Dr. Lordou Eirini Child Psychiatrist MD, MSc


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Stress is defined as an intense unpleasant feeling involving an indefinite danger that is imminent, a threat. It is a common reaction observed in the majority of people when faced with mild or intense stressful events.

From physiological fears to pathological anxiety.

Stress in the form of fear is, in principle, a normal reaction of the human psyche, involving the neurological system (Autonomous nervous system) and is an adaptive and necessary reaction, because it warns the person that a condition is physically or lychologically harmful and poses a threat to him.

Simple and normal fear is distinguished by stress,   in terms of its is not in the context of normal psychological development beyond voluntary control adaptability, if it affects for example negatively the functionality of the child, in the social field (relationships with children his age and other members of his family) and in his school   performance,  the intensity and duration (at least the duration is longer than 6 months).

What are the manifestations of anxiety?

The main clinical manifestation of anxiety is avoidance. Accompanying symptoms are physical   discomforts, from gastrointestinal, nausea, vomiting, from cardiorespiratory, precardial elgos, shortness of breath, frequent urination, dizziness, feeling of stasis, fainting tendencies, sweating, concentration difficulties, sleep disturbances,  sleeplessness, nightmares and social isolation.

Prevalence of anxiety and gender differences

Anxiety and its manifestation are among the most common disorders of childhood and adolescence and are found in 7.3% of the girls are twice the population.

How can a child transition from normal fears to pathological anxiety – Anxiety disorders?

Many factors contribute to a child developing an anxiety disorder. The reasoning is multifaceted and is divided into three categories:

  • Factors that start with the child himself.

Genetic risk.

Children with anxiety disorder have earlier, in infancy, a temper with suspended behavior, high motor activity, irritableness, react to new situations with withdrawal, avoidance or discomfort; in addition, as children tend to be shy, avoid challenges, etc. It has also been found in research that children with extreme suspended behavior have a consistently high heart rate.

  • Factors that start with the child’s family.

Parents of insecure children are sometimes characterized by a lack of sensitivity and response to their needs. So an insecure bond is created between the mother of a child and as a consequence of this creating an image of the child for the world as unreliable, unpredictable and a view of himself that it is powerless to face the challenges.

There is also  evidence that overprotectiveness on the part of parents contributes to and enhances the maintenance of the child’s anxiety by avoiding stressful situations. this leads to a vicious cycle, low self-esteem, increased anxiety and further insufficient emotional support avoidance.

Factors that start at school.

Various incidents on site may increase the stress a child experiences. For example, the child may be bullied by other children, a condition that causes severe anxiety and phobias. Obligations of courses, especially when combined with some learning difficulty or difficulty concentrating can also cause anxiety.

In what forms can stress manifest itself?

The forms of anxiety depending on the cause and symptoms are classified in the following categories:

Special Phobias

Their characteristic is a strong and persistent fear, which is excessive or unjustified and caused by the presence or waiting of a particular object or situation.

Specific phobias vary , for example in age:

  • 7 years old, the phobia of animals begins,
  • at the age of 9 begins the fear of blood
  • at the age of 12 the phobia about the dentist
  • in adolescence, phobia of enclosed spaces and social phobias

Separation anxiety disorder

The central feature of this disorder is excessive anxiety about the separation of the child from the people to whom it is attached, usually with parents.

The age of onset of symptoms is about 5 to 8 years and appears as an excessive concern that something bad will happen to a person adhesion, nightmares include separation issues, while the child’s possible refusal to go to school is due to separation anxiety. Older children also experience discomfort and physical symptoms, such as stomachache, headache.

School phobia

It is defined as a fear of some aspect of the school environment accompanied by symptoms of panic or anxiety during participation.

The average starting age is 10 years. The most common causes are school change, parental illness, death or stay at home due to chronic illness or accident. Sometimes there’s no obvious reason.

Obsessive compulsive disorder

The above disorder is characterized examples of coercion by strong ideas-thoughts, persistent and repetitive and impulse-forced acts that are beyond the control of the child, are irresistible and are often recognized as irrational (in children this may not be possible).

When it comes to persistent thoughts, the most common are the fear of infection and the thought that something bad will happen to himself or to familiar faces.

The starting age after 7 years with an average age of 10 years.

Its evolutionary course is chronic with some pause breaks but with a high degree of co-morbidity, as with other anxiety disorders or depression.

Generalized anxiety disorder

In this case the child is characterized by persistent and unfounded concerns about competition, acceptance, abilities and whether or not his behaviour has been inappropriate in the past or in the future.

The starting age is in adolescence.

Disorder after psych traumatic stress

This ranks the stressful symptoms that begin after intense psycho-traumatic events. Some of them are, like, an accident, mass-type disasters, like war, fire. The child may have been directly threatened or witnessed by others who threatened their physical integrity. Any form of abuse such as physical, verbal and sexual can also cause severe psycho-traumatic stress.

Why a child develops psycho-traumatic stress after such an event and another child does not, depends on many factors, such as the child’s temperament and whether he or she was properly supported by his or her environment, family, school, society.

Panic Disorder: It occurs mainly after 18.

Treatment and Interventions

Psychoeducation concerning the information of both parents and the child about his psychopathology.

Psychotherapeutic interventions that concern both the child individually and the parents as well as the whole family.

Pharmacotherapy, where necessary.