Dealing with childhood fears

Treatments are available if your child is showing signs of high levels of anxiety

Jason saw his grandmother get viciously mauled by a dog two years ago. He was just six years old.

That violent incident left him with an understandable fear of dogs, but it didn’t stop there. Shortly after, Jason (not his real name) developed a fear of gas stations and bathrooms, and came up with all sorts of excuses to get out of his soccer games for fear of injury.

“When you’re born, everything is perfect, and so he saw this happen to his grandmother and realized that bad things can happen to
you,” Jason’s father says. “From that point on he started questioning everything. ‘If this happens can I get sick? Can I die?’ He tries to rationalize the safety aspect of everything he does.”

Jason’s increased anxiety is not uncommon.

“Anxiety seems to be on the rise in Western society both among children and adults,” says Dr. Tali Shenfield, a registered psychologist practicing in Richmond Hill. “It is estimated that 12 to 20 percent of children suffer from a diagnosable anxiety disorder.”

Anxiety can present itself in many different ways, and there are a number of anxiety-related disorders to look out for, including social phobia, post-traumatic stress disorder and generalized anxiety.

Though these disorders exist, it’s important to realize that anxiety is a normal part of being human, says Dr. Robin Alter, clinical child psychologist.

“We can’t live without anxiety,” she says. “(It’s) a signal to us that something may not be right … It’s our warning system.”

Though anxiety is always distressing, Alter says it’s when it starts to interfere with a person’s ability to function in the normal areas of life that it becomes a problem.

Shenfield says there are certain warning signs parents can look out for that may indicate a problem.

“Parents should become alarmed if they see observable changes in the child’s behaviour or mood,” she says.

If a usually outgoing child becomes withdrawn and doesn’t want to spend time with family or friends, or if a child who enjoys school suddenly refuses to go, Shenfield says there could be a problem. Other indicators include a sharp change in academic performance, clinginess to parents, irritability, trouble sleeping, changes in appetite or the constant need for reassurance.

“Any of these changes will tell a parent that it’s time to pay closer attention to the child and perhaps take some action.”

Parents can monitor a child’s temperament at a very early age, says Dr. Gili Adler Nevo, staff psychiatrist at Sunnybrook Health Sciences Centre’s Youth Anxiety Clinic. While some kids will want to explore, are curious and separate easily from their mom, she says, other kids are very inhibited.

“They are cautious and it takes time before they try out something new,” she says. “Studies show that some of these kids will turn out to have anxiety disorders, especially social phobia or generalized anxiety disorder.”

However, Adler Nevo says other factors come into play, and having a supportive environment will make a difference in how the child develops.

While increased anxiety can be triggered by a multitude of things, Dr. Sandra Mendlowitz, a psychologist on the Anxiety Disorders Team at the Hospital for Sick Children, says genetics is a factor.

“Anxious parents tend to have children who are anxious.”

But, she say, not all anxious parents have to pass it along. If a parent is aware that they are a worry wart but makes an effort not to model anxious behaviours in front of their child, then that child is less likely to develop an anxiety disorder, she says.

Dr. Marian Boer, chief psychologist of the York District School Board, says for concerned parents, speaking with their child, family doctor and teachers to see if they noticed any changes can help explore the issue further.

“If some of the issues are confirmed and parents are not reassured that everything is okay then they can seek help from a mental health professional,” she says.

Boer says it’s not helpful to avoid the situation that causes anxiety.

“If the child starts to become anxious about going to school, it’s important that we don’t say ‘okay, you don’t have to go to school’.”

Instead, she says, it is key to find a way to give the child support and help them stay in that environment.

“What we want is for people to learn active, healthy coping strategies so that they can deal effectively with the things that come up in
life that may make you anxious.”

Shenfield says it is also important to take it seriously and empathize with the child.

“It is most discouraging to children when parents try to minimize or brush aside their complaints.”

Helping the child to understand what situations make them feel scared and how much is also a step in the right direction. Shenfield said parents should then help the child think of some ways to feel safe in those situations and encourage them to participate in things that induce mild to moderate anxiety.

“It is very important for parents and teachers to make the child feel understood and supported.”

On a professional level, Shenfield says cognitive-behavioural therapy has proven to be the most effective approach when treating anxiety disorders.

Mendlowitz agrees. She says cognitive behavioural therapy is about learning how anxiety manifests itself in terms of emotions, physiological sensations, worry thoughts and what you do as a result of that.

“Once you identify that, you can then learn strategies to cope more effectively,” she says.

If anxiety disorders are left untreated in childhood they can spill over into adolescence and adulthood, Boer says.

“Really what it does is it interferes with an individual being able to develop to their full potential.”

There is a light at the end of the tunnel. Mendlowitz says some child anxiety disorders can, in most cases, be alleviated within 10–12 sessions of treatment.

Jason’s parents have taken him to a psychologist for five sessions and are already seeing marked improvement, he’s even pet the neighbour’s dog.

“He sees there is a chance he can get over it,” says his father.

About this article:

By: Nicole Miller
Posted: May 13 2010 12:15 pm
Filed in: NEWS
Edition: Toronto