1. How intense are the fears or worries? Are they overwhelming to your child? Does it appear that your child cannot control the worry or fear even when they try to? Does the fear captivate them, become all consuming for a period of time? The higher the intensity of a child's anxiety, the more significant the problem.
2. What is the impact upon your child's life? How impacted is the parent and family's life? Is the fear significantly interfering with obligations, social relationships, academic progress, developmental progress, and the physical well-being of the child or other family members? The impact of the child's anxiety on the child and other family members is the second indicator of the significance of the problem.
3. How exaggerated is the fear? Does your child worry about normal childhood, age appropriate fears or are their fears over-the-top, far beyond what other children consider normal fear? Does it seem exaggerated given the circumstances? Did the fear appear to "come out of nowhere?" The exaggeration of a fear is third indicator of the severity of the problem.
4. What is the duration of time that your child has struggled with his or her fear? There are many fears that are consistent with normal child development and they work through them as they grow. However, if you answered yes to the first 3 questions and there is no lessening of the fear or it even appears to be worsening over time, then the duration of the problem is another indicator of a potentially significant problem.
To prevent worry and anxiety from becoming a long-term struggle (when untreated it can last into adulthood), the sooner you get help, the greater the probability of success in containing and/or fully eliminating the problem. If your child's fear fits three, or certainly four of these measures, then your child probably needs help.
The first person you could seek help from is your pediatrician. Because child anxiety is on the rise, they are on the front lines of recognizing the signs of it and can recommend a course of action for treatment. There are also many talented mental health specialists who work with children struggling with an anxiety disorder. If your doctor thinks it's best to get further help, ask him or her for a referral. They usually have a few they prefer to work with.
Common child anxiety disorders include Generalized Anxiety Disorder (GAD), Panic Attacks, Social Phobia, Obsessive-Compulsive Disorder (OCD), and Separation Anxiety Disorder. Remember these labels are only meant to describe a set of symptoms that are present in an individual's life. The symptoms can vary to a great degree and therefore so do the treatments. One child's OCD may need to be treated with medication while another child's OCD may only need further education and encouragement.
An excellent resource to help you sort through the questions regarding what the different types of anxieties are, when to get help, and if you should consider the use of medications, is "Med FAQs" (www.myanxiouschild.com/child.php). Med FAQs is an interview with nationally recognized Neuropsychiatrist, Dr. James Lee, M.D. A Duke University graduate and professor, clinical researcher and practicing physician, Dr. Lee has vast amount of training and experience in the treatment of child anxiety. Dr. David Russ and myself interview Dr. Lee and cover virtually all the questions a parent may have regarding child anxiety.
There are plenty of written materials to be found on the internet regarding childhood fears and anxiety. Much of this is very informative and helpful for the parent, but not necessarily for the child. Parent education is a vital component in helping a child with anxiety, but a parent is not a therapist and should be cautious in treating their own child. There are many helpful books for both parents and children (c.f. Amazon.com/child anxiety). Some are based on clinically proven research and techniques. Others are based upon the personal experience of the writer with their own child. Their wisdom may be helpful for some but many times it does not adequately apply to the broader population.
After experiencing great frustration in being able to offer our anxious child clients professional materials that spoke directly to them a friendly manner, Dr. David Russ and I created Turnaround: Turning Fear Into Freedom. Utilizing the acting talents of 14 kids and 6 adults, we created a therapeutic program based upon clinically proven theory and treatment methods to speak directly to children, thus eliminating the need for the parent to be a therapist. Turnaround invites the anxious child to join 6 other anxious children on an imaginary 10 day hiking trip. Over the course of 10 days in this adventuresome setting, the children meet many entertaining characters and face life-changing challenges that teach them how to manage, and ultimately overcome, their anxieties. Kids in the comfort of their own home listen to each day's lesson and then complete exercises in the Turnaround Journal, a 72-page workbook designed to build upon and reinforce the material taught in the audio program. It may be a program that could greatly benefit the parent's anxious child (Turnaround: Turning Fear into Freedom, www.myanxiouschild.com).
If you're a parent, and have concerns regarding your child's fears and worries, don't hesitate in seeking help. Treating it now can eliminate potential escalating anxiety problems in the future. Many child anxiety issues can be treated without medication, and many children who need medication, only need it for a season if they are equipped to deal with it at the same time. Research shows that medication and treatment have the best results in greatly reducing, or eliminating, child anxiety. Help is available. Don't delay.
Christopher T. McCarthy, M.Ed., LPC
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