How to Know If Your Child is Anxious (and How to Help)

Were you scared of the dark as a child? Or perhaps you feared an unseen monster lurking in your closet or under your bed. These are common childhood anxieties that most of us grow out of over time. For some children, however, this type of feeling lasts throughout childhood. It’s not just about fearing the dark or monsters, but other worries like not making friends, having difficult schoolwork, or not doing well at sports. When worries begin to dominate a child’s thoughts, it can often be a sign of childhood anxiety. Although we may think of childhood as carefree and worry-free, anxiety can burden a child’s experience. Being aware of the signs of childhood anxiety can help you know when to seek help for your child.

Normal Worries Versus Anxiety

It’s not uncommon for children to experience worries from time to time. Young children, for example, often get nervous about leaving their parents’ side when attending daycare or preschool. Even older children might get nervous before a test or tryout for a team. Anxiety, however, is different from these common childhood worries. Childhood anxiety is a level of worry or nervousness that interferes with a child’s routine and activities. If a child is so anxious that they refuse to attend school, play with friends, or try new activities, there may be a cause for concern. Children with anxiety might experience extreme self-consciousness, disrupted sleep, stomach aches, or trouble concentrating.¹ 

Unfortunately, anxiety among children is not all that uncommon in today’s world. In light of the global COVID-19 pandemic, mental health problems among children have risen dramatically in recent years.² Recent studies estimate that as many as one in five children and adolescents experience anxiety.² Although we might think of anxiety as worry or nervousness, children can exhibit different types of anxiety. Among children, the most common types of anxiety include social anxiety, general anxiety, panic disorder, separation anxiety, selective mutism, and (less commonly) obsessive compulsive disorder (OCD).¹ While each of these types of anxiety has specific sources of worry and varying symptoms, they all fall under the umbrella of anxiety and each can impact children’s life and well-being.

The Multi-Faceted Origins of Childhood Anxiety

As is the case with all human behavior, understanding the origins of anxiety in children is complex. There clearly seem to be some genetic and temperamental factors at play in the development of anxiety. Studies show that toddlers with a more inhibited temperament tend to grow up to have higher rates of anxiety. This inhibited temperament often shows up early in life with behavior such as avoiding new interactions, not exploring their environment or clinging to their parents excessively.³ This is not to say that all children with an inhibited temperament will develop anxiety, but there does seem to be a link.

Genetics may also play a role in the development of anxiety. It has been well-established that anxiety tends to run in families.³ This, however, could be a combination of both genetic and environmental factors. Children may inherit a tendency towards anxiety from parents but may also observe parents’ anxiety and their behavior patterns. Parents with anxiety may inadvertently model anxious behaviors that children pick up and emulate.³ Anxious parents may use parenting strategies that foster a more fearful, anxious approach to interacting with the world.

The environmental context in which children are raised may also contribute to the development of anxiety. It’s well-established that children who experience physical or psychological abuse from caregivers⁴ or trauma⁴ (such as violence or disasters) are at a higher risk for developing anxiety. Although these types of experiences may seem rare, studies find that two-thirds of children may experience some form of trauma by the time they are 16 years old.⁵ Although trauma is most commonly thought of as extreme events such as violence, trauma could also include experiences like the death of a close loved one, serious accidents, or natural disasters.⁵ It’s not hard to see why experiences such as these could increase a child’s chances of developing anxiety. All these experiences provoke a child’s (or adult’s) “fight or flight” reaction. That is, they prompt the body’s natural alarm system that alerts us to danger.⁵ Even when the immediate danger has passed, the physiological response of our body may still remain heightened. Children may be hyper-aware of threats or experience a tendency to withdraw or feel irritable.

Treatment Options for Children with Anxiety

Being aware of your child’s mental health, their reactions to events, and their temperamental tendencies will help you identify if you think your child is suffering from anxiety. If your child is experiencing anxiety to the level that it is interfering with their daily activities, it can be helpful to seek out professional support. Luckily, today we have more research and resources available to parents to help support their child’s mental health. 

Perhaps the most well-known and well-researched treatments for children with anxiety are therapy-based treatments like Cognitive Behavioral Therapy (CBT). This approach to the treatment of anxiety is based on the idea that our thoughts and actions partially influence our emotions. Therefore, if we can help a child change the behavior and thoughts that are contributing to the anxiety, we can help them move past it. One key component of CBT is the notion that anxiety provokes avoidance in children or adults. When we feel anxious about a situation or interaction, our first instinct is to avoid it. With anxiety, however, avoidance is not a long-term strategy because the more we avoid anxiety-producing situations, the more powerful the anxiety grows. With CBT, children are coached on how to no longer avoid the anxiety-provoking situation but learn how to work through it.⁶ As children work through and learn to cope with the situation, their anxiety decreases, but they also gain the coping skills they need to face other anxieties. Overall, research on CBT shows that it can be quite effective for children with anxiety and even shows signs of long-lasting positive changes in children’s well-being.⁷

In addition to formal therapy, parents can play a role in their children’s treatment of anxiety. Psychologists encourage parents to support their children’s coping skills and avoid accommodating too much to children’s anxiety. This might mean listening empathetically to their anxious thoughts but encouraging them to face the anxiety-provoking situation anyway and not avoiding it.⁸ Additionally, parents can express confidence in their children’s ability to handle the situation, despite their anxiety about it. Programs designed for parents⁹ to help support their children’s management of anxiety symptoms have been shown to be very effective. As long as parents teach children the coping skills they need to handle their anxiety and do not accommodate them as much, children have a better chance of reducing their anxiety symptoms.⁹

Coping with Childhood Anxiety and Moving Forward

Seeing your child experience anxiety can be heart-wrenching as a parent. In the majority of cases, however, childhood anxiety can be treated effectively and you can play an important supportive role in that process. With treatment and your guidance, your child with anxiety can learn to cope with their fears and move into adulthood with confidence. 

Disclaimer: The information provided on this site is NOT medical advice and is for informational purposes only. It is not intended to diagnose, provide medical or behavioral advice, treat, prevent, or cure any disease, condition, or behavior. You should consult with a qualified healthcare professional regarding your child’s development to make a medical diagnosis, determine a treatment for a medical condition, or obtain other related advice.

References

1. Child Mind Institute (2022) Quick Guide to Anxiety in Children, Child Mind Institute, https://childmind.org/guide/anxiety-in-children-quick-guide/ 
2. Racine, N, McArthur, B.A., Cooke, J.E., Eirich, R., Zhu, J., Madigan, S. Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis, JAMA Pediatrics;175(11):1142–1150, https://jamanetwork.com/journals/jamapediatrics/fullarticle/2782796  
3. Weir, K. (2017) Brighter Futures for Anxious Kids, American Psychological Association Monitor, Vol 48, No. 3, https://www.apa.org/monitor/2017/03/anxious-kids 
4. McLaughlin, K.  and Lambert, H. (2017) Child Trauma Exposure and Psychopathology: Mechanisms of Risk and Resilience, Current Opinion in  Psychology,14: 29–34, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111863/  
5. Substance Abuse and Mental Health Services Administration (2022) Understanding Child Trauma, SAMHSA, https://www.samhsa.gov/child-trauma/understanding-child-trauma  
6. Bubrick, J. (2022) Behavioral Treatment for Kids With Anxiety, Child Mind Institute, https://childmind.org/article/behavioral-treatment-kids-anxiety/ 
7. Bertie, L, Hudson, J. (2021) CBT for Childhood Anxiety: Reviewing the State of Personalised Intervention Research, Frontiers in Psychology, Vol. 12, https://www.frontiersin.org/articles/10.3389/fpsyg.2021.722546/full 
8. Goldstein, C. (2022) What to Do (and Not Do) When Children Are Anxious, Child Mind Institute, https://childmind.org/article/what-to-do-and-not-do-when-children-are-anxious/ 
9. Elsevier. (2020) New treatment for childhood anxiety works by changing parent behavior, ScienceDaily, https://www.sciencedaily.com/releases/2020/04/200402110133.htm