Specialist paediatric Psychiatry Clinic
At the child psychiatry clinic we have practitioners that review children and their families throughout development up to the age of 21years. These children may have a myriad of problems ranging from what may appear as very mild to severe. Common presentations include:-
- Depression
- Autism
- Attention deficit hyperactivity disorders
- Anorexia
- Self-harm
- Recreational drug abuse
- Psychosis
- School refusal
- Defiance’
- Anxiety
And many more……….
When a child is attended to at the psychiatry clinic it does not necessarily mean they will be put on medication or are crazy or out of their minds. A large number will undergo treatments that may involve behaviour modification, parent management training, psychotherapy, counselling , lifestyle adjustments and a few may require medication.
The primary role of the psychiatrist who is first a medical doctor specialised in mental disorders is to make a clinical diagnosis and rule out any physical conditions that may be causing or contributing to the symptoms. These may include infections, metabolic disorders, hormonal problems, tumours, substances, toxins, medication and so on. The doctor will then go ahead to make a plan of management based on scientific evidence. The clinic is run by qualified specialist psychiatrists and will address the child`s individual needs in collaboration with a multi-disciplinary team. This team includes a social worker, clinical and counselling psychologists, play therapist, paediatrician, neurodevelopmental specialist, neurologist, gastroenterologists among many others.
The beauty of having a child, teenager or adolescent whose mental health issues are addressed early is that it guides the trajectory of their life toward their best potential.
Anxiety in Children
Anxiety is excessive and persistently inappropriate fear or worry that may affect one`s wellbeing. It may occur in children just as it does in adults.
What makes children anxious?
Most worries are a normal part of life and growing up. Separation anxiety between the ages of 8 months and 3 years is normal. It presents as a clingy child who cries when they are separated from their parent, guardian, nanny or anyone they are used to.
Children may also fear heights, darkness, blood, animals, insects and so on but gradually outgrow these fears.
It is normal for a child to be anxious on their first day of school, before a sport competition, before an examination and so on.
Children with Attention Deficit Hyperactivity Disorder or Autism Spectrum Disorder are more likely to suffer anxiety.
Teenagers are also prone to social anxiety.
When does anxiety turn into a problem for Children?
When your child is unable to perform their day-to-day activities like sit their exams, attend school, enjoy their sports, play with their friends, approach teachers or adults for help then their anxiety is now problematic.
Severe anxiety for a prolonged period may harm a child`s mental and emotional well-being and affect their self-esteem and confidence. This in turn may make your child avoid and use excuses to keep away from the things/situations/places that make them anxious.
What are the signs of anxiety?
Anxiety is one of those disorders whereby the child may not understand or express themselves. You may also misinterpret their behaviour as a parent/guardian/adult if you are not keen. You may notice the following:-
- Your child becomes fussy, tearful and clingy
- Your child may have difficulty falling asleep or keep waking up at night.
- Your child may start bedwetting after achieving months of dry nights.
- Your child may have increased nightmares ( more than 1 per week)
- He/she may be unable to face simple age-appropriate challenges and avoid attempting new things
- Have difficulty concentrating at home or in school
- Keep having angry verbal outburst or tantrums
- Keep thinking about negative things that are going to happen
- Withdraw from their friends or going to public places
- Refuse to go to school
- A large majority of children present with physical symptoms that may make you think they are physically unwell. Common physical symptoms include:-
- Dizziness
- Restlessness
- Feeling tired frequently despite adequate rest
- A noticeable heartbeat that may be quite fast and irregular( palpitations)
- Muscle aches and tensions especially around the neck, shoulders and upper back. This is more common among teenagers and older children
- Trembling or shaking
- Excessive sweating
- Stomach aches and headaches that are investigated and have no physical medical explanation
- A dry mouth
- Nausea and appetite changes
What causes anxiety in children?
Some children are more prone to anxiety than others. A few experiences are known to trigger anxiety in children. These include:-
- A new school
- A new home or a change in living arrangements
- A distressing experience like a car accident or house fire
- Family arguments or conflicts especially among parents or relatives that may make a child feel insecure and anxious
- Bullying
- Child abuse ( sexual, physical or emotional that may present as neglect)
How can I help my anxious child?
- Start by identifying that your child is anxious. This may be easily missed or misinterpreted as bad behaviour or simply being naughty.
- Talk to your child and reassure them before normal day-to-day anxiety provoking activities like examinations
- You may explain to your child what anxiety is if he/she is old enough to understand. It is important to bring up the links between physical symptoms( like headaches and stomach aches) and anxiety that you may understand.
- Think out solutions to combat your child`s anxiety provoking situations together with your child. Do not always give your child the option of avoidance or giving up especially when it comes to day-to-day challenges that he/she may need to face in future. Pulling out your child from a sport they enjoy or transferring their schools due to anxiety may not necessarily solve the issue unless you note a clear trigger not related to your child.
- Address external issues that may be contributing to your child`s anxiety like parental conflict.
- Seek medical advice at the specialist psychiatry clinic for children.
What Can I do to prevent my child from being anxious?
A healthy level of anxiety is good as it helps your child develop various survival and improvement tactics. To help your child cope you can do the following:-
- Keep routines and a predictable lifestyle for your child. Children thrive in routines
- In the case of an adverse life experience like bereavement encourage discussion around the event. Look at books and movies that address various emotions to help your child understand their feelings, worries and fears that may arise.
- Teach your child how to recognise their own signs of anxiety and seek help from you or any other trusted adult.
- Prepare your child for any life changes like a new school, new home, parental separation etc.
- Try NOT to be anxious yourself or overprotective. It is advisable NOT to do everything for your child to protect them from anxiety provoking situations. Instead encourage them to face their fears and support them in their own thought out tactics to manage these worries.
- Practice relaxation techniques with your child like breathing exercises or anything else you may have noted helps your child calm down.
When should we seek help?
You should make an appointment at the specialist psychiatrist clinic that deals with children if:-
If your child`s anxiety is not improving or is getting worse despite your self-help interventions.
When your child`s anxiety is persistent and now affecting their academic life, interactions at home and friendships.
Remember severe anxiety for a prolonged period may harm a child`s mental and emotional well-being and affect their self-esteem and confidence into the future.
What should I expect at my psychiatry clinic appointment?
- You will meet a doctor who will ask you more about the child`s symptoms
- The doctor will make sure there is no physical medical explanation for your child`s symptoms. This may be through relevant tests or referrals to other consultants.
- You may be given questionnaires that screen and attempt to differentiate various types of anxiety disorders in children to guide treatment
- You will have counselling and more education on the child`s anxiety and ways you can help
- A treatment plan will be instituted once the diagnosis is confirmed. This may include relation techniques training, talk therapy for older children ( cognitive behaviour therapy) and rarely medication known as anxiolytics may be prescribed on individual basis. You will be given a chance to discuss your child`s management.
Keywords: anxiety, school refusal, bedwetting, headaches, stomach aches