Panic disorders, phobias and other childhood anxiety conditions should be treated during childhood so that they won’t be carried over into adulthood, according to advice in the latest Harvard Mental Health Letter.

Various studies show that anxiety disorders are among the most common psychiatric conditions present during childhood. In many instances, adults with anxiety disorders experienced their first symptoms during their early childhood years.

Yet many parents may not be aware that their child is experiencing such symptoms. Since children’s minds and emotions change over time, it may be difficult to distinguish between normal, age-appropriate fears - such as a 2-year-old’s fear of strangers, or a preschooler’s fear of the dark - and real anxiety disorders, according to the Harvard experts.

Real anxiety disorders in children are similar to those experienced by adults. What’s more, like adults, a child with an anxiety disorder such as social phobia is likely to have other anxiety disorders as well.

Children with social phobia, or social anxiety disorder, are extremely shy and fear unfamiliar people or surroundings. They may, for example, be afraid to initiate a conversation or to attend a birthday party.

Children with generalized anxiety disorder, previously referred to as overanxious disorder of childhood, experience the same uncontrolled worry that adults afflicted with the disorder experience.

Other anxiety disorders experienced by children include obsessive-compulsive disorder, panic disorder, separation anxiety, simple phobias - such as fear of water, fear of choking, or fear of insects, and post-traumatic stress disorder, which is often the result of severe child abuse.

The cause of such disorders can be both genetic and environmental. Studies suggest that some anxiety disorders may be hereditary. Some children can show signs of extreme shyness, for example, as early as 4 months; their heart rate increases and they cry and “shrink back” around strangers, according to the health letter.

Yet, children usually grow out of such fears or can be treated for them through a variety of means, including play therapy or cognitive behavioral treatment, the best-known treatment for anxiety disorders in children and adolescents.

Parents need not fear that their child will always be extremely shy, or that those recurrent nightmares from some horrifying event they experienced - one symptom of post-traumatic stress disorder - will indefinitely plague their child throughout their adulthood.

Shy children do not always become anxious adults and post-traumatic stress disorder symptoms may fade as children grow older, according to the Harvard mental health experts. “This is one field in which optimism is a plausible attitude for mental health professionals,” they write.

Commenting on the mental health letter, psychologist Dr. Joseph Pirone, an expert in reality-based anxiety, such as post-traumatic stress disorder, said that “non-reality based experiences like shyness and social phobia can be, in some instances, undone just by creating a supportive teaching environment or social environment.”

In the case of post-traumatic stress disorder, however, studies suggest that “unless the individual processes it, symptoms will not go away” as children transition to adulthood, said Pirone, of the State University of New York’s Rockland Community College campus.

“PTSD is the anxiety disorder of our time ... unfortunately produced by man-made circumstances,” he said.

Pirone added that in order to reduce such symptoms among children, like those traumatized by the attacks on the US on September 11, “we need to create a world with less and less hatred, and thereby less and less revenge and a safer environment for children to grow.”

SOURCE: Harvard Mental Health Letter, December 2004.