Matthew Biel, MD, MScGeorgetown Day SchoolMay 7, 2012

When To Worry About Your Child’s Worries

Anxiety can be a good thing

• Anxiety is a normal and adaptive system in the body that tells us when we are in danger.

• Sometimes our bodies warn us about danger that isn’t real.

Anxiety is a partof childhood• Stranger anxiety• Separation anxiety• Fears• Worries• Stress

When To Worry About Anxiety?

• Anxiety becomes a problem when it interferes with functioning:– Intensity

• What is the degree of the stress present?– Impairment

• Does the stress interfere with daily life?– Flexibility

• Can your child recover when the stressor is not present?

When To Worry About Anxiety

Severe anxiety is:– unrealistic– out of proportion– unwanted and uncontrollable– doesn’t go away– leads to avoidance

Facts About Anxiety Disorders

• Anxiety disorders affect approximately 13% of American children and adolescents.

• Anxiety disorders are the greatest predictors of mood disorders and alcohol abuse in adulthood.

• More than 40 million adults in the US (18%) have reported disabling anxiety that negatively impacts their lives.

Generalized Anxiety Disorder

• Characterized by pervasive, unwarranted worry about a variety of everyday things

• Often focused on performance in school or sports

• Can lead to physical symptoms like stomachaches and headaches

Separation Anxiety Disorder

• Characterized by inappropriate and excessive anxiety about separating from parents or caregivers

• Difficulty separating is normal in early childhood development; it becomes a disorder if the fear and anxiety interfere with age-appropriate behavior.

• Usually occurs before age 10

Social Anxiety Disorder

• Characterized by excessive self-consciousness that goes beyond common shyness or nerves– Performance anxiety– Anxiety about interactions

• Mostly affects adolescents• Can lead to isolation and depression

Selective Mutism (SM)

• Children with SM are unable to speak outside the home

• Should not be confused with reluctance to speak

• Can cause severe distress

Specific Phobias

• Characterized by an excessive and irrational fear of an object or situation not normally considered dangerous

• Common childhood phobias– Natural environment– Animals– Blood

Obsessive-Compulsive Disorder (OCD)

• Characterized by unwanted thoughts, images or impulses (called obsessions) that a child attempts to fend off or neutralize by performing compulsions (ritualized or repeated behaviors).

• OCD can manifest as early as 5 years old.

What to Do When Kids Are Anxious

• Try to manage anxiety, not eliminate it• Model healthy ways of handling anxiety• Don’t reinforce fear• Stop avoiding• Talk things through• Find help

Where to find help

• Georgetown University Hospital www.georgetownpsychiatry.org

• Children’s National Medical Center– www.cnmc.org

• Great resources right here at GDS– Amy Killy– Adrienne BIel

Learn more about anxiety on childmind.org

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Speak Up for Kids!