My son will be 14yrs by April 2008. Since the last few months, he has had fears of death. He hates the word "TERRORIST" and is afraid of terrorism. He has the phobia that soon we will all die, and he will be left alone. Previously, he was a lively child surrounded with friends and was a fun loving boy. Now since the last 5-6 months, he prefers to be alone and likes to be in his room and does not want to mingle with any of his peer groups. On the other hand, he prefers to be with boys elder to him. He is not interested in studies anymore and is not participating in any sports or extra curricular activities.

I am genuinely worried about my son because now I find him totally a different individual. Please help me out.

Answered by: Anne Marie Albano

It is difficult to say exactly what is happening with your son, except that he is experiencing severe anxiety and withdrawal from others, and evidences a significant change in his academic and social functioning.

When a parent describes a sudden change in behavior, to the extent that the adolescent drops out of his usual activities, withdraws so completely from friends, and expresses a severe fear or phobic reaction, it raises questions about what was happening in his life immediately prior to this change and how well was he actually functioning all along?

In the absence of a possible substance abuse problem, these changes may signify a major depressive episode, significant anxiety disorder, traumatic stress reaction, or potentially a prodromal phase of a serious mental disorder. The very first thing that must occur is a thorough psychiatric evaluation with a child psychiatrist or clinical child psychologist.

In addition to a thorough assessment of symptoms and functioning, the evaluation should include the taking of a careful developmental, academic and medical history, and concurrently there should be a thorough physical examination. Only with a thorough assessment can we begin to piece together what is happening to this young man, and then plan appropriate interventions that may involve psychotherapy, medication, and family therapy.

This is a situation where I would strongly and urgently press the parents to seek an evaluation as quickly as possible.

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Anne Marie Albano,
Director, Columbia University Clinic for Anxiety and Related Disorders 

Anne Marie Albano is Professor of Medical Psychology in Psychiatry at Columbia University and Director of the Columbia University Clinic for Anxiety and Related Disorders. She received her Ph.D. from the University of Mississippi. 

 Dr. Albano is a Fellow of the American Psychological Association and the Association for Behavioral and Cognitive Therapies, Founding Fellow of the Academy of Cognitive Therapy, a Beck Institute Scholar, and is Board Certified in Clinical Child and Adolescent Psychology. She is the 2015 recipient of the Association for Behavioral and Cognitive Thera...
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