Anxiety and Anxiety-related Problems

Mental health problems disrupt millions of peoples lives all over the world every year; two of the most common types of childhood distress are anxiety and phobias. Fear is the dominant emotion related to these irritating feelings; anxiety is a fear of something that has already happened, or what we think has happened and dread happening again. Phobias are more of a fear of an object or situation, such as snakes, spiders or a certain place. Lots of people experience mild cases of anxiety when faced with certain situations (e.g. a speech); however, anxiety disorders are very different and can severely affect the sufferer's day-to-day life.

Panic attacks can occur as a result of extreme anxiety. In this case, the fight or flight response is very strong. The panic causes a range of symptoms, including over-breathing, palpitations and pains in the chest, which can be very alarming.

A phobia is an irrational and uncontrollable fear of an object or a situation that most people can face without anxiety. Feelings of intense panic are common when confronted with the source of fear. Most people go to considerable lengths to avoid the cause of distress.

Obsessions, like phobias, are irrational and uncontrollable. They appear as recurring thoughts or ideas, which are frightening or distressing. The obsessions may be accompanied by ritual behaviour, which may be compulsive. Obsessive compulsive disorder is rare in young children, but the rate increases towards adult rates at puberty.

Some people are prescribed tranquillisers and sleeping pills for anxiety and anxiety- related problems. However, due to unpleasant side-effects and problems with addiction, other treatments are generally preferred, such as relaxation techniques, psychotherapy and counselling, self-help groups and cognitive behaviour therapy.

Sleep problems

Many children and young people have sleep problems. These can include nightmares, night terrors and sleepwalking. As with all sleep problems, nightmares do not necessarily mean that a child is emotionally disturbed. They could be triggered, for example, by a television programme, or by the sight of a frightening dog in the park. If they remember the nightmare the next day, they may be afraid to go to sleep. But if the nightmares persist, there could be a deeper cause.

Night terrors occur most often in small children – a child sits up in bed, staring into space and screaming in apparent terror. Mostly, children do not remember these episodes. Night terrors are not always a sign of some deeper problem or worry, but this may be the case.

Sleepwalking is quite common in children and young people, and normally tails off in the late teens. It usually occurs in the deep stages of sleep and the child is not aware of it. It may be a sign of a minor anxiety, but if it happens regularly there could be a deeper emotional cause.

Sleep problems can be discussed with a GP, and sometimes a referral can be made to a sleep clinic, where parents will learn about the sleep problems faced by children and learn how to deal with them. Counselling may also be appropriate, to help families deal with problems which may occur.

Depression

Depression may include symptoms such as depressed mood, loss of interest and pleasure in activities, reduced energy, suicidal ideas, and sleep and appetite disturbance. The depressed child may feel sad or irritable, and may have problems at school due to difficulties in concentrating.

About 2 in 100 children under the age of 12 are depressed to the extent that they would benefit from seeing a specialist child psychiatrist. About 4 or 5 per cent in this age group show significant distress and some of these could be described as on the edge of depression. The rate increases with age, so that at least 5 per cent of teenagers are seriously depressed and at least twice that number show significant distress. These figures apply to children living in stable, settled populations in reasonably good social circumstances. In troubled, inner city areas with high rates of broken homes, poor community support and raised neighbourhood crime rates, the level of depression may be double that quoted. [47]

Causes of depression amongst children and young people are as many and varied as in the adult population, and can be linked to family or relationship problems, academic pressure or worries about the future.

Young people who are depressed are often referred to specialist child and adolescent mental health services, both in community and hospital settings, which may involve working with the family as well as the young person. Counselling, psychotherapy and psychological methods such as cognitive or behavioural therapies and drugs are used for the treatment of depression.

In 2003, the Medicines and Healthcare products Regulatory Agency issued new guidance on the prescription of SSRI antidepressants for children and young people under the age of 18. Because there is insufficient evidence for their efficacy and some evidence that they cause increased suicidal feelings in this age group, the only SSRI that may be given for depression in children is Prozac (fluoxetine), which must be prescribed by a child psychiatrist. There is also little evidence for the efficacy of other, older antidepressants in children. [48]

(Statistics from Mind.org.uk)

The passages below consist of statistics and information out eating disorders and their effects on sufferer's physical and emotional well-being. If you would like to find out more about this subject or about the other eating distress 'binge-eating disorder', please have a look at our Eating Disorders section.

Eating distress Many children and young people struggle with their body image. They are, after all, growing up in a culture where they are constantly faced with images and messages about the desirability of being thin, from television, magazines and advertisements.

Eating distress can take different forms. People with anorexia starve themselves by eating little or nothing, while people with bulimia binge or stuff themselves with food then induce vomiting and/or take laxatives. Both conditions can cause severe weight loss or gain, other physical health problems and can sometimes result in death. Between 1 in 5 to 1 in 7 of those with anorexia die as a result of their illness or take their own lives. The average age of onset of anorexia is 15 and of bulimia, 18.

Eating problems are more common among girls and young women, but more boys and young men are experiencing problems with food. Around 10 per cent of cases of anorexia are male. [54] In the past, there has been less cultural pressure on men than women to stay slim, but this is changing.

A specialist in eating disorders, Professor Arthur Crisp, says that, since anorexia so often starts at puberty, it is linked with a fear of growing up and a desire to avoid the physical and emotional changes of adolescence. "Puberty isn't invited and some people find it very threatening. They panic about the physical changes and they panic about the challenges they are facing within their family and within society. If they don't have the coping skills to deal with all these changes, they may use dieting as a way of coping, but they need help to accept the process of growth and maturation." [55]

Helping children to have a more positive body image could prevent eating problems such as anorexia and bulimia. Therapy sessions that involve all the family may be particularly helpful for people whose anorexia started under the age of 17.

Attention deficit hyperactivity disorder (ADHD)

Some children are consistently found difficult to manage. They may have problems concentrating, are quick to react, tend to act impulsively, cannot settle, lack self-confidence and may be both disruptive and destructive. These children are often described as suffering from ‘attention deficit hyperactivity disorder’ (ADHD).

Some child psychiatrists advocate treatment with amphetamine-related stimulant drugs such as Ritalin (methylphenidate). The British National Formulary advises that this drug is not given to children under six, and cautions that it should be used selectively, since one side-effect is to retard growth and the long-term effects are not known. Many experts believe that drug treatment is only appropriate in the most severe cases, and would advocate its use only in combination with psychological therapies.

It has been suggested that ADHD is closely related to lack of sleep. Many parents do not put their children to bed nearly as early as was normal 30 or 40 years ago, and many children have television and computers in their bedrooms, encouraging them to stay awake. Lack of sleep causes people to feel restless and makes concentration difficult. Diet is also implicated in ADHD. Children’s behaviour and concentration frequently improves with a diet that is low in sugar, carbonated drinks, and artificial colourants.

Schizophrenia

Schizophrenia is the name given to describe a range of symptoms which cause a dramatic disturbance in an individual’s thoughts, feelings and perception of their surroundings. These symptoms include hallucinations, delusions and thought disorder, in which ideas seem jumbled and illogical to the listener.

Schizophrenia affects about 0.4 per cent of people in Britain at any one time and about 1 in 100 people during their lifetime. The onset of childhood schizophrenia is usually at puberty. Figures show rates of 0.02 per cent of 12 to 16 year-olds and 0.5 per cent of 17 to 19 year-olds. [56] Antipsychotic medication is the usual treatment, with periods of time in hospital when the situation is desperate. Some people are offered counselling or psychotherapy, and treatment often involves working with the whole family to look at how they deal with emotional problems.

Hearing voices

A study has suggested that about 8 per cent of children hear voices, and about one third of these fulfil the criteria for some kind of psychiatric diagnosis. This indicates that for most children voices are not a sign of mental disturbance. The voices were more likely to persist in cases where they were more frequent and perceived as negative, and were associated with anxiety or depression, appeared more randomly, and when the child had told more people about them. Being in receipt of mental health care did not influence their persistence. [57]

(Statistics from Mind.org.uk)

As we can see from the statistics above, mental illnesses are so common especially disorders such as anxiety and phobias. Yet many sufferers feel alone and embarrassed about their feelings. If you would like to find more information about different mental disorders, please visit our Types of Distress section.