Children – like adults – will experience anxiety or depression at some point in life. We each face various stressors in life – whether it be the ongoing uncertainty and fear caused by the COVID-19 pandemic, the loss of a loved one, a divorce, or the first day of school.
However, for some children, these feelings of stress or ‘the blues’ may last for long periods and eventually impact daily functioning, possibly indicating an anxiety disorder or depression.
It is important to understand that anxiety disorders and depression are not the same; however, they may co-exist.
Anxiety disorders are the most common type of mental health disorder in childhood, affecting approximately eight percent of all children and adolescents, according to the American Academy of Pediatrics. The four most common anxiety disorders affecting young people are generalized anxiety disorder (excessive worry over everyday things), panic disorder (panic attacks), separation anxiety disorder, and phobic disorders (irrational fears).
Signs and symptoms
While there are many types of anxiety disorders, common signs and symptoms include:
Recurring fears and worries about routine parts of everyday life.
Physical complaints such as a stomach ache or headache.
Fear of social situations.
Fear of separation from a loved one.
Refusing to go to school.
Diagnosing an anxiety disorder in children can sometimes prove difficult not only because many of these symptoms are internal, but also because certain signs may be misinterpreted as attention deficit hyperactive disorder (ADHD). However, children with anxiety present more pronounced and excessive degrees of symptoms when compared to children with ADHD.
The encouraging news for parents is that anxiety disorders are treatable. Effective treatments include medication and cognitive behavioral therapies (CBT).
CBTs teach techniques that help children restructure their thoughts into a more positive light, leading to positive functioning. In essence, this therapy teaches a child how to identify anxious feelings, recognize her body’s responses to those feelings, and then enable techniques that minimize the symptoms.
The American Academy of Pediatrics reports that behavior therapies are among the most proven and effective non-medication treatments for anxiety disorders. In addition, research has also shown that parental involvement in the treatment process will impact the child’s outcomes.
Approximately three percent of children and eight percent of adolescents suffer from depression, according to the American Academy of Pediatrics.
Signs and symptoms
Common signs and symptoms of depression in children include:
Not enjoying things that used to make them happy.
A major change in weight or eating, either up or down.
Sleeping too late at night or too much during the day.
No longer wanting to be with family or friends.
A lack of energy or feeling unable to do simple tasks.
Feelings of worthlessness or guilt (low self-esteem).
Trouble with focusing or making choices.
Not caring about what happens in the future.
Aches and pains when nothing is really wrong.
Frequent thoughts of death or suicide.
Please note that any child can exhibit these symptoms at some point, but when they are seen together and on a regular basis, it may be time to talk with your child’s pediatrician.
As with anxiety disorders, childhood depression is treatable. Effective treatments include antidepressant medications and psychotherapies (including cognitive behavioral therapy and interpersonal therapy).
Parents also play an important role in a child’s treatment for depression. Promote good mental health by making sure your child eats a healthy diet, gets enough sleep, exercises, and makes positive connections with other people at home and at school.
You can also help your child learn through thinking and coping skills – i.e., relaxing with physical and creative activities, talking to and listening to your child with love and support, learning to describe their feelings, looking at problems in a more positive way, and breaking down problems or tasks into smaller steps so your child can be successful.
The COVID-19 pandemic
There is no doubt that the pandemic has taken a significant toll on the pediatric population. The American Academy of Pediatrics reports that since the start of the pandemic, hospitals have seen a rise in mental health emergencies.
Between March and October 2020, the percentage of emergency department visits for children with mental health emergencies rose by 24% for children ages 5 to 11 and 31% for children ages 12 to 17. There was also a more than 50% increase in suspected suicide attempt emergency department visits among girls ages 12 to 17 in early 2021 as compared to the same period in 2019.
It is important for parents to continue checking in on their children and watch for any signs that they are struggling. Remember that your pediatrician is a great resource for any questions or concerns you may have.
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