Anxiety in children: At what age does it become dangerous, how can it be controlled?

Perhaps an adult can easily understand how their life is defined by fears and anxieties – which they may have had as a child. However, we cannot expect a child to be able to express everything they feel, everything that may frighten, stress, or trouble them. In essence, we cannot expect them to know what fear, anxiety, problems, or the emotions that overwhelm them in general are, so that they can express them. Someone has to explain it to them. They need to be given the necessary information about joy, sadness, anger (etc.) in simple and understandable words and through repeated discussions. You can imagine how much more difficult this process becomes when the child is not yet speaking.

The US Centers for Disease Control and Prevention has a special link for children's mental health, as well as a special reference to anxiety and depression.

It states that «many children have fears and worries and may feel sad and hopeless at times. Strong fears may arise at different times during development. For example, toddlers are often very distressed because they are away from their parents, even if they are somewhere where they feel safe and cared for. Although Fears and worries are typical in children., Persistent or extreme forms of fear and sadness may be due to anxiety or depression. Because the symptoms mainly involve thoughts and feelings, they are sometimes called internalization disorders».

How stress can manifest itself in children

Some examples anxiety disorders in children:

• They get scared when they're away from their parents (separation anxiety).
• They have an extreme fear of something specific, whether it is an object (dogs, insects) or a situation (visiting the doctor).
• They feel anxious when they are at school or in crowded places (social anxiety).
• They worry about the future and the bad things that happen (general anxiety).
• They have recurring episodes of sudden, unexpected, and intense fear accompanied by symptoms such as a pounding heart, difficulty breathing, dizziness, trembling, or sweating (panic disorder).

Anxiety can manifest itself as fear or anxiety, or it can make children irritable and angry. More general symptoms include sleep problems, fatigue, headaches, and stomachaches. Some children keep their anxieties to themselves. Parents cannot understand that something is wrong and miss the symptoms.

When children feel sad or indifferent about things that previously excited or entertained them, when they feel helpless or hopeless, they may be diagnosed with depression.

Examples of behaviors often observed in children with depression, include:

• Very often feelings of sadness, despair, and irritability.
• They don't want to do fun things – or they don't enjoy them.
• They show changes in eating patterns – eating much more or much less than they used to.
• They experience changes in sleep – they sleep much more or much less.
• They show changes in energy – they are regularly tired, sluggish, and restless.
• They have difficulty concentrating.
• They feel guilty or useless.
• They exhibit self-harming or self-destructive behavior.

If the child does not talk about how they feel, they appear to act without motivation and, while they are depressed, they are characterized as disruptive or lazy.

Severe depression can lead a child to think about or plan suicide, which is one of the leading causes of death among 10- to 24-year-olds. Therefore, prevention can save lives.

How common is anxiety in children?

According to the CDC, More than 71% of children aged 3 to 17 have been diagnosed with anxiety., However, there are also many who, while struggling with this, are not necessarily diagnosed. One in three adolescents (30%) meets the criteria for anxiety disorder. It has also been observed that there have been significant increases in diagnoses of anxiety and depression in children as the emotional well-being of their parents and guardians has declined.

The pandemic, lockdown, and isolation were many, cumulative shocks for young children who, as it turns out, were and continue to be severely tested. How is this evident? In the US, there has been an increase in visits to hospital emergency rooms, while visits for eating disorders, anxiety, trauma, and obsessive-compulsive disorders have doubled.

All this was not only due to the pandemic, but also to social media, as well as the fact that «there is no single, comprehensive system for monitoring children's mental health.» The report emphasized that absolute priority was given to the impact of Covid-19 on adults. «If more children received adequate mental health care, far fewer would end up in emergency rooms, a place that is not designed for the treatment of psychiatric conditions.».

Advice for screening ages 8 to 19

That's how the crisis in children's mental health. For the first time in its history, the U.S. Preventive Services Task Force raised the issue of mental health screening (specifically for anxiety) in children, adolescents, and young adults aged 8 to 19.

The independent working group consists of 16 volunteer clinicians in primary care (pediatrics, family medicine, obstetrics, gynecology, nursing, psychology) and prevention. It is appointed by the US federal government to make recommendations to healthcare providers on clinical preventive care. It is funded, staffed, and appointed by the US Department of Health and Human Services Agency for Healthcare Research and Quality.

All members of the USPSTF, which has existed since 1984 by decision of Congress, have experience in methodology – at the epidemiological level, biostatistics, health services research, decision sciences, and health economics. And they had very clear reasons for recommending mental health screening for ages 8 to 19. Such as?;

Early detection is important

The USPSTF recommended stress check regardless of whether a clinician has been informed of any symptoms, as «it is crucial that surgery can be performed before a life is disrupted» as Martha Kubik, a member of the working group and professor of nursing at George Mason University, told the New York Times.

According to a report by the Child Mind Institute (a non-profit organization that provides treatment and other services to families with mental disorders and learning difficulties), anxiety disorders in childhood have been linked to an increased risk of depression later in life, for behavioral problems and substance abuse.

The working group said it does not yet have enough evidence to recommend for or against screening children under 8 years of age for anxiety. It reiterated its recommendation for preventive screening for depression in children aged 12 years and older.

How to check for anxiety in children

«Our review found that the many different surveys and questionnaires used for screening, the pre-symptomatic screening tools, are effective in identifying anxiety in young people before obvious signs and symptoms appear,» explained Dr. Kubik, adding that Ideally, the check should be done during the annual check-up..

If it indicates that a child needs additional support, this is not a diagnosis but as a starting point for a broader discussion for further monitoring – which may include referral to a mental health provider.

Psychotherapy has been identified as the «first-line treatment.» Medication may also be necessary if anxiety is interfering with the child's ability to function normally or if psychotherapy alone is not effective.