Anxiety in kids

Towards the end of the school year, an 8th grader girl, P, came into the ER after fainting at school before a performance. P reported feeling “funny” as soon as she woke up. She said what was strange was that her fingers and toes felt funny and she had trouble “catching her breath” intermittently. By the time she got to the band room that morning, she felt nauseous, lightheaded and could feel her heart pounding, and then fainted.

P did not want to return to school until 2 days from now when all the performances were over. Her mother was stunned because she thought her daughter “loved playing”. P told me that playing her instrument was fun and that she worked hard at it because her mom said it was important to “stay on top”.

We all get “butterflies” before big events – that is certain common in kids and adults and not unexpected. P’s symptoms, however, were not typical – she suffered a true panic attack over her fear of performing. What was even more impressive was that her mother was completely unaware of how nervous P was until she fainted – and her mom may have inadvertently contributed by innocently pushing her daughter to strive at something she felt her daughter was good at. Her mom clearly has P’s best interests in mind but P’s body actually started to shut down under the pressure.

Anxiety in children is more common than you may realize. The US Surgeon General’s office reports that 13% of children and adolescents suffer from anxiety disorders. This boils down to 1 in 8 children aged 9 to 17. Anxiety in kids can take on many forms from performance/social anxiety, stranger anxiety, separation anxiety, fear of school, and excessive shyness. All our kids will experience flashes of each of these throughout their development and lives but when the symptoms start to interfere with getting through the day and participating with their peers, then there is a real problem that will require more than just an extra hug and TLC.

You may be wondering what the downside is of not being aggressive with getting kids with anxiety help early. Studies show that kids with untreated anxiety often develop more intense problems as they become teens – such as social isolation, major depression and drug use. So, it’s very important that we know what to look for and when to call for help. And, as parents, we need to learn better how to balance gently motivating our kids to putting actual intense pressure on them. In a day and age where kids are over scheduled and lives are hectic, this can be a huge hurdle for all of us as we strive to give our kids the experiences other kids have.

The American Academy of Pediatrics suggests parents call for help in the following circumstances:

1. Your child won’t participate in school or family events
2. Your child has trouble making or keeping friends
3. Your child looks for excuses to not go to parties or school
4. Your child is not sleeping or eating well or vague medical complaints like headaches, feeling tired, and stomach aches
5. Your child is developing compulsive or obsessive behaviors

Psychiatric illness does occur in children and I will be covering the topic much more over the next school year. Remember, calling for help is not a sign of weakness or an indictment of our ability to parent our kids. Calling for help is the best way we can show our kids we love them – and to teach them sometimes help outside the family is needed from time to time.

© 2005 Pediatrics Now.
All rights reserved. PEDIATRICS NOW is a trademark of Pediatrics Now.

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