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Updated: December 1, 2013 16:09 IST
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Is your child anxious?

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Talking therapy helps the child understand what causes anxiety. Photo: H. Vibhu
The Hindu
Talking therapy helps the child understand what causes anxiety. Photo: H. Vibhu

When the problem starts to interfere with school, family or everyday living, it may be time to seek professional help

Meena was combing her seven-year-old daughter’s hair, when she found a bald patch. She was horrified and consulted a paediatrician. She was told that her daughter, most likely, had an anxiety- related issue and was asked to watch her daughter’s behaviour. Meena was surprised to find her daughter, no matter what she was doing, was rubbing one spot on her head, and this probably had lead to the bald patch. Meena just could not come to terms with the fact that a child as young as her daughter could be suffering from anxiety.

Many people believe that children do not have anxiety problems. But the fact is that children as young as age five are commonly affected. Children demonstrate their anxiety in a number of ways, which may be hard for an adult to recognise. Behaviour expression is an indication that a young child feels fear and anxiety and cannot find relief.

What is anxiety?

It is a natural, normal feeling we all experience from time to time. All children and young people get anxious at times, and this is a normal part of their development as they grow up and develop their ‘survival skills’. We all have different levels of stress we can cope with, but some children and young people worry more than the rest, and have greater difficulty coping with the challenges of growing up. Anxiety is not a nice feeling. It creates unpleasant thought processes that affect behaviour negatively. The child may have stomach cramps, palpitation, sweating and tense muscles. He may feel scared, panicky or ashamed. It is quite possible that he may have difficulty with sleeping and concentration and have angry outbursts.

It is not easy to say what causes anxiety. It can run in the family. Research shows that maternal anxiety and depression during pregnancy or early years of the baby can lead to anxiety disorder. Also, frequent changes of school and home, divorce, separation, domestic violence, physical illness, bereavement and relationship problems can trigger the onset of an anxiety disorder. Anxiety must be addressed at the earliest, as it has a negative effect on the child. It has a serious impact on self-confidence, social skills and learning. It can prevent children and young people from doing their best at school. Also, parents of anxious children become very anxious themselves.

Anxiety in children can manifest itself in a wide range of signs and symptoms, which are often displayed as medical symptoms, which leads many parents to their doctors for treatment. It is important that the child is diagnosed correctly, especially before considering medication.

Right diagnosis

As a parent, you can help your family doctor or a specialist make the right diagnosis by telling him the following:

- Things your child has difficulty with

- The time of the day he is most affected

- Settings which are most difficult

- Events or circumstances that have caused difficulties

- Things you have done when your child is having difficulty

Though there are different types of anxieties, the most common anxiety, which is specific to childhood, is separation anxiety where the child becomes anxious because of separation from home or major attachment figures, when he knows that he cannot count upon total parental protection. Then, there is school-based anxiety. Eight-year-old Tarun threw tantrums every morning. He refused to go to school. School refusal is not just “school jitters”. It may be a symptom of a deeper problem. Find out what is happening at school or with friends.

Om Sai Ramesh, faculty (Psychiatry) and head, Department of Medical Sciences at the National Institute for Mentally Handicapped (NIMH), says that most anxiety-related issues can be resolved with non-medical management, such as counselling, cognitive behaviour therapy (CBT), and talking therapy, which helps them understand what causes anxiety and find strategies for coping.

Sometimes there may be need for psychological intervention where parental and family counselling will help. He feels that parents, teachers and peers can assist by minimising environmental stresses. In individuals where the case is intrinsic, i.e. the anxiety is caused from within — it may be part of their temperament, and medical intervention in the form of psychotherapy or sometimes medication is an option.

Dr. Om Sai has a word of caution for parents. Many parents get information from the Internet. They must be wary of those details, as they are neither validated nor authenticated.

Most importantly, a question the parent of an affected child must answer is, “Is he picking up your own worry?”

Look for the signs

- Having frequent outbursts of anger

- Losing appetite, difficulty sleeping

- Rebelling against authority

- Worrying constantly

- Experiencing frequent mood swings

- Less energy or motivation

- Attempting to injure self

(The writer is a remedial educator

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