Being Afraid

Have you ever been afraid? Everyone gets scared sometimes. Do thunder and lightning make your
heart beat faster? Maybe your mouth goes dry when your teacher announces a pop quiz, or your
palms sweat when it's your turn to give your report in front of the class. Perhaps you get
butterflies in your stomach when you see the bully who picks on you.

Everyday Worries

We all have fears from time to time. That's true no matter how big we are or brave we can be.
Fear can even be good for you sometimes and even help you stay healthy. Fear of getting too
close to a campfire may save you from a bad burn. And fear of getting a bad grade on a test may
make you study more.

Being a bit on edge can also sharpen your senses and help you perform better in a recital or
during a track meet. Some people even enjoy being a little scared. That's why they like to watch
scary movies — or go on roller-coaster rides.

What Happens When You're Scared?

Have you ever wondered why being scared makes your heart beat faster and makes you breathe
quicker? The body's reaction to fear is called the "fight or flight" response. And people have had it
since the beginning of time.

Here's how it works. Imagine you're a caveman or cavewoman alive 100,000 years ago — and you
come face to face with a hungry saber-toothed tiger. You have two choices: 1) Run for it (that's
flight), or 2) pick up your club and battle with the tiger (that's fight). A final choice (be eaten)
doesn't seem like such a good one!

Today, you can apply fight or flight to that bully who confronts you and won't listen to reason. You
have two choices: 1) Turn and walk away (flight), or 2) fight, even though you know fighting won't
solve the problem.

To prepare for fight or flight, you body does a number of things automatically so it's ready for
quick action or a quick escape. Your heart rate increases to pump more blood to your muscles and
brain. Your lungs take in air faster to supply your body with oxygen. The pupils in your eyes get
larger to see better. And your digestive and urinary systems slow down for the moment so you can
concentrate on more important things.

What Is Anxiety?
Usually, our bodies go into fight or flight only when there is something to fear. However,
sometimes this occurs when there doesn't seem to be anything to be frightened about. When you
feel scared but there doesn't seem to be a clear reason, that's called anxiety (say: ang-zye-uh-
tee).

There might be other feelings that come along with anxiety — like a feeling of tightness in your
chest, a bellyache, dizziness, or a sense that something horrible is going to happen. These feelings
can be very frightening. Sometimes anxiety can interfere with things you need to do, like learning
and sleeping.

For some kids, feelings of anxiety or worry can happen anytime. For others, they might occur only
at certain times, like when they are leaving their home or family to go somewhere. In some
people, this feeling of anxiety occurs almost all the time and gets in the way of doing what they
want to do.

Some kids may have a phobia (say: foe-bee-uh), which is an intense fear of something specific,
such as being up high, getting dirty, the number 13, or spiders.

Why Do People Have Anxiety?

Anxiety can run in families. Or a person might develop anxiety after something terrible happens,
like a car crash. Sometimes certain medical illnesses can cause feelings of anxiety. So can abusing
alcohol or other drugs, like cocaine.

Another part of the explanation has to do with the different chemicals in the nerve cells of the
brain. How the chemicals in our brain's nerve cells are balanced can affect how a person feels and
acts. One of these chemicals is serotonin (say: sir-uh-toe-nun). Serotonin is one of the brain
chemicals that helps send information from one brain nerve cell to another. But for some people
with anxiety, this brain chemical system doesn't always seem to work the way it should.

Also, some scientists think that a special area in the brain controls the fight or flight response.
With anxiety, it's like having the fight or flight response stuck in the ON position — even when
there is no real danger. That makes it hard to focus on everyday things.

Dealing With Anxiety

Anxiety can be treated successfully. Tell your mom or dad if find yourself more scared than you
feel you should be or if your anxiety becomes strong and is getting in the way of what you want or
need to do. Your parents might take you to a doctor, who can help find out if a medical problem is
making you feel anxious, or to a therapist, who can help find a way to lessen the anxiety through
talking, activities, relaxation exercises, or medication (or a combination of these things).
Of course, if you do come face to face with a hungry saber-toothed tiger, there's just one thing
you should do . . . RUN!

Reviewed by: David V. Sheslow, PhD

Date reviewed: November 2007

Phobias
"Come on, Marisa!" all of the fifth graders yelled from inside the big elevators. "Hurry up, don't
you want to get to the top?"

Marisa looked glum and thought to herself, "Of course I want to get to the top — that's why I
came on this field trip." But when she glanced back at her friends, she felt jealous — how come
none of them were terrified of riding in the elevator?

"I'm OK," she said as brightly as she could. "I'll take the stairs and meet you there." When she
realized how many stairs that would be, Marisa wasn't too happy. But she breathed a sigh of relief
knowing that she wouldn't have to take that scary elevator ride.

What's a Phobia?

A phobia (say: fo-bee-uh) is the fancy name for a fear. But a phobia isn't just any kind of fear.
It's normal for kids to be afraid of things — like taking a hard test at school, passing a growling
dog on the street, or hearing a huge clap of thunder.

A phobia is different because it is an extremely strong fear of a situation or thing. It is also a kind
of fear that doesn't go away. Kids who have a phobia will be afraid of something every time they
see or experience it. They won't just be afraid once or twice. Kids who have phobias often go out
of their way to avoid the situation or thing that scares them.

That's why Marisa had to take the stairs. She has a phobia of being in closed-in spaces and was
too scared to take the elevator. Sometimes, when forced to face what's scary, a kid with a phobia
might get very nervous and have a panic attack.

What's a Panic Attack Like?

Panic attacks can be really scary and may make someone shake, sweat, and breathe quickly.
Some people who have panic attacks might have chest pains, feel dizzy, or feel like their hearts
are pounding and they can't breathe.

A panic attack can cause a kid to think something awful is going to happen, that he or she can't
escape or might lose control. Some kids who have panic attacks say that when the attacks are
happening, they feel like they can't think straight or that they're "going crazy."

Panic attacks only last a short time. But to somebody who is having one, they can feel much
longer. Sometimes, even a kid who knows that the phobia doesn't make sense may not be able to
stop the mind and body from reacting and having a panic attack.

Different Kinds of Phobias

There are many different kinds of phobias. The most common kind is a social phobia, which can
make someone feel scared of being embarrassed in front of other people.

A kid with a social phobia might feel scared of talking to a teacher or a coach or might be afraid of
walking in front of the whole classroom when he or she needs to go to the restroom.

A social phobia can make it nearly impossible for a kid to stand up and give a book report or even
enjoy a birthday party. Although most kids might be a little afraid of giving a book report to a big
group of kids or talking to a teacher, kids with a social phobia become so afraid that they can't
fully enjoy life or function the way other kids do.

Sometimes people may think that a kid with a social phobia is just shy, but it isn't the same thing.
A kid with a social phobia may want to go out and have lots of friends, but just can't control the
fear of being with others.

Agoraphobia (say: ah-guh-ruh-fo-bee-uh) is another kind of phobia. This causes someone to

worry about having a panic attack in a place where leaving would be hard or embarrassing. The
fear of the panic is so strong that they often avoid places (like crowds, highways, or a busy store)
where they might have a panic attack.

Marisa's fear of riding in the elevator was caused by claustrophobia (say: klos-truh-fo-bee-uh).
Claustrophobia is the fear of being in an enclosed space, like an elevator, a tunnel, or an airplane.

There are almost as many phobias as there are things and situations: arachnophobia (say: uh-
rak-nuh-fo-bee-uh) is a fear of spiders, whereas ablutophobia (say: uh-bloo-tuh-fo-bee-uh) is a
fear of washing yourself or taking a bath or shower.

Why Do Kids Get Phobias?

No one really knows exactly why certain kids get phobias. Some scientists think that a person's
genes may have something to do with it, and that a kid who has a social phobia might have a
parent with one, too. Sometimes a traumatic thing in a kid's life — like the death of a parent,
dealing with a divorce, or a big move — can cause a phobia to start.

Scientists do know some things about phobias, though. They know that about 5 out of 100 people
in the United States have one or more phobias. Women are slightly more likely to have phobias
than men. Most social phobias start when a person is a teenager, although this and other kinds of
phobias can also start when a kid is younger.

How Are Phobias Treated?

Kids who have phobias often start by seeing their doctors. In many cases, the doctor will suggest
that the kid visit a psychologist, psychiatrist, or therapist. If a kid is diagnosed with a phobia, one
of these specialists can help.

Some kids will take medications that help them better handle their phobias. Sometimes a kid can
learn new ways of dealing with the phobia. This could include relaxation exercises that help the kid
feel more in control. Part of handling the phobia may be facing it head on.

For instance, part of Marisa's treatment might be riding on an elevator, though she might start
slowly by just watching other people get on an elevator or just stepping inside with the doors
open.

Depending on the kid and how severe the phobia is, treatment can take weeks, months, or longer.
In the meantime, the important thing to remember is that phobias can be treated, and kids can
learn to deal with them and feel more in control of their lives.

Reviewed by: Colleen Sherman, PhD

Date reviewed: June 2010

Anxiety, Fears, and Phobias

Everyone, from the youngest child to the oldest adult, experiences anxieties and fears at one time
or another. Feeling anxious in a particularly uncomfortable situation never feels very good.
However, with kids, such feelings are not only normal, they're also necessary. Experiencing and
dealing with anxieties can prepare young people to handle the unsettling experiences and
challenging situations of life.

Anxieties and Fears Are Normal

Anxiety is defined as "apprehension without apparent cause." It usually occurs when there's no
immediate threat to a person's safety or well being, but the threat feels real.

Anxiety makes someone want to escape the situation — fast. The heart beats quickly, the body
might begin to perspire, and "butterflies" in the stomach soon follow. However, a little bit of
anxiety can actually help people stay alert and focused.

Having fears or anxieties about certain things can also be helpful because it makes kids behave in
a safe way. For example, a kid with a fear of fire would avoid playing with matches.

The nature of anxieties and fears change as kids grow and develop:
 • Babies experience stranger anxiety, clinging to parents when confronted by people they
don't recognize.

• Toddlers around 10 to 18 months old experience separation anxiety, becoming emotionally

distressed when one or both parents leave.

• Kids ages 4 through 6 have anxiety about things that aren't based in reality, such as fears
of monsters and ghosts.

• Kids ages 7 through 12 often have fears that reflect real circumstances that may happen
to them, such as bodily injury and natural disaster.

As kids grow, one fear may disappear or replace another. For example, a child who couldn't sleep
with the light off at age 5 may enjoy a ghost story at a slumber party years later. And some fears
may extend only to one particular kind of stimulus. In other words, a child may want to pet a lion
at the zoo but wouldn't dream of going near the neighbor's dog.

Signs of Anxiety

Typical childhood fears change with age. They include fear of strangers, heights, darkness,
animals, blood, insects, and being left alone. Kids often learn to fear a specific object or situation
after having an unpleasant experience, such as a dog bite or an accident.

Separation anxiety is common when young children are starting school, whereas adolescents may
experience anxiety related to social acceptance and academic achievement.

If anxious feelings persist, they can take a toll on a child's sense of well being. The anxiety
associated with social avoidance can have long-term effects. For example, a child with fear of
being rejected can fail to learn important social skills, causing social isolation.

Many adults are tormented by fears that stem from childhood experiences. An adult's fear of public
speaking may be the result of embarrassment in front of peers many years before. It's important
for parents to recognize and identify the signs and symptoms of kids' anxieties so that fears don't
get in the way of everyday life.

Some signs that a child may be anxious about something may include:

• becoming clingy, impulsive, or distracted

• nervous movements, such as temporary twitches
• problems getting to sleep and/or staying asleep longer than usual
• sweaty hands
• accelerated heart rate and breathing
 • nausea
• headaches
• stomachaches

Apart from these signs, parents can usually tell when their child is feeling excessively uneasy
about something. Lending a sympathetic ear is always helpful, and sometimes just talking about
the fear can help a child move beyond it.

What's a Phobia?

When anxieties and fears persist, problems can arise. As much as a parent hopes the child will
grow out of it, sometimes the opposite occurs, and the cause of the anxiety looms larger and
becomes more prevalent. The anxiety becomes a phobia, or a fear that's extreme, severe, and
persistent.

A phobia can be very difficult to tolerate, both for kids and those around them, especially if the
anxiety-producing stimulus (whatever is causing the anxiety) is hard to avoid (e.g.,
thunderstorms).

"Real" phobias are one of the top reasons children are referred to mental health professionals. But
the good news is that unless the phobia hinders the everyday ability to function, the child
sometimes won't need treatment by a professional because, in time, the phobia will be resolved.

Focusing on Anxieties, Fears, or Phobias

Try to answer the following questions honestly:

Is your child's fear and behavior related to it typical for your child's age? If the answer to
this question is yes, it's a good bet that your child's fears will resolve before they become a serious
cause for concern. This isn't to say that the anxiety should be discounted or ignored; rather, it
should be considered as a factor in your child's normal development.

Many kids experience age-appropriate fears, such as being afraid of the dark. Most, with some
reassurance and perhaps a night-light, will overcome or outgrow it. However, if they continue to
have trouble or there's anxiety about other things, the intervention may have to be more
intensive.

What are the symptoms of the fear, and how do they affect your child's personal, social,
and academic functioning? If symptoms can be identified and considered in light of your child's
everyday activities, adjustments can be made to alleviate some of the stress factors.
Does the fear seem unreasonable in relation to the reality of the situation; and could it
be a sign of a more serious problem? If your child's fear seems out of proportion to the cause
of the stress, this may signal the need to seek outside help, such as a counselor, psychiatrist, or
psychologist.

Parents should look for patterns. If an isolated incident is resolved, don't make it more significant
than it is. But if a pattern emerges that's persistent or pervasive, you should take action. If you
don't, the phobia is likely to continue to affect your child.

Contact your doctor and/or a mental health professional who has expertise in working with kids
and adolescents.

Helping Your Child

Parents can help kids develop the skills and confidence to overcome fears so that they don't evolve
into phobic reactions.

To help your child deal with fears and anxieties:

• Recognize that the fear is real. As trivial as a fear may seem, it feels real to your child and
it's causing him or her to feel anxious and afraid. Being able to talk about fears helps —
words often take some of the power out of the negative feeling. If you talk about it, it can
become less powerful.

• Never belittle the fear as a way of forcing your child to overcome it. Saying, "Don't be
ridiculous! There are no monsters in your closet!" may get your child to go to bed, but it
won't make the fear go away.

• Don't cater to fears, though. If your child doesn't like dogs, don't cross the street
deliberately to avoid one. This will just reinforce that dogs should be feared and avoided.
Provide support and gentle care as you approach the feared object or situation with your
child.

• Teach kids how to rate fear. A child who can visualize the intensity of the fear on a scale of
1 to 10, with 10 being the strongest, may be able to "see" the fear as less intense than
first imagined. Younger kids can think about how "full of fear" they are, with being full "up
to my knees" as not so scared, "up to my stomach" as more frightened, and "up to my
head" as truly petrified.

• Teach coping strategies. Try these easy-to-implement techniques. Using you as "home
base," the child can venture out toward the feared object, and then return to you for
safety before venturing out again. The child can also learn some positive self-statements,
 such as "I can do this" and "I will be OK" to say to himself or herself when feeling anxious.
Relaxation techniques are helpful, including visualization (of floating on a cloud or lying on
a beach, for example) and deep breathing (imagining that the lungs are balloons and
letting them slowly deflate).

The key to resolving fears and anxieties is to overcome them. Using these suggestions, you can
help your child better cope with life's situations.

Reviewed by: D'Arcy Lyness, PhD

Date reviewed: November 2007
Originally reviewed by: David B. Sheslow, PhD