Anxiety is the most common, chronic, costly emotional disorder in the U.S. (NIMH) and in 16 of 17 countries (WHO-2004). Moreover, the lifetime diagnosis of anxiety or depression among children aged 6 to 17 years increased from 5.4% in 2003 to 8.4% in 2011–2012. Current anxiety or depression increased from 4.7% in 2007 to 5.3% in 2011–2012 ( Journal of Developmental & Behavioral Pediatrics: June 2018 – Volume 39 – Issue 5 – p 395–403. American Academy of Pediatrics). Foxman (2019) attributes the current state of affairs due to the influence of the post 9-11 world & “war on terrorism,” media information overload & perceived threats, and the economy.
“Normal” Anxiety is a physiological response that serves a survival function by alerting individuals to a potential life-threatening/dangerous situation. It can be a healthy emotion—it forces us to focus on our problems, and work hard to solve them. But sometimes, anxiety grows out of control, and does just the opposite. It cripples our ability to solve problems. When this happens, irrational thoughts often play a role. Pathological anxiety occurs when this survival response becomes generalized to situations that are not dangerous or life threatening and/or the intensity, frequency, and duration of response is out of proportion the situation.
Children grow/develop a sense of self through reflected appraisals from significant others (i.e. parents, teachers, peers). Parents,’, teachers, and peers’ faces act as mirrors and reflect back to children how they feel about them or how children make them feel. Positive reflections build an internalized sense of security and confidence while negative reflections build a negative sense of self. Exacerbating this natural process is the fact that about 20% of children have biological sensitivities that predispose them to developing anxiety under conditions like those cited above. In addition, since executive functions (EF), which have the role of regulating thinking and emotions, are developmentally the last part of the brain to fully mature (between 18 to 20 years of age), important EF like inhibition and emotional control are not fully available to “put on the brakes” when stimulation is too intense to digest.
As a result, more children are presenting with separation anxiety that manifests itself as school refusal, generalized anxiety disorder with its’ somatic symptoms, panic disorder, and obsessive compulsive disorder. Therapeutic approaches include psychoanalytic, cognitive behavioral, as well as mindfulness and, when needed, medication. For parents and teachers, the fundamental principle governing the exposure of children to an overwhelming amount of stimulation is to consider limiting the demands by regulating the quantity and speed with which information is presented. This includes media use which has become an increasingly larger factor in the development of worry.
While everyone experiences anxiety under certain conditions, when nervousness becomes frequent, intense, and occurs in situations where anxiety would be unexpected or the degree of anxiety is out of proportion to the events, it is time to consider speaking with a professional.