Diagnosis

• A mental health professional will conduct a comprehensive evaluation to assess biological, psychological, familial and social factors of the anxiety. They will rule out any underlying illness, assess the extent to which the anxiety impairs daily functioning and consider the potential role of any medications, caffeine or drugs. The diagnosis of an anxiety disorder is premised upon what causes the anxiety. Separation anxiety results from fears related to leaving parents or home, social anxiety arises from problems socializing, and school refusal is severe anxiety that stops the child from going to school. If there is a pervasive anxiety defined by more than a single context, then generalized anxiety disorder may be the diagnosis. Other possible diagnoses related to anxiety are obsessive compulsive disorder and panic disorder.
  
  

Treatment

• The overall goal of treatment is to relieve the child's distress and minimize emotional and behavioral effects that interfere with daily living. If symptoms are not severe, then psychotherapy is the first choice. Otherwise medications are used to reduce the anxiety and the common manifestation of depression. Two types of medications used to treat childhood anxiety are those that reduce anxiety and antidepressants.
  
  

Anxiety-Reducing Medications

• Anxiety is believed to be caused by excessive nerve activity in the brain, so antianxiety medications function by reducing this activity. The first choice of medications for anxiety is a class called benzodiazepines. Benzodiazepines enhance the effect of the chemical that reduces the chemical communication between nerves, thus helping to relieve anxiety. They generally cause sedation and muscle relaxation. This category includes the medications Xanax, Ativan, Valium, and Klonopin. Another medication---Buspar---can be used for generalized and moderate anxiety. It does not cause tiredness, which is a typical side effect of the benzodiazepines.
  
  

Antidepressant Medications

• There are three classes of antidepressants: atypical, tricyclic and selective serotonin reuptake inhibitors (SSRIs). They all affect the chemicals in the brain that transmit signals between nerves, but SSRIs have fewer side effects, so they are usually the first choice. SSRIs work specifically to prevent the neurotransmitter serotonin from being reabsorbed into the brain. This leaves more of the chemical available for the brain to use, thus improving mood. SSRIs may also protect the brain areas related to anxiety and depression from being overly activated. The SSRIs include Prozac, Zoloft, Paxil, Lenox, Celexa, Effexor and Lexapro.
  
  

Role of Parents

• Parents need to be sure that their children are regularly taking their medications. These are strong medications and some may cause withdrawal reactions, including seizures, if the child suddenly stops taking them. Additionally, parents need to be educated about the medication so that they can watch for potential side effects and enforce any dietary restrictions.