Anxiety in Children
By Sharon Omiwole & Michael Keane
Has your child ever felt anxious about going to a new school, standing up in front of group of people or trying something new? Before you wonder if your child may suffer from some kind of anxiety disorder, let’s talk a little about what anxiety is and what function it has in our life…
What is anxiety and why do we feel anxious?
Anxiety is a natural and normal physiological response of our body to stress. While we are feeling anxious we may worry about what will happen, feel like things are going to go wrong or that we are in danger. However, while anxiety is a natural response to stressful events in many situations, having too much anxiety can be problematic, particularly when anxiety episodes prevent a person from going about her/his day-to-day life.
If your child feels anxious a lot, she/he is not alone. Anxiety symptoms are among some of the most common mental health conditions, affecting about 20% of children and adolescents.
Symptoms of anxiety can vary across people, although they generally consist of some of the following:
Feelings panic, fear and/or uneasiness
Not being able to stay calm and still
Shortness of breath or shallow, rapid breathing
Cold, sweaty, numb or tingling hands or feet
Heart palpitations (sensation that your heart has skipped a beat or added an extra beat)
Tachycardia (increased heart rate)
Heartburn (acid reflux)
Increased blood pressure
Tinnitus (hearing noise or ringing in the ears)
Nausea or vomiting
Tense muscles (often in the neck)
Remember, these symptoms are a normal response to events that make us anxious. It’s only when they interfere with everyday functioning that they are considered an “anxiety disorder”
What causes anxiety?
Anxiety has a number of causes, including:
Genetics: some families have a genetic predisposition towards anxiety. In addition to this, it has been found that if a child has a family history of any anxiety disorder then he/she will be at risk of exhibiting symptoms of anxiety disorder at some stage in his/her life.
Environment: a stressful work or family environment, bereavement, a particularly important exam, problems with money or even crowds of people can cause anxiety. Verbal, emotional and sexual abuse are also risk factors for anxiety disorder in children, adolescents and adults.
Brain chemistry: Research has extensively shown that anxiety disorders are strongly associated with imbalances in specific brain regions and chemicals that regulate emotions.
Medical issues: some medical issues can have anxiety as an effect
Withdrawal from substances: the interruption of regular intake or use of substances like prescription medicines, illicit drugs or other drugs like alcohol or cigarettes, can trigger anxiety episodes, sporadically or consistently.
Negative thinking patterns: engaging in negative thinking styles, like catastrophizing (e.g. I didn’t get that essay done on time, I am the worst student ever!) can lead people to feel anxious quite a lot.
It is important to understand what the causes of anxiety are as we try to manage and treat it.
Anxiety cure / overcoming anxiety
Your GP or a mental health professional will be able to recommend a plan to treat anxiety. Cognitive behaviour therapy (CBT) is often used to treat children with an anxiety disorder, while medication is rarely chosen as therapeutic strategy.
How to help a child or teenager with anxiety
As a parent, there are also things you can do to help your child deal with anxiety:
1. Adopt a supportive, patient and understanding approach. This creates a safe space where your child can speak openly about how they feel.
2. Children learn by observing and modelling behaviour, so explaining and showing how you deal with stressful and anxiety-provoking situations can be helpful.
3. Help your child to label the full range of their emotions (e.g. help them to use sentences like “I’m feeling sad about…”)
4. Avoid the temptation to problem-solve for your child. Instead, encourage them to try to think of possible solutions for themselves.
5. Notice and manage your own anxiety.
6. Facilitate your child to face the things they fear, beginning with a small step (e.g. if they are afraid of dogs, begin by showing them pictures of friendly dogs!)
7. Avoid avoidance where possible.
How to spot an anxiety disorder in a child
Some different types of anxiety disorders that a child can have include:
Generalised Anxiety Disorder: this is a common anxiety disorder where children will worry excessively about normal everyday things such as taking a test or what will become of them in the future. They will often ask “what if?” type questions.
Separation Anxiety Disorder: the child fears being separated from a person they highly value such as a parent, a care giver or a nanny. The child may cry or cling onto the adult when they try to go to work, leaving them behind at home.
Selective Mutism: this is an anxiety disorder found in childhood where a child can speak in some situations but not in others. For example, a child may be comfortable speaking to family members at home, but once that child goes to school they have trouble speaking to their classmates and their teachers.
Posttraumatic Stress Disorder: this anxiety disorder is usually associated with having witnessed or gone through a traumatic experience. It can cause distressing flashbacks and nightmares.
Obsessive Compulsive Disorder: children with this anxiety disorder will have obsessions that will preoccupy their thoughts, and these will be accompanied by compulsions (repeated actions) to manage the obsessions. Some examples might include excessive hand washing/cleaning or having to do sequences of actions.
Social Anxiety Disorder: the excessive fear of negative judgements by others in social situations. This may cause a child to avoid situations such as performing in front of a crowd or even celebratory events like birthdays or parties.
If you notice your child happens to experience anxiety more frequently or more intensely than before or than others their age, then consider booking an appointment with us here at Actualise, with your GP or a Mental Health Professional.
For more information on anxiety in children check out:
Signs your child may be struggling with anxiety: https://www.understood.org/en/friends-feelings/managing-feelings/stress-anxiety/signs-your-young-child-might-be-struggling-with-anxiety
Helping Anxious Children: http://www.heretohelp.bc.ca/visions/anxiety-disorders-in-children-and-youth-n14/helping-anxious-children
The MNT Editorial Team. (2017). Anxiety: Causes, Symptoms, and Treatments. Medical News Today, [online]. Available at: https://www.medicalnewstoday.com/info/anxiety
Beyond Blue. (2018). Strategies to Support Anxious Children. [online]. Available at: https://healthyfamilies.beyondblue.org.au/age-6-12/mental-health-conditions-in-children/anxiety/strategies-to-support-anxious-children
Healthline Editorial Team. (2016). Anxiety Overview. Healthline, [online]. Available at: https://www.healthline.com/health/anxiety .
Anxiety and Depression Association of America. (2015). Childhood Anxiety Disorders. ADAA, [online]. Available at: https://adaa.org/living-with-anxiety/children/childhood-anxiety-disorders
KidsHealth. (2014). Anxiety Disorders. [online]. Available at: https://kidshealth.org/en/parents/anxiety-disorders.html
AnxietyBC. (n.d.). Childhood Anxiety and Related Disorders. [online]. Available at: https://www.anxietybc.com/parenting/childhood-anxiety
1. Wehry, A.M., et al., Assessment and treatment of anxiety disorders in children and adolescents. Curr Psychiatry Rep, 2015. 17(7): p. 52.
2. Lazor, T., et al., Instruments to measure anxiety in children, adolescents, and young adults with cancer: a systematic review. Support Care Cancer, 2017. 25(9): p. 2921-2931.
3. Beesdo, K., S. Knappe, and D.S. Pine, Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatr Clin North Am, 2009. 32(3): p. 483-524.
4. Dillon-Naftolin, E., Identification and Treatment of Generalized Anxiety Disorder in Children in Primary Care. Pediatr Ann, 2016. 45(10): p. e349-e355.
5. Vrolijk-Bosschaart, T.F., et al., Physical symptoms in very young children assessed for sexual abuse: a mixed method analysis from the ASAC study. Eur J Pediatr, 2017. 176(10): p. 1365-1374.
6. Ollendick, T.H., S.G. Mattis, and N.J. King, Panic in children and adolescents: a review. J Child Psychol Psychiatry, 1994. 35(1): p. 113-34.
7. Moreau, D. and M.M. Weissman, Panic disorder in children and adolescents: a review. Am J Psychiatry, 1992. 149(10): p. 1306-14.
8. Creswell, C., P. Waite, and P.J. Cooper, Assessment and management of anxiety disorders in children and adolescents. Arch Dis Child, 2014. 99(7): p. 674-8.