Wednesday, November 13, 2013

The Anxious Child and Panic Disorder

Childhood.  Just the mention of the word conjures up visions of carefree, winsome children playing with friends and siblings at the park or in the backyard, while laughter and singing echoes around them. Sadly, as teachers we know the reality that not all children experience such an Utopian childhood.  For many, there are daily struggles and challenges that they face both at home and at school.  For ten percent of Americans under the age of 18, anxiety disorders plague their daily life.  Chances are you have a student in your classroom right at this moment who is suffering from anxiety.  You may be the parent of an anxious child.  And chances are that some of your little ones may also be suffering from Panic Disorder.

What is Panic Disorder? 

Do you often suffer from the "Sunday Blues"?  You know, that feeling of dread that you must return to work on Monday and that your hectic pace and schedule begins again?  Do you have a lingering feeling of dread that may even start on Saturday night, that remains, brews, and grows on Sunday?  Does the thought of returning to work the next day cause headaches, stomach aches, and other physical symptoms?  Do you fret and worry about how you will get everything done that needs to be accomplished in the upcoming week?  If you can relate to any of this, then you have a small glimpse into what anxiety and Panic Disorder is like for an afflicted individual  Like the child it affects, you may like your job, like school, but you cannot stop the barrage of overwhelming feelings of uneasiness and worry.

Panic Disorder is marked by recurring panic attacks and persistent worry that they will happen again.  A panic attack is "an episode of intense fear and unease, comprised of physical symptoms and a number of fearful thoughts" (The Child Anxiety Network)

Characteristics of Panic Disorder
  • Numerous, unpredictable panic attacks and feelings of imminent death, a heart attack, and a disconnection from reality
  • Chest pain, heart palpitations, shortness of breath, dizziness, trembling, tingling and pain in the arms
  • Hot or cold flashes
  • An intense urge to flee the situation
  • Fear of losing control
  • Nausea
  • Sweating
  • Sobbing, crying
  • Intense worry

Many people who suffer from Panic Disorder avoid locations of previous attacks, especially if they could not escape easily and quickly.  Panic attacks may occur in public places, but they may also strike during a relaxing time at home. Some children and adults avoid leaving their home alone and some may become housebound. They are unpredictable and present with both physical and emotional symptoms, as illustrated in the list above.  

Although Panic Disorder is rare in childhood, it does affect children as young as three years old. However, most often, Panic Disorder manifests during adolescence. My youngest child suffers from an anxiety disorder called Selective Mutism.  In addition, he also suffers from panic attacks and has since he was three years old. At the time, I thought that he was going through a phase, the "tumultuous threes".  The doctor that diagnosed him with Selective Mutism, helped me to understand that my child was also having severe panic attacks.  His inability to speak in public places and even at home was caused by anxiety.  But so were his temper tantrums, episodes of intense crying and sobbing, meltdowns, anger, difficulty falling asleep and awaking during the night, and his reluctance to leave the house.  It is common for panic attacks in children to be mistaken for tantrums or oppositional behavior.

Some children refuse to attend school.  For my own child, even now that he is almost seven years old, there are times when his anxiety will intensify and I will have to hold him, get him dressed, and soothe him as he cries uncontrollably or lashes out in anger over having to go to school.  Often, he will complain of headaches, stomach aches, have diarrhea, and verbalize his obsessive worries.  If left untreated, children with anxiety disorders may fail academically, have difficulty with relationships, suffer from substance abuse, or develop agoraphobia ( a fear of open spaces).

If you suspect that your child or student may have an anxiety disorder, it is imperative that a physician is consulted.  This is especially important if there is a family history of anxiety disorders, Bipolar Disorder, and/or depression, as they are risk factors. In addition to a genetic component, profound stress and life changes can trigger anxiety and/or Panic Disorder. A general practitioner doctor, a pediatrician, a psychologist, or a psychiatrist may be involved in the diagnosis and treatment.  Psychotherapy, especially cognitive behavioral therapy has proven to be effective.  In some instances, the child may be prescribed anti-anxiety and anti-depressant medications.

For my own son, we have not sought to treat him with medication, but have used a variety of strategies here at home. I wrote about the different techniques I implemented at home in an article published in The Educator's Room, an online magazine.  You can read that post here.

Next time, I will discuss specific strategies that can be used in the classroom by teachers to help ease the anxiety for these precious little ones.  In the meantime, if you have ideas and techniques that you have had success with, please share by leaving a comment!


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  1. I just found your blog....I've been struggling as a parent of a child with SM. His social phobia became extreme when he entered middle school last year. He has been in therapy for a year with little progress and just began medication. I'm looking forward to following and learning all that I can to help my son!

    1. Hi! The middle school years are tough for anyone, let alone for a child with S.M. Does your son talk at all at school? From what I have learned,dealing with the anxiety first and learning coping strategies helps the child to relax and eventually talk. I wish you all the best and hope that my articles continue to be helpful to you! :-) Lauren

  2. Thanks for the support. It's nice to find someone who understands. He will whisper to peers in the classroom but has yet to speak to an adult at school. His anxiety is so high that he has difficulty doing the work in class as well. Some of his teachers have been sending work to him via email and he can communicate with them that way. Some of his teachers have not been very understanding at all. I think some teachers are exacerbating the problem and I have been struggling to educate them. It's been hard.

    Your blog and twitter has led me to all kinds of great resources though! I'm so grateful. :)

  3. I am so sorry to hear that some of your child's teachers do not understand S.M., and I have had the same issue. I am so happy that the resources I have shared have been helpful. S.M. is a recognized disorder according the DSM V. Have you considered an IEP or 504 plan for your son?


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