Childhood anxiety

Childhood anxiety is an umbrella term that refers to anxiety disorders occurring during childhood. While these disorders can interfere with daily life, effective treatment can help children to develop strong coping skills and overcome anxiety symptoms.

What is childhood anxiety?

Childhood anxiety is an umbrella term that can refer to a range of anxiety disorders occurring in children. While everyone feels worried or fearful from time to time, children with anxiety disorders display a level of fear or worry that is excessive, or that is developmentally inappropriate.

For example, it’s generally developmentally appropriate for toddlers to show some nervousness when separated from parents, but if they do not outgrow this separation anxiety, and it persists into the middle childhood years, they may meet criteria for an anxiety disorder ^[1].

There are various types of anxiety disorders that can occur in children. While they differ in their context and presentation, what these childhood anxiety disorders have in common is that they involve an excessive level of fear or worry that interferes with important areas of life, such as friendships and functioning at school.  

Some specific anxiety disorders that can occur in children are described in more detail below ^[1]:

• Separation anxiety disorder: Children with separation anxiety experience intense fear when away from parents or caretakers. They may worry that something bad will happen to people they love during times of separation. This can make it difficult for children to go to school or participate in common childhood activities like sports teams.
• Specific phobias: Children who have specific phobias show intense anxiety when exposed to specific situations, such as flying on a plane, or objects, such as dogs or spiders.
• Social anxiety: Social anxiety disorder involves intense fear or worry when in social situations. Children with this condition are concerned that they will be negatively judged by others in social situations.
• General anxiety: This anxiety disorder occurs in children who are significantly worried or fearful about various aspects of life, such as bad things potentially happening in the future. Children with generalized anxiety disorder show excessive worry that is out of proportion to the threat posed by the situation causing the anxiety.
• Panic disorder: When children have panic disorder, they will experience sudden panic attackswithout any clear warning or trigger. During these panic attacks, a child will experience physical symptoms like sweating, racing heart, dizziness, and shortness of breath.

Signs of anxiety in children

The specific signs and symptoms of anxiety in children can vary depending upon the type of anxiety disorder a child is experiencing. Some symptoms of general anxiety disorder in children are as follows ^[2]:

• Ongoing fears or preoccupations
• Constant fear about regular aspects of life, such as going to school
• Difficulty concentrating
• Sleep disturbances
• Excessive worrying that occurs most of the time
• Complaining of stomach aches or headaches
• Difficulty with leaving home or separating from family
• Irritable behavior
• Restlessness
• Fatigue

What causes anxiety in children?

There is not one single cause of childhood anxiety. Rather, the risk of anxiety disorders in children is increased by several factors. Some of the following risk factors increase a child’s chance of developing an anxiety disorder ^[3]:

• Inhibited temperament: Children with an inhibited temperament tend to be socially withdrawn and fearful in new situations. This sort of temperament significantly increases the risk of childhood anxiety disorders.
• Genetics: Children who have a parent with an anxiety disorder are almost twice as likely to develop an anxiety disorder themselves. This suggests that genetic risk factors play a role in the development of childhood anxiety.
• Parenting behavior: Research concerned with environmental factors that contribute to childhood anxiety has found that when the behavior of parents is overly controlling, children are at higher risk of developing anxiety. Parents who struggle with anxiety and who model anxious/fearful behavior can also contribute to anxiety development in children.

How to manage your child’s anxiety and fears

If you’re worried about your child’s anxiety, there are ways to manage their symptoms, so they do not interfere significantly with daily life. Consider the tips below:

• Validate your child’s concerns without reinforcing them: If your child is anxious in social situations, or extremely fearful of going to the dentist, acknowledge and validate the child’s fears by stating that you understand they are afraid. Offer your support and remind them that youare there to support them. However, you should be careful not to reinforce the anxiety by allowing the child to avoid social situations or the dentist’s office, for example. Avoiding situations that cause anxiety only serves to reinforce the anxiety.
• Model healthy behaviors: You can help your child learn how to cope with anxiety by modeling healthy behaviors yourself. This means that when you’re feeling stressed or anxious about something, you can show your child how to handle it in a healthy way. For instance, you can model remaining calm and regulating your emotions when you’re under You may alsotalk with your child about how you exercise or take a bath to calm yourself.
• Seek treatment for your child if needed: If your child has chronic anxiety that doesn’t seem to improve with self-management strategies, and they’re beginning to have a difficult time functioning in everyday life, it may be time to seek professional treatment. Talk with your child’s pediatrician about your concerns, and they will likely be able to refer you to a mental health professional. Childhood anxiety is often treated with psychotherapy, or “talk therapy.” A particular form of therapy called cognitive behavioral therapy (CBT) can be especially beneficial for treating anxiety in children, as it can help to correct negative or distorted thinking patterns that contribute to fear and worry. Some children with anxiety may be treated with medication, but this isn’t usually the first line of treatment, given potential side effects ^[3].