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Anxiety in children prevalent

May 28, 2006 12:50 am

TENSION, irritability, palpitations, insomnia, head- aches, abdominal pain, diarrhea. What kind of neurotic would have this constellation of symptoms? I would picture some hard-boiled type-A executive in an overly demanding job, with a terrible commute and maybe a marriage on the rocks.

Wrong. These are all symptoms I have seen recently in school kids.

There is this tendency to think of teenagers as lollygagging and carefree, but often this is not the case. And far from teaching our kids strategies to stand them in good stead for the rest of their lives on how to deal with stress, schools are compounding the problem with their frenetic schedules, competitive atmosphere and requirement to learn such mind-numbing esoterica as advanced-placement algebra.

It may be perverse to write about stressed school kids when the school year is about to end and they're all going to hang loose for three months--or so I thought. One college student just home for the summer put me right. She jumped down my throat when I quipped about three months of sleeping in. "I'm going to be working three jobs. Someone's got to pay the tuition."

Overly mature perfectionists who showed tension, irritability, apprehension, need for reassurance and negative self-image is the profile that researchers at the University of Texas came up with in a study on generalized anxiety disorder in children and adolescents. About 72 percent had physical complaints, as well, such as headaches, abdominal pains and heart palpitations. These problems are what often lead anxious patients to my door.

Generalized anxiety disorder is a very common disease in adults, and it causes or aggravates many of the illnesses we see in the office. But it has its roots in childhood. In another study, on cognitive behavioral treatment of GAD in adolescents in Canada, the authors note that "in most patients, GAD develops gradually during adolescence."

Closer to home, the people who see stressed kids up close and personal are the school counselors, says Carol Houchin, director of counseling at North Stafford High School. Anxiety and anger are what they see a lot of, she says.

Often, a child will deny feeling angry. "But if you take a few more minutes, oftentimes the kid will open up," Houchin says.

She has seen the biggest, most defiant kid change from angrily declaring "I'm not angry" to pouring out his heart about how his mother died when he was 3.

Maybe I'm overly sentimental in clinging to this Elysian fantasy that childhood should be carefree and fun. But what particularly disturbs me is that we are laying the ground-work for what kind of people these kids will turn out to be in later life. If, instead of stressing them out at school, we could teach them strategies for dealing with stress and anxiety, we would do them a real favor.

Perhaps it's unfair to accuse the schools of being the cause of their anxiety, as our whole society should be held accountable. It is societal policy that has led to overloading kids with homework and contriving insane time-pressured schedules, as our scholars try to fit in sports, volunteer activities, band and all sorts of other extracurricular stuff that getting into a half-decent college requires.

Incidentally, the stress and competitiveness are not just restricted to the kids. I see plenty of stressed-out teachers in the office. They are subjected to the same kind of treatment with their own madly competitive hurdy-gurdy when, for example, the advanced-placement exam results are published for all to see and for the parents to say, "Oooh, look, so-and-so's class didn't get very good results."

It is my impression that school administrators--and the indoctrinated kids--are myopic. All they can see is what needs to be done to get them through the next exam and into a decent college, not what's going to be good for them 10, 20, 30 years down the road.

Instead of teaching them AP algebra, wouldn't it be nice if we were teaching our children how to deal with the stresses and strains of life?

I pick on AP algebra as being probably one of the more esoteric subjects that will not help many people later in life, but there is a whole mess of other stuff we've all had to learn in the course of our education, just to show we can do it. Knowledge that has been of precious little use.

Why couldn't we have been using that time and brain power to learn a whole lot of other life skills? Things like business management, housekeeping, arts and crafts, cooking and gardening would have been far more useful in making well-rounded, fulfilled citizens.

Though I am accusing the whole education curriculum/administration of compounding the problem rather than helping prevent our kids from developing anxiety disorders, I am not denigrating the valiant job that the school staff, and particular counseling departments, do.

The counseling departments and other staff are on the lookout for kids with anxiety. These kids typically show uneasiness, apprehension and worry, says Bill Carter, one of the counselors at James Monroe High School in Fredericksburg. Counselors have an open-door policy, he says, and will oftentimes liaise with the parents and the child's teacher if there is some stressful life event taking place.

"I would seek to understand what is causing the anxiousness," Carter said.

He said he also would explore whatever coping mechanisms the child may have.

But I think we can do better than this. I have this fantastic notion of not just playing catch-up, not just dealing with kids once they are stressed, but of some institutionalized prevention.

I see zillions of adults in the office with GAD and other anxiety problems, and no clue how to go about dealing with it--having never been taught any of these skills. They know nothing other than to come to the doctor and get a pill. Then they all give me this sideways look when I tell them they should go learn meditation, biofeedback, yoga or another relaxation strategy.

There are some schools teaching kids to meditate--the Maharishi School in Kelmersdale, Lancashire, England, for example, where they attribute having the best GCSE (the exam roughly equivalent to the SAT) results in the county as being due to the kids spending 20 minutes twice a day meditating.

There are others in the U.S., and mostly they seem to be teaching Transcendental Meditation, which is the sort of "yuppie meditation" that was made famous by the Maharishi and his acolytes, the Beatles, in the '60s.

Some people are a bit skeptical about the whole commercialization of this. But that by no means invalidates the whole idea of meditation in its many, many other forms, which have nothing to do with any kind of religion.

All you purists will tell me that teaching preventive health care is not the domain of the schools. I would say it's not such a far cry from teaching PE and health.

I just wonder if the math teachers could be reprogrammed to teach mediation instead of AP algebra.

DR. PATRICK NEUSTATTER can be reached at
Email: pneustatter@prattmed.com.