How to help spot the signs of anxiety in children

Contrary to what many people may believe, anxiety is a condition that affects both adults and children. It may seem like adults have more serious life stressors, but children and teens can experience the same type of feelings regarding going to daycare, completing homework assignments, studying for end-of-year final exams or even just going to a friend’s house. Therefore, understanding whether a child is experiencing appropriate day-to-day stress or displaying the symptoms of an anxiety disorder can pose a challenge for many parents.

It’s normal to feel anxious from time to time, but when those feelings are constant and intense, to the point that it affects nearly every part of a person’s life, it can become a health concern. Anxiety disorders are one of the most common health conditions in the U.S., impacting more than 40 million adults and approximately 7 percent of children aged 3-17.

“Anxiety is a problem that often first reveals itself during childhood,” said Dr. Gary Rosenberg, a medical director in behavioral health population services at UnitedHealthcare. “But it is hard to pinpoint when anxiety becomes a ‘disorder’ and when it is just a normal reaction to daily stress.”

Dr. Rosenberg said there are a few key symptoms that parents can look for, to help them understand when anxiety rises to the level of a childhood anxiety disorder.

Some common characteristics of anxiety include: a feeling of persistent, excessive fear or worry on a daily basis. But when symptoms, such as feelings of dread, irritability, restlessness and anticipating the worst, are paired with the following physical characteristics, it may indicate that the child is suffering from an actual anxiety disorder.

  • Racing or pounding heart or shortness of breath
  • Dry mouth
  • Sweating, clammy hands or feeling hot
  • Tremors or twitches
  • Headaches
  • Fatigue or insomnia
  • Frequent urination
  • Upset stomach or diarrhea

Common anxiety disorders among children

Among the possible anxiety disorders, the most common in children and teens include:

Generalized anxiety disorder (GAD)

Generalized anxiety disorder (GAD) is characterized by a child worrying almost daily about many different things – from normal stressors like homework, tests and making small mistakes to routine events like recess, parties, lunchtime or even riding the bus. 

Social anxiety disorder

Social anxiety disorder, also known as social phobia, occurs when a child is too afraid to engage in social interaction, which can cause them to avoid going to school or hanging out with friends. This type of anxiety typically occurs after puberty. 

Specific phobias

Specific phobias are defined as a child feeling intense, long-lasting fear about a specific thing, such as animals, spiders, shots, thunderstorms, clowns or the dark. While it’s normal for younger children to feel scared about these types of things, older children with a phobia may be hard to calm or console.

Next steps

According to Dr. Rosenberg, a child may be more likely to develop an anxiety disorder if they experience any one of the following:

  • An associated disorder, such as autism, depression or ADHD
  • A parent who has anxiety or another mental health condition 
  • An Adverse Childhood Experience (ACE), such as experiencing abuse, neglect or household dysfunction

If you believe your child is showing signs of an anxiety disorder, consult your pediatrician or primary care physician. They may suggest that your child try relaxation exercises, mindfulness skills or deep breathing. If those techniques don’t seem to work, they may refer you to a therapist who can administer a medication or provide cognitive behavioral therapy (CBT), a type of talk therapy that helps families, kids and teens learn how to manage anxiety. 

“Dealing with anxiety can be a lifelong struggle. It doesn’t need to be classified as a disorder to be addressed,” Dr. Rosenberg said. “Listening to how a child describes their feelings and providing them with the support and help they need are the best things a parent can do to help them mitigate the intensity of their anxiety.”

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