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Anxiety and Stress Disorders (Children)

Treatment Options for Anxiety

02/05/2007

Question:

Dear Expert, My daughter is 13 years old and has general anxiety. She is in therapy .She has always been an anxious child but since her grandmother`s death, she worried about having a stroke or heart attack.She also sees a psychologist in therapy. She lately has been staying up late, and takes hours to fall asleep.She loves school, has friends, is a good student. We are beginning to practice Cognitive Behavior Therapy. My question is, should I get her on medication, her psychologist, says no, because despite her anxiety, she copes well in her every day life and should I have her assessed by a psychiatrist? She doesn`t want to talk to a psychiatrist, she worries if she is labelled crazy, which she isn`t. She has improved by staying in her room and eventually falling asleep. This staying up late doesn`t happen every night.

Answer:

Cognitive behavioral therapy works well for generalized anxiety disorder and it appears that you have just started that treatment.  Antidepressants work equivalently well and there is an additive effect with CBT.  The sleep problem must be teased from normal sleep phase delay syndrome common with teenagers, but I do not believe it to be related to Generalized anxiety.  I would continue to assess whether treatment with CBT alone seems to solve all of her problems.

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Response by:

Floyd R Sallee, MD
Professor
College of Medicine
University of Cincinnati