When Should You Worry About Your Child's Anxiety? Understanding Anxiety Disorders In Kids

Anxiety disorders are some of the most common mental health conditions seen in kids. While they're prevalent in the general population, children with ADHD are more likely to have an anxiety disorder. Like adults, all kids worry, so it can be tough to scope out when to step in. So, when should parents feel concerned about childhood anxiety? If you feel concerned about your child's anxiety, what can you do?

In this article, we'll discuss the difference between anxiety and typical nervousness, when to worry about child anxiety, and when to seek professional help.

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When Is Anxiety Normal in Children?

Some level of worry is adaptive and normal. For example, if young kids worry about going to school for the first time but adjust shortly after, it's likely not a cause for concern. What sets normal worry apart from something more serious? There are a number of symptoms of anxiety to look out for in kids, which we'll go over shortly.

It's important to treat anxiety accordingly. Early detection and appropriate support can set children up for success and give them the coping skills they need early on, leading to better mental health outcomes later in life.

When Parents Should Worry About Anxiety

Anxiety becomes a problem when it is chronic, persistent, and causes distress or impedes functioning in daily life activities. Facets of daily life impacted by anxiety can include but aren't restricted to school, transit (e.g., taking the school bus), home life, and social connections.

Some kids have generalized anxiety, meaning that they feel anxious about a variety of topics and circumstances. Other kids have an anxiety disorder that causes them to worry about something more specific. For example, social anxiety disorder or social phobia can cause a child to worry specifically about social situations.

Here are some signs that a child may live with an anxiety disorder or symptoms of anxiety otherwise worth addressing.

They avoid certain activities or situations

Kids with social anxiety may avoid school, birthday parties, playing with other kids, and other situations. A child with separation anxiety disorder may avoid any circumstances that require being away from their parents or caregivers. Alternatively, a child with specific phobias, such as a fear of heights or bugs, may avoid the object or situation they're afraid of.

Some children may feel deeply self-conscious or struggle to try new things, even if they want to. For example, a child might run out of the room when they show up to their first dance class despite showing a desire or talent for dancing.

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They're focused on what can go wrong

Anxiety often lives in the future, and one potential symptom parents notice in kids with anxiety is a lot of "what if" questions. If a child is focused on what could go wrong, they may ask quite a few questions. For example, "What if I get the answer wrong? What if I fail the test? What if the other kids don't like me? What if I don't like school? What if I can't do it?"

However, other kids may internalize their fears and show symptoms of anxiety more subtly. Kids may ruminate internally, even if they don't necessarily verbalize their fears. Look out for subtle physical or emotional signs of worry if you suspect something. 

They have trouble sleeping 

Trouble sleeping can occur for many reasons. Unfortunately, it can be a vicious cycle with anxiety, as lack of sleep may worsen anxiety symptoms. If a child has trouble sleeping, is afraid to go to sleep, has nightmares, or wakes up early, anxiety may be the cause. This is particularly relevant if you notice other signs of anxiety in your child, such as extreme fear, being easily startled, or feeling anxious in circumstances where most children wouldn't.

They have physical symptoms (stomach pain, headaches) of anxiety

If your child has unexplained physical symptoms, it may indicate anxiety. Physical symptoms of anxiety can include but aren't limited to:

• Stomach pain or nausea
• Headaches
• Frequent need to urinate
• Picking skin
• Grinding teeth
• Muscle tension
• Heart racing
• Hyperventilating
• Dizziness
• Fatigue

Anxiety symptoms interfere with normal activities (like going to school)

If worry makes it hard for a child to go to school, function optimally while in school, ride the school bus, talk to other people, participate in family life and enjoyable hobbies, or otherwise affects their life, it's a sign to seek professional help. In severe cases, a child may experience school refusal, have panic attacks, or face other intense symptoms that impact daily obligations. 

The anxiety is persistent or relentless

Even if kids are technically able to engage in most activities, it doesn't always mean that they're okay. If a child experiences extreme distress, fear, worry, or stress more often than what is typical, it may be beneficial to start teaching a child healthy coping skills or to seek help from a child and adolescent therapist, counselor, or psychologist. Many kids internalize their fears because they don't yet know how to communicate feelings of anxiety, which means that it can be tough to pick up on childhood anxiety disorders.

Can A Parent Cause Anxiety In A Child?

Mental health conditions are complex, and many factors can play a role in their development. Family history of anxiety is a risk factor that can increase the likelihood that a child will have an anxiety disorder, but this does not mean that parents “cause” anxiety. Certain behaviors among parents, such as those marked by over-control, can increase worry and anxiety in kids. If a parent knows how to discuss and approach anxiety with their kids in an open, loving way, it can be incredibly valuable for a child. 

How To Address An Anxiety Disorder In Kids

Although anxiety is often used as a blanket term, there's more than one anxiety disorder. Many children experience separation anxiety disorder, specific phobias, panic disorder, generalized anxiety disorder, or social anxiety disorder. Selective mutism is another anxiety disorder seen in kids.

To some extent, treatment may depend on a child's diagnosis and the way symptoms impact their life. Forms of therapy like cognitive behavioral therapy (CBT) are the first line of treatment for anxiety disorders like generalized anxiety disorder or social anxiety disorder in children. CBT and similar modalities are also useful for stress, depression, grief, and other issues children may face. For CBT can be used for ADHD children. Parent-child psychotherapy can also be used.

At-home calming techniques and coping skills (many of which are taught in therapy) are beneficial to learn and use when a child is feeling anxious. For example, meditation, deep breathing, soothing sensory stimuli or comfort objects, and talking through anxiety-inducing situations together.

Some kids with anxiety disorders may work with a child-adolescent psychiatrist for medication management in addition to talk therapy. Kids with severe anxiety especially may benefit from extra support.

Takeaway 

Anxiety disorders are common in children, and they are treatable conditions. Signs of anxiety parents can look out for in their child include but aren't limited to trouble sleeping, avoidance of certain activities, or feelings of fear that disrupt a child's ability to engage in activities, emotional state, and so on. Treatment options for anxiety disorders include therapy, medication, and other approaches. When kids learn skills that help them cope with anxiety early on, it sets them up for success. If you're worried that your child could have an anxiety disorder, consult with their pediatrician.