Anxiety Disorders & Depression in Children
The days when it was thought children could not truly experience anxiety or depression have passed. We now accept that the roots of anxiety disorders in adults are probably established during childhood or adolescence. Clinical depression in children is still quite rare but the rate increases during adolescence to around 15 percent. Very few adults with anxiety disorders develop their first anxiety-related problems after adolescence. Vulnerability to anxiety as a child or adolescent increases the risk of periods of anxiety throughout adult life.
The true extent of anxiety disorders in children isn't really known but a variety of studies suggests somewhere between 5-10 percent are affected. In pre-adolescent children, separation anxiety disorder is by far the most common issue. Also, because young children are still developing at a cognitive and social level, they have yet to acquire the intellectual capacity deemed necessary for social anxiety or full panic disorder to develop. During adolescence the balance starts to tip. The fear of separation diminishes only to be overtaken by concerns about social performance. This is the potential trigger for social anxiety and, as an understanding of mortality takes hold, so does the potential for panic.
The risk factors for anxiety and depression are very similar. Negative life experiences, genetic predisposition and parenting issues are significant. There is clear evidence that anxiety and depression can run in families but what is less clear is the relationship between genes and the environment the child is brought up in. Some research suggests around one-third of childhood anxiety is genetic. On that basis the remaining two-thirds is environmental and contextual.
Style of parenting is believed to be important, especially the extent to which a child perceives rejection and control. As parents are the primary role models for children it seems likely that fears and maladaptive behaviors are learnt from anxious or depressed parents. These days parents are often accused of being over-protective or over-controlling in the lives of their children. No doubt there is a measure of truth in this in some cases more than others. Of course parenting is a two-way process and we can't discount the possibility that an anxious or depressed child influences the style of parenting.
Adolescence is an emotionally unsettling time where it is actually quite normal for symptoms of anxiety and depression to be seen. This may affect diet, sleep, moods and the content of conversations. Although disturbing for parents, real concerns are probably unnecessary unless symptoms regularly start to interfere with daily functioning. At this point professional assistance should be sought.
Ely, T. C., Bolton, D., Connor, T.G et.al. (2003). A twin study of anxiety-related behaviors in pre-school children. Journal of Child Psychology and Psychiatry, 44, 945-960.
Harrington, R., Rutter, M., and Fombonne, E. (1996). Developmental pathways in depression: a test of continuities with data from a family study. British Journal of Psychiatry, 162, 627-633.