Children can be fearful of separating from loved ones, being away from family, or worrying that something bad might happen to their loved ones. Daily expressions of this anxiety can look like excessive questioning, reassurance-seeking, distress when having to be away from home or parents (such as sleep overs, school camps).
Specific fears and phobias
Phobias are common in childhood and can include fear and therefore avoidance of: the dark, animals or insects, storms, dental and medical procedures, injections and blood, heights, vomit. The distress caused by being in such frared sitations can result in unpleasant physical symptoms including nausea, heart palpitations, sweating and difficulty breathing.
Obsessions can be described as unwanted and intrusive, repetitive thoughts that the child cannot get out of their head. Common obsessions in children include fear of germs, contamination, need for order, fear of "bad things" happening (threatening or dangerous outcomes), need for tidiness and/or symmetry. Compulsions (or rituals) are behaviours the child feels compelled to do over and over in order to relieve anxiety caused by the obsession - for example, hand washing to relieve the obsession that they are dirty or unclean
Also known as Generalised Anxiety Disorder, excessive worry in children is expressed as a tendency to worry persistently about many things. It can include daily expressions of anxiety in the form of worry, reassurance seeking and questioning, thinking about worst case scenarios, anticipating negative outcomes, physical complaints such as headaches, stomach aches, or tiredness. Children who worry excessively can express fear of : death/dying themes, appearances or impressions, new unfamiliar situations, safety (such as burglars, nature disasters, being late, getting in trouble, health and school work.
Children can become preoccupied and worry persistently about social situations. Children with social anxiety are fearful about acting in a way that will cause them embarrassment or humiliation. They worry excessively about negative judgment or evaulation from others. When faced with social or performance situations, some children feel so distressed that they cry, hide or freeze. they can experience very unpleasant physiological symptoms including shaking, sweating, feeling hot or going red in the face, and feeling sick in the stomach. Other times children will avoid social situations wherever possible, such as going to parties, public speaking, initiating conversation, or participating in group discussions.
Mood problems in children can take various forms. Signs of childhood depression can include the child looking sad and withdrawn, the child saying that they feel excessively sad or dperessed, feeling irritable, losing interest in their usual activities, no longer finding things fun or enjoybale, crying or having angry outbursts. Teachers at school may also notice some of these signs. Feeling down or depressed can also begin to affect other areas of the child's life including their friendships, sleep, and academic performance.
All children demonstrate challenging and difficult-to-manage behaviour from time to time. In some children these behaviours occur often and cause great disruption in the family home or the school setting. Behaviours of concern can include verbal or physical aggression, displays of anger or expressions of intense frustration, oppositional behaviours and defiance of authority, behaviours associated with hyperactivity and inattention, and impulsive behaviours.
It can be devastating for children when they continually feel left out, excluded, not liked or like they just don't fit in with their peers. Problems with friendships can cause ripple effects including feeling down or anxious, and sometimes school refusal. Bullying, teasing or exclusion can often be the source of the interpersonal problems while at other times issues such as ineffective social skills, social anxiety or hyperactivity can be part of the problem.
Hair Pulling / Skin Picking
Thought to be related to problems with impulse control, hair pulling (trichotillomania) is seen in children who feel uncontrollable urges to pull their hair from scalp, eyebrow, eyelash or other parts of the body. Children offen describe a sense of relief, soothing or comfort that comes immediately after pulling their hair however this relief is often short-lived and very quickly followed by feelings of shame and/guilt or general unhappiness. Untreated trichotillomnania can result in significant hair loss and subsequent social problems due to fear of negative judgment from peers. Compulsive skin picking is another type of impulse control problem that an lead to long term physical and emotional problems for the child. Therapy can help children understand their urges and triggers better, as well as finding some strategies to minimise or halt the pulling or picking behaviours.