Anxiety in Children
Anxiety Overview
Anxiety is generally defined as extreme worry or unease. It is an emotion characterized by feelings of tension, continuous or persistent worried thoughts, and physical changes such as increased heart rate or difficulty breathing. It can present itself in similar and different ways in children than it does in adults.
Symptoms in Children
Anxiety in children can often disguise itself as something else or be viewed as typical traits of “just being a kid.”
Some of these symptoms include:
- Trouble sleeping
- Complaining about stomach aches or other physical problems
- Avoiding certain situations
- Being clingy around parents or caregivers
- Trouble concentrating in class
- Being very fidgety
- Tantrums or other behavioral concerns
- Being very self-conscious
Types of Anxiety
Generalized anxiety disorder:
Children who worry about many things in their everyday life. These worries are not caused by any one thing, and are significant enough to affect their day to day life.
Symptoms of generalized anxiety disorder in children can include:
- Restlessness
- Feeling on edge
- Feeling tired much of the time
- Problems concentrating
- Feeling angry
- Trouble sleeping
Separation anxiety disorder:
Children who are extremely upset when they are away from their parents/caregivers. These symptoms and feelings go beyond the typical worries of children their age.
Symptoms of separation anxiety include:
- Worry about parents/caregivers getting sick or dying
- Refusing to leave home or go to school
- Fear of sleeping or being alone
- Nightmares about separation
- Physical symptoms before a separation
Social anxiety disorder:
Children who are extremely conscious or themselves and others in public situations. They often feel afraid of being embarrassed and avoid social situations or being the “center of attention.”
Symptoms of social anxiety disorder in children include:
- Avoiding most social situations or feeling terrible when participating in them
- Physical symptoms like shaking, sweating or trouble breathing in social situations
- In young children, tantrums and crying in social situations
- Fear of others seeing their anxiety and judging them for it
Selective mutism:
Children who have a difficult time speaking in certain situations, like school. This is more than being shy, children often feel frozen and are unable to speak.
To get a diagnosis of selective mutism, the child must:
- Be able to speak in some situations but not others
- Have had the problem for at least a month
- Have problems with school and social activities as a result
- Speaking difficulty is not due to a communication disorder or language barrier
Panic disorder:
Children who have frequent, unexpected panic attacks. These attacks can cause physical feelings of distress that may make children feel they are dying.
Symptoms of panic disorder in children include:
- Constant fear of more panic attacks
- A big change from normal behavior after the panic attacks, like avoiding places that remind them of an attack
- Other medical causes and disorders ruled out
Specific phobia:
Children who are extremely afraid of one or more specific things or events. This fear is typically of something that is normally not considered dangerous. Phobias cause disruptions in a child’s life as they often go out of their way to avoid the thing they fear.
Common phobias in children include:
- Animals or insects
- Parts of the natural world, like water or heights
- Blood or shots
- Specific situations, like crowds or tight spaces
- Others including vomiting, choking or loud sounds
Treatment Approaches
Many types of anxiety are best treated with cognitive behavioral therapy (CBT). CBT assists in understanding how we think and act are affected by how we feel. Those participating learn to identify and work to change negative thoughts and unhealthy actions that affect their feelings.
Through the use of role play, coping skill identification, and increasing their ability to communicate, children can work to adjust their reactions to interactions, events, and ideas that cause them anxiety.
For some children, medication management to address anxiety in addition to therapy is extremely beneficial. Medication can help to dial back day to day anxious feelings to address overall anxiety in the therapeutic setting.
Written by Emma Morgan on January 4, 2022.