Some signs of Selective Mutism are the child standing motionless and expressionless, turning his/her head away, chewing or twirling her/his hair, avoiding eye contact or withdrawing into a corner. They become anxious before entering an unfamiliar situation and suffer the common symptoms of anxiety beforehand, which include stomach aches, headaches, etc. Selective Mutism sufferers will often display more symptoms of severe anxiety such as separation anxiety, moodiness, inflexibility, tantrums and crying, insomnia and unnatural shyness, which can manifest in infancy.
A specific phobias are extreme, irrational terror of an animal or situation. Fears of such things are common in childhood, and often go away. They are diagnosed as phobias if the fear continues for at least 6 months and interferes with a child’s life, such as a child who will not play outside for fear of encountering a dog. Some common childhood phobias are animals, storms, heights, water, blood, darkness and medical procedures.
Most of these are instincts from primordial times when they were necessary to preserve the child’s life, and are still useful today. A child who does not fear water is in danger of drowning, and one which has no fear of heights is liable to fall. These children do not often recognize that their fear is irrational or extreme, and they may not voice their fears. Such children will avoid the situations or things that they fear, or endure them with anxiety which can manifest as crying, tantrums, freezing, clinging, avoidance, headache or stomachache.
Generalized Anxiety Disorder mostly affects children between the ages of six and eleven, causing excessive worry and anxiety over a variety of things, which include, among others, grades, performance in sports, punctuality, family issues, earthquakes and health. The sufferer cannot control their worry, which then interferes with their life. Some physical symptoms are restlessness, fatigue/insomnia, attention deficit, irritability and muscle tension. Child GAD sufferers are usually very hard on themselves and strive for perfection to a ridiculous degree, whilst seeking constant approval or reassurance.
A child is diagnosed with Panic Disorder after suffering from at least two unexpected attacks, followed by a month of anxiety over having another attack, “going crazy” or losing control. Panic Disorder usually starts in the early to mid twenties, and is uncommon in young children, but can begin in adolescence. A Panic Attack is the abrupt manifestation of intense fear and discomfort, which peaks in about 10 minutes and includes at least four of these symptoms. A feeling of imminent danger or doom, the need to escape, sweating, trembling, palpitations, shortness of breath or a smothering feeling, a sensation of choking, chest pain or discomfort, nausea or abdominal discomfort, dizziness or lightheadedness, a sense of things being unreal, depersonalization, a fear of losing control or “going crazy”, a fear of dying, tingling sensations and chills or hot flushes.
Children will become anxious in situations or places where they have had attacks, and may try to avoid them. Agoraphobia sometimes develops when the child starts to avoid places or circumstances where he/she has had a panic attack before, or from which the child feels that they would not be able to escape if they had an attack.