Anxiety Disorders

​Anxiety disorders can be described as frequent fears, worries, or anxiety that negatively impact an individual’s ability to function within multiple environments (i.e.; school, home, socially). There are several different types of anxiety disorders which may impact an individual’s functioning in varying ways. According to the Centers for Disease Control and Prevention , 7.1% of children aged 3-17 years (Approximately 4.4 million) have diagnosed anxiety disorders. ​These diagnosis include: 

Generalized Anxiety Disorder:

​Generalized anxiety disorder (GAD) is a persistent state of heightened anxiety and apprehension including excessive worrying, fear, or dread occurring more days than not for at least 6 months. Per The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013), the individual may find it difficult to control the worry to the extent that it negatively creates distress or dysfunction in the individual. According to Gale and Millichamp (2016) Generalized anxiety disorder (GAD) affects about 1% of children and 3% of adolescents. Children with a diagnosis of GAD may experience difficulty coping in their home, daily task, and in completion of self-care activities. Females are particularly at risk for experiencing generalized anxiety disorder (GAD), specifically, females are twice as likely to experience generalized anxiety disorder (GAD) (American Psychiatric Association, 2013). In children, GAD may involve fears about the family, performance at school, maintaining friendships, and social status amongst their peers. Per (Elia J., 2021), COVID-19 and the associated school closures and isolation from extended family, peers, teachers, etc. increased stress and anxiety in nearly all children.

​Symptoms:

• Feeling restless.
• Becoming tired easily.
• Difficulty maintaining concentration.
• Irritability or a “quick fuse”.
• Muscle tension or appearing “stiff”.
• Difficulty falling or staying asleep.

Separation Anxiety Disorder (SAD)

​Separation anxiety disorder (SAD) is developmentally inappropriate and excessive debilitating fear or anxiety regarding the child’s real or imagined separation from individuals to whom they are attached. Per the DSM-V (American Psychiatric Association, 2013), the 6-12 month prevalence of SAD among children in the United States is 4%, while the 12 month prevalence of SAD among adolescents is 1.6%. Separation Anxiety Disorder (SAD) is the most prevalent anxiety disorder in children younger than 12 years of age. 

Symptoms: 

• Frequent distress when thinking about or anticipating separation from a key figure in their life
• Persistent and excessive reluctance to go away from home, to school, to work, while away from a key figure in their life. 
• Persistent fear or reluctance to be alien 
• Repeated nightmares involving the process of separation 
• Refusal to sleep away from home or go to sleep without the key figures in their life being in the area.
• Frequent complaints of bodily/physical complaints (i.e.; upset stomach, headache)

​Social Anxiety Disorder (Social Phobia)

​Social anxiety disorder (Social Phobia) is a sense of anxiety resulting from one or more social situations where the child or adolescent may be exposed to negative scrutiny by peers or adults. The child or adolescent may fear humiliating or embarrassing themselves, which may result in an avoidance of the situation or immediate fear or anxiety when in the situation or thinking about being in the situation. The month prevalence estimates of social anxiety disorder is around 7%, similar to the 12 month prevalence of social anxiety disorder found in children and adolescents (DSM-5; American Psychiatric Association, 2013).

Symptoms:

• Fear of that he or she will act in a way that will be negatively evaluated by peers in social situations.
• Excessive worry surrounding attendance at social events.
• Excessive worry surrounding class presentations or speaking engagements to a group (i.e.; speech, giving an answer in front of peers, working collaboratively in a group).
• The social situations are avoided or endured while almost always provoking fear or anxiety (i.e.; avoidance of school, not going to social functions, not eating in front of others).
• Complaints often referring to physical or bodily symptoms (i.e.; stomachache, headache).
• Fear or anxiety is persistent, normally lasting 6 months or more.
• Symptoms in children may include tantrums, crying, freezing, clining, or withdrawing in social situations. 

Panic Disorder

​Panic disorder includes recurrent panic attacks that happen often (at least once/week). A panic attack is an increase of intense feelings of fear or discomfort, lasting about 20 minutes, which can happen from a calm state or an anxious state. Panic disorder is much less common among children who have not reached puberty in comparison to adolescents (Elia J., 2021). Often, individuals go to the ER as a result of their symptoms, not realizing that they may be experiencing a panic disorder along with the associated symptoms listed below. 

Symptoms: according to The Diagnostic and Statistical Manual of Mental Disorder - 5th Edition (DSM-5)

• Pounding heart.
• Sweating.
• Trembling or shaking.
• Feelings of shortness of breath.
• Feelings of choking.
• Chest pain or discomfort.
• Nausea or abdominal distress.
• Feeling dizzy, unsteady, light-headed or faint.
• Chills or heat sensations.
• Numbness or tingling sensation.
• Feelings of unreality or being detached from themselves.
• Fear of losing control or “going crazy”.
• Fear of dying.

Depressive disorders

Depressive disorders are characterized by feelings of sadness or irritability which impact the individual's ability to function or create distress in them (Elia J, 2021). Depressive disorders may impact the child’s ability to actively take part in aspects of their environment, and as a result of a potential difficulty expressing what they are feeling, an awareness of the symptoms of depressive disorders is key. Depressive disorders include disruptive mood dysregulation disorder (DMDD) and major depressive disorder (MDD) among others. 

Disruptive mood dysregulation disorder (DMDD)

Disruptive mood dysregulation disorder (DMDD) includes frequent displays of outburst in the form of physical aggression towards others and self, that are out of proportion to the situation, provocation, and the individual’s developmental level. This particular diagnosis is not made before the age of 6 years old of after 18 years old.

​Symptoms:

• Frequent displays of temper outburst (i.e.; verbal rage and/or physical aggression toward people, self, or property).
• Persistent irritability between outbursts that is observed more often than not.
• Becoming angry in response to their environment quickly.
• Seeming as though their anger goes from “0 to 100”.
• Difficulty returning back to “normal” state after becoming angry or upset.
• The child may appear unconsolable or unable to be comforted during such periods where they experience an increase in anger that is not developmentally appropriate for their age. 

​Major Depressive Disorder (MDD)

Symptoms: 

Neurodevelopmental disorders

​Neurodevelopmental disorders (NDDs) are multifaceted conditions characterized by impairments in cognition, communication, behavior and/or motor skills resulting from abnormal brain development. Disorders such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are diagnoses which fall into the domain of neurodevelopmental disorders.

​Attention-Deficit/Hyperactivity Disorder (ADHD)

Attention-deficit/hyperactivity disorder is a disorder which impacts an individual’s ability to maintain attention, concentration, and control their impulses, while in the process impacting their ability to function in multiple environments (home, school, socially). There are three forms of ADHD, namely, predominantly inattention, predominantly hyperactive/impulsive, and combined forms (Sulkes S., 2020). ADHD is considered a neurodevelopmental disorder, meaning it impacts one of more of the following: attention, memory, perception, language, problem-solving, or social interaction (Sulkes S., 2020). It is important to note that ADHD begins in childhood and has been suggested as being present in 5% of children (DSM-5; American Psychiatric Association, 2013).

Symptoms: according to The Diagnostic and Statistical Manual of Mental Disorder - 5th Edition (DSM-5)

(Inattention)

• Difficulty giving close attention to details or making careless mistakes.
• Difficulty sustaining attention in tasks or play activities.
• Does not seem to listen when spoken to directly.
• Often does not follow through on instructions and may fail to finish school work or chores.
• Difficulty organizing tasks.
• Often avoids, dislikes, or is reluctant to engage in task that require sustained attention
• Often loses things necessary to complete tasks.
• Often becomes easily distracted by the objects in their environment.
• Is often forgetful in daily activities. 

​
​(Hyperactivity and impulsivity)

• May appear fidgety
• May leave their seat often even when they are expected to remain seated.
• May run or climb in situations where it is not appropriate.
• May be unable to play quietly.
• May appear to be often “on the go”.
• Often talk excessively
• Often blurts out answers prior to the question being completed.
• Often interrupts others in conversation or intrudes on others (butting into conversations)

Autism Spectrum Disorder (ASD)

According to the Centers for Disease Control and Prevention, Autism spectrum disorder is a developmental disability that can cause significant social, communication, and behavioral challenges. Although those with ASD may appear similar to others, individuals with ASD may communicate, interact, and behave, and learn in ways that are different to most. In order to receive a diagnosis of Autism spectrum disorder (ASD) an individual must display persistent deficits in social communication and social interaction among multiple environments and situations (DSM-V; American Psychological Association, 2013). Additionally, those with ASD must display restricted, repetitive patterns of behavior, interests or activities (DSM-V; American Psychological Association, 2013). Estimates suggest that children and adults have similar prevalence rates of ASD, specifically, 1 % of the population. Similar to other diagnoses, symptoms of ASD often become displayed during the second year of life (12-24 months), but may also appear earlier than 12 months if the developmental delays are severe (DSM-V; American Psychological Association, 2013). 

Symptoms: adapted from the Centers for Disease Control and Prevention

• Not pointing at objects to show interest.
• Not looking at objects when another person points to it.
• Having trouble relating to others or not having an interest in others.
• Avoiding eye-contact.
• Difficulty understanding other people’s feelings or talking about their feelings.
• Difficulty understanding sarcasm or humor.
• May be interested in people but be unsure of how to talk, play, or relate to them.
• Repeating words or phrases spoken to them.
• Repeating actions over and over again.
• Having trouble adapting to changes in their routine.
• Experiencing unusual reactions to the way things smell, taste, look, feel, or sound.
• Fixated interest on one area (i.e.; toys, school subjects).
• Repetitive bodily regulation movements (stim movements) including tapping their feet, rubbing their hands, snapping fingers, etc. ​

PTSD

Symptoms: 

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