DEAR DOCTOR K: I believe my second-grader suffers from anxiety. How is anxiety treated in children?
DEAR READER: Many kids have anxiety disorders. There are several different kinds, and most are suffered both by kids and adults, such as generalized anxiety disorder, social phobias, panic disorder and post-traumatic stress disorder.
Before your child is diagnosed with an anxiety disorder, however, consider this: Some children who are anxious have good reason to be afraid. For example, your child may be a victim of abuse by a relative or a classroom bully. Try to find out if this is the case.
If your child is diagnosed with an anxiety disorder, the treatment options are:
• Cognitive behavioral therapy (CBT). CBT is the best-confirmed treatment for anxiety disorders in children.
A common CBT method is called graduated exposure. In this method, young children with phobias, for example, are placed near the feared object while doing something reassuring and enjoyable.
• Drug therapy. The FDA has not approved any drugs for childhood anxiety disorders. (The only exception is the use of selective serotonin reuptake inhibitors (SSRIs) for obsessive-compulsive disorder.) But some SSRIs are effective and approved for the treatment of anxiety disorders in adults. As a result, many doctors prescribe these antidepressants for anxious children.
• Combination treatment. Among children and teens especially, combining CBT and drug therapy is often successful.
You and other family members can also help your child. For example, learn techniques for managing your child’s anxiety. Provide models of self-confidence and problem-solving, and give rewards for overcoming fears.
Sometimes a family problem is the source of the child’s anxiety, or an anxious child may think he or she is the cause of any trouble in the family. In that case, joint family therapy may be a good idea.