Anxiety Disorders in Children and Teens

Anxiety is a human experience. We have all experienced anxiety, for example before that important exam, or when being called upon to speak in public. Anxiety in children and teens can also be developmentally normal. The anxiety, or distress, of the preschool child when faced with a separation from parents. A child’s short-lived fears of monsters under the bed.

A child or teen with an anxiety disorder, however, is in a great deal of emotional pain. Whether experiencing a generalized anxiety disorder, with symptoms that may include exaggerated worry over everyday events, panic disorder, with it’s associated feelings of extreme fear that can strike unexpectedly and is accompanied by intense physical symptoms, OCD, characterized by unwanted, intrusive thoughts and rituals, or any of the other disorders characterized as an anxiety disorder (PTSD, phobias, social anxiety, etc) our children and teens are suffering. And often, they suffer quietly. Either not wanting to alert their parents to their difficulties, or not understanding that what they are suffering has a name, is common, and can be treated by mental health professionals experienced in working with the complexities of an anxiety disorder.

Attention Deficit Disorders in Children and Teens

Attention deficit disorder, with and without hyperactivity (ADHD & ADD, respectively) is one of the most commonly diagnosed disorders of childhood, affecting an estimated 2 million children in the United States. It is diagnosed two to three times more often in boys than girls, and it often continues into adolescence and adulthood. Symptoms most often associated with this disorder can include impaired concentration, inattentiveness (except toward those activities that the child enjoys, including watching television or playing video games), impulsivity, hyperactivity and distractibility. Children and teens with these disorders often suffer from impaired peer relationships, and it often has a negative impact on academic and vocational performance.

How do you know if your child or adolescent has this disorder? After all, the majority of children, at certain stages of development, exhibit some or all of the symptoms described above. Furthermore, many other disorders, including depression, exhibit a symptom picture not unlike that of ADD or ADHD. It is very important to consult professionals who are specially trained in working with children and their families, to assure an accurate diagnosis and to receive appropriate help for your child and family.

Behavioral Issues in Children and Teens

All children and adolescents can be oppositional. In fact, oppositional behavior is a normal part of development, especially in young children and adolescents. In children and teens with oppositional defiant disorder, however, there is a recurrent pattern of defiant, negativistic, disobedient and hostile behavior.

Children and teens who have great difficulty following rules and behaving in socially acceptable ways may have a conduct disorder. Some of the common behaviors exhibited here might include the deliberate destruction of property, intimidation of others through bullying or threats, physical aggression towards others or cruelty toward animals, a consistent pattern of lying or stealing.

A child or teen presenting with symptoms of oppositional defiant disorder or conduct disorder should be evaluated as soon as possible. Children and teens with these disorders can be treated, and appropriate treatment can help ameliorate the likelihood of ongoing, or increasingly severe problems.

Depression in Children and Teens

Research suggests that 3-10% of children and teens suffer from depression, a serious disorder that can affect the individual’s mood, energy level, interest in activities, sleep, appetite and overall functioning at home and at school. Children and teens suffering with childhood depression may display moods and behaviors that are different from those of depressed adults. Symptoms of childhood and teen depression may include increased irritability and/or anger, frequent feelings of sadness, a sense of hopelessness, low self-esteem, difficulty in concentrating, low energy level, decreased interest in activities or social isolation, thoughts or expressions of self-harm, self-mutilation or suicide. Diagnosing and treating children and teens with depression is critically important and can help ameliorate the social, emotional, academic and behavioral difficulties that so often accompany depression.

Eating Disorders in Children and Teens

Eating disorders involve serious disturbances in eating behaviors. It is estimated that as many as up to 10% of all pre-teen and teenage girls suffer with an eating disorder, including anorexia, or anorexia nervosa, bulimia, and binge eating disorder. While primarily affecting females, males with eating disorders are on the increase. Individuals suffering with an eating disorder strongly feel that they have little or no control over their symptoms, which may include a preoccupation with food, severe calorie restriction, a categorization of particular foods as ‘good’ or ‘bad’, an irrational belief that he/she is fat, binging on large quantities of high calorie food, self-induced vomiting, excessive use of laxatives etc. Common to all with an eating disorder is secrecy, shame, guilt and self-blame.

An eating disorder is both very serious and very complex, affecting one’s emotional, behavioral and physical self. There are a wide range of physical health complications associated with eating disorders, including heart problems, kidney problems, rotting teeth, hair loss and, in some rare cases, death. Individuals with eating disorders can be treated successfully. The sooner treatment is sought, the better the outcomes tend to be. Treatment for these complex disorders may require a team approach, including psychotherapists specially trained in working with individuals and families experiencing this disorder, nutritionists, and medical personnel.

Bipolar Disorder in Children and Teens

Childhood bipolar disorder is primarily characterized by extreme shifts in mood, energy level and overall functioning. Unlike normal mood swings, a child or teen with bipolar disorder, previously called manic depression, experiences severe mood fluctuations. He or she may fluctuate between being overly energized, easily distracted, and feeling on top of the world to periods of depressed moods, hopelessness, and withdrawal. Especially when diagnosed pre-puberty, it may co-occur with ADHD or have a symptom mix that has features in common with ADHD or other behavioral disorders. Symptoms of childhood bipolar disorder can significantly interfere with everyday functioning, impacting family relationships, school functioning, and interactions with peers.

Children and teens with bipolar disorder can be effectively treated. It is a complex disorder that requires a thorough psychological evaluation, parent and family education, psychotherapy and mood stabilizing medication.

Learning Disabilities in Children and Teens

There are many reasons why a child or teenager might have difficulty with learning in school. One common cause of such difficulties is the presence of one or more learning disabilities. Learning disabilities, which can run in families, are primarily neurological and affect the way in which information is received, processed and/or communicated. Learning disabilities are not related to intelligence but can significantly affect academic performance. A child or teenager with an undiagnosed learning disability is likely to feel frustrated, anxious, and/or depressed, and might suffer from a negative sense of their self and their academic ability. In addition, children with undiagnosed learning disabilities often engage in acting out, disruptive or negative attention-seeking behaviors when confronted with difficulty or frustration in learning.

When a parent suspects that their child may have learning issues, a comprehensive evaluation may be in order. Such an evaluation can help determine if your child has a learning disability or other emotional, cognitive or neurological condition that may be impacting school performance. Recommendations may be made to parents and teachers for educational strategies that maximize the child’s learning strengths and compensate for any learning weaknesses. Sometimes individual therapy, family therapy or parent training is recommended to help the family better understand and work with their child.

Other common issues that arise during childhood and adolescence

Parent-child conflicts, especially during the teenage years, can be very challenging for families. Parents and children can feel frustrated and angry, and the family experiences significant conflict. Many families navigate these conflicts successfully. However, there are times when seeking outside help can be very important. Therapy may be indicated if you or your child are engaging in aggressive, violent behavior, if you suspect your child is using or abusing drugs or alchohol, if you feel that the situation is out of your control, if your child or teen seems depressed, anxious, or you suspect he/she is engaging in self-harming behaviors, including cutting etc.

Loss and/or grief due to a death, a divorce or an emotional abandonment can be a very difficult experience, especially for the developing child or teen. A healthy grieving process around the loss is of critical importance. If your child seems to have a very strong emotional response when the loss is mentioned, if there seems to be a change in appetite, nightmares, lack of concentration, depressive symptoms, a drop in school grades, increases in angry outbursts, excessive clinginess when seperating from parents, or feelings of guilt associated with the loss, then seeking outside help may be in order.

Substance use or abuse in adolescence is often a signal that your teenager is in emotional pain. It is critical to treatment that the issues underlying substance use or abuse be addressed. A teen may use or abuse substances as a temporary escape from the pain of depression, social difficulties, family difficulties etc. Addressing that which led your teen to use or abuse substances needs to be understood and therapeutically worked through so that he or she can learn to cope in more healthy ways with life’s stresses. We provide drug and alcohol education while addressing the underlying problems. If an intensive substance abuse program is considered a necessary initial step, we can provide those recommendations.

Other problems that can arise during childhood and adolescence include anger issues, difficulty with adjustment to a new situation, relational difficulties, separation anxiety, school refusal, abuse issues (including emotional, verbal and sex abuse), other trauma, self-esteem issues and difficulty with social skills. We, at Psychological Associates of North Jersey, have highly trained and very experienced therapists who successfully treat children and adolescents with these, and other, difficulties.

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