Anxiety is a necessary part of the human condition. All of us have anxieties and our children are no exception. Anxiety is our natural alarm system, which alerts us to uncertain or potentially dangerous situations.

It can begin in infancy as some babies experience anxiety when left alone at night or when separated from their parents. To an infant this is perceived as a life threatening situation, as they depend on their parents for survival. Some experts feel much of the anxiety we experience throughout our lives is related to this “separation” experienced early in life.

In this article we will discuss childhood anxiety disorder and focus on the school age child, with a special word on school phobia.

Anxiety Disorder

This disorder is described as excessive worrying or having intense fears that interfere with the child’s daily existence and enjoyment of life. Dr. Sharon Ryan Montgomery, a child psychologist in Morristown, NJ , stresses that all children may experience anxiety at some time in their childhood as a response to a new situation or developmental challenge. The birth of a sibling, a move to a new home, the start of the school year, and illness or death of a close family member or pet are common examples of situations that can provoke anxiety in any child.

Some children, because of their own temperament, may be more prone to anxiety and have ore fears than other children. These are children who are shy, have always had difficulty with separation or new situations, or with change or transitions. As infants they may have had more difficulty settling down and may have reacted more suddenly to loud noises.

When a child is experiencing anxiety, a parent may observe a change in appetite, difficulty sleeping, nightmares, or physical symptoms such as head-aches, dizziness or stomach aches. Some children may suddenly not want to be left alone or go to a friend’s house to play or sleep over. For most children or adolescents, these symptoms will be short lived and the child will work through these fears and develop a feeling of mastery over the challenge. In fact, learning how to face fears and cope with new experiences are vital skills for our children to learn.

However, for some children, the anxiety begins to intensify and become more pervasive, and fear may spread beyond the original source of the anxiety. For example, an initial reaction to parents leaving a child at home with a relative while they take a trip, may extend to fear of any separation between parent and child. Difficulty sleeping or eating will worsen the child’s physical state and decrease the child’s ability to cope. These greatly magnified fears and anxieties will then begin to interfere with the child’s enjoyment of daily life.

Dr. Montgomery offers the following advice for parents who suspect their child is having anxiety or increased fearfulness.

• Talk to your child about what he or she may be afraid of (remember children will not understand what anxiety is). Find out what is happening in the child’s world, especially school. What changes or losses have occurred for your child?
• Make adjustments if possible to ease the situation, but don’t overprotect. Remember that it is unrealistic to think that you can remove all of the stress from a child’s life. So, try to help your child face his or her fears with gentle support. Encourage your child’s independence in age appropriate areas.
• Maintain structure and set limits on behavior. These make a child feel safe.
• Reduce your child’s exposure to frightening media reports. These alone have been responsible for some children’s sudden fears.
• Anxiety is very contagious. Children can easily pick up on a parent’s anxiety. In addition, remember to examine family stresses to see if your child is picking up on someone else’s anxiety.
• For the same reasons, be aware of your own anxieties and fears. Be careful not to discuss these with your child.

When do you need to seek professional help?

If a child’s symptoms last longer than a month, seem to be getting worse instead of easing, have spread to other areas of the child’s life, or are interfering with school functioning, or if all your attempts to help your child cope are not working, then it is time to speak to your pediatrician or seek help from a child therapist.

Our aim as parents should be to teach our children better coping for handling stressful situations, rather than trying to eliminate stress in our children’s lives. Because the reality is – whether child or adult – we live in a stressful, rapidly changing world, that requires coping skills to survive.

School Phobia
An important type of anxiety disorder is when a child suddenly develops tremendous anxiety about going to school. Physical symptoms are very common with stomachaches and headaches leading the list. Once a medical cause has been ruled out, the school avoidance has to be acted on immediately. This is the one situation that a parent should not wait several weeks before addressing. The child should be firmly, but gently, returned to school as soon as possible. The worst thing is for a child to get into a pattern of staying home. The longer this goes on, the harder it is to return the child to the classroom. To achieve this sometimes requires a collaboration and cooperation of parents, teachers, the pediatrician, and the therapist.