By Jacqueline Oberst
Feeling overwhelmed? Some stress is ok, but long-term stress can be harmful—and adults aren’t the only ones who feel it.
Anxiety ranks right up with attention-deficit hyperactivity disorder, autism and depression in prevalence among American children. In an average U.S. classroom of 20 children, four have one of these mental disorders, according to the Centers for Disease Control and Prevention. Parents and clinicians should be concerned about anxiety in children not only because anxious children suffer–anxiety can place children at risk for other disorders, such as depression, as these children mature.
“Many types of anxiety are kind of normal,” says Daniel Pine, M.D., chief of the Section on Development and Affective Neuroscience in the National Institute of Mental Health’s (NIMH) Intramural Research Program at the National Institutes of Health (NIH). “It may be difficult for parents to tell the difference between anxiety that is a normal part of development and anxiety that can go on to cause serious problems for a child.”
Stress or anxiety entails both yin and yang components. “Good” types of stress exist; these do not last long and do not cause extreme suffering. For example, when children become slightly anxious when being called on in class or taking a test, these moments can help children perform well. However, prolonged periods of stress–divorce or a sick family member– eventually interfere with one’s daily life and health. Moreover, some children with anxiety disorders experience severe anxiety that lasts for many days when they are required to do things that are mildly stressful, like answer questions or take a test.
Generalized anxiety disorder (GAD) is diagnosed when a child or adult worries excessively about a variety of problems for at least 6 months. People with GAD can’t seem to eliminate their concerns, even though they typically know their anxiety is more intense than necessary. They can’t relax, startle easily and have difficulty concentrating. Often they have trouble falling asleep or staying asleep. Physical symptoms that often accompany the anxiety include headaches, muscle aches and having to go to the bathroom frequently (see sidebar).
The disorder develops gradually and can begin at any time, although the years of highest risk are between childhood and middle age. Other anxiety disorders, depression, or substance abuse often accompany GAD, which rarely occurs alone. GAD is commonly treated with medication such as selective serotonin reuptake inhibitors or behavior-modification known as cognitive behavioral therapy. Co-occurring conditions must also be treated using the appropriate therapies.
GAD sometimes runs in families. Environment also plays a role. Researchers have found that several brain areas, including two memory hubs, the hippocampus and amygdala, are involved in fear and anxiety.
Pine’s group, along with other researchers, has found that people with anxiety disorders have increased attention toward anything that seems threatening. One way to downshift their intense focus seems a bit counter-intuitive: playing video games. Upon interacting with a virtual computer game resembling an old video game, Pong, patients in Pine’s lab have shown a reduction in their anxiety severity.
Meanwhile, more traditional resources exist. Adults can consult their primary physician to rule out other physical conditions for their own heightened stress. A similar route can be taken with children.
Jacqueline Oberst is a science writer at the National Institute of Mental Health.
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