For Families > Disorders and Treatments > A-Z Disorder Guide > Anxiety

Anxiety in Childhood: Prelude to Anxiety in Adulthood?

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Anxiety disorders are the most common mental health illness in this country and affects more than 25 million people. According to recent research, most adults suffering from anxiety developed the problem at a young age. The manifestations of anxiety in children and adults were discussed in a presentation by Harold S. Koplewicz, M. D., Director of the NYU Child Study Center, on April 4, 2005, the initial lecture in the Positive Behavioral Intervention Series. The following outline is based on his presentation.

Anxiety is a normal, natural emotion experienced by most human beings. Some children, however, experience anxiety more intensely and more readily than others to a degree that interferes with their lives. When anxiety leads to distress in a child, adolescent or adult and to dysfunction in every-day life it may be considered a disorder. Anxiety Disorders are among the most common childhood conditions, but are amenable to intervention. Often the symptoms of adult Anxiety Disorder first appear in childhood, underscoring the fact that identification and treatment in childhood are critical aspects of prevention in adults. This article summarizes the types of childhood anxiety, how they may affect adult anxiety, and the available treatment options.

Stranger anxiety is normal in a 7-to-ll-month old infant. However, in a child, adolescent or adult the anxiety may be manifested in Social Phobia. The person may be painfully shy and fear exposure to anything unfamiliar.

Psychosocial treatment:

  • Behavior therapy
  • Cognitive behavior therapy
  • Social skills group therapy

Medication treatment:

  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • Luvox (fluvoxamine)
  • Prozac (fluoxetine)

Separation anxiety, or the fear of being away from home or caregivers, is normal at 18 to 36 months of age. If the anxiety occurs in an older child or adolescent it can be a Separation Anxiety Disorder; in an adult it may be Panic Disorder, a sudden feeling of overwhelming dread or impending doom, accompanied by intense physical sensations.

Psychosocial treatment:

  • Behavior therapy

Medication Treatment:

  • Tricyclic Antidepressants (TCA)
  • Tofranil (imipramine)
  • Selective Serotonin Reuptake Inhibitors (SSRIs)
    Luvox (fluvoxamine)
    Prozac (fluoxetine)

Common fears are normal at ages 2 to 5 years and usually abate. If fears persist in a child, adolescent or adult they be manifested in Simple Phobia.

Psychosocial treatment:

  • Behavior therapy
  • Desensitization

No medication treatment is recommended.

Performance Anxiety, or the fear of being judged by others, is common from age 5 through adulthood. However, when a person is overly self-conscious, self-doubting and concerned about meeting other people's expectations, they may have a Generalized Anxiety Disorder.

Psychosocial treatment:

  • Behavior therapy

Medication treatment:

  • Selective Serotonin Reuptake Inhibitors (SSRIs)
    Luvox (fluvoxamine)
    Prozac (fluoxetine)
    anafranil (clomipramine)

Rituals and superstitions can be present in children from age 4 into adulthood. When they persist and result in dysfunction in children, adolescents and adults, Obsessive Compulsive Disorder (OCD) may be present. In OCD the individual experiences the intrusion of unwanted thoughts which cause mounting tension, sometimes relieved by repetitive actions.

Psychosocial treatment:

  • Exposure
  • Response prevention

Medication treatment:

  • Selective Serotonin Reuptake Inhibitors (SSRIs)
    Luvox (fluvoxamine)
    Prozac (fluoxetine)

Summary: The importance of identifying anxiety, one of the most common problems in childhood, is critical not only in relieving the child's distress and dysfunction, but also in affecting the progression of the problem into adolescence and adulthood.