Signs of Anxiety in Children
Anxiety, defined as a behavioral, cognitive or affective response to a perceived danger, is an entirely normal emotion that everyone has to deal with. It is the body’s standard response to life stresses and is widespread among people of all ages, including children.
Anxiety may be a hallmark trait of being human, but it can be a serious problem when it is out of proportion to the triggering cause or if it results in significant distress. When anxiety begins to affect your child’s daily thoughts or behavior and disrupts their usual activities, professional intervention may be necessary to help them overcome the condition.
The key to effective treatment of anxiety in children is early intervention, so the first step for parents is to familiarize themselves with the signs of anxiety in children.
What Is Anxiety, and How Is It Different to an Anxiety Disorder?
Anxiety is a normal emotion, and one that we all must navigate throughout our lives. When we are faced with a perceived danger, a stressful situation or a new challenge, a wave of brain activity better known as the "fight or flight" response is triggered. Often, this results in feelings of fear, nervousness and apprehension that can be severe and emotionally distressing.
When the usual signs of anxiety in children become so severe that they interfere with daily activities, such as performance at school, social interactions and participation in sports and other hobbies, this may indicate an anxiety disorder. Anxiety disorders are incredibly common among children and adolescents; in fact, they are widely considered to be the most prevalent mental health issue affecting this age group.
The term "anxiety disorder" is very general, and may refer to any one of a number of specific anxiety disorders. These are:
- Generalized anxiety disorder (GAD): characterized by uncontrollable and excessive worrying about everyday events, usually leading to severe distress and impaired daily functioning.
- Separation anxiety disorder: in which children experience extreme distress when separated from the home or a person to whom they have a strong attachment.
- Selective mutism: a persistent reluctance or refusal to speak in specific situations, despite speaking normally in other settings.
- Social anxiety disorder: extreme anxiety triggered by social situations.
- Panic disorder: which may or may not be accompanied by agoraphobia.
- Specific phobia: a profound, disproportionate and often debilitating fear of a specific object or situation.
- Obsessive compulsive disorder (OCD): in which individuals perform the same routine repeatedly (compulsions) or have certain thoughts repeatedly (obsessions).
- Post-traumatic stress disorder (PTSD): usually triggered when a person witnesses or experiences something deeply traumatic.
Your child may be affected by any of the above anxiety disorders. Most of these are also common in adults, though separation anxiety disorder and selective mutism are usually only diagnosed in children and adolescents.
With an estimated 15-20% of children and teens battling anxiety, this is a very common condition that parents need to be aware of, so they can step in with the necessary help. But how can you spot the symptoms of anxiety in children, and what can you do to help your child overcome their anxiety?
What Are the Signs of Anxiety in Children?
The symptoms of anxiety often vary from one child to the next, and may differ depending on the age of your child.
Symptoms and signs of anxiety in young children may include:
- Loss of appetite
- Disrupted sleep patterns (including difficulty sleeping, bad dreams and frequently waking up at night)
- Uncharacteristic bed-wetting
- Irritability and tension
- Difficulty concentrating
- Excessively "clingy" behavior
- Angry or violent outbursts
- Excessive worrying or nervousness
- Using the toilet more frequently
- Complaints of feeling unwell (e.g. frequent complaints of stomach-ache)
Symptoms and signs of anxiety in older children and teenagers may include:
- Loss of appetite
- Sleep problems (such as difficulty falling asleep, frequent waking and poor-quality sleep)
- Excessive worrying and nervousness
- Frequent negative thoughts and moods and a persistent sense that "something bad" is going to happen
- Angry outbursts
- Difficulty concentrating
- Avoidance of everyday activities (such as attending school, seeing friends, going out in public or participating in sports)
What Causes Anxiety in Children?
There is no one specific cause of anxiety, and it may simply be that some of us (children included) are more prone to anxiety than others. If your child is a natural "worrier", they may be more susceptible to anxiety and the distress it can cause.
Other potential risk factors for anxiety in children include:
- Frequent periods of change (for example, moving to a new house or changing schools)
- Traumatic events (such as the death of a close friend or relative, a serious accident or experiences of abuse)
- Exposure to family conflict and frequent arguments in the home
- Serious illness or injury
- Problems at school (such as bullying or exam-related stress)
- Age: the age of your child can affect their likelihood of developing certain anxiety disorders. For example, adolescents are twice as likely to experience social anxiety as younger children)
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How Can You Help a Child with Anxiety?
If you think your child is struggling with anxiety, the first thing to do is to encourage them to talk about their feelings. Gently prompt them to open up about their anxieties, the main causes of their worries and how they feel when faced with triggering situations.
If your child is upset — stay calm, try to reassure them and encourage them to think through their problems and find solutions. Asking open-ended questions, like "what would make (dealing with X) easier for you?" or, "how are you feeling (about X)?" can help to direct a child into working through and coping with their anxieties, rather than shying away from the situations that trigger them.
Make sure the child knows that you understand how they feel and that they are not alone; this may help them to know that what they are experiencing is a common problem, and one that everyone has to face. If a child is uncomfortable discussing their anxiety with a parent, encourage them to speak to a trusted family member, friend or teacher about what they are dealing with.
When Should You See a Doctor?
It is normal for children to experience some degree of anxiety, and professional intervention may not be necessary. However, if your child’s anxiety is persistent, severe, and negatively impacts their everyday activities, you should take them to see a doctor. Your doctor will be able to make a more accurate assessment of your child’s mental health and can offer advice about potential treatment options, if needed.
Treatment Options for Anxiety in Children
Certain medications can be used to alleviate the symptoms of anxiety in children, and may be prescribed in cases where the condition is severe and disruptive to everyday life. There are several different types of antidepressant and anti-anxiety drugs that are commonly prescribed to children and teens with anxiety disorders. Speak with your doctor to discuss the most suitable option for your child.
Psychotherapy treatment can be a highly effective way of tackling anxiety in children. Strategies often focus on the teaching of self-soothing and relaxation techniques, while helping children to identify and cope with anxiety-provoking thoughts and situations. Other common methods include practicing problem-solving as a means of coping with upcoming challenges, cognitive structuring or (in the case of specific phobias) controlled exposure to objects or situations that spark fear.
Psychotherapy has been found to effectively reduce anxiety symptoms and can help foster more robust coping-mechanisms in anxious children. This can have long-term benefits that help children deal with anxiety into their teen and adult years — an invaluable tool for anyone prone to the condition!
Commonly used psychotherapy techniques for addressing signs of anxiety in children include:
- Cognitive behavioral therapy (CBT): this form of therapy is widely accepted as the most effective psychotherapy treatment for childhood anxiety.
- Mindfulness-based psychotherapy: this form of therapy teaches children to focus their attention on the present moment and has a high success rate in treating anxiety.
Signs of Anxiety in Children: The Bottom Line
Anxiety is a completely normal part of life, and is the body’s natural response to stressful situations and challenges. Children frequently experience anxiety, and often, the best way to help them is by encouraging them to voice their worries and work towards effective solutions and coping mechanisms. However, if your child’s anxiety is severe and persistent, it may start to interfere with their everyday activities and can negatively impact their overall well-being.
If your child’s performance at school, social interactions or participation in usual activities is suffering as a result of their anxiety, you should take them to a doctor for professional assessment. In some cases, medication or psychotherapy may be recommended as a treatment option for children with anxiety.