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Posted at: Jun 8, 2019, 12:37 AM; last updated: Jun 8, 2019, 12:37 AM (IST)

That shyness can be a malady

Anxiety disorders are more common in children than perceived. However, several factors keep them from receiving treatment

Dr Prakriti Poddar

In a social setting that puts children through sky-high expectations, it is normal for a child to feel anxious sometimes — before a key examination, before a stage appearance or a sports competition. What is not normal is having a child who displays symptoms of anxiety and phobia without any substantial reason or cause.

Misunderstood symptoms

It is often incomprehensible for parents to believe that children might have anxiety disorders like adults. A number of times, children complaining of symptoms such as headaches, stomachaches, bed- wetting or feeling unwell are brushed aside as being fussy or lazy or their complaints perceived as deliberate ways of avoiding school or any other task. At other times, their symptoms are perceived as normal pangs of growing up. Unfortunately, many children with anxiety disorders fail to find right medical attention for a long time, resulting in aggravation of their condition and suffering. It is important to identify and treat anxiety disorders in children as these have the potential to grow into adult anxiety disorders as well as psychopathologies such as depression, substance-use problems and suicide attempts.

Sufficient evidence

A growing body of research in the past two decades has found that a substantial number of children and adolescents do suffer from anxiety disorders. Many factors such as increasing parental expectations, a nuclear family set-up that limits children’s family connections and inadequate social mingling may have contributed to the rise of anxiety disorders among children in recent years.

A study published in the Journal of Post Graduate Medicine found that approximately 11 per cent of school students studying in Classes III to X in Mumbai had signs of anxiety disorders. Similarly, another study documented that 11 per cent students studying in Class VIII in Jamshedpur had symptoms of overall anxiety. Yet another research in Kolkata found that 19 per cent of students studying in Classes VIII to XII had high anxiety.

A study published in the Journal of Clinical Child and Adolescent Psychology conducted structured interviews of preschooler’s and their parents in the US to conclude that 19.6 per cent of the 3-4 year old subjects had an anxiety disorder. These preschoolers were more likely to have depression, sleep problems, behavioural issues and Oppositional Defiant Disorder.

Impact of untreated problems

Anxiety disorders often go undiagnosed in children for years because of their inability to express themselves as well as the vagueness of symptoms. However, it is important to ensure that any such condition is identified early on and gets the requisite medical attention. It is important to underline here that anxiety disorders are not the usual ‘pangs of growing up’ and children will not outgrow them. Yet, when given the right medical and therapeutic attention, children do overcome such conditions and go on to live normal and productive lives. With cognitive behaviour therapy, most of the affected children show favourable outcomes.

Anxiety disorders can have a devastating effect on academic performance. If left untreated, these can even lead to the child’s dropping out from school. It is important, therefore, to not overlook any signs of anxiety and depression in children, howsoever vague. Any sudden or radical behaviour change such as withdrawal, inability to sleep, bed wetting or loss of interest in activities they once enjoyed must be discussed with a doctor. In fact, school teachers must also be trained to pay attention to identify mental duress among children at school. 

Signs to watch out for

The term “anxiety disorder” refers to a group of mental illnesses that includes six forms of disorders namely generalized as anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder (also called social phobia), and specific phobias. Some prominent symptoms that parents should confront with seriousness include complaints of stomachaches especially before certain tasks such as going to school; withdrawing from social opportunities; performance anxiety; physical distress and not feeling well frequently without any apparent cause as well as trouble sleeping.

Social withdrawal vs shyness

Sometimes parents mistake social withdrawal as shyness; at other times, complaints of physical distress are misunderstood  as pretense for not wanting to go to school. For many children, the symptoms manifest in seemingly unrelated ways that makes it hard to find the underlying cause of the problem. Private schools and higher institutes and always emphasise that when children are younger, especially in pre-teen years, they tend to “internalise” the condition more than display overt signs. For example, some kids fighting anxiety and depression might exhibit symptoms such as aggression, hyperactivity or difficulty in eating, rather than the more commonly understood signs.

— The writer is a mental health expert and director, Poddar Wellness Ltd

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