The following are additional issues that relate to children with anxiety that deserve mention, either because they have anxiety as a central component or because they can produce anxiety in children. Understand as you read this that information is an excellent defense against an illness that at times can feel so all-encompassing. That means the more you know the better — it will help you realize the path you need to take with your particular child.

PANDAS

PANDAS is an abbreviation for pediatric autoimmune neuropsy-chiatric disorders associated with streptococcal infections. Though rare, this term is used to describe children who develop obsessive-compulsive disorder (OCD) and/or tic disorders such as Tourette's syndrome. These symptoms worsen following strep infections such as strep throat and scarlet fever, and often have a dramatic or “overnight” presentation. Moodiness and separation anxiety are also common in PANDAS.

Oppositional Defiant Disorder

ODD stands for oppositional defiant disorder. A child with ODD resists or refuses the demands of authority figures, and is generally negative, hostile, and defiant. Children with ODD can be argumentative, prone to losing their tempers, blaming, resentful, and spiteful or vindictive. In addition, children with ODD sometimes deliberately annoy others and can be touchy and easily annoyed themselves. Though it is clear that the general presentation of ODD is an angry one, anxiety sometimes lurks below the surface. Children with ODD can also suffer from depression or other mood issues, which should be thoroughly evaluated as a possible cause of acting-out behavior. For example, children with anxiety may refuse to go to school, which can look like defiant behavior when in fact it is fearful behavior.

Differently Abled

Children with physical disabilities or disabling medical conditions (severe allergies or asthma, diabetes, and so on) are prone to anxiety because the demands of the physical body both tax and are overtaxed by the emotional system. Additionally, some of the medicines used to treat chronic conditions can produce the side effects of anxiety or depression.

Social rejection can be common, and socializing can be difficult given your child's specific needs. Group therapy can often be a way for kids who feel different because of these circumstances to experience a sense of belonging and support, which helps them reduce anxiety or depression related to their condition. Check with your child's physician to see if he knows of groups or organizations that might be helpful to you and your child.

Is My Child Gifted?

As seen in Chapter 4, giftedness, like creativity, is complex and troublesome to measure because it is multidimensional, affecting many areas in your child's life. Generally, if your child is gifted, he may show many of the signs of active-alert children. He may complain of being bored or get in trouble for being restless at school. He may refuse to do “busywork” that requires little creative effort. He may sleep little, and read, draw, or want an opportunity to be more creative while doing projects or homework. Gifted children can sometimes be anxious or perfectionist as well, and may show a low frustration tolerance when their abilities do not always match what their minds create. There are many resources for gifted children at school and in the community. At home, try to provide opportunities for both focused work and unstructured time, and remember to help your child put on the brakes if she seems to be overfocused, over-stimulated, or overly perfectionist.