Anxiety Disorders Panic Attack
Panic Anxiety Disorders
Anxiety and stress are a normal part of life. However, anxiety disorders occur when anxiety becomes irrational, excessive, and negatively affects a person’s functioning. Children and adolescents with anxiety disorders typically experience intense fear, worry, or uneasiness that can last for long periods of time. This anxiety significantly affects their lives. If not treated early, anxiety disorders can lead to problems in school, reluctance to go to school, social difficulties with family and peers, low self-esteem, abuse of alcohol or substances, trouble in work settings, and anxiety disorder in adulthood.
Effective therapies for anxiety disorders are available, and research is uncovering new treatments that can help most people with anxiety disorders lead productive, fulfilling lives.
Some common anxiety disorders include:
* Generalized Anxiety Disorder (GAD)
* Obsessive-Compulsive Disorder (OCD)
* Panic Disorder
* Post Traumatic Stress Disorder (PTSD)
* Social Anxiety Disorder
Generalized Anxiety Disorder (GAD)
Generalized Anxiety Disorder can begin at any age though it is most likely to start in childhood.iv People with Generalized Anxiety Disorder (GAD) will worry excessively about a variety of everyday problems for at least 6 months.v Children, pre-teens, and teens with GAD can’t relax, may startle easily, have trouble focusing, and will sometimes have trouble sleeping. Other signs of GAD can include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes. When their anxiety is bothering them, children with GAD can have trouble completing tasks, like homework.
If you think your son or daughter might have GAD, talk to a health care provider like a nurse or doctor, the counselor at your child’s school, or a mental health professional.
Obsessive-Compulsive Disorder (OCD)
Children, pre-teens, or teens with obsessive-compulsive disorder (OCD) constantly have thoughts that bother them (obsessions). They will develop routines and rituals (compulsions) in an attempt to control the stress these thoughts cause. At their worst, these rituals can take over a young person’s life.
Parents concerned about OCD should look for the most common OCD compulsions
* Excessive hand washing due to fear of germs
* Counting constantly
* Repeating words silently
* Repeatedly rechecking completed tasks
OCD affects about 2.2 million Americans.vii It usually appears in childhood, adolescence, or early adulthood.viii OCD can change over time, and the effects of OCD can get weaker or stronger. Sometimes these effects fade completely.
In some cases, OCD can prevent children from feeling comfortable and behaving normally at home, at school, or in social situations. Some people with OCD may try to help themselves by avoiding situations that will upset them. In some cases, teens with OCD will turn to alcohol or drugs to try to calm themselves.
If your son or daughter shows signs of OCD, or you have any questions, talk to a health care provider like a nurse or doctor, the counselor at your child’s school, or a mental health professional.
Panic Anxiety Disorder
Panic disorder causes sudden attacks of terror. These attacks are called panic attacks and can last minutes to hours. During these panic attacks, a teen can experience:
* A pounding heart
* Weakness, dizziness, or feeling faint
* Nausea
* Chest pain
* Numbness in the hands
* Feeling like they are being smothered
Children can suffer a panic attack at any time, even during sleep. Panic attacks often begin in late adolescence or early adulthood.xi However, just because a teen has a panic attack doesn’t mean that he or she has panic disorder – one panic attack does not equal panic disorder.
If you are concerned that your son or daughter might have panic disorder, talk to a health care provider like a nurse or doctor, the counselor at your child’s school, or a mental health professional.
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Post-Traumatic Stress Disorder (PTSD)
We often hear about Post-Traumatic Stress Disorder (PTSD) as something that affects adults (such as war veterans), but it can happen to a child who has experienced or witnessed trauma or traumatic events.
PTSD can affect children who have survived some sort of trauma. Children don’t have to be physically harmed to suffer from PTSD. Children can suffer from PTSD if something bad happens to them, if they witness a traumatic event, or a trauma happens to someone they love.
Children suffering from PTSD can show the following signs:
* Difficulty sleeping
* Emotional numbness (not feeling happiness or sadness, for example, when they should)
* Losing interest in favorite activities or hobbies
* Aggression
* Displays of violence
* Flashbacks
* Frequent bad dreams
PTSD affects about 7.7 million American adultsxii, but it can occur at any age, including childhood.xiii Children suffering from PTSD may also face depression, substance abuse, or one or more of the other anxiety disorders.
If you believe that you child is suffering from PTSD, please talk to a health care provider like a nurse or doctor, the counselor at your child’s school, or a mental health professional.
Social Anxiety Disorder (Social Phobia)
Children with social anxiety disorder, also called social phobia, are so self-conscious that they find it very, very hard to take part in social situations. Children with social anxiety disorder have an intense and often constant fear of being watched and judged by others. They are very afraid of doing something that will embarrass them.
Sometimes this fear is caused by one specific thing or situation. For example, a child might worry for days, even weeks, leading up to a school test or oral presentation. Sometimes this fear is not caused by anything specific. In this case, a child with social anxiety disorder may be uncomfortable around anybody except family. This can make it very hard for a child or youth to make friends or attend school.
Signs of social phobia in children and youth include:
* Being overly sensitive to criticism
* Having trouble being assertive
* Suffering from low self-esteem
Social phobia affects about 15 million Americans It usually begins in childhood or early adolescence. People with social anxiety disorder may also have other anxiety disorders or depression. Some people with social anxiety disorder may also develop problems with substance abuse.
If you have questions or think your son or daughter might have social anxiety disorder, talk to a health care provider like a nurse or doctor, the counselor at your child’s school, or a mental health professional.
Social Phobia Anxiety
Social Phobia Anxiety
“In any social situation, I felt fear. I would be anxious before I even left the house, and it would escalate as I got closer to a college class, a party, or whatever. I would feel sick in my stomach-it almost felt like I had the flu. My heart would pound, my palms would get sweaty, and I would get this feeling of being removed from myself and from everybody else.”
“When I would walk into a room full of people, I’d turn red and it would feel like everybody’s eyes were on me. I was embarrassed to stand off in a corner by myself, but I couldn’t think of anything to say to anybody. It was humiliating. I felt so clumsy, I couldn’t wait to get out.”
Social phobia, also called social anxiety disorder, is diagnosed when people become overwhelmingly anxious and excessively self-conscious in everyday social situations. People with social phobia have an intense, persistent, and chronic fear of being watched and judged by others and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends.
While many people with social phobia realize that their fears about being with people are excessive or unreasonable, they are unable to overcome them. Even if they manage to confront their fears and be around others, they are usually very anxious beforehand, are intensely uncomfortable throughout the encounter, and worry about how they were judged for hours afterward.
Social phobia can be limited to one situation (such as talking to people, eating or drinking, or writing on a blackboard in front of others) or may be so broad (such as in generalized social phobia) that the person experiences anxiety around almost anyone other than the family.
Physical symptoms that often accompany social phobia include blushing, profuse sweating, trembling, nausea, and difficulty talking. When these symptoms occur, people with social phobia feel as though all eyes are focused on them.
Social phobia affects about 15 million American adults.1 Women and men are equally likely to develop the disorder,10 which usually begins in childhood or early adolescence.2 There is some evidence that genetic factors are involved.11 Social phobia is often accompanied by other anxiety disorders or depression,2,4and substance abuse may develop if people try to self-medicate their anxiety.4,5
Social phobia can be successfully treated with certain kinds of psychotherapy or medications.
Obsessive Compulsive Disorders
Obsessive Compulsive Disorders
“I couldn’t do anything without rituals. They invaded every aspect of my life. Counting really bogged me down. I would wash my hair three times as opposed to once because three was a good luck number and one wasn’t. It took me longer to read because I’d count the lines in a paragraph. When I set my alarm at night, I had to set it to a number that wouldn’t add up to a ’bad’ number.”
“I knew the rituals didn’t make sense, and I was deeply ashamed of them, but I couldn’t seem to overcome them until I had therapy.”
“Getting dressed in the morning was tough, because I had a routine, and if I didn’t follow the routine, I’d get anxious and would have to get dressed again. I always worried that if I didn’t do something, my parents were going to die. I’d have these terrible thoughts of harming my parents. That was completely irrational, but the thoughts triggered more anxiety and more senseless behavior. Because of the time I spent on rituals, I was unable to do a lot of things that were important to me.”
People with obsessive-compulsive disorder (OCD) have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. Most of the time, the rituals end up controlling them.
For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Being afraid of social embarrassment may prompt people with OCD to comb their hair compulsively in front of a mirror-sometimes they get “caught” in the mirror and can’t move away from it. Performing such rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts.
Other common rituals are a need to repeatedly check things, touch things (especially in a particular sequence), or count things. Some common obsessions include having frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts the person dislikes, or having thoughts that are prohibited by religious beliefs. People with OCD may also be preoccupied with order and symmetry, have difficulty throwing things out (so they accumulate), or hoard unneeded items.
Healthy people also have rituals, such as checking to see if the stove is off several times before leaving the house. The difference is that people with OCD perform their rituals even though doing so interferes with daily life and they find the repetition distressing. Although most adults with OCD recognize that what they are doing is senseless, some adults and most children may not realize that their behavior is out of the ordinary.
OCD affects about 2.2 million American adults,1 and the problem can be accompanied by eating disorders,6 other anxiety disorders, or depression.2,4 It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood.2 One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families.3
The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. If OCD becomes severe, it can keep a person from working or carrying out normal responsibilities at home. People with OCD may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves.4,5
OCD usually responds well to treatment with certain medications and/or exposure-based psychotherapy, in which people face situations that cause fear or anxiety and become less sensitive (desensitized) to them. NIMH is supporting research into new treatment approaches for people whose OCD does not respond well to the usual therapies. These approaches include combination and augmentation (add-on) treatments, as well as modern techniques such as deep brain stimulation.