Anxiety in Children: Common Types, Symptoms, and Treatment

Feeling anxious is a normal experience for many people, both young and old alike. It can happen before a big event or when anticipating an outcome for a certain situation. However, there is a point where anxious or worried feelings can turn into recurring symptoms of something more concerning.

Anxiety is a common mental health concern that affects both adults and children. It has become more prevalent in recent years, with data showing that approximately 5.8 million children aged three to 17 years were diagnosed with the condition [*]. In young people, anxiety can manifest in different ways. This makes it all the more important for adults to learn about the children’s anxiety, including its causes, symptoms, and treatment options.

Anxiety in Children

Some degree of anxiety in kids is normal. People, whether children or adults, all experience fears in life that may cause feelings of unease and anxiety. As long as the anxious response is appropriate to the situation, there shouldn’t be any cause for alarm.

Anxiety is often seen as a negative thing, but it can also be useful. It can allow children to navigate dangerous circumstances by helping them stay alert, be more aware of risks, and motivating them to solve problems. For instance, anxiety can be useful in avoiding social situations where negative behavior is present.

However, too much anxiety can affect a child’s ability to live and enjoy life.

Common Causes of Anxiety in Children

There are some common causes of anxiety in young children. Some are biologically predisposed to the condition. Others may pick up anxious behavior from being around anxious people.

External stressors may also cause anxiety in kids. These are usually events that involve a lot of change, including but not limited to:

• Quarreling parents
• Experiencing abuse or neglect
• Academic pressures
• Social difficulties, such as bullying
• Frequently moving homes or schools
• Traumatic experiences, such as major injuries or accidents
• Experiencing the death of a close friend or loved one
• Having other conditions such as ADHD and autistic spectrum disorder

Common Symptoms of Anxiety in Children

Anxiety can be a confusing feeling for many people. This is especially true for children, who are still learning about complex emotions and sensations. They may not always be able to understand or express these feelings, so some symptoms may arise, such as:

• Irritability
• Tearfulness or clinginess
• Difficulty sleeping or interrupted sleep
• Recurring nightmares
• Wetting the bed

The above symptoms are more commonly seen in younger children. Older kids may other symptoms as well:

• Lack of confidence
• Inability to face everyday tasks
• Difficulty concentrating
• Sleeping problems
• Inconsistent or low appetite
• Angry outbursts
• Having more negative thoughts than usual
• Always worried about what’s going to happen
• Avoiding everyday activities (going to school, seeing friends, etc.)

Common Types of Anxiety in Children

There are many types of anxiety that children can experience. The most common are the following:

Separation Anxiety

Children experience this type of anxiety when they are separated from their parents or caregivers, even for short periods of time. They often get very upset and feel extremely anxious when their guardians aren’t around. This is apparent in behaviors such as the refusal to attend play dates, sleepovers, or school trips. Children who experience separation anxiety are very fearful that something bad will happen to themselves or their loved ones while separated.

Social Anxiety

Many kids with anxiety experience an intense fear of social situations, commonly known as social anxiety. Children who have this type of anxiety feel very anxious and self-conscious around their peers and other adults. This usually comes from worries about being judged or embarrassed.

Specific Phobia

Some children are anxious about more specific fears. Called phobias, these are severe, irrational fears that are triggered by certain situations or things, such as thunderstorms, animals, or blood.

Why Some Children Are More Vulnerable to Anxiety

Some children have been found to be more vulnerable to anxiety than others. The reasons for this often stem from a complex interplay of factors, including the following:

Biological Factors

Biological factors refer to the role that genes and brain wiring play on one’s susceptibility to certain conditions — in this case, anxiety. Studies have paid close attention to a specific part of the brain called the amygdala [*], which is responsible for the fight or flight response. Children with anxiety disorders often have hypersensitivity in this area of the brain.

Family History

Research has found that children of parents who have had or currently have an anxiety disorder are more likely to develop the same condition [*]. This may be attributed to genetic causes, but it may also be due to upbringing as children learn anxious, fearful, and avoidant behaviors from anxious parents.

Psychological Factors

A child’s temperament and coping strategies may determine whether they develop anxiety disorders. Some theories have pointed to the possibility that certain personality types are more likely to experience anxiety than others. For example, a study found that children who are shy or emotionally sensitive are more at risk [*].

External Factors

Research has shown that children who have troubled childhoods filled with adversity or difficult experiences may go on to develop mental health conditions such as childhood anxiety and depression [*]. External factors such as abuse, parental conflict, or death can deeply impact a child and lead to difficulties later on.

Treating Anxiety in Children

The appropriate anxiety treatment for any child will depend on their individual circumstances. Treatment options will often be determined by the child's age and the specific cause of their anxiety.

Counseling is one treatment that can help children pinpoint what is making them anxious. It then equips kids with the skills to work through the situation. Cognitive behavioral therapy is a form of talk therapy that can help children manage anxiety by modifying the way they think and behave.

Anxiety medications may be prescribed to children with severe anxiety symptoms that cannot be addressed by therapy alone.

Ways Parents Can Help and Support an Anxious Child

Parents play an important role in helping their child through anxious times. Here are several ways that parents can help and support an anxious child:

Personalization and Externalization

Asking a child to recognize their anxiety by giving it a name can help them cope more easily. Labeling anxiety also creates a healthy distance, allowing children to be in charge of the condition rather than the other way around. Once kids personalize their anxiety, they can use various anxiety coping statements to keep it at bay.

Set an Example of Confidence

Children can sense their parents’ emotions, including negative feelings of anxiety. To set a more confident example, parents can be more mindful of what they model through words and actions. As much as possible, parents may temper their overanxious reactions into more positive behaviors.

Allow Kids to Feel Distressed

It is important to allow children to feel whatever they feel when they are anxious. Avoiding the distress that comes with anxiety only invites it to appear at another time. Using anxiety coping skills such as deep breathing and grounding exercises can help children calm down eventually.

Gradual Exposure

Gradually and carefully exposing one’s child to stressful experiences can help rewire the brain. For instance, a child who gets anxious over public speaking may start with ordering food at a restaurant. At first, the child may communicate what they want through their parents. Eventually, they will feel more confident talking to the waiters and waitresses while feeling less anxious.

Things to Avoid Doing When a Child is Anxious

Many things can be done to help a child manage their anxiety. However, there are also several things to avoid doing when a child is anxious. These include but are not limited to the following:

• Dismissing a child’s emotions
• Pressuring children to feel a certain way
• Always giving way to a child’s anxious feelings
• Completely avoiding situations that trigger a child’s anxiety
• Asking leading questions (e.g., “Are you worried about your big test?”)
• Reinforcing the child’s fears
• Leaving anxious symptoms undiagnosed and untreated

When Should You Be Concerned About Your Child’s Anxiety?

It is important for parents and guardians to remember that some level of anxiety is normal for children to experience. However, if the anxiety starts to interfere with your child’s everyday life, then it might be time to consider treatment.

FAQs

Is it normal for a child to be anxious sometimes?

Yes, it is normal for children to be anxious from time to time. The key is to recognize when anxiety symptoms are present more often than usual.

At what age does anxiety typically start?

The average age of onset for anxiety in children is 5 to 7 years old.

What is the most common anxiety disorder in children?

The most common anxiety disorder in children is separation anxiety.

The Bottom Line

Having anxiety may be unpleasant for kids, but the good news is that it is manageable and treatable. Understanding the condition in more detail and knowing what treatment options are available can make a huge difference.

When in doubt, it’s always best to consult a professional regarding your child’s anxiety concerns.

References:

1. Centers for Disease Control and Prevention. Data and Statistics on Children’s Mental Health. 2022.
2. McClure E, Monk C, Nelson E, et al. Abnormal attention modulation of fear circuit function in pediatric generalized anxiety disorder. 2007.
3. Chapman L, Hutson R, Dunn A, et al. The impact of treating parental anxiety on children’s mental health: An empty systematic review. May 2022.
4. Biederman J, Hirshfeld-Becker D, J Rosenbaum, et al. Further evidence of association between behavioral inhibition and social anxiety in children. October 2001.
5. Beesdo K, Knappe S, Pine D. Anxiety and Anxiety Disorders in Children and Adolescents: Developmental Issues and Implications for DSM-V. September 2009.