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Key Takeaways:

  • Some degree of anxiety is an expected part of the human experience.
  • For children, various stressors and life events may trigger anxiety.
  • When anxiety is diagnosed, treatment options include psychotherapy and medications.

Feeling anxious is a normal human experience that everyone deals with occasionally, regardless of age. For example, a child who’s feeling anxious before an event, like a test or presentation, can be compelled to perform at their best. However, persistent anxiety in children may indicate the presence of a disorder.

Childhood anxiety can manifest in different ways. Physical symptoms and changes in their behavior can affect their performance and quality of life.

This makes it important for adults (parents, teachers, and caregivers) to learn about anxiety in kids, including its causes, symptoms, and treatment options.

What is Anxiety in Children?

Anxiety in children is a condition that involves excessive worrying, fear, or apprehension that is out of proportion to the actual threat or situation at hand.

Whereas occasional anxiety is a normal part of childhood — it can allow children to navigate dangerous circumstances by helping them stay alert, be more aware of risks, and solve problems — too much of it interferes with their ability to function well in life.

What Causes Anxiety in Children?

There are some common causes of anxiety in young children. Some are biologically predisposed to the condition, meaning they are genetically more susceptible to it. 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 the following:

  • Quarreling parents
  • Experiencing abuse or neglect
  • Conflict with peers
  • 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
  • Health issues

Having other conditions such as ADHD (attention deficit hyperactivity disorder) and autism may also make a child more prone to having anxiety due to the way their brains function [*][*].

What are the 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.

Anxiety in young children may manifest as:

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

Older kids may manifest the following symptoms:

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

What are Common Types of Anxiety in Children?

There are several types of anxiety that affect children. Some common ones are:

  • Generalized Anxiety Disorder (GAD) - Children with GAD worry excessively about different things. This includes their school performance, punctuality, health, and relationships with peers.
  • Social Anxiety Disorder - This isn’t just shyness. Children with this disorder are so fearful of embarrassment that they avoid situations where they might be scrutinized. As a result, they refuse to attend social events and speak in class.
  • Selective Mutism - A child is unable to speak or communicate in specific social situations, despite being able to do it comfortably with family members. Watch out for consistent silence in public places and restlessness when they’re expected to speak.
  • Panic Disorder - In this disorder, a child has a history of panic attacks (intense episodes of fear or discomfort that peak within a short period). These panic attacks happen unexpectedly or may be triggered by stress or crowded environments.
  • Obsessive-Compulsive Disorder (OCD) - Obsessions, such as unwanted thoughts, worries, or impulses can trigger anxious feelings in children. To reduce their anxiety, children with OCD develop repetitive actions, called “compulsions.”
  • Separation Anxiety Disorder - 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.
  • Specific Phobias - Some children are anxious about more specific fears. Known as phobias, these are severe, irrational fears that are triggered by certain situations or things, such as thunderstorms, animals, heights, or blood.

How is Anxiety in Children Diagnosed?

A thorough evaluation done by a licensed health professional can create an accurate diagnosis. The process usually entails asking about and noting the child’s behavior and symptoms, and even speaking with their teachers and other caregivers to better understand the child’s function in different environments.

It’s also important to be aware that some children who receive a diagnosis of anxiety may also be experiencing depression.

In addition to reaching out to a health professional, parents and caregivers may seek resources, such as the Anxiety Disorders Association of America, to gain an understanding of a diagnosed or undiagnosed anxiety disorder [*].

What are the Treatment Options for Anxiety in Children?

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

Kids with anxiety may be treated with the following:

Psychotherapy

Psychotherapy, especially CBT (cognitive behavioral therapy), gives children the skills to manage their anxiety themselves. The way CBT works is that it teaches them to recognize the impact of their thought patterns on their feelings and actions.

Children’s anxiety can be managed through CBT as kids learn various relaxation strategies like deep breathing, progressive muscle relaxation, and visualization. They also learn the CBT triangle, which serves as a framework for practicing challenging negative thoughts.

Medications

Medication is often used in combination with CBT, as research shows this combination approach is the most effective treatment for childhood anxiety disorders.

According to a meta-analysis, kids who received CBT were more likely to experience improvements in their anxiety symptoms compared to those who received no treatment at all or were placed on a waitlist for treatment [*].

Antidepressants, particularly SSRIs (serotonin reuptake inhibitors), are the medications of choice for anxiety.

Tips to Help an Anxious Child Manage Symptoms

Besides psychotherapy and medication, anxiety symptoms can be effectively managed in children through a combination of the following:

  • Lifestyle adjustments, such as regular exercise, a nutrient-dense diet, and adequate sleep
  • Relaxation techniques to cope with anxiety-provoking situations
  • Provide your child with a supportive environment, such as encouraging open communication, setting up a calm-down corner at home, and establishing a predictable routine
  • Limiting screen time and introducing alternative activities
  • Modeling healthy coping techniques
  • Avoiding putting too much pressure on your child

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. For educational and therapeutic resources on childhood anxiety, we recommend checking out our Anxiety Worksheets.

References:

  1. van der Meer, D., Hoekstra, P. J., van Rooij, D., Winkler, A. M., van Ewijk, H., Heslenfeld, D. J., Oosterlaan, J., Faraone, S. V., Franke, B., Buitelaar, J. K., & Hartman, C. A. (2018). Anxiety modulates the relation between attention-deficit/hyperactivity disorder severity and working memory-related brain activity. The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry, 19(6), 450–460. https://doi.org/10.1080/15622975.2017.1287952
  2. Anxiety in Autism Spectrum Disorder. (n.d.). Anxiety and Depression Association of America, ADAA. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/anxiety-autism-spectrum-disorder
  3. Anxiety and Depression Association of America, ADAA | Anxiety and Depression Association of America, ADAA. (n.d.). Anxiety and Depression Association of America, ADAA. https://adaa.org/
  4. Asarnow, J. R., Rozenman, M. S., & Carlson, G. A. (2017). Medication and Cognitive Behavioral Therapy for Pediatric Anxiety Disorders: No Need for Anxiety in Treating Anxiety. JAMA pediatrics, 171(11), 1038–1039. https://doi.org/10.1001/jamapediatrics.2017.3017

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