Information about Anxiety and Depression

*Descriptions of psychological disorders are presented for educational purposes. These descriptions are not sufficient to diagnose oneself or one's child. If you are looking for a formal diagnosis, please seek the help of a trained professional.*

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) is among the most chronic and debilitating of the anxiety disorders.  GAD is associated with excessive, uncontrollable worry in a variety of domains including school performance, making friends, appearance, neatness/order, health, and “little things”.  GAD may interfere with a child’s ability to participate in relationships, activities, and school, and typically, symptoms do not remit without effective treatment.  Lifetime prevalence of GAD has been estimated above 5%.  Key symptoms include:

  • Excessive and uncontrollable worrying
  • Restlessness or feeling on edge
  • Irritability
  • Fatigue
  • Muscle tension
  • Sleep disturbance
  • Difficulty concentrating
Social Anxiety Disorder

Social Anxiety Disorder  is an intense fear of becoming embarrassed or humiliated in social situations.    Some situations that commonly make children with social phobia anxious are public speaking or performing, meeting new people, social gatherings, eating in public, using public restrooms, and speaking to authority figures. Children with social phobia often worry that they will do or say something that will lead to humiliation, or that their anxiety will be noticed by others who will then judge them negatively.  As a result, these children tend to either avoid the situations they fear or endure them with considerable distress. Social anxiety is more severe than shyness, and may lead to impairment in several domains of functioning (e.g., school attendance and performance, social activities, initiating and maintaining peer relationships).  Key symptoms include:

  • Intense fear of social situations
  • Exposure to feared situations almost invariably provokes significant anxiety (e.g., crying, tantrums, freezing, shrinking)
  • Excessive worry about embarrassment or being judged by others
  • Avoidance of feared social situations
  • Performance anxiety
Separation Anxiety Disorder

Separation Anxiety Disorder (SAD) is characterized by excessive anxiety about being away from home or one’s caregiver.  Children with SAD often worry that something bad will happen to them (e.g., getting kidnapped) or their caregiver (e.g., car accident, heart attack) if they are apart.  This separation-based worry and anxiety can lead to impairments in several domains of a child’s functioning including school (e.g., school refusal), social activities (e.g., avoidance of sleepovers), and adaptive independent behavior (e.g., difficulty sleeping alone at night).  Key symptoms include:

  • Excessive anxiety about separation from home or caregiver
  • Excessive worry about loss or harm to self or caregiver
  • Fear of being alone without adults
  • Fear of sleeping without caregiver nearby
  • Nightmares about separation
  • Complaints of physical symptoms when away from caregiver
  • School refusal behavior
Specific Phobias

Specific phobias are intense, irrational fears of specific objects, animals, or situations. Common fears include heights, water, public transportation, storms, closed spaces, tunnels, bridges, and certain animals (spiders, snakes, bees, dogs, etc.). Children with specific phobias typically make a conscious effort to avoid the situation or experience that they fear, and exposure to the feared object or event almost invariably elicits considerable anxiety.  These fears become a significant problem when they interfere with a child’s daily life (e.g., fear of dogs prevents a child from going over her friend’s house).  Key symptoms include:

  • Intense, persistent, and irrational fear that is associated with significant anxiety and cued by the presence or anticipation of a specific object or situation
  • Exposure to feared object or situation almost invariably provokes significant anxiety (e.g., crying, tantrums, freezing)
  • Persistent effort to avoid the feared object or situation
Panic Disorder/Agoraphobia

A panic attack is a sudden, acute episode of intense anxiety that occurs “out of the blue”.  A panic attack involves such a high level of anxiety that children might feel they are having a heart attack, going to die, going crazy, or losing control.  When a child has recurring, unexpected panic attacks, fears future panic attacks, and makes changes in his or her behavior as a result, a diagnosis of Panic Disorder is given.  During a panic attack, children may experience acute physical symptoms such as shortness of breath, tingling sensations, ringing in the ears, a sense of impending doom, trembling, a feeling of choking, chest pain, sweating, and heart pounding.  In the case of Panic Disorder, the child’s catastrophic misinterpretation and subsequent fear of these somatic symptoms are the source of future panic attacks.  Children with Panic Disorder often avoid certain places (e.g., movie theatres, malls) in which they fear they might have a panic attack, a condition known as Agoraphobia

Depression

Major Depressive Disorder (MDD) in childhood features a depressed or irritable mood and a loss of interest or pleasure in daily activities for at least 2 weeks.  These symptoms represent a change from the child's normal mood and result in impairment in the child’s school and interpersonal functioning.  MDD is one of the most common and serious mental health problems facing children and adults today.  Every year, more than 1 in 20 Americans experience a depressive episode.  Key symptoms include:

  • Depressed or irritable mood
  • A loss of interest or pleasure in daily activities
  • Significant weight loss or weight gain
  • Sleep disturbance
  • Fatigue or loss of energy
  • Psychomotor agitation or retardation
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Difficulty concentrating or indecisiveness
  • Recurrent thoughts of death or suicide 
Persistent Depressive Disorder (PDD)

Persistent Depressive Disorder (PDD) is characterized by sad or irritable mood for at least one year.  The symptoms of PDD are the same as those listed above for major depression, but are generally less intense.  An episode of dysthymia tends to be less severe but lasts much longer than a typical depressive episode.