The burden of anxiety disorders in adolescents has been a long standing issue in the field of mental health. Anxiety disorders often begin in the childhood and main remain asymptomatic till adulthood before clinical manifestations become apparent.
The epidemiology of anxiety disorders shows that anxiety disorders are the commonest psychiatric disorders occurring in children and adolescents. About 5% to 30% of children suffer from one form of anxiety or the other and it has been estimated that there is an equal prevalence among young boys and girls until adolescence within 2:1 to 3:1 females to males.
Anxiety disorders in children and adolescents can present in many ways which may include school absenteeism or school refusal, poor academic performance, or grades that are lower than would be expected based on the child’s abilities.
It is also not uncommon for adolescents to experience symptoms of incomprehensible and undifferentiated worries and fears and multiple somatic complaints such as muscle tension, headache or stomachache and emotional outbursts such as extreme forms of anger which could be misdiagnosed as oppositional defiant disorder (ODD). This is so named because adolescents in such situations often attempt to avoid anxiety-provoking situations and in doing so further leads to anxiety and its attendant symptoms. Children and adolescents in such situations often have to worry about injury, rejection, failure and even parental separation. Older children and adolescents on the other hand may face worries and fears related to school performance (performance anxiety) and social competence such as the worries about social skills such as being able to play outdoor games. The culmination of these symptoms often lead to adolescent and children having episodes of depression on one end and symptoms comparable to mania on the other hand which parents and guardians might underreport or which they might report as hyperactivity and aggression.
Anxiety disorder in children is a public health burden and the fact that only limited attention is accorded to it exacerbates the problem. Furthermore, most afflicted individuals do not receive specialty mental health treatment and are instead managed within general health sector which may not be quite sufficient to improve their quality of life.
The early management of anxiety disorders in children and adolescents is necessary in order to avoid the development of depressive disorders and panic disorders. The treatment of anxiety should involve the various combinations of therapeutic interventions, such as psychological education, cognitive therapy, behavioral shaping, school consultation, and pharmacotherapy. Psychotherapy should be considered as a first line treatments approach in the management of anxiety disorders in children and adolescents. Such psychological education should not be limited to adolescents alone but should involve the child’s parents, guardians and even school teachers. Cognitive behavioral therapy has been suggested in many journal articles as one of the most effective treatment approaches for reducing symptoms of severe anxiety which might be beneficial to children and adolescents before having to resort into taking medications. This has a long-term advantage than medications since it prepares and teaches children how to manage anxiety themselves.