Anxiety is a common
emotion we have all experienced. At some stage in their life every individual
will feel anxious when faced with a difficult situation. Sweating, increased
heart rate, shallow breathing, butterflies in the stomach, and a dry
mouth, are typical symptoms of anxiety.
best understood when compared with the emotion of fear. We experience
fear in the presence of real, immediate danger. For example, being chased
by a vicious dog. Alternatively, anxiety is a more general response
that may be out of proportion to environmental threats. Specifically,
anxiety tends to be associated with worrying about future or past difficulties,
rather than an immediate situation. For example, an individual worrying
before an examination represents an anxious response (Oltmanns &
experience anxiety, as part of their normal development. However what
may be considered an appropriate fear at an early stage of development,
for instance a fear of the dark at age three, or a fear of going to
school in grade 1, may be considered less appropriate, when a child
reaches adolescence. In other words, an individuals age must be
taken into account when thinking about anxiety responses.
and youth experience different levels of anxiety, and cope with anxiety
in more, or less effective ways. Anxiety becomes a problem when it prevents
individuals from enjoying normal life experiences for a long period
of Anxiety Disorders
difficulties may be manifested in different forms. The most common anxiety
Anxiety Disorder is characterised by excessive worry and fear
about future or past events. This disorder is usually accompanied
by somatic symptoms like headaches, stomach aches, vomiting, and sleep
Anxiety Disorder is the fear of separating from primary caregivers,
home or other familiar surroundings.
Phobia is a fear associated with a specific object or situation,
such as fear of needles, dogs, heights, or the dark.
Stress Disorder is characterised by the presence of severe anxiety
reactions or feelings, following a traumatic event, such as witnessing
a death or being involved in a near death experience.
Phobia is the fear of being humiliated or embarrassed in front
of other people. For instance, meeting new people, being at the centre
of attention, or in a group social situation.
Compulsive Disorder is characterised by intrusive, obsessive thoughts
which are usually alleviated by compulsive actions (e.g. washing hands
60 times a day), and checking behaviours (e.g. checking bag 20 times
before going to school in case they have forgotten something). This
disorder is extremely rare in children.
Attack is a discreet period in which there is a sudden onset of
intense apprehension, fearfulness or terror often associated with
feelings of impending doom. These feelings are accompanied by physical
symptoms such as palpitation, chest pain or discomfort, difficulty
breathing, and choking smothering sensations.
essentially anxiety about, or avoidance of, places or situations from
which it may be difficult and/or embarrassing to escape, and/or help
may not be available if a panic attack should occur. For instance, being
outside the home alone, being in a crowd, travelling in bus or being
on a bridge.
Please note that
the purpose of the information above is NOT to classify children according
to a particular disorder. Rather this section simply aims to provide
background information on Anxiety.
of Anxiety Disorders
disorders represent the most common form of psychological distress in
childhood and youth. Research has consistently found high rates of anxiety
disorders in children and youth: 8 years old 25.7%,12 years old 15.7%,
17 years old 21.4%. Although specific figures differ, gender differences
appear to exist for the reported levels of anxiety disorders. Specifically,
girls tend to report more anxiety disorders compared with boys.
is an emotional state marked by great sadness and apprehension, feelings
of worthlessness and guilt, withdrawal from others, loss of sleep, appetite,
and sexual desire, or loss of interest and pleasure in usual activities.
Just as most of us experience anxiety, so too, we will probably have
more than an ample amount of sadness during the course of our lives,
although perhaps not to a degree or with a frequency that warrants the
diagnosis of depression. Often depression is associated with other psychological
problems and with medical conditions. For example, when conflict within
a family increases, a child often withdraws from others and may become
depressed. When this is the case, depression is best viewed as secondary
to the other condition.
is an exhausting effort for the depressed. They cannot take in what
they read, and what other people say to them. Conversation is also a
chore, for many people prefer to be alone and remain silent. They may
speak slowly, after long pauses, using a monotonous voice. Others, especially
children, may appear agitated, and cannot sit still. When depressed
individuals are confronted with a problem, no ideas for its solution
occur to them. Their thoughts are predominantly focused upon self-recriminations,
and they may neglect personal appearance. Utterly dejected, and completely
without hope and initiative, they may appear apprehensive, despondent,
and anxious much of the time.
There is some variation
in the symptoms and signs of depression across the life span. Depression
in children sometimes results in their being overly active and aggressive;
in adolescents, it is sometimes manifested by negativism, antisocial
behaviour, and a feeling of being misunderstood; and in older adults,
depression is often characterised by distractibility and memory loss.
Furthermore, an individual seldom shows all aspects of depression: the
diagnosis is typically made if at least a few signs are evident, particularly
a mood of profound sadness that is out of proportion to the individuals
life situation and a loss of interest or pleasure in previously enjoyable
Between Anxiety and Depression
of a strong relation between depression and anxiety in children and
adolescents is beyond dispute (Cole, Peeke, Martin, Truglio & Seroczynski,
1998). Equally clear, however, is the existence of noteworthy differences
between these disorders, especially with regard to age of onset, duration,
or associated features. Children with both anxiety and depression tend
to be older than their anxious only, or depressed only counterparts.
They also seem to be more symptomatic, with anxiety symptoms typically
predating the depressive symptoms. Research in the United States and
the Netherlands is now beginning to provide support for a temporal,
if not causal, relation between anxiety and depression.
of Early Intervention and Prevention Programs
the high prevalence of anxiety disorders in childhood and youth, and
the important link between anxiety and depression, early intervention
programs represent an important and necessary step to benefit individuals,
families and communities at large. These programs are designed to prevent
the development of anxiety and depressive disorders by increasing individuals
emotional resilience, and promoting positive coping skills.
of early intervention programs is accentuated by research that suggests
children who suffer from high anxiety are more likely to become anxious
adults (Mattison, 1992). Early anxiety intervention programs have been
shown to reduce the number of children and youth developing anxiety
disorders (the full report of this research is published in The Journal
of Consulting and Clinical Psychology (Dadds, Spence, Holland, Barrett,
& Laurens,1997). Furthermore, such programs are cost-effective by
reducing the cost for future professional services, as well as targeting
large groups of individuals, over a short period of time. In short,
effective early intervention and prevention programs represent a significant
opportunity to prevent a great deal of suffering for individuals and
of Early Anxiety Intervention Programs
the high prevalence of anxiety disorders in childhood and youth, early
intervention programs represent an important and necessary step to benefit
individuals, families and communities at large. These programs are designed
to prevent the development of anxiety disorders, by increasing individuals
emotional resilience and coping skills. The importance of early anxiety
intervention programs is accentuated by research that suggests children
who suffer from high anxiety are more likely to become anxious adults
(Mattison, 1992). Early anxiety intervention programs have been shown
to reduce the number of children and youths developing anxiety disorders.
Furthermore, such programs are cost-effective by reducing the cost for
future professional services, as well as targeting large groups of individuals,
over a short period of time. In short, effective early anxiety intervention
programs represent a significant opportunity to prevent a great deal
of suffering for individuals and their families.