Source: Indys Child Parenting Magazine

Recognizing Anxiety and Depression in Kids
What to look for, and what parents can do

by Carrie Bishop

November 01, 2011

Kids are going to feel sad. Theyíre going to feel anxious. These emotions are a normal part of life. Most of the time kids bounce back. Itís when they donít that sounds an alarm.

Because anxiety and depression can affect kids of all ages, itís important parents are familiar with the symptoms of each. The very young may not have the verbal skills to express their feelings. Older children may not want to share them with their parents. Plus, anxiety and depression donít always look the way parents may expect.

What anxiety looks like

According to Susan Oxfurth, licensed social worker with North Meridian Psychiatric Associates, all kids have anxiety. They worry about school or a friend and thatís normal. The difference is when it starts to interfere with their life.

She notes that anxiety disorders can come in many forms including separation anxiety, generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, specific phobias, panic attacks, and social anxiety.

Most parents are familiar with separation anxiety because it affects so many young healthy children. Some kids, however, experience it more acutely. Their symptoms may include a mirage of physical pains that appear to have no basis. Your child may check out healthy during a pediatric examination, yet his physical symptoms persist. A child may also have intense fears about the safety of his parents, refuse to go to school, throw tantrums when it comes time to separate from parents, or be overly clingy. Itís normal for young kids to have some separation anxiety, itís when their anxiety interferes with their ability to function that is cause concern.

Social anxiety also affects many kids and is said to be on the rise. In general, social anxiety is a fear of meeting or talking to people to a point where the child avoids social interactions and has few friends outside his or her family. Kids with social anxiety are often anxious about speaking in front of class or being called on by the teacher or even calling people on the phone. Perhaps unsurprisingly itís become more comfortable for many kids to text than to speak.

Other symptoms of an anxious child may include frequent nightmares or general trouble with sleeping, being easily distressed, asking repetitive reassurance questions such as ďWhat would happen if...,Ē saying for days on end that he or she is worried, experiencing a change of appetite, fearing that they will make a mistake, and having low self-esteem.

What depression looks like

While some anxiety is normal for everyone, Oxfurth said children really shouldnít be depressed unless thereís been a loss such as a death, divorce or other normal situation. If parents feel their child is depressed, then itís a red flag that something clinical could be going on and the child should get help quickly.

Jessie Fogle, licensed clinical social worker at Meridian Youth Psychiatric Center, said with depression parents may see a lot of sadness, tearfulness, crying, or irritability and anger. Children with depression often show a lack of interest in the things they used to do to have fun. Like anxiety, Fogles said kids suffering from depression may identify they feel bad physically before they are able to identify they feel bad emotionally. They may say their tummy hurts or they have a headache.

According to the American Academy of Child and Adolescent Psychiatry (AACAP), other symptoms of depression include changes in appetite and sleep patterns, appearing to be physically sped up or slowed down, heightened tiredness or fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, thoughts or expressions of suicide, self destructive behavior, difficulty with relationships, and even boredom.

What parents can do

The bottom line if a parent suspects their child is suffering from anxiety or depression, is to ask for support. ďItís important for parents to know they are not a bad parent if their child is suffering from emotional distress,Ē said Elizabeth C. White, licensed mental health counselor and licensed school counselor with the Well Counseling and Consulting Group.

White encourages parents to talk to teachers and counselors at the childís school, talk with his or her primary care physician, or seek the help of a private practice therapist.

Fogle believes some parents are scared to pursue outpatient counseling fearing their child will automatically be put on medication. She said thatís not the case. Therapy allows the child to talk about their feelings, discuss whatís stressful, and gain necessary coping skills.

Many therapists use cognitive behavior therapy to treat children with anxiety and depression. This treatment helps kids begin to learn they have the power to change their thinking. They relearn how to manage their worries, fears or sadness.

Aside from formal therapies, Oxfurth said, ďThe best advice for parents is to set a calm example. Donít freak out yourself. Model how to manage stress and use it as a teaching moment.Ē She also advises parents to never dismiss a childís feelings even if the parent feels the issue has been dealt with.

Other strategies for good mental health include making sure the child is physically active, has good sleeping patterns, eats a well-balanced diet, and has a regular routine they can count on. Also, limit the childís ability to watch repetitive news and hear adults talking about news repetitively because children donít know how to process this information.

For more information about anxiety or depression, parents may consider speaking with their childís school counselor or visiting the AACAP website,