Anxiety in Children: Signs, Symptoms, and Treatment
Reviewed by Theresa Fry, LPC, NCC, CTP-CE
Anxiety in Children: Signs, Symptoms, and Treatment
Anxiety is a normal response to stress that both children and adults can experience. All children will experience times when they are worried or afraid. However, some children may experience more intense episodes of anxiety that can be overwhelming for them. In these cases, the child may be diagnosed with an anxiety disorder. Children with anxiety disorders may have anxiety that interferes with their home life, social interactions, or schoolwork. Around 7.1%1 of children between the ages of three and 17 have been diagnosed with anxiety.
Why Do Children Get Anxiety?
All children will experience periods of worry or fear from time to time, but not all will develop an anxiety disorder. There are a variety of factors at play for why some children develop anxiety while others do not.
Some children are born with a genetic predisposition toward anxiety. Generalized anxiety disorder (GAD), for example, is believed to have a genetic link. Others may have a reduced ability to cope with stress, which can lead to an anxiety disorder. Some children may also pick up anxious thoughts and behaviors from the people around them.
Children who experience trauma may also be at a higher risk for anxiety disorders. Events like the death of a close family member or friend, having to frequently move house, growing up in poverty, experiencing abuse or neglect, or becoming seriously ill or injured can all increase anxiety.
Experiencing other mental health issues can also increase the risk of anxiety, including autistic spectrum disorders and attention-deficit/hyperactivity disorder (ADHD). Changes in the serotonin and dopamine levels in the brain can also cause feelings of anxiety.
What Types of Anxiety Are Common in Children?
Children can experience different types of anxiety. These include:
- Separation anxiety: This is a common kind of anxiety in young children (between 18 months to 3 years) who worry when they can’t see a parent or loved one. If the worry persists in older children, it may be diagnosed as separation anxiety disorder.
- Generalized anxiety disorder: Children with GAD will have anxiety or worry about a range of things in their environment, such as schoolwork, family problems, friends, and performing in sports or other extracurricular activities.
- Social anxiety: Some children may experience anxiety of social situations or of interacting with people.
- Obsessive-compulsive disorder (OCD): Children may have unwanted thoughts (obsessions) that lead them to act on specific behaviors (compulsions) in order to alleviate the distressing thoughts. For example, a child might wear a specific item of clothing because they believe something bad will happen if they don’t.
- Panic disorders: Children diagnosed with a panic disorder will have had at least two panic attacks.
- Selective mutism: This is a severe type of social anxiety. This leads the child to be silent in some social situations, although they talk freely in others.
- Phobias: Phobias in childhood are often tied to a specific distressing event the child either experienced directly or witnessed, such as losing power during a terrible storm, being targeted by a large and aggressive dog, or almost drowning in a lake or sea.
Signs & Symptoms of Anxiety in Children
Anxiety may not always be easy to spot in children. Many of the common signs and symptoms can be similar to other issues that children may experience. In addition, some children may be quieter or eager to please, which can make symptoms difficult to spot.
Some children with anxiety may cry, want to miss school or other events, and may experience physical symptoms like shaking, clammy hands, shortness of breath, and a fast heartbeat. Other common signs and symptoms of anxiety in younger children are:
- Changes in appetite
- Trouble at school
- Nervous ticks/habits
- Social withdrawal
How to Treat or Deal with Anxiety in Children
Anxiety in children can be treated in a number of different ways, including therapy, medication, and helping children learn coping techniques that they can use on their own. A trained therapist who specializes in childhood anxiety can help you determine the right course of action for your child.
Therapy is often one of the first lines of treatment for children who are experiencing mild to moderate anxiety. Talk therapies, like cognitive behavioral therapy (CBT), are common and can be effective for children. With CBT, children not only get to share their thoughts and feelings, but the therapist can also help them learn what anxiety is, how to recognize the signs of anxiety, and how to effectively manage their symptoms.
Another therapy that is sometimes used is exposure therapy. In exposure therapy, the therapist helps the child face their fears. This usually begins in a controlled environment (like the therapist’s office) with remembering or reliving the thing or event that caused the fear. Over time, the child may become more comfortable facing the situations or objects that caused fear.
Hypnotherapy has also been used to help children with anxiety. It can be used alone or combined with CBT.
In some cases, medications may be used to treat anxiety in children. Selective serotonin reuptake inhibitors (SSRIs) and other antidepressants are often prescribed. SSRIs increase serotonin in the brain, which helps to increase feelings of wellbeing. Antidepressants are usually the first choice of medication for childhood anxiety.
If a child has severe anxiety, other medications may be used. Benzodiazepines may be used for short time periods, but can become addictive.
Combining medication with therapies like CBT may be more effective than medications alone. One study2 found that combining CBT with SSRIs was more effective than using either one alone.
Coping with Childhood Anxiety
If you are wondering about how to deal with anxiety in children, there are also ways that parents and other loved ones can help children cope with anxiety. Parents can help model confidence for their children in environments where children might be anxious or afraid. This can include previewing experiences with children and narrating the experience with them.
While it may be tempting to avoid situations that distress children, therapists suggest that the anxiety may just rise in other areas. Instead, helping children manage and tolerate some level of anxiety can be a useful skill. This is done by slowly exposing children to situations that might make them anxious and helping them manage their anxiety in tolerable amounts.
Some techniques that can help children tolerate and manage anxiety include:
- Deep breathing exercises
- Creating a worry journal or worry box
- Using muscle relaxation techniques
- Creating a relaxation kit
- Giving the child a hug
- Using the 5-4-3-2-1 technique that engages the child’s senses
- Encourage positive thinking
- Practice mindfulness techniques
If your child is struggling with anxiety, a therapist trained in childhood anxiety can be an important step in getting the help you and your child need. Make an appointment with a therapist today.
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