Treatment for Anxiety in Children

What is Anxiety?

Does your child appear constantly fearful or worried?  Do they have difficulty relaxing or calming down?  Is your child unduly distressed when you leave them alone or with another adult? 

Just like fear, anger, disgust, or sadness, anxiety is an emotional state.  Feelings of anxiety arise when we anticipate a threat or uncertainty to prepare us to respond.  Fear is very similar to anxiety, with a few important distinctions (DSM-5; Getz, 2014):

Definitions

  • Fear:  Emotional response to an actual and present threat (e.g. a bear is attacking you right now)
  • Anxiety:  Emotional response to an anticipated threat (e.g. you think a bear is going to attack soon)

When It Happens

  • Fear: Typically occurs when the threat is present
  • Anxiety: Occurs when one believes a threat is oncoming or possible

How the Body Responds

  • Fear: Brief “Fight or Flight” response:
  1. Threat is detected
  2. Stress hormones (e.g. adrenaline and cortisol) flood the bloodstream
  3. Blood vessels constrict, pupils dilate, heartrate increases
  4. Body is prepared to address the threat by attacking (fight) or running away (flight)
  5. After the threat is addressed, body returns to baseline and relaxes
  • Anxiety: Long-term “Fight or Flight” response:
  1. Threat or uncertainty is anticipated
  2. Stress hormones are released into bloodstream
  3. Body become alert (hypervigilant) and prepared for threat
  4. Body maintains state of alertness, but threat may not occur
  5. Brain begins to associate alertness with safety, thereby making anxiety the default

Why It Happens

  • Fear: To survive immediate danger
  • Anxiety: To prepare for future danger

Anxiety is divided into: bodily symptoms (somatic) and mental symptoms (cognitive).  Some examples of bodily symptoms include shakiness, edginess, irritability, and difficulty sleeping.  Some examples of mental symptoms include worry, difficulty concentrating, and fixation on certain fears or thoughts. 

Anxiety is one of the most common mental health issues in the United States, particularly amongst children and teens (DSM-5; Baxter, Scott, Vos, & Whiteford, 2012; Steel et al, 2014).   This is partially because the symptoms of anxiety are present in many different diagnoses. 

Here are a few of the most common examples:

Generalized Anxiety Disorder (GAD)

  • A long-standing prevalence of intense worry that is difficult to control

Post-traumatic Stress Disorder (PTSD)

  • Fearfulness, nightmares/flashbacks, and avoidance of certain situations
  • Onset is caused by a traumatic event (witnessing death, victim of abuse, etc)
  • Abuse victims are at the highest risk (Lindert, von Ehrenstien, Grashow, Gal, Braehler, & Weisskopf, 2014)

Obsessive-compulsive Disorder (OCD)

  • Fixation with certain behaviors (e.g. cleaning, tapping), numbers, or other patterns that help the person feel safe

Panic Disorder

  • Frequent panic attacks (feeling a loss of control, racing heart, sensation of choking/ dizziness)

Social Anxiety Disorder

  • Intense anxiety regarding social situations, speaking or eating around other people, etc.
  • Can also include performance or competition anxiety

Separation Anxiety Disorder

  • Intense fear reactions related to being apart from parent figures
  • Typically seen in younger children and toddlers

Anxiety disorders can be deeply rooted and highly disruptive for children.  Left untreated, anxiety disorders can follow and continue to affect children well into adulthood (see Cummings, Caporino, & Kendall, 2014; Essau, Lewinsohn, Olaya, & Seeley, 2014).  This can include difficulty with school, making friends, and spending time outside the home. 

Treatment for Anxiety

A common theme amongst anxiety disorders is a lack of felt safety.  When we help people with anxiety, we hope to restore their ability to feel secure. 

Thankfully, Cognitive-Behavioral Therapy (CBT) has been found to be an effective treatment option for anxiety (Öst & Ollendick, 2017; Warwick et al, 2017).  In treating anxiety disorders, my process begins with a thorough intake interview and diagnosis.  Based on the diagnosis and the goals for your child, I design an evidence-based treatment plan with a focus in symptom reduction. 

Therapy can help anxious and fearful children:

  • Learn to talk about worries
  • Regulate emotions and self-soothe
  • Decrease “avoiding” behaviors, such as refusing to go to school
  • Increase tolerance for feelings of anxiety
  • Improve social skills
  • Enhance feelings of confidence and self-efficacy
  • Understand triggers of anxious feelings
  • “Grounding” techniques that can stop panic attacks

I believe that therapy is the fastest, most effective way to help your child overcome their anxiety.

Together, we can help your child feel safe again. 

Interested?  Let’s Connect!

If you are interested in therapy services, please contact me as soon as possible. I would love to hear from you and answer any questions you may have about my practice. 

It is never too late to receive treatment.  I believe I can help make a difference in your child’s life. 

Read About Dr. Montgomery

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Dr. Montgomery holds dual certifications in Clinical Psychology (California Board of Psychology PSY28475) and Family Therapy (California Board of Behavioral Sciences MFT49608). He has dedicated his professional and academic activities to understanding and addressing psychological, behavioral and interpersonal health in children, adolescents, and families. 

Education:

  • Psy.D. Clinical Psychology
  • M.A. Clinical Psychology
  • M.S. Counseling Psychology
  • B.A. Psychology

Want to learn more about me? 

Click on the About tab to find out more about my credentials and get a better sense for who I am.

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References

Baxter, A. J., Scott, K. M., Vos, T., & Whiteford, H. A. (2013). Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychological medicine43(5), 897-910.

Cummings, C. M., Caporino, N. E., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychological bulletin140(3), 816.

Essau, C. A., Lewinsohn, P. M., Olaya, B., & Seeley, J. R. (2014). Anxiety disorders in adolescents and psychosocial outcomes at age 30. Journal of affective disorders163, 125-132.

Getz, G. E. (2014). Applied biological psychology. Springer Publishing Company.

Lindert, J., von Ehrenstein, O. S., Grashow, R., Gal, G., Braehler, E., & Weisskopf, M. G. (2014). Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis. International Journal of Public Health59(2), 359-372.

Öst, L. G., & Ollendick, T. H. (2017). Brief, intensive and concentrated cognitive behavioral treatments for anxiety disorders in children: A systematic review and meta-analysis. Behaviour Research and Therapy.

Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., & Silove, D. (2014). The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. International journal of epidemiology43(2), 476-493.

Warwick, H., Reardon, T., Cooper, P., Murayama, K., Reynolds, S., Wilson, C., & Creswell, C. (2017). Complete recovery from anxiety disorders following Cognitive Behavior Therapy in children and adolescents: A meta-analysis. Clinical psychology review52, 77-91.