It is fairly common that as I’m about to finish up a routine Well Child appointment, where the child is growing well and developing perfectly, that parents finally get brave enough to bring up lingering concerns. One of the more common ones is if their child’s feelings of worry or sadness are normal. This is a challenging question since most children at some point will show periods of extreme worry and sadness by the simple fact that growing up is inherently stressful. Since some degree of worry and sadness is normal the question changes from “Is this worry or sadness normal?” to “Does this worry or sadness interfere with my child living their life?” If you can answer the second question with a “No” then odds are what you are watching is a normal part of growing up and allowing your child to learn how to deal with this worry and stress will likely help them grow into healthy adults. On the other hand, if you find this worry leads to difficulty in daily aspects of your child’s life, such as poor school performance, avoiding activities they once enjoyed, prolonged periods of symptoms greater than six months, disrupted sleep, or having difficulty with relationships with friends, then you might need to consider if something else is going on.
It was once believed that childhood offered almost magical protection against Anxiety Disorders and Depression, but it is clear that while the symptoms often present differently than they do in adults, children are still at risk for periods of prolonged sadness and excessive worry. Recognizing symptoms of anxiety and depression can be difficult at times. While an adult may say “I feel anxious” or “I feel depressed” children and adolescents are less likely to put words to what they are feeling, but instead show changes in behaviors. Examples of these changes might be:
- Irritability or anger
- Social withdrawal
- Increased sensitivity to rejection
- Changes in appetite — either increased or decreased
- Changes in sleep — sleeplessness or excessive sleep
- Vocal outbursts or crying
- Difficulty concentrating
- Fatigue and low energy
- Physical complaints (such as stomachaches, headaches) that don’t respond to treatment
- Reduced ability to function during events and activities at home or with friends, in school, during extracurricular activities, and in other hobbies or interests
- Feelings of worthlessness or guilt
- Impaired thinking or concentration
- Thoughts of death or suicide
Having or showing these behaviors, especially for short periods of time, is not always indicative of a serious problem, but if you have noticed any of these signs, taking time to consider what is going on in your child’s life is time well spent. Realizing that your child may be suffering from anxiety or depression can be very daunting and upsetting since many of us are unfamiliar with what help is available. The use of counseling, specifically Cognitive Behavioral Therapy (CBT), has consistently been shown to alleviate much of the difficulties that are occurring and is a great place to start. In situations that are resistant to counseling the use of medications as an additional tool may be considered since they may help someone become more fully engaged in working on ways to deal with their feelings of anxiety and depression.
If you have concerns about your child and how they might be dealing with periods of worry and sadness, feel free to contact us here at Canyon View Pediatrics to discuss it further.
Links and additional resources are included below.
- American Academy of Pediatrics Anxiety Fact Page.
- American Academy of Pediatrics Depression Fact Page.
- The Book, “What Do You Do When You Worry Too Much?” by Dawn Huebner PhD
