Is My Child’s Anxiety Normal or Something More?

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If your child is showing signs of anxiety, they’re not alone. Anxiety is the most common pediatric mental health condition. More than 10% of kids ages 3 to 17 have a diagnosed anxiety disorder in the United States.

Sometimes, anxiety is temporary and easily managed. But other times, it can cause your child to struggle with school or other activities. In cases of severe anxiety, you may need to seek professional help.

If your child seems overly worried, here’s what you should know about childhood anxiety, including anxiety symptoms in kids. Discover how to help an anxious child at home and when to see a therapist for child anxiety.

What Is Child Anxiety?

In general, anxiety means feeling worried about something.

Every child has these feelings from time to time. But when the worry becomes chronic, severe, and interferes with your child’s daily life, it’s an anxiety disorder.

The Centers for Disease Control and Prevention (CDC) reports that 11% of kids ages 3 to 17 have anxiety disorders. The total is 16% among adolescents and teens ages 12 to 17.

Experiencing anxiety as a child can make it more likely to experience it as an adult. It’s also a risk factor for depression. So, it’s important to recognize the signs and get treatment.

The United States Preventive Services Task Force (USPSTF) recommends anxiety screening for kids ages 8 to 18.

What Causes Child Anxiety?

Many different things can trigger anxiety in children, including:

• Academic pressure.
• Bullying.
• Family history of anxiety or depression.
• Family problems.
• Life events (like the death of a loved one or going to a new school).
• Social pressure (including social media).
• Trauma.

What Are the Types of Child Anxiety?

The most common types of childhood anxiety include:

• Generalized anxiety disorder (GAD) — Chronic anxiety about everyday life and activities. This anxiety often doesn’t have a specific cause; it’s just a constant part of life.
• Obsessive-compulsive disorder (OCD) — A chronic type of anxiety disorder. People with OCD have obsessions (unwanted, uncontrollable thoughts) and compulsions (unwanted actions).
• Panic disorder — A type of anxiety that causes sudden, intense bursts of fear (panic attacks). They can happen in response to a trigger or for no known reason.
• Phobias — Extreme, irrational fears or worries about specific things. Children with phobias will try to avoid their triggers at all costs.
• Selective mutism — An extreme version of shyness. Children with selective mutism can speak in some situations but not others. For example, they may talk normally at home but struggle at school or in social situations.
• Separation anxiety — Common in younger children, separation anxiety involves feeling worried about being away from their parent or caregiver, like at school or daycare. Their anxiety may manifest with physical symptoms like headaches or stomachaches.
• Social anxiety — This intense fear or worry in social situations can cause people to avoid social situations altogether. Social anxiety is more common in adolescents and teens.

What Are the Signs My Child Has Anxiety?

There are many different symptoms of child anxiety. They range from behavioral and emotional to physical. Symptoms may appear when your child confronts an anxiety trigger.

Common anxiety symptoms or signs include:

• Anger.
• Avoiding school or social situations.
• Bed-wetting.
• Clinginess.
• Concentration problems.
• Crying a lot.
• Eating problems.
• Expressing negative thoughts or worries.
• Headaches.
• Heart palpitations.
• Irritability.
• Nervousness.
• Nightmares.
• Panic attacks.
• Stomachaches.
• Tantrums.
• Tiredness.
• Trouble sleeping.

Some of these symptoms depend on your child’s age. Younger children are more likely to be clingy, irritable, or wet the bed. Older children are more likely to have bursts of anger, avoid social situations, or express negative thoughts.

The symptoms of anxiety can interfere with children’s lives.

When Should I Talk to My Child’s Doctor About Their Anxiety?

Many different triggers can cause anxiety in kids, and anxiety can be temporary. But if you see your child struggling with anxiety for four weeks or longer, call their medical provider. You should also contact them if your child’s anxiety is starting to interfere with their daily life.

Your child’s provider can evaluate your child and determine if they need anxiety treatment. They can also give you tips to support your child’s emotional well-being.

The two main treatments for anxiety in children are therapy and medication.

Cognitive behavioral therapy (CBT)

CBT teaches children how to turn negative thoughts into positive ones. It provides coping exercises for kids with anxiety to help them overcome their triggers. It may expose them to their fears or worries in a safe space — that way, they learn how to cope.

Often, CBT for children involves their parents/caregivers, other family members, and, sometimes, their school. The goal is to provide childhood stress support.

The American Academy of Child and Adolescent Psychiatry (AACAP) recommends CBT as a first-line treatment for anxiety.

Medications for anxiety

If your child has severe anxiety or CBT isn’t effective, their doctor may recommend medication. Medication can work in tandem with therapy to help kids with anxiety.

The main medications for anxiety are selective serotonin reuptake inhibitors (SSRIs). A specific type of antidepressant, these include fluoxetine (Prozac®), sertraline (Zoloft®), and escitalopram (Lexapro®).

Another antidepressant approved for use in kids ages 7 and up with generalized anxiety disorders is duloxetine (Cymbalta®).

How Can I Help My Child with Their Anxiety?

Parents and caregivers don’t like to see their kids struggling with anxiety. The good news is that there are ways you can help.

Whether your child’s anxiety is mild or severe, you can support them. What you do at home can complement the work they’re doing in therapy.

Here are some parenting tips for child anxiety management.

Be aware of anxiety

It can sometimes be hard to spot the signs of an anxiety disorder. Kids may not know they have an anxiety disorder, or they may not want to talk about it.

That’s where you come in. It’s important to be aware of any changes in your child’s emotions or behaviors. That way, you can step in.

Talk to them — and listen

If you see your child is anxious or stressed, or they’re avoiding places or things, talk to them. Ask them how they’re feeling, and listen to what they have to say.

The more information you have, the more you can help them.

Be encouraging

Anxiety can be scary if you’re going through it alone. Being supportive can go a long way.

Tell your child that anxiety is common and that you’re there to help in whatever way you can. Don’t overpromise: You can’t guarantee they’ll pass that big test, but you can let them know they have your support.

Don’t dismiss their anxieties

Kids can be anxious or afraid of lots of different things, many of which aren’t dangerous. But you should still respect what they’re anxious about. Use supportive language — tell them you understand and that you’re there to help.

But don’t reinforce their anxieties

When your child worries about something, they might try to avoid that trigger altogether. But letting them avoid what causes their anxiety can make it become more ingrained.

It can be tempting to be overprotective, but try to avoid that impulse. Removing them from a situation that causes their anxiety or letting them avoid it altogether sends the wrong message. The goal is to find healthy ways of coping with anxiety, not trying to avoid it altogether.

Work out a solution

Anxiety’s the problem, so what’s the solution? Talk to your child about simple things they can do to manage their anxiety when it happens.

For example, you can create simple coping mechanisms like taking deep breaths or creating a “worry box.” If they’re worried about moving or starting a new school, help them make plans for their new room or their first day.

Be a good role model

Everyone experiences anxiety — parents and kids alike. And you can help your child by practicing what you preach.

Modeling healthy behaviors of dealing with anxiety reinforces those healthy behaviors for your child. It helps show them that anxiety is natural, and it’s possible to manage it.

Don’t be afraid to ask for help

Parents don’t have all the answers — although life would be so much easier if they did. Sometimes, the best thing you can do is ask for help.

If you’re struggling to help your child with their anxiety, don’t hesitate to ask for help. Talk to their primary care provider for tips, or ask for a referral to a child mental health specialist. Sometimes, it takes a team approach to manage anxiety.

The Behavioral Health Science Division at UPMC Children’s Hospital of Pittsburgh helps kids with all types of mental health needs. We’re here to help kids with anxiety, fears, and other concerns. For information on our services, visit our website.