Freedom from fear

I work closely with international schools and often see children whose anxiety is reinforced by their parents’ stress: the office workload is high for the breadwinner, while trailing spouses have plenty of adjustments to cope with. Moving abroad also magnifies a child’s normal transitional issues like changing schools, and schools in Shanghai often lack the counseling resources families would find in their home countries.

In children, anxiety can manifest as hyperactivity. Children or teens may experience extreme fear or shyness that makes them avoid certain places or activities. High school kids might become more oppositional – going out to clubs, drinking. The important thing is for parents to recognize symptoms and know when to seek help.

School phobia, social phobia and separation anxiety have roots in normal patterns of development. A child with separation anxiety may have unrealistic worries about something bad happening if they are separated from a parent. A child with a school phobia may use extreme tactics to avoid going. He or she might complain of stomache pains, or throw a tantrum when forced to leave home. Social phobia is prevalent in one percent of children and adolescents. Psychologically, these individuals overestimate the physical or social threat of interaction and underestimate their own coping ability.

Post-Traumatic Stress Disorder can occur after a person goes through a traumatic event. PTSD can worsen depending on the adolescent’s pre-existing anxiety, family stress and parental response to the trauma. Common symptoms include: flashbacks or nightmares of a traumatic event; avoidance of any reminders of the event; inability to remember what happened; difficulty falling or staying asleep; and feeling irritated, distant or uninterested.

Treatment
Anxiety disorders can be treated with Cognitive Behavioral Therapy, which takes a goal-oriented approach to treating dysfunctional emotions, behaviors and thinking. CBT looks at the way an individual thinks about and reacts to the source of anxiety and often encourages gradual exposure to the feared object or situation. Rewards are given for positive behavior in approaching the object. Some studies have shown that CBT leads to sustained, long-term mental health benefits. Family should be involved in the treatment to prevent relapse. With a combination of therapy and positive encouragement, treatment can allow your child to let go of fear and embrace a better life.
Paul Wang is a clinical psychologist at Shanghai United Family Hospital