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Column originally published Apr 16, 2013

Severe Anxiety May Need Anti-Depressant

Question: I am worried about our seven-year-old daughter. She is extremely anxious, and her problem has escalated in the past two years. She is constantly worried about being sick, and sometimes she talks about dying, and that her heart has stopped beating. A few months ago, when I was pregnant with our new baby, my reflux made it hard for me to swallow, so I went to see my doctor. Not too long afterwards, our daughter started eating less and complained that she had trouble swallowing. She refused to eat her favourite foods. She would chew and chew her food and then spit it out. Finally, I told her that my doctor had said that my throat would get better in two days, and that would happen to her also. Miraculously, she got better after two days. I know this is related to her anxiety. I have the same problem with anxiety that started at her age. I worried about everything, but didn’t get any help until I was in university. Finally I went to a doctor and was started on an anti-depressant, and my anxiety has been much better. I don’t want my daughter to suffer like the way that I did. Is it safe for a young child to take medicine for anxiety?


I am sorry to hear that your daughter has such severe anxiety at this young age. As you have learned from your own experience, anxiety can start to affect some children when they are very young. This can have significant impact on her social development, and may greatly influence her future career also.

Before discussing about medications that can help a person with anxiety, let me explain a little about this medical condition so that you can have better understanding about it. This can help you to decide whether she should take medicine or not.

All animals (may be with the exception of the largest ones like the lions and tigers) have the natural instinct of caution, being careful in environments that may not be safe. This is of utmost importance in the natural world, where larger animals prey on smaller ones. If one doesn’t have that fear, he would not survive very long, and become another animal’s next meal.

Normal amount of caution and worry is important for survival of every individual. This natural instinct is passed on from one generation to another through the genes. However, excessive worry, or being too anxious, also comes through the same genes. Excessive anxiety can be harmful. Some people become house-bound because they become too anxious when they go out. Others worry too much about their own health, always feeling that there is something wrong with their body. These excessive worries are often irrational, and they have difficulty ignoring these worrisome thoughts.

Sometimes children can develop chest pain when someone in the family has a heart attack. Your daughter felt that she couldn’t swallow food after you developed reflux symptoms. This is not uncommon in children who have anxiety.

You have done a marvelous job in reassuring your daughter when she was anxious about her throat. The next time if she said that her heart has stopped, you can help her by putting her hand over her chest. She should be able to feel her heart beating, and this can be very reassuring for her.

For those who have anxiety, this kind of excessive worry can be there much of the time. Although they appear to be irrational to those without anxiety, they are very real to those who suffer from this medical condition. It can affect their relationship with peers and harm their social development. Their self-esteem can be severely affected, and they may not pursue careers that they are interested in or fully capable of, because they are just too afraid.

I have found some success with children and teenagers through hypnotism. The idea behind it is to teach them self-recognition and self-relaxation. They need to learn to recognize when they are worrying excessively. Once they recognize this, they can use different techniques to calm themselves, including deep breathing and self-imagery. Some children find this very helpful, although the benefit can vary from person to person.

As you have found through your own experience, medicine can be very beneficial for those with severe anxiety. Anti-depressants have been used for adults with anxiety and depression. Although large scale research has not been done on children, clinical experience by many specialists have found that they are also effective for children with severe anxiety.

There is a warning about use of anti-depressants in children. Some have reported thoughts of self-harm. As a result, Health Canada has a warning about the use of this group of medications in children and teenagers, worried that thought of self-harm may lead some to commit suicide.

Therefore, it is very important to consult with a paediatrician or a child psychiatrist who is familiar with these medications. If it is decided that anti-depressants should be tried because of the severity of her medical condition, she should be monitored carefully and make sure that the medicine is effective in reducing the severity of her anxiety.

I hope this information is useful for you to make the proper decision for your daughter. It is very hard for parents to see their children suffer. A balanced approach is necessary to make sure that anxiety does not harm her growth and development. At the same time, if medicine is felt to be necessary, it is important to make sure that there is minimal side effect, and that the medicine is effective to alleviate her problem.