxious disorder and separation anxiety, although many physicians and psychologists also include panic disorder and obsessive-compulsive disorder, which tend to occur more frequently in adults. Anxiety that is the result of experiencing a violent event, disaster, or physical abuse is identified as post-traumatic stress disorder (PTSD). Most adult anxiety disorders begin in adolescence or young adulthood, and are more common among women than men.
Symptoms
Psychological symptoms of anxiety include tension; self-consciousness; fearfulness; self-doubt; worry; constant need for reassurance; distractibility; feeling as if one is about to have a heart attack, die, or go insane; irritability; and insomnia. Physical symptoms include rapid heartbeat, sweating, trembling, muscle aches (from tension), dry mouth, headache, stomach distress, diarrhea, constipation, frequent urination, hot flashes or chills, throat constriction (lump in the throat), and fatigue. Anxiety symptoms are very similar to those of depression, and as many as 50% of children with anxiety will also suffer from depression. Generally, physiological hyperarousal—excitedness, shortness of breath, the "fight or flight" response—characterizes anxiety disorders; whereas underarousal—lack of pleasure and feelings of guilt—characterizes depression. Other signs of anxiety problems are poor school performance, loss of interest in previously enjoyed activities, obsession about appearance or weight, social phobias (e.g., fear of walking into a room full of people), and the persistence of imaginary fears after ages six to eight. Shyness does not necessarily indicate a disorder, unless it interferes with normal activities and occurs with other symptoms. A small proportion of children do experience avoidant disorder, incapacitating shyness that persists for months or more, which should be treated. Similarly, performance anxiety experienced before athletic, academic, or theatrical events does not indicate a disorder, unless it significantly interferes with the activity.
Treatment
Depending on the severity of the problem, treatments for anxiety include school counseling, family therapy, and cognitive-behavioral or dynamic psychotherapy, sometimes combined with antianxiety drugs. Therapies generally aim for support—providing a positive, entirely accepting, pressure-free environment in which to explore problems; insight—discovering and working with the child or adolescent's underlying thoughts and beliefs; and exposure—gradually reintroducing the anxiety-producing thoughts, people, situations, or events in a manner so as to confront them calmly. Relaxation techniques, including meditation, may be employed in order to control the symptoms of physiological arousal and provide a tool the child can use to control his or her response.
Parents may also be trained to address their own symptoms, as well as their child's symptoms, if the parents also suffer from anxiety. Creative visualization, sometimes called rehearsal imagery by actors and athletes, may also be used. In this technique, the child writesdown (or draws pictures of) each detail of the anxietyproducing event or situation and imagines his or her movements in performing the activity. The child also learns to perform these techniques in new, unanticipated situations.
In severe cases of diagnosed anxiety disorders, antianxiety and/or antidepressant drugs may be prescribed in order to enable therapy and normal daily activities to continue. Previously, narcotics and other sedatives, drugs that are highly addictive and interfere with cognitive capacity, were prescribed. With pharmacological advances and the development of synthetic drugs, which act in fairly specific ways on brain chemicals, a more refined set of antianxiety drugs is now available. Studies have found that generalized anxiety responds well to these drugs (benxodiazepines are the most common), which serve to quell the physiological symptoms of anxiety. Other forms of anxiety such as panic attacks, where the symptoms occur in isolated episodes and are predominantly physical (and the object of fear is vague, fantastic, or unknown), respond best to the antidepressant drugs. Childhood separation anxiety is thought to be included in this category. Psychoactive drugs should only be considered as a last treatment alternative, and extra caution should be used when they are prescribed for children.
For Further Study
Books
Carter, Frank, and Peter Cheesman. Anxiety in Childhood and Adolescence: Encouraging Self-Help through Relaxation Training. New York: Croom Helm, 1988.
Kendall, Philip C, et al. Anxiety Disorders in Youth: Cognitive-Behavioral Interventions. New York: Pergamon Press, 1991.
Newman, Susan. Don't be S.A.D.: A Teenage Guide to Handling Stress, Anxiety and Depression. Englewood Cliffs, NJ: J. Messner, 1991.
Organizations
Anxiety Disorders Association of America
Address: 6000 Executive Boulevard, Dept. A
Rockville, MD 20852
Telephone: (301) 231-9350
National Institute of Mental Health (NIMH)
Telephone: toll-free information services for panic and
other anxiety disorders: (800) 647-2642
NIMH Public Inquiries
Address: 5600 Fishers Lane, Rm. 7C-02
Rockville, MD 20857
This is the complete article, containing 902 words
(approx. 3 pages at 300 words per page).
