Anxiety: Types of disorders

​Find out about the different types of anxiety disorders and how long they must exist before a diagnosis can be made.

Key points

• There are six main types of anxiety disorders.
• An assessment for an anxiety disorder is needed when a child’s anxiety symptoms interfere with their daily activities for a certain period of time.
• A doctor will only consider diagnosing generalized anxiety disorder, specific phobias, or social anxiety disorder if a child has experienced signs and symptoms for at least six months.
• Obsessive-compulsive disorder and post-traumatic stress disorders are no longer considered to be anxiety disorders.

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1- Introduction

The term “anxiety disorder” can refer to one or more of a number of conditions. These include:

• generalized anxiety disorder
• panic disorder
• separation anxiety disorder
• specific phobia
• social anxiety disorder
• selective mutism.

2- More information

A-generalized anxiety disorder

Generalized anxiety disorder (GAD) is a common anxiety disorder in children and teens. Its main feature is that a person experiences many different fears and worries.

Younger children may have hopes about their future, their grades at school, natural disasters, or events in the news. Older children and teens have similar worries but might also worry about the family’s finances, their parents’ relationships, and their own relationships, among other things.

Because of their fears and worries, children and teens with GAD might experience other symptoms such as headaches, stomach aches, difficulties sleeping, and muscle tension.

Duration of symptoms before GAD is diagnosed

For a child or teen to meet the criteria for GAD, they must have a number of excessive fears and worries for at least six months.

B-Panic disorder

Panic disorder is rare in young children but becomes more common in older children and teens. The main symptoms of panic disorder are repeated panic attacks.

A panic attack is an event that lasts about 10 to 15 minutes and involves a number of physical and psychological sensations. Physical sensations may include:

• a feeling of choking
• difficulty breathing
• a racing heartbeat
• sweating
• dizziness
• naughty
• shakiness

Psychological sensations are less common in children but can include feeling that everything is ‘not real’ or having an ‘out-of-body experience.

Older children and teens with panic attacks fear that the attacks may make them very sick or even cause death. As a result, they fear that panic attacks will happen again and start avoiding situations where the panic attacks have occurred. Eventually, they might stop leaving their home, a condition known as agoraphobia.

Duration of symptoms before panic disorder is diagnosed

For children or teens to meet the criteria for a panic disorder, they must have the above signs and symptoms for at least one month.

C-Separation anxiety disorder

Separation anxiety disorder occurs more commonly in children under 12 years of age, though it can also occur during the teen years.

Children with this disorder usually experience significant distress when separating from a parent or caregiver. They will frequently express worries that something bad will happen to them or their caregiver when they are not together.

Children and teens with a separation anxiety disorder may also experience physical symptoms such as stomach aches and headaches around the time of separation. They may also have difficulties with sleeping and might not want to sleep away from home or even in a separate room from their parent or caregiver.

Duration of symptoms before separation anxiety disorder is diagnosed

For a child or teen to meet the criteria for separation anxiety disorder, they must have excessive difficulties with separation for their developmental age for at least four weeks.

D-specific phobia

A specific phobia is the most common anxiety disorder in children and teens. As the name suggests, a specific phobia involves a fear of particular things or situations. The most common sources of fear include animals, needles or blood, heights, and natural disasters.

Duration of symptoms before a specific phobia is diagnosed

For a child or teen to have a specific phobia, their fear must exist for at least six months and interfere with their everyday routine.

E-social anxiety disorder

Social anxiety disorder symptoms include an intense fear of being judged by others or a fear of embarrassment. Children and teens with a social anxiety disorder may have great difficulties in the group or public situations, such as:

• meeting new people
• giving presentations at school
• attending school in general, especially if they recently joined a new school or class
• engaging in group activities
• eating in public
• using public bathrooms
• having their picture taken.
  

Duration of symptoms before social anxiety disorder is diagnosed

For a child or teen to be diagnosed with social anxiety disorder, their signs and symptoms must exist for at least six months and interfere with their everyday routine.

F-Selective mutism

Selective mutism occurs when anxiety prevents a child from speaking to others. This disorder is more common in younger children.

Children and teens with selective mutism usually do not speak in specific situations where they would normally be expected to speak, such as at school. They might whisper or not speak at all outside of the home but speak freely and in a regular voice in other situations, for instance at home with their parents or closest family members.

Duration of symptoms before selective mutism is diagnosed

For a child or teen to meet the criteria for selective mutism, they must have ongoing difficulties speaking outside the home while, in general, having average language abilities.

3- Treatment

Treatment for anxiety disorders

Depending on the type of anxiety disorder that is diagnosed, a child may be prescribed medications and/or recommended to have therapy or make some lifestyle changes​.

4- Follow-up care

Other disorders

In the past, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) were considered as other types of anxiety disorders. However, they are now classified as separate mental health disorders in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5).