Identifying Anxiety and Stress in Young People

Anxiety

According to the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV), there are several different types of Anxiety Disorders:

• Panic Disorder is diagnosed when people are having repeated Panic Attacks
• Specific Phobias are significant fears of particular objects or situations (e.g., spiders, flying, needles), which often cause people to avoid these objects and situations
• Social Phobia is significant fear of social or performance situations
• Obsessive-Compulsive Disorder is where people have recurrent thoughts or obsessions about things (e.g., germs) and then are compelled to perform rituals or routines (e.g., hand washing, not stepping on cracks, checking locks, etc.)
• Posttraumatic Stress Disorder is when people re-experience a very traumatic event (e.g., sexual abuse, witnessing someone being badly harmed) and feel fearful and make efforts to avoid things that remind them of the trauma
• Generalized Anxiety Disorder is when people are excessively anxious and worried about a variety of things for a period of at least six months.

Anxiety Disorders

Although some of these disorders are more common in some age groups than others, children, adolescents, and adults can be diagnosed with any of these Anxiety Disorders. More

Separation Anxiety Disorder

Classified as a disorder that is usually diagnosed in childhood. The essential feature of this disorder is excessive anxiety concerning separation from the home or from those whom the child is emotionally attached. More

Sometimes, a stressful life event can lead to a young person experiencing behavioral health issues that meet criteria for a mental disorder known as Adjustment Disorder. The important feature of an Adjustment Disorder is the development of clinically significant emotional or behavioral symptoms in response to a specific stressor (e.g., divorce of parents, a parent's military deployment, starting school, etc.)

Adjustment Disorder with Anxiety is a diagnosis associated with a young person who is responding mostly to a stressor with symptoms of anxiety. For instance, if a child has an upset stomach, reports nervousness, has fears about a parent not coming home, and is having difficulty sleeping during a period of deployment, and these symptoms are significantly impacting the child's ability to function daily, he or she may be experiencing an Adjustment Disorder with Anxiety.

It is estimated that 6-18% of children suffer from an Anxiety Disorder.^{4, 5} Rates of Anxiety Disorders vary depending upon age. For instance, young children are more likely to suffer from Separation Anxiety Disorder than older children.^{4, 5} Other Anxiety Disorders begin to show up as children age.⁵ Girls are more likely than boys to be affected by an anxiety disorder.⁶ A survey of 1,004 children by KidsHealth^® found that among young people between the ages of 9 and 13, the most common worry is school grades, followed by appearance, problems at home, and being "liked" by peers. More

Concerned that your child may be experiencing Separation Anxiety Disorder? Take this online quiz.

Anxiety Disorders in Children: A Test for Parents

Anxiety Disorders in Adolescents: A Self-Test

Some amount of anxiety is normal and adaptive to stressful events. It is important to communicate this to young people, and support them during difficult times. Child/adolescent self-care and stress management information may be helpful resources for young people coping with stress. If you are concerned that your child or adolescent is suffering from an anxiety disorder, talk to your pediatrician or a mental health provider.

Stress

Stress is more or less the opposite of relaxation, feeling calm, and in a state of well-being. Stress can be defined in terms of four components:¹

1. A stressor or trigger is present (e.g., deployment, divorce, changing schools, uncertainties).
2. The individual experiencing the stressor evaluates the situation or trigger as stressful.
3. The individual attempts to cope with the stressful demands. Not everyone copes with stressors in the same way. Some people will be more effective at handling stressors than others.
4. A complex set of reactions takes place in both the mind and the body. Stress reactions are experienced differently by individuals.

More Information about different kinds of stress
Adolescents and children, particularly young children, may have difficulties expressing their feelings. Unlike an adult, they may not report, "I feel stressed." Instead, they may report stomach aches, exhibit behavior problems, have difficulty sleeping, or withdraw socially. More

Parenting Quiz: Is your teenager stressed out?

Stress is an inevitable by-product of living. Its effect on children is estimated to have increased 45% over the past 30 years.⁷ Service members and their families are likely to experience stress, during a deployment. It's important to understand how much stress may be too much for your child, and know how your child copes under stress. One style does not fit all - the type and severity of reactions varies by individual. The important thing is to acknowledge a stressful period and seek support before a stressful period turns into a more serious behavioral health issue.

Even though symptoms of stress overlap with many behavioral health disorders, "stress" is not considered a mental disorder. Posttraumatic Stress or Acute Stress Disorders are very specific reactions to stressful events. Learn more about PTSD. Young people who do not effectively cope with stress are at risk for developing a psychiatric disorder, including depression², substance abuse³, or an Anxiety Disorder.

¹Lazarus, R. S. (1993). From psychological stress to the emotions: A history of changing outlooks. Annual Review of Psychology 44, 1-21.

²Voelkner, R. (2004). Stress, sleep loss, and substance abuse create potent recipe for college depression. Journal of the American Medical Association 291 (18), 2177-2179.

³McQuaid, J.R., Brown, S.A., Aarons, G.A., Smith, T.L., Patterson, T.L, Schuckit, M.A. (2000). Correlates of life stress in an alcohol treatment sample. Addictive Behaviors 25(1), 131-137.

⁴Christopherson, E. R., & Mortweet, S. L. (2005). Treatments that work with children. Washinton, DC: American Psychological Association.

⁵Laurent, J., & Potter, K. I. (1998). Anxiety-related difficulties.In. T. S. Watson & F. M. Gresham (Eds.). Handbook of child behavior therapy (pp. 239-260). New York: Plenum Press.

⁶U.S. Department of Health and Human Services. (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services.

⁷National Institute of Health, Medical Encyclopedia.What do children worry about? A fact sheet for Teachers and Parents. Accessed 5/17/06