How To Treat the Growing Problem of Childhood Anxiety

Whether it’s feeling nervous to attend a new school, afraid of a scary looking bug, or scared of the dark, most children experience some form of anxiety. But up to one in three children experience more severe anxiety that affects their ability to learn and socialize.

Children with anxiety disorder may be unable to learn in school or make friends. They may have persistent stomach aches or headaches and refuse to sleep without a parent in the room. Research shows that when childhood anxiety is not treated, it is more likely to persist through childhood and increase the risk of adult disorders including anxiety, depression, substance abuse and suicide.

Two new systematic reviews take a careful look at the treatments for childhood anxiety. Researchers from the Mayo Clinic reviewed 115 studies with a total of more than 7,700 youth and teenagers; their results were published in the Journal of the American Medical Association. Additionally, researchers from the Agency for Healthcare Research Quality, part of the U.S. Department of Health and Human Services, reviewed 206 studies testing treatment for childhood anxiety in nearly 2,500 youth.

The reviews came to the same conclusions: They found that cognitive-behavioral therapy is the most effective treatment in improving symptoms of anxiety.

Cognitive behavioral therapy is based on the idea that our actions and thoughts affect how we feel. Essentially, changing children’s actions and thoughts will reduce their anxiety. For some children, this may mean exposing them to things that make them feel anxious in small doses and a safe environment. For example, a child who is afraid of dogs may meet a therapy dog who behaves exceptionally well and is gentle with children. The idea is that the child may feel a small amount of anxiety, but then learns he or she can cope with it.

The reviews also found that medications – specifically serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors – are also effective in reducing anxiety in children, but less effective than cognitive-behavioral therapy. However, medications have the added risk of side effects including stomach aches, insomnia and headaches. There is no conclusive evidence about the long-term effects of these medications for children.

The reviews both found that, for serious cases, a combination of medications and cognitive behavioral therapy is more effective than either treatment on its own.

The take-home message: Anxiety disorders are a serious problem for millions of children and can lead to larger problems if not treated. A large body of research demonstrates that cognitive-behavioral therapy is helpful. For some children, medication may be helpful as well.

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