Specific phobias are fears of particular things or situations. These fears are quite common in children. Some common childhood phobias include the dark, storms, dogs, spiders, costumed characters (for example, clowns), heights, blood and injections.
Say a child is scared of the dark or of a dog, and happens to be in a darkened room or facing a barking dog. The child might become very anxious and distressed. As with other anxieties, children with specific phobias will try to avoid the situation they’re afraid of. Or they might be extremely distressed if they have to go through it.
Although these anxieties are common, it’s worth seeking some professional help if your child’s fear:
- is really interfering with your child’s daily life
- is something you feel your child should have grown out of
- persists for longer than six months.
Obsessions are thoughts that children can’t get out of their heads. Examples might be:
- ‘I’m going to get very sick if I touch that dirty handle.’
- ‘Something terrible will happen if my books aren’t in the right order.’
Compulsions are things children feel they must do over and over. Examples might be:
- washing hands repeatedly
- organising toys in a very specific way.
Other types of obsessions and compulsions include:
- hoarding (not being able to throw anything away)
- thoughts about hurting someone (accidentally or intentionally)
- religious concerns or satanic images
- horrific images
- counting or tapping.
Obsessions and compulsions can be quite normal. For example, preschoolers will often go through stages of repeating certain actions (such as playing the same game over and over). They might also have mild superstitious behaviours (such as always wearing the same t-shirt to dance class).
Obsessive-compulsive disorder (OCD)
You might suspect obsessive-compulsive disorder (OCD) if a child’s obsessions and compulsions are repeated for long periods. Another sign is when the obsessions and compulsions affect the child’s ability to relax and enjoy life. Children with OCD will perform their rituals even if it gets them in trouble.
Typically, a child will do a compulsive behaviour after an obsession to stop something she’s afraid of from happening. For example, ‘If I tap my fingers seven times then nothing bad will happen to Mum’.
After the compulsive behaviour, children usually feel less anxious for a little while. But the anxiety peaks again the next time the obsessive thought comes into their minds.
If obsessions or compulsions are interfering with your child’s daily activities, consider seeking professional help.
Panic attacks are a sudden rush of fear accompanied by physical feelings such as a racing heart, breathlessness, tightness in the throat or chest, sweating, light-headedness, and/or tingling. During a panic attack, children might believe that they are dying or that something terrible is happening to them.
These kinds of episodes are quite rare in young children.
The fear of, or anxiety about, having panic attacks is known as panic disorder. For children with panic disorder, the fear is of the panic attack itself (‘I might be dying’) rather than of the situation (people laughing, dog biting, getting lost).
Panic disorder is not common in young children and is more likely to be found in older adolescents and young adults. Rates of panic disorder in children and younger adolescents have been shown to be less than 1%.
If children start avoiding situations because of their panic attacks, this is referred to as panic disorder with agoraphobia. If this occurs, it’s worthwhile seeking professional help.
Post-traumatic stress is a reaction to a severe traumatic event in which the child was hurt or felt extremely scared or threatened. Events that might trigger such reactions include:
- natural disasters
- being attacked
- car accidents
- sexual, physical and emotional abuse.
Children who have been affected by a traumatic event will usually show some anxiety for a few weeks afterwards. The anxiety will then gradually disappear.
Post-Traumatic Stress Disorder (PTSD)
In some cases, children will suffer anxiety for many months and years after a traumatic event. This can interfere with their daily lives. This is when you might consider whether the child has Post-Traumatic Stress Disorder (PTSD).
Children might keep remembering the traumatic event or have bad dreams about it, perhaps even including the trauma in their play. They might suddenly act or feel as if the event is happening again and become very upset. They will often try hard to avoid situations that remind them of the trauma and might become emotionally distant. They might be jumpy or irritable and have sleep difficulties.
Children suffering PTSD usually require professional help
You know your child best. If you’re worried about your child’s behaviour or anxieties, consider seeking professional help. Here are some places to start:
- your child’s school counsellor
- your child’s GP or paediatrician (who might refer you to a child psychologist)
- your local children’s health or community health centre
- a specialist anxiety clinic (present in most states).