Fear, Anxiety and Depression

Resource - Rocky View Schools - This webpage outlines the prevalence and impact of anxiety in children and the difference between anxiety, fear and depression.

Anxiety in Children

The Basis of Anxiety

Fears are natural. We all experience fear from time to time (e.g. turbulence on airplane). Fear is essential to survival – it stops us from getting hurt. When confronted with a life-threatening or dangerous situation (e.g a vicious dog) we automatically respond with the flight or fight response. Chemical messengers such as adrenalin are produced and prepare our body for a defensive reaction. Our muscles tense, our heart rate increases supplying extra oxygen to the body, our vision and hearing becomes more acute and focused. Fear allows us to run away as quickly as we can (flight) or attack back (fight). Fear is an appropriate reaction to real danger or threat.

Developmental Fears

Childhood fears are also a normal aspect of development. Humans are pre-programmed to develop some fears. Children who possessed certain fears and avoided the associated objects and situations were more likely to survive. Such fears are age-appropriate and usually transitory and each common fear is linked to a particular period of growth:

  • Under two years - Stranger anxiety
  • Throughout the preschool years - Separation anxiety
  • 8 to 10 years of age - Worry about death and growing awareness of concepts of time and death as permanent
  • Middle childhood - Worries about performance, taking tests, oral reports, performing in school or sports
  • Adolescence - Social concerns - physical appearance and others's perceptions of them, whether they are popular and have enough friends, larger global issues

Fear vs. Anxiety

Children can understand that anxiety can be unhelpful and is like having an alarm go off when you don’t need it. False alarms can become tiresome and annoying, even distressing. It is like having your smoke detector over your toaster. The smoke detector may be working fine, but it is in the wrong place at the wrong time- unnecessary. It will be going off often- even when you don’t need it. With anxiety, your alarm system or fear response is working fine (even over-working) and is being activated when you don’t need it.

Many children go through their day in a high state of arousal, which is exhausting and hinders performance and enjoyment in daily life. Social and emotional learning programs help children learn how to turn off the fear response and turn down their anxiety and physiological arousal.

Fear: Tends to be experienced in the presence of a real, immediate danger

Anxiety: Is the fear response in the absence of, or out of proportion to, environmental threat. It tends to be associated with worrying about future of past difficulties.

Is anxiety good or bad?

Anxiety can be functional and helpful. It can be motivating and prevent excessive risk-taking. Mild to moderate levels of physiological arousal can help you perform optimally on tests, giving presentations or playing sports, for instance.

When is anxiety a problem?

  1. Firstly, when the child experiences significant distress, which is out of proportion to the threat. It is more intense than is what is normally experienced by a child that age (e.g. severe stomachaches and throwing up or  separation anxiety distress persisting into middle of school year).
  2. When it interferes with a child’s or family’s life and relationships and daily functioning are impaired. It may also interfere with a child’s ability to participate in age appropriate activities and meet age-expected norms such as making and keeping friends and meeting expectations at school (e.g. regular attendance, homework completion, taking tests, giving oral reports).  Activities may become restricted (. avoiding going to a park because they are worried there will be a dog there or avoiding birthday parties because of shyness.)
  3. When the anxiety is developmentally inappropriate and appears at the wrong age or developmental period or persists past expected lifespan (e.g. trouble separating from parents in middle school).
  4. When the fear endures. When the fear is not transitory, but lingers (eg. Separation distress persists whole year). Anxiety disorder is when difficulties have existed for a period of six months or more.

The Impact of Anxiety

Anxiety is a real and serious health problem that causes significant personal suffering. Anxiety interferes with normal functioning and can create social isolation, underachievement and depression. Anxiety is highly co-morbid with other mental illnesses. Sixty-five to 95 per cent of children with an anxiety disorder will be diagnosed with more than one anxiety disorder. Nine per cent will experience depression. All children diagnosed with an anxiety disorder have an increased probability of substance abuse.

Anxiety is the most common mental health problem among children today (more than ADHD, or conduct disorders). Having an anxiety disorder increases the risk of developing other anxiety and mental health disorders. Fifteen per cent of preschoolers suffer from atypically high levels of depression and anxiety. Anxiety is chronic – without intervention likely to lead to significant problems into adulthood.

Symptoms of anxiety and depression

The number one descriptor for anxiety is worry and avoidance. The number one descriptor for depression is sadness and a cognitive style of hopelessness and helplessness. Youth who are depressed tend to lose pleasure in things they previously enjoyed. They often withdraw socially, and may refuse to be with friends or participate in activities. Anxious youth want to socialize but are nervous and avoid social situations because of fear of rejection or embarrassment. Depressed youth often present with flat affect- no emotion, while anxious children demonstrate physiological arousal and physical complaints. Both anxious and depressed youth have low concentration, sleep difficulties, and may appear irritable and uncooperative.

Symptoms of AnxietySymptoms of Depression
Excessive Excessive

Worry (anticipatory)

Avoidance

Attention to threat

Fast/sustained physiological arousal

Psychosomatic complaints

Difficulty in resting and going to sleep

Shyness

Social withdrawal

Perfectionism

Sadness

Loss of pleasure

Social withdrawal

Early morning insomnia

Hopelessness and helplessness

Irritability

Negative memory biases

Poor concentration

Flat affect

Appetite changes

Resilience

Resilience means to spring back, or rebound. It's the ability to overcome adversity and to achieve good outcomes regardless of life events or circumstances.

Factors that can negatively impact a child's resilience include temperament sensitivity, threat-focused attention, traumatic life events and even school.

Protective factors include attachment and affection, cognitive style, family and friends and a healthy pattern of sleep, exercise and diet.

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