Mental Health Awareness Month

What can anxiety look like in children?

When a child does not outgrow the fears and worries that are typical in young children, or when there are so many fears and worries that they interfere with school, home, or play activities, the child may be diagnosed with an anxiety disorder. Examples of different types of anxiety disorders include:

  1. Being very afraid when away from parents (separation anxiety)
  2. Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)
  3. Being very afraid of school and other places where there are people (social anxiety)
  4. Being very worried about the future and about bad things happening (general anxiety)
  5. Having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic disorder)

Anxiety may present as fear or worry, but can also make children irritable and angry. Anxiety symptoms can also include trouble sleeping, as well as physical symptoms like fatigue, headaches, or stomachaches. Some anxious children keep their worries to themselves causing symptoms to be missed.

What can Oppositional Defiant Disorder look like in children?

When children act out persistently so that it causes serious problems at home, in school, or with peers, they may be diagnosed with Oppositional Defiant Disorder (ODD). ODD usually starts before 8 years of age, but no later than by about 12 years of age. Children with ODD are more likely to act oppositional or defiant around people they know well, such as family members, a regular care provider, or a teacher. Children with ODD show these behaviors more often than other children their age.

Examples of ODD behaviors include:

  1. Often being angry or losing one’s temper
  2. Often arguing with adults or refusing to comply with adults’ rules or requests
  3. Often resentful or spiteful
  4. Deliberately annoying others or becoming annoyed with others
  5. Often blaming other people for one’s own mistakes or misbehavior

What can Obsessive Compulsive Disorder look like in children?

Having OCD means having obsessions, compulsions, or both.

Examples of obsessive or compulsive behaviors include:

  1. Having unwanted thoughts, impulses, or images that occur over and over and which cause anxiety or distress
  2. Having to think about or say something over and over (for example, counting, or repeating words over and over silently or out loud)
  3. Having to do something over and over (for example, hand washing, placing things in a specific order, or checking the same things over and over, like whether a door is locked)
  4. Having to do something over and over according to certain rules that must be followed exactly in order to make an obsession go away

Children do these behaviors because they have the feeling that the behaviors will prevent bad things from happening or will make them feel better. However, the behavior is not typically connected to actual danger of something bad happening, or the behavior is extreme, such as washing hands multiple times per hour.

A common myth is that OCD means being really neat and orderly. Sometimes, OCD behaviors may involve cleaning, but many times someone with OCD is too focused on one thing that must be done over and over, rather than on being organized. Obsessions and compulsions can also change over time.

What can Post-Traumatic Stress Disorder look like in children?

All children may experience very stressful events that affect how they think and feel. Most of the time, children recover quickly and well. However, sometimes children who experience severe stress, such as from an injury, from the death or threatened death of a close family member or friend, or from violence, will be affected long-term. The child could experience this trauma directly or could witness it happening to someone else. When children develop long term symptoms (longer than one month) from such stress, which are upsetting or interfere with their relationships and activities, they may be diagnosed with post-traumatic stress disorder (PTSD).

Examples of PTSD symptoms include:

  1. Reliving the event over and over in thought or in play
  2. Nightmares and sleep problems
  3. Becoming very upset when something causes memories of the event
  4. Lack of positive emotions
  5. Intense ongoing fear or sadness
  6. Irritability and angry outbursts
  7. Constantly looking for possible threats, being easily startled
  8. Acting helpless, hopeless or withdrawn
  9. Denying that the event happened or feeling numb
  10. Avoiding places or people associated with the event

Because children who have experienced traumatic stress may seem restless, fidgety, or have trouble paying attention and staying organized, the symptoms of traumatic stress can be confused with symptoms of attention-deficit/hyperactivity disorder (ADHD). 

Examples of events that could cause PTSD include:

  1. Physical, sexual, or emotional maltreatment
  2. Being a victim or witness to violence or crime
  3. Serious illness or death of a close family member or friend
  4. Natural or manmade disasters
  5. Severe car accidents

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