 Be more restless than usual (out of seat in class)

 Have a sudden worsening of inattentiveness or forgetfulness

 Suddenly make worse grades without any other changes in life

 Become more irritable, oppositional or defiant (refusing to do homework)

 Become more impulsive (trying to decrease the energy of the stress of anxiety)

 Become withdrawn from family, friends or social occasions (particularly girls)

 Develop sleep problems such as nightmares, restless sleep or insomnia

 Hide report cards and letters from teachers and counselors (performance issues)

 Appear depressed and cry for no reason (depression and frustration)

 Become obsessed with a ritual such as hand washing or cleanliness (germ-safety-fear issues)

 Complain of more headaches, stomachaches, fatigue or just not feeling well.

 Suddenly stop responding to medication that has worked

 If possible, identify the anxiety type causing most of the behavior change. Is it fear, insecurity, a response to a horrible event, or unknown?

 Involve your family physician, pediatrician, psychologist or ADHD specialist as soon as possible

 Help your doctor decide which anxiety related disorder should be treated first so that the area of greatest impairment is corrected first. This will result in a faster decrease in your child’s anxiety and may return them back to a “near-normal status”.

 Provide your child with open conversation opportunities to allow them to discuss fears, feelings of insecurity, feelings of loss or abandonment and fear of failure. The death of a loved pet, friend or grandparent may be the source of such fears. A personal near death experience, such as being in a car wreck, could also provide the basis.

 Work with your doctor to decide about medications used for anxiety, such as buspirone, paroxetine, venlafaxine, buproprion, and depakote. These are not addicting and can be used in very small amounts with good results.

 Discuss referral for family counseling. Everyone will need to be involved as anxiety and panic disorders can be terribly hard to treat without the entire family “buying-in” to the plan.

 Openly explain what is going on in your child’s life to teachers, other parents and extended family members. The larger your emotional support base, the more likely treatment will be successful.

 Work with your child on social issues, such as having more than one friend or attending over-night parties. You may have to approach this slowly at first because this is where a lot of security issues usually pop up.

 Above all, be supportive of your child’s emotional need for reassurance and frequent pats on the back