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Anxiety is the experience of fear, distress, or worry, often felt in response to a stressful situation. Thoughts and feelings of stress and worry are common for any person facing the challenges of a serious illness, such as pediatric cancer. In most cases, children and adolescents are resilient and cope well during and after cancer.
Less often, anxiety causes ongoing distress or interferes with daily life. This may indicate a specific anxiety disorder. Research shows that children with cancer are not more likely to have an anxiety disorder compared to other children. However, all pediatric cancer patients can benefit from strategies to help with anxiety. A variety of resources and services are available to manage symptoms, improve mental health, and promote quality of life during and after cancer.
Each person experiences anxiety differently. This is especially true for children and teens. Younger children may have trouble identifying feelings of anxiety. Older children and teens may not want to talk about their worries because they don’t want to upset their parents or make things more stressful.
Signs and symptoms of anxiety may include:
Many of these symptoms can occur due to physical illness or as a side effect of cancer treatment. A mental health provider can help families understand anxiety symptoms and how to best manage them.
An anxiety disorder is ongoing fear or worry that interferes with a person’s daily life or causes extreme distress. Usually, what we consider anxiety is part of a normal range of thoughts and emotions. However, symptoms of anxiety may also indicate an anxiety disorder or other mental illness that needs specific treatment. Talk to your care team if a child’s anxiety symptoms get worse, interfere with daily activities, or continue even after the stressful event is over.
Each type of anxiety disorder has a collection of symptoms that lead to a specific diagnosis. Some anxiety disorders may have similar symptoms and treatments. However, an assessment by a trained professional is important to make sure anxiety is treated in the best possible way.
In separation anxiety disorder, a person has intense anxiety about being separated from another person. In the case of a child, this is often the fear of being separated from one or both parents. The child may worry that something bad will happen if mom or dad leaves. The idea of being separated causes extreme distress. Other symptoms of separation anxiety disorder may include clinging behavior, nightmares, and avoiding being alone.
A person with a specific phobia has an intense fear of a specific object or situation. This often leads a person to worry about the phobia and take steps to avoid the object or event.
In social anxiety disorder, a person has extreme fear or anxiety about social situations or performing in front of others. A person might worry about being embarrassed and may avoid certain settings. This can often lead to problems in school or work. A child with social anxiety disorder may appear shy or withdrawn.
In panic disorder, a person has repeated, sudden panic attacks. The attacks are very distressing but usually last only a few minutes. They may be unexpected or be triggered by a feared object or event. During a panic attack, a person may have increased heart rate, sweating, and trembling. The person may have shortness of breath or a feeling of being smothered. The panic attack is accompanied by feelings of intense fear and a sense of being out of control or that something bad is going to happen.
In generalized anxiety disorder (GAD), symptoms of anxiety occur almost daily and continue for at least 6 months. Symptoms include uncontrolled feelings of worry, irritability, restlessness, problems concentrating, fatigue, muscle tension, and sleep problems. Symptoms are severe enough to interfere with a person’s ability to function at school, work, or home.
In obsessive-compulsive disorder, a person has repeated disturbing thoughts or worries. The person may have an intense need to do certain things (compulsions) to relieve distress. Examples of rituals or compulsive behaviors include hand-washing, counting, checking, or specific routines. OCD usually develops in teens or young adults and may run in families. The person often knows that the thoughts and behaviors are not rational but is not able to control them.
Post-traumatic stress disorder may develop after a person experiences a scary, threatening, or emotionally traumatic event. PTSD includes symptoms of re-experiencing the event, avoiding reminders of the trauma, and being on edge or easily startled. The person may have trouble remembering details of the event or have negative thoughts and feelings such as guilt, sadness, or hopelessness.
Managing anxiety is important, whether or not a patient has a diagnosable anxiety disorder. High levels of anxiety can:
Managing symptoms of anxiety is important for health and quality of life during and after cancer. It is best to use several different strategies to deal with anxiety. Care team members that can help include psychologists, psychiatrists, social workers, counselors, mental health nurses, child life specialists, music therapists, art therapists, and chaplains.
In addition to reducing anxiety, many of these therapies have other benefits for children with cancer including helping with pain, nausea, and depression.
A doctor may prescribe medicine to help with symptoms of anxiety. Sometimes, a medicine may be given to help a patient relax before a procedure. These medicines tend to work quickly, and the effects go away after a short time.
Some patients may need anti-anxiety medicines that work over time to treat an anxiety disorder. These medicines take longer to work. Some patients may need a combination of medicines. Medicines used to treat anxiety disorders in children may include:
Patients taking medicines for anxiety need regular doctor visits to make sure the medicines are working properly and to monitor any side effects. It is important to follow dosing instructions carefully. Patients should not take more than prescribed and should not stop taking the medicine without medical supervision. Be sure to let a doctor know if anxiety does not improve.
Questions to ask your doctor when prescribed an anti-anxiety medicine:
Medicines used to treat anxiety can be unsafe if taken more often or in greater amounts than prescribed or if stopped too quickly. Please ask your doctor before making any dose changes. Also, be sure to store medicines safely, and keep out of the reach of children.
Together does not endorse any branded product mentioned in this article.
Reviewed: January 2019