Fear Factors

FEAR FACTORS recognize the signs of anxiety disorders in kids

WORDS ELAINE ROGERS

First there were tantrums. Then uncooperativeness. “She couldn’t transition between activities well either,” says Keri Stoner Davis of Lewisville, whose daughter Kaylee was in preschool at the time. “They told us she would hang onto her anger for days.”

“Even at home, when new people were invited to the house, he’d ask all these questions about who they were and why they had to come over,” Nintzel reveals.

Nintzel brought her concerns to their pediatrician but says the doctor “pretty much discounted the whole situation” and labeled it as a phase.

“It’s hard because other people don’t understand,” she continues. “It’s sort of like an invisible thing.”

INSTINCTS ON OVERDRIVE

Invisible though it may be, anxiety is pervasive: According to the Anxiety and Depression Association of America (ADAA), anxiety disorders affect 25% of children ages 13–18, and the National Institute of Mental Health puts this figure closer to 32%. If untreated, experts say, kids are at higher risk of performing poorly in school and engaging in substance abuse as well as missing out on important social experiences.

Nicholas Westers, a clinical psychologist at Children’s Health and assistant professor at UT Southwestern Medical Center, says parents often miss anxiety indicators because it can manifest differently in children.

“Because younger children don’t have the emotional vocabulary yet to express when they’re anxious or scared, the child might be acting physically aggressive or breaking things at home, or even hiding under the bed when it’s time to go to school,” he explains.

Ardis Lo, a counselor and play therapy specialist at Therapy on the Square in McKinney, says children commonly exhibit signs of separation anxiety as early as ages 3 to 4.

“By the time they’re in second to third grade … kids start becoming more aware of and anxious about the academic expectations,” she explains. “We tend to see social anxiety becoming more of an issue for pre-adolescents, although that can start younger too.”

Westers notes that anxiety in and of itself “is not a bad thing. Emotions serve functions, and our fight-or-flight response can keep us safe. Anxiety is only too much if it begins to impair a child’s functioning.”

ANXIOUS PARENTS, ANXIOUS KIDS

Someone with a parent or sibling with social anxiety disorder is reportedly two to three times more likely to develop the disorder than someone without a family history. Some say anxiety may seem to run in the family due to passed-on behaviors.

“When parents are hypervigilant, anxious, worried and on edge, kids are too,” explains Kathryn Everest, director of counseling services for Fort Worth ISD. “If Mom gets stressed out when she watches politics on TV or is always complaining about drama with friends or co-workers, that rubs off on the children.”

Everest theorizes that devices are also a factor. “Think about all the gadgets and electronics our kids have,” she says. “Everything’s louder, screens are larger and the action is fast, fast, fast. It gets way more intense than what previous generations dealt with.”

Westers says a child might be genetically predisposed to shyness or anxiety and then begin to experience “clinical levels of anxiety” as a result of bullying, perhaps, or trauma.

That doesn’t mean it’s possible to avoid anxiety disorders by avoiding stress. “A better strategy,” notes Westers, “is to help them learn to tolerate and have strategies in place for dealing with stressful situations.”

Everest notes that parents sometimes struggle to understand. “They think, ‘What do you have to be anxious about? I feed you, I clothe you, I get you where you need to be,’” she explains.

Parents may attach a stigma to anxiety disorder and be reluctant to seek treatment, or they might view anxiety as a phase.

“It’s not uncommon for parents or even teachers to say things like, ‘Everybody has emotions like that’ or ‘He’ll grow out of it,’” Westers says, adding that adults may respond by saying, “Just relax.” For a child who has anxiety, such phrases can invalidate their feelings.

ADDING TO THE MIX

Davis took the teachers’ concerns seriously and signed her daughter up for play therapy. It helped Kaylee, and helped her parents understand how she expressed anxiety. She went on to cognitive behavioral therapy (CBT).

The CBT approach is “something like, ‘I know you’re scared. That’s OK. We can get through this. It’s not fun, but that’s the anxiety talking,’” Westers says. “The next step is to teach them how to talk back to the anxiety. … It helps them become aware of [it,] and they have some strategies in place and ways of coping.”

Davis believes CBT made it possible to delay medication for her daughter’s attention deficit hyperactivity disorder (ADHD). Anxiety often co-exists with ADHD, depression and similar disorders. By the time Garland mom Christina’s son was 4, he had been diagnosed with three conditions, including anxiety disorder. (She asked to keep her last name private.)

“It was so stressful—even doing homework was combative,” Christina recalls. “We’d get calls from school because he would withdraw, act out or freak out.”

A BUMPY ROAD AHEAD

Christina’s son became happier after transitioning to a private school that specializes in serving students with these conditions. He is medication-free, although they tried different prescription drugs. “Those either aggravated his symptoms or he was totally out of it,” she shares.

The Nintzels started Liam on a very low dose of antianxiety medication. His mother says she’s keeping an eye on it because antipsychotics and antidepressants, often prescribed for anxiety, can make symptoms worse or cause other health problems. Counseling has helped Liam. Still, it’s a struggle for families such as theirs to maintain coping strategies as kids age and anxiety triggers change.

“And it’s distressing that he thinks there’s something wrong with him,” Nintzel says. “We have to constantly tell him there’s nothing wrong with him—it’s just who he is.”

Liam’s parents coined a phrase to help their son cope: “Anxiety just doesn’t make any sense.”

“The fear is irrational … but that doesn’t matter,” Nintzel points out. “It’s how he feels, so it’s very, very real.”