"Suffering In Silence": Children and Anxiety Disorders

Anxiety is the most common child mental health condition. According to the United States Department of Health and Human Services, 13 out of every 100 children and adolescents between the ages of 9 and 17 are anxious! Often we parents are not aware of the signs of anxiety or if we recognize the signs, we may not know exactly what to do about it. The purpose of this article is to provide brief information about anxiety conditions often seen in children and to give parents a few recommendations that can be done within their homes. Lastly, there will be a checklist that will help you decide whether a specialist is needed.

Anxiety disorders have two main components that we typically address in treatment. There is the "thought" component which may include worry, fear, or obsessional thinking about a feared object or situation. There is also the "action" component which may involve avoiding certain things, places, or situations. The action component may also involve rituals that children often believe will magically ward off feared objects or situations. Below are some examples of the more common anxiety conditions seen in children:

Separation Anxiety
Carol Standfield, an 8 year old girl in the 3rd grade, always seem to get stomachaches while at school or when she stays at her granny and grandpa's house. She has always been a "momma's girl," but Mrs. Standfield is beginning to wonder if Carol's behavior is a problem she should be concerned about.

This is a fictional character, but there are serious "true" cases where a child complains about being ill simply to avoid being away from their parents. The avoidance is the "action" component, but the "thought" component may involve fear about a parent dying or some other tragic thought.

Social Anxiety
Paul Thomas, a 14 year old teenage boy, has a hard time focusing in class because he thinks his peers are looking at him and whenever he hears a "chuckle" in the back of the class, he KNOWS they are talking about him. He does not go to football games because of this and really only has one friend who lives in his neighborhood. His mother always asks him why he does not go to the games with his older brother, but Paul simply shrugs his shoulders and goes to his room.

Another fictional character, but not a fictional scenario! Children and teens with social anxiety can lose precious years all because of beliefs that are not true.

Obsessive-Compulsive Disorder (OCD)
Jevanté Davis, a 7 year old boy, has a ritual before he leaves for school that involves counting the concrete partitions in his yard. Mrs. Davis initially just ignored it since it really did not cause any problems, but his teacher called yesterday to inform her that Jevanté had a "breakdown" at school because she would not allow him to count the cinder blocks in the wall on the way to the lunchroom. She went on to state that she usually just ignores him when he "counts" at school, but this time he lost his count half-way to the lunchroom and got really upset with her when she would not allow him to go back to his class to start his count over.

You may be thinking to yourself – this could never happen! Oh, but it does. It is often less complicated to "accept" a few minor changes in routine, than to force a child to confront his OCD symptoms. Nevertheless, eventually the condition becomes more severe, sometimes even leading to the avoidance of places where parents feel the child may become overwhelmed.

Specific Phobia
Latrice Jackson, a 10 year old girl, has always been afraid of heights, which has really been no problem until recently since her parents could simply avoid tall buildings and "hilly" areas. Unfortunately (…or fortunately), Mr. Jackson received notice that he is being promoted but he will have to transfer to the company's central office in Denver, Colorado! Latrice told her parents that she would "die" if they made her go – she is sure that a strong wind alongside a mountain is going to cause her to tumble to her death!

I hope that Mr. Jackson decides to accept the promotion – but there is a chance that he will not since his daughter is very precious to him and he does not want her to suffer. An extra $3,000 per month may not be worth it to him! Again, this fictional character demonstrates the "thought" component and the "action" component. You also can see how caring parents can change their behavior in response to the child's condition, which is exactly the opposite of what needs to be done.

Resources for Parents
Although working with a child mental health specialist is recommended for severe cases, which would involve functional limitations at home (e.g., taking 2-hour baths because of routines) or at school, parents can use the following to assist them with helping children with minor anxiety symptoms.

Select an appropriate book from the American Psychological Association (APA) Magination Press, a publisher of child mental health books for parents and professionals. There are over 25 books under Anxiety and Fears! A few of my personal favorites include, I Don't Know Why…I Guess I'm Shy: A Story About Taming Imaginary Fears for social anxiety, Into the Great Forest: A Story for Children Away From Parents The First Time for separation anxiety, and What to Do When Your Brain Gets Stuck: A Kid's Guide to Overcoming OCD.

After explaining to a child his condition by using one of the books above or some other appropriate book, you can observe the child to see if he is willing to stop avoiding the feared object or situation. There is no need to force him – just allow him to read the book and discuss "baby steps" that could possibly be taken towards approaching the feared object or situation. This will work better if the child comes up with the list of "baby steps" they are willing to take.

Normalizing a condition involves sharing with the child that she is not alone! Go over the different types of anxiety conditions with your child and tell her that 13 out of every 100 children have a problem with anxiety. Even better, actually calculate how many students at her school has anxiety by researching the total population at her school, divide by 100 and then multiply by 13. Then empower your child by telling her how brave she is because she is doing something about her fears, whereas other children may not be strong enough to confront their fears just yet.

When to Seek Professional Help
Often children are not brought in for treatment for internalizing disorders, such as anxiety and depression. The externalizing disorders, such as oppositional defiant disorder and Attention Deficit Hyperactivity Disorder (ADHD), get a lot of the attention in clinics because these disorders are more noticeable, whereas a child with an internalizing disorder "suffers in silence." If you are able check any of the following as true, please seek professional help by calling your insurance company and asking for therapists on their panel of providers or by asking for referrals from family and friends. Finding providers in the phone book and "interviewing" them to make sure that you get someone with experience in treating children and in treating the type of condition that needs to be treated is also an option.

 My child's condition has caused our family to make several changes in travel and in the way we do things at home.


 My child's condition has caused him/her to miss several days at school because of "illnesses" for which the doctor can never find a cause.


 My child's condition has caused him/her to withdraw and isolate himself/herself from other children/teens.


 My child cries often and make statements like, "I wish I was different" or "I wish I was like other popular kids at school."


 My child appears to be very distressed and have fears that are totally not normal for a child his/her age


 My child's condition has caused another significant problem not listed above, which is causing significant problems for him/her or the family

Although anxiety is the most common child mental health condition, it is also one of the most treatable conditions. Recognizing the signs is the first step. The second step is deciding whether treatment is needed. Hopefully this article has helped you to decide what is best for your child (…and your family).

HoPE Center

This center takes a holistic approach to counseling and therapy - focusing on the mind, body, and spirit! Visibility on Facebook allows access to parents and individuals who have questions for Dr. Jackson. This blog serves as an avenue for Dr. Jackson to share her thoughts related to parenting, culture, Christian-based approaches to treatment, and other topics that are near and dear to Dr. Jackson's heart.

We are supposed to use the gifts God gave us to help one another. Let me know how my gift of "healing the mind" acn be of service to the community. Although I learned plenty in graduate school (M.A. and Ph.D. in Clinical Psychology, Child/Adolescent Specialist), the most important lessons I have learned are from the Bible...this blog is one of many ways I hope to be able to serve!

Adolescent Initiation Rites in Africa: Are We Throwing Out The Baby With The Dirty Bath Water?

African communities often had initiation rites for adolescents. The purpose was to provide training to adolescent males and females that would enable them to become functional adults within the culture. Lately, there has been a lot of controversy over the negative aspects of the training (i.e., female genital mutilation) but not much is known about other aspects of the initiation. Below is a reference for an article that discusses this issue. I have often wondered whether there are certain "values" and trainings from African-Americans' past that could save our children today. I will be looking forward to your thoughts on this topic.


Demythologization and Demystification of African Initiation Rites: A Positive and Meaningful Educational Aspect Heading for Extinction P. Masila MutisyaJournal of Black Studies, Vol. 27, No. 1 (Sep., 1996), pp. 94-103

African-American Boys! The Pain of Our Brothas...

Thanks for your comments (on-line and via personal email) and your support! This is a topic that I am very passionate about and hope to find like-minded individuals to join in the fight to save our children. Books will soon follow on related topics (...so keep an eye out :-)! It will take a group of spiritual leaders, writers, motivational speakers, politicians - "A Village" - to really attack this issue. Did you know that 19.5% of African American men between 16-29 are unemployed (the next highest group are Hispanic men at 8.0%!)? Did you know that only 77.4% graduate from High School and around only 7.4% graduate from college! 10.1% are in prison (next highest group, Hispanic males at 3.6%). Females are doing "better than the males" but not as well as they should. I will not even go into the death rates because THAT is TOO depressing. What is the answer? Or, is the answer "there is no answer."

Welcome!!

We have come so far as a community and as a country! Barack Obama - need I say more? Black, White, young, old, men, and women have all joined together to show that "hopes and dreams" that were once thought to be impossible, actually are very possible. This new hope is one of the main reasons why I wanted to start this blog to begin discussions (...and hopefully, actions) related to a grand problem in our country.

All people - not just African-Americans - are concerned about the negative statistics that are meant to offer a "summary" of things that are going on in sub-communities within the African-American community, mostly lower-income communities. What's being done to help the children from these communities? Maybe something is being done but the media is simply not covering the "positive statistics" as much as they are the negative...or maybe everyone is waiting for the next "guy or gal" to do something? As a clinical psychologist and researcher, I have published papers about racial disparities in schools, interventions for children, etc., but it is time for me to do more because people are typically not aware of things published in these professional journals. Bill Cosby's recent book and public discussions on the issue and his putting the issue "on blast," as my students described it, was a start - but much more needs to be done!

We can send a man to the moon, but we can not figure out how to engage "disengaged" Black boys in education? What's the deal people??