Understanding Childhood Fears and Anxieties
by Healthy Children
www.healthchildren.org



My child seems to be afraid of a lot of things. Should I be worried?

From time to time, every child experiences fear. As youngsters explore the world around them, having new experiences and confronting new challenges, anxieties are almost an unavoidable part of growing up.

Fears are common
According to one study, 43 percent of children between ages 6 and 12 had many fears and concerns. A fear of darkness, particularly being left alone in the dark, is one of the most common fears in this age group. So is a fear of animals, such as large barking dogs. Some children are afraid of fires, high places or thunderstorms. Others, conscious of news reports on TV and in the newspapers, are concerned about burglars, kidnappers or nuclear war. If there has been a recent serious illness or death in the family, they may become anxious about the health of those around them.

In middle childhood, fears wax and wane. Most are mild, but even when they intensify, they generally subside on their own after a while.

Phobias
Sometimes fears can become so extreme, persistent and focused that they develop into phobias. Phobias – which are strong and irrational fears – can become persistent and debilitating, significantly influencing and interfering with a child's usual daily activities. For instance, a 6-year-old youngster's phobia about dogs might make him so panicky that he refuses to go outdoors at all because there could be a dog there. A 10-year-old child might become so terrified about news reports of a serial killer that he insists on sleeping with his parents at night.

Some youngsters in this age group develop phobias about the people they meet in their everyday lives. This severe shyness can keep them from making friends at school and relating to most adults, especially strangers. They might consciously avoid social situations like birthday parties or Scout meetings, and they often find it difficult to converse comfortably with anyone except their immediate family.

Separation anxiety is also common in this age group. Sometimes this fear can intensify when the family moves to a new neighborhood or children are placed in a childcare setting where they feel uncomfortable. These youngsters might become afraid of going to summer camp or even attending school. Their phobias can cause physical symptoms like headaches or stomach pains and eventually lead the children to withdraw into their own world, becoming clinically depressed.

At about age 6 or 7, as children develop an understanding about death, another fear can arise. With the recognition that death will eventually affect everyone, and that it is permanent and irreversible, the normal worry about the possible death of family members – or even their own death – can intensify. In some cases, this preoccupation with death can become disabling.

Treating fears and phobias
Fortunately, most phobias are quite treatable. In general, they are not a sign of serious mental illness requiring many months or years of therapy. However, if your child's anxieties persist and interfere with her enjoyment of day-to-day life, she might benefit from some professional help from a psychiatrist or psychologist who specializes in treating phobias.

As part of the treatment plan for phobias, many therapists suggest exposing your child to the source of her anxiety in small, non threatening doses. Under a therapist's guidance a child who is afraid of dogs might begin by talking about this fear and by looking at photographs or a videotape of dogs. Next, she might observe a live dog from behind the safety of a window. Then, with a parent or a therapist at her side, she might spend a few minutes in the same room with a friendly, gentle puppy. Eventually she will find himself able to pet the dog, then expose herself to situations with larger, unfamiliar dogs.

This gradual process is called desensitization, meaning that your child will become a little less sensitive to the source of her fear each time she confronts it. Ultimately, the child will no longer feel the need to avoid the situation that has been the basis of her phobia. While this process sounds like common sense and easy to carry out, it should be done only under the supervision of a professional.

Sometimes psychotherapy can also help children become more self-assured and less fearful. Breathing and relaxation exercises can assist youngsters in stressful circumstances too.

Occasionally, your doctor may recommend medications as a component of the treatment program, although never as the sole therapeutic tool. These drugs may include antidepressants, which are designed to ease the anxiety and panic that often underlie these problems.

What parents can do
Here are some suggestions that many parents find useful for their children with fears and phobias.

  • Talk with your youngster about his anxieties, and be sympathetic. Explain to him that many children have fears, but with your support he can learn to put them behind him.
  • Do not belittle or ridicule your child's fears, particularly in front of his peers.
  • Do not try to coerce your youngster into being brave. It will take time for him to confront and gradually overcome his anxieties. You can, however, encourage (but not force) him to progressively come face-to-face with whatever he fears.

Since fears are a normal part of life and often are a response to a real or at least perceived threat in the child's environment, parents should be reassuring and supportive. Talking with their children, parents should acknowledge, though not increase or reinforce, their children's concerns. Point out what is already being done to protect the child, and involve the child in identifying additional steps that could be taken. Such simple, sensitive and straightforward parenting can resolve or at least manage most childhood fears. When realistic reassurances are not successful, the child's fear may be a phobia.