A mixed mood & anxiety disorder is a diagnosis given when the child presents with both mood problems and anxiety. They may not necessarily meet a specific diagnosis of depression or generalized anxiety disorder. However, symptoms are usually significant enough to contribute to emotional and behavioral problems, as well as anxiety that is interfering with the child’s ability to function. Regarding mood, young children may not be described as being depressed, per se, but are more irritable. As these children age, they significantly struggle to regulate their emotions and control their behaviors. They are often prone to frustration and exhibit frequent meltdowns, emotional outbursts, and temper tantrums when denied their way. Although temper tantrums are very common among children, those with mood and anxiety challenges struggle to self-calm. Temper tantrums are very frequent, usually daily, and their outbursts may carry on excessively. Aggression, violence, self-harming, and threatening statements may be present as well, but not necessarily.
With respect to anxiety, these children frequently show signs of excessive stress, worry, or fear. There are several types of anxiety, but younger children may not present with a specific type of anxiety, say a phobia, until they are older. Some children struggle with their inability to control their environment. They may be seen as fixated, repetitive, and obsessed over things they cannot control. They typically do not do well with ambiguous situations, and as such, they may ask questions repetitively and are often described as “nosey.” These children are often very bossy with their siblings or friends, which can contribute to peer-conflict, frustration, and aggression. Other children may present as very worrisome. They worry about everything, including the well-being and whereabouts of family members, school, friends, upcoming events, tornados, or getting injured. While others, may be described as very “clingy” when at home. These children do not like to be left out of anything or left alone even for only a moment. They may even go to extremes such as intruding on privacy (e.g., while a parent is showering or using the restroom). Sometimes these children tend to be reluctant to try new things, fearful of new situations, making new friends, avoiding crowds of people, and may lack confidence. This very commonly interferes with their ability to care for themselves or attempt homework or school assignments.
Anxiety and mood disturbances usually are attributed to brain development and environmental circumstances, but can improve with age and intervention. In general, interventions (e.g., therapy) can often help to improve functioning and teach the child effective coping strategies to manage their anxiety and mood. If anxiety and/or mood problems are severe and other forms of intervention have not proven useful, medication may be helpful. However, medication should always be used in conjunction with behavioral intervention. Family-based intervention works best.